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      Smartphone Application of Primary Care Guidelines used in Education of Medical Students

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          Abstract

          Background and Objective: The guidelines of the German College of General Practitioners and Family Physicians (DEGAM) on frequent and important reasons for encounter in Primary Care play a central role in the teaching of Family Medicine. They were edited by the authors into an app for mobile phones, making them available at all times to General Practitioners and medical students. This study examines the issue: how useful do students consider this application within their learning process in Family Medicine?

          Method: The short versions of the 15 DEGAM guidelines were processed as a web app (for all smartphone software systems) including offline utilisation, and offered to students in the Family Medicine course, during clinical attachments in General Practice, on elective compulsory courses or for their final year rotation in General Practice. The evaluation was made with a structured survey using the feedback function of the Moodle learning management system [ http://www.elearning-allgemeinmedizin.de] with Likert scales and free-text comments.

          Results: Feedback for evaluation came from 14 (25%) of the student testers from the Family Medicine course (9), the clinical attachment in General Practice (1), the final year rotation in General Practice (1) and elective compulsory courses (4). Students rated the app as an additional benefit to the printed/pdf-form. They use it frequently and successfully during waiting periods and before, during, or after lectures. In addition to general interest and a desire to become acquainted with the guidelines and to learn, the app is consulted with regard to general (theoretical) questions, rather than in connection with contact with patients. Interest in and knowledge of the guidelines is stimulated by the app, and on the whole the application can be said to be well suited to the needs of this user group.

          Discussion: The students evaluated the guidelines app positively: as a modern way of familiarising them with the guidelines and expanding their knowledge, particularly through its use in waiting periods and the attractive medium smartphone. However, the latter prevents a mandatory curricular use in compulsory courses, since not all students use smartphones. It is a meaningful addition to existing teaching materials and supports evidence-based teaching in Family Medicine and is suitable for use not only in university course teaching but also during clinical training.

          Translated abstract

          Hintergrund und Fragestellung: Die Leitlinien der Deutschen Gesellschaft für Allgemeinmedizin (DEGAM) zu häufigen und wichtigen Beratungsanlässen in der Hausarztpraxis sind ein zentraler Inhalt der Lehre im Fach Allgemeinmedizin. Durch die Autoren wurden sie als App für Mobiltelefone aufbereitet und stehen somit nun Hausärzten und Studierenden jederzeit zur Verfügung. Die vorliegende Studie untersucht die Fragestellung: Wie bewerten Studierende den Nutzen dieser Anwendung für ihren Lernprozess im Fach Allgemeinmedizin?

          Methodik: Die Kurzversionen der 15 DEGAM-Leitlinien wurden als (Smartphone-Betriebssystem-unabhängige) Web-App mit Möglichkeit der Offline-Nutzung umgesetzt und Studierenden in Kurs, Blockpraktikum, Wahlfächern und PJ (Praktisches Jahr) Allgemeinmedizin angeboten. Die Evaluation erfolgte durch eine strukturierte Befragung über die Feedbackfunktion der Moodle-Lernplattform www.elearning-allgemeinmedizin.de mit Likertskalen und Freitextkommentaren.

          Ergebnisse: Der Evaluations-Rücklauf kam von 14 (25%) der 56 studentischen TesterInnen aus dem Kurs Allgemeinmedizin (9), dem Blockpraktikum (1), dem PJ (1) und Wahlfächern (4). Die App selbst sehen die Studierenden als Mehrwert zur Print/PDF-Version. Sie nutzen sie häufig und erfolgreich in Nischenzeiten und vor/während/nach Lehrveranstaltungen. Neben allgemeinem Interesse / Kennenlernen der Leitlinien und Lernen wird sie zum Nachschlagen konkreter (theoretischer) Fragestellungen eingesetzt, weniger im Zusammenhang mit Patientenkontakten. Interesse und Kenntnis der Leitlinien wird durch die App gefördert, insgesamt ist die Anwendung für die Bedürfnisse dieser Usergruppe gut geeignet.

          Diskussion: Die Leitlinien-App wurde von Studierenden sehr positiv bewertet: Als moderne Form, ihnen die Leitlinien näher zu bringen und ihre Kenntnisse zu erweitern, gerade auch durch den flexiblen Einsatz in Nischenzeiten und das attraktive Medium Smartphone. Letzteres verhindert aber auch eine verbindliche Curriculare Implementierung in der Pflichtlehre, da nicht alle Studierenden Smartphones nutzen. Sie ist eine sinnvolle Ergänzung mit Mehrwert zu den bereits bestehenden Lernangeboten und unterstützt die Evidenz basierte Lehre im Fach Allgemeinmedizin – die nicht nur für die universitären Kurse, sondern auch für Famulaturen geeignet ist.

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

          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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            A Systematic Review of Healthcare Applications for Smartphones

            Background Advanced mobile communications and portable computation are now combined in handheld devices called “smartphones”, which are also capable of running third-party software. The number of smartphone users is growing rapidly, including among healthcare professionals. The purpose of this study was to classify smartphone-based healthcare technologies as discussed in academic literature according to their functionalities, and summarize articles in each category. Methods In April 2011, MEDLINE was searched to identify articles that discussed the design, development, evaluation, or use of smartphone-based software for healthcare professionals, medical or nursing students, or patients. A total of 55 articles discussing 83 applications were selected for this study from 2,894 articles initially obtained from the MEDLINE searches. Results A total of 83 applications were documented: 57 applications for healthcare professionals focusing on disease diagnosis (21), drug reference (6), medical calculators (8), literature search (6), clinical communication (3), Hospital Information System (HIS) client applications (4), medical training (2) and general healthcare applications (7); 11 applications for medical or nursing students focusing on medical education; and 15 applications for patients focusing on disease management with chronic illness (6), ENT-related (4), fall-related (3), and two other conditions (2). The disease diagnosis, drug reference, and medical calculator applications were reported as most useful by healthcare professionals and medical or nursing students. Conclusions Many medical applications for smartphones have been developed and widely used by health professionals and patients. The use of smartphones is getting more attention in healthcare day by day. Medical applications make smartphones useful tools in the practice of evidence-based medicine at the point of care, in addition to their use in mobile clinical communication. Also, smartphones can play a very important role in patient education, disease self-management, and remote monitoring of patients.
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              The Use of the Personal Digital Assistant (PDA) Among Personnel and Students in Health Care: A Review

              Background Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications. Objective The aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care. Methods The literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen’s Model of System Acceptability as a theoretical framework in structuring and presenting the results. Results From the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen’s Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning. Conclusions This overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.
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                Author and article information

                Journal
                GMS Z Med Ausbild
                GMS Z Med Ausbild
                GMS Z Med Ausbild
                GMS Zeitschrift für Medizinische Ausbildung
                German Medical Science GMS Publishing House
                1860-7446
                1860-3572
                21 February 2013
                2013
                : 30
                : 1 , Einsatz von Social Media und Web 2.0 in der (tier/zahn)medizinischen Aus- und Fortbildung
                : Doc6
                Affiliations
                [1 ]University of Ulm, Institute of General Practice, Ulm, Germany
                [2 ]University of Bonn, Institute of General Practice, Bonn, Germany
                Author notes
                *To whom correspondence should be addressed: Uta-Maria Waldmann, University of Ulm, Institute of General Practice, Helmholtz Straße 20, 89069 Ulm, Germany, Phone: +49 (0)731/50-31107, Fax: +49 (0)731/50-1231107, E-mail: uta-maria.waldmann@ 123456uni-ulm.de
                Article
                zma000849 Doc6 urn:nbn:de:0183-zma0008498
                10.3205/zma000849
                3589688
                23467657
                901f0301-aecc-4916-bae5-c1d23aa3be2d
                Copyright © 2013 Waldmann et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/). You are free to copy, distribute and transmit the work, provided the original author and source are credited.

                History
                : 28 June 2012
                : 11 January 2013
                : 03 January 2013
                Categories
                Article

                Medicine
                family medicine,general practice,primary care,guidelines,medical training,mobile learning,app
                Medicine
                family medicine, general practice, primary care, guidelines, medical training, mobile learning, app

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