Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

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Abstract

Purpose:

Smartphone technology offers a multitude of applications (apps) that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones.

Methods:

In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100%) were calculated to assess the frequency of their use of general features (email, text) and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test.

Results:

A total of 184 residents responded (response rate, 53.0%). The average score for using general features, 14.4/20 (72.2%) was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001). The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1%) than year 1–2 residents, 14.1/20 (70.5%, P=0.035), and for internal medicine residents, 14.9/20 (74.6%) in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001). The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5%) than for year 1–2 residents, 13.7/44 (31.1%; P=0.044). Only 21.7% of respondents had received prior training in clinical smartphone use.

Conclusion:

Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

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Most cited references 18

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Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK): a regional survey

Karl Frederick Braekkan Payne, Heather Wharrad, Kim Watts (2012)

Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps) has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257) of medical students and 74.8% (n=98/131) of junior doctors owned a smartphone, with 56.6% (n=115/203) of students and 68.4% (n=67/98) of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, p<0.001). Both populations showed similar trends of app usage of several times a day. Over 24hours apps were used for between 1–30 minutes for students and 1–20 minutes for doctors, students used disease diagnosis/management and drug reference apps, with doctors favouring clinical score/calculator apps. Conclusions This study found a high level of smartphone ownership and usage among medical students and junior doctors. Both groups endorse the development of more apps to support their education and clinical practice.

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Emergency department workplace interruptions: are emergency physicians "interrupt-driven" and "multitasking"?

Carey Chisholm, Edgar Collison, David R. Nelson … (2000)

Although interruptions have been shown in aviation and other work settings to result in error with serious and sometimes fatal consequences, little is known about interruptions in the emergency department (ED). The authors conducted an observational, time-motion task-analysis study to determine the number and types of interruptions in the ED. Emergency physicians were observed in three EDs located in an urban teaching hospital, a suburban private teaching hospital, and a rural community hospital. A single investigator followed emergency staff physicians for 180-minute periods and recorded tasks, interruptions, and breaks-intask. An "interruption" was defined as any event that briefly required the attention of the subject but did not result in switching to a new task. A "break-intask" was defined as an event that required the attention of the physician for more than 10 seconds and subsequently resulted in changing tasks. The mean (+/-SD) total number of patients seen at all three sites during the 180-minute study period was 12.1 +/- 3.7 patients (range 5-20). Physicians performed a mean of 67.6 +/- 15.7 tasks per study period. The mean number of interruptions per 180-minute study period was 30.9 +/- 9.7 and the mean number of breaks-in-task was 20.7 +/- 6.3. Both the number of interruptions (r = 0.63; p < 0.001) and the number of breaks-in-task (r = 0.56; p < 0.001) per observation period were positively correlated with the average number of patients simultaneously managed. Emergency physicians are "interruptdriven." Emergency physicians are frequently interrupted and many interruptions result in breaks-in-task.

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Smartphone app use among medical providers in ACGME training programs.

Timothy F Tirrell, Orrin I Franko (2012)

The past decade has witnessed the advent of the smartphone, a device armed with computing power, mobility and downloadable "apps," that has become commonplace within the medical field as both a personal and professional tool. The popularity of medically-related apps suggests that physicians use mobile technology to assist with clinical decision making, yet usage patterns have never been quantified. A digital survey examining smartphone and associated app usage was administered via email to all ACGME training programs. Data regarding respondent specialty, level of training, use of smartphones, use of smartphone apps, desired apps, and commonly used apps were collected and analyzed. Greater than 85% of respondents used a smartphone, of which the iPhone was the most popular (56%). Over half of the respondents reported using apps in their clinical practice; the most commonly used app types were drug guides (79%), medical calculators (18%), coding and billing apps (4%) and pregnancy wheels (4%). The most frequently requested app types were textbook/reference materials (average response: 55%), classification/treatment algorithms (46%) and general medical knowledge (43%). The clinical use of smartphones and apps will likely continue to increase, and we have demonstrated an absence of high-quality and popular apps despite a strong desire among physicians and trainees. This information should be used to guide the development of future healthcare delivery systems; expanded app functionality is almost certain but reliability and ease of use will likely remain major factors in determining the successful integration of apps into clinical practice.

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Author and article information

Journal

Journal ID (nlm-ta): J Educ Eval Health Prof

Journal ID (iso-abbrev): J Educ Eval Health Prof

Journal ID (publisher-id): JEEHP

Title: Journal of Educational Evaluation for Health Professions

Publisher: National Health Personnel Licensing Examination Board of the Republic of Korea

ISSN (Electronic): 1975-5937

Publication date Collection: 2015

Publication date (Electronic): 29 October 2015

Volume: 12

Electronic Location Identifier: 48

Affiliations

[1 ]Department of Internal Medicine, University of Utah School of Medicine & George E. Whalen VA Hospital, Salt Lake City, UT, USA

[2 ]Department of Emergency Medicine, Brigham and Women’s Hospital/Massachusetts General Hospital, Boston, MA, USA

[3 ]Department of Emergency Medicine, Universidad de Antioquia, Medellin, Colombia

[4 ]Department of Internal Medicine Administration, University of Utah School of Medicine, Salt Lake City, UT, USA

Author notes

*Corresponding email: sonja.raaum@ 123456hsc.utah.edu

Author information

Sonja E. Raaum http://orcid.org/0000-0001-8032-0853

Christian Arbelaez http://orcid.org/0000-0002-4669-3469

Carlos Eduardo Vallejo http://orcid.org/0000-0001-5677-8557

Andres M. Patino http://orcid.org/0000-0002-4599-4016

Jorie M. Colbert-Getz http://orcid.org/0000-0001-7419-7588

Caroline K. Milne http://orcid.org/0000-0002-4782-1901

Article

Publisher ID: jeehp-12-48

DOI: 10.3352/jeehp.2015.12.48

PMC ID: 4671182

PubMed ID: 26582632

SO-VID: 6fdbda60-75b5-453e-bce6-1e4ec230a2f6

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

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Preventive and Emergency Medicine Insights

Most cited references 18

Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK): a regional survey

Emergency department workplace interruptions: are emergency physicians "interrupt-driven" and "multitasking"?

Smartphone app use among medical providers in ACGME training programs.

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