Study: Medical students need good reasons to use mobile devices

By Neil Versel
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ipad_710x187Contrary to conventional wisdom, medical students do not always flock to mobile devices for educational or clinical uses. They need a good reason to incorporate smartphones and tablets into their learning, a recently published study suggests.

"The use and utility of mobile devices depended on the learner, the device, the circumstances and the teacher or preceptor. Mobile technologies, like other technologies used for educational purposes, are not intrinsically good or bad, desired or rejected," said a paper published in the November issue of the journal Medical Teacher.

"The expectation of senior leaders that school-issued mobile devices would be regularly, even enthusiastically, used to replace more traditional media has proved unfounded. Learners did make substantial use of mobile technologies but in quite heterogeneous and asymmetrical ways," continued the article, written by researchers at the Northern Ontario School of Medicine in Sudbury, Ontario.

"There is a misalignment between learners and preceptors," corresponding author Rachel H. Ellaway, assistant dean of curriculum and planning and acting director of simulation at NOSM, told MobiHealthNews. "That's a transitional thing," she added, one that she expects to change over time.

The school has had a mobile device program of some sort since 2007.  Since 2010, NOSM has issued laptops and iPads to incoming students, and a new laptop and either an iPhone or iPod Touch to those entering their third year, covered by a technology fee added to their tuition.

However, curriculum was not designed specifically for mobile usage. A librarian recommended an "app of the week" to students via a blog, as well as Facebook and Twitter, but faculty received no support from administration on integrating mobile devices into coursework or clinical teaching.

"This has meant that, while all learners in our undergraduate medical program were issued with mobile devices, they were not required to use them in any formal teaching context. This created an opportunity to examine learner use of mobile technologies relatively free of other potentially confounding factors," the paper said. 

The researchers surveyed a total of 101 students, 43 of whom were in the first of their four years of medical school, for a year starting in November 2011.

About half reported never using their smartphones or tablets for scheduling or managing their calendars. They were more likely to browse the Web or manage e-mail than engage in any classroom activities on mobile devices. "It was more a Web and e-mail appliance than a study guide," Ellaway said.

Less than one-third of respondents said they viewed online curriculum on their phone or tablet, and a similarly small number never took notes on their handheld devices, according to the study.

"Most learners had used their device as a document reader at some point, but such use was infrequent, as they expressed a preference for paper or a laptop for reading quantities of text," the paper said.

Indeed, the researchers said students viewed mobile devices as an accessory rather than a replacement for their laptops. About 53 percent reported occasionally using their tablet or smartphone as an alternative to a full-featured computer, and 28 percent never did so. Just 8 percent only used a mobile device, while 11 percent often turned to a mobile device as a laptop replacement.

Usage often depended on context and setting, as participants were more likely to employ a mobile device while studying than while in class. "The device was particularly useful in the clinical setting; for learners’ personal use, as a way of supporting the healthcare teams they were working with, and occasionally to enhance communication with patients," the study said.

"The great majority of them would use them as part of their clinical learning," Ellaway explained. Most often, students used mobile devices as reference tools, particularly when seeking "just-in-time information," Ellaway said.

Some respondents said the iPad was too large, while others complained about the iPhone being too small. Both types of devices were called difficult to type on. However, respondents generally liked that the devices helped them keep in touch with instructors and fellow students. "A few learners also commented on preferring using an iPad in small group learning to reduce the physical barriers set up by laptop screens," the study said.

Students have grown increasingly unhappy with the mandatory technology fee and lack of device choices, as not all preferred Apple products. Starting with the 2013-14 school year, they now are asked to opt into the program. Ellaway expressed interest in repeating the study in a couple of years to see whether device choice makes a difference.

Usage tended to be based on individual preference, as Ellaway and her team had difficulty establishing patterns. "In each class there were those who used their mobile devices regularly and others who used them infrequently or not at all. Some learners used their mobile devices in almost everything they did while others used them predominantly for just one or two tasks," the researchers wrote.

Third- and fourth-year students in particular ran into problems with instructors thinking they were socializing on their phones. "That was actually written on one of my formal evaluations about my cellphone use, which sent me right over the edge, because I was furious. I'm not socializing while I'm working, I'm looking things up," one said, according to the article.

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