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      Mobile learning in medicine: an evaluation of attitudes and behaviours of medical students

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          Abstract

          Background

          Mobile learning (mLearning) devices (such as tablets and smartphones) are increasingly part of the clinical environment but there is a limited and somewhat conflicting literature regarding the impact of such devices in the clinical learning environment. This study aims to: assess the impact of mLearning devices in the clinical learning environment on medical students’ studying habits, attitudes towards mobile device supported learning; and the perceived reaction of clinicians and patients to the use of these devices as part of learning in the clinical setting.

          Methods

          Over three consecutive academic years, 18 cohorts of medical students (total n = 275) on a six-week rotation at a large teaching hospital in London were supplied with mLearning devices (iPad mini) to support their placement-based learning. Feedback on their experiences and perceptions was collected via pre- and post-use questionnaires.

          Results

          The results suggest mLearning devices have a positive effect on the students’ perceived efficiency of working, while experience of usage not only confirmed pre-existing positive opinions about devices but also disputed some expected limitations associated with mLearning devices in the clinical workplace. Students were more likely to use devices in ‘down-time’ than as part of their clinical learning. As anticipated, both by users and from the literature, universal internet access was a major limitation to device use. The results were inconclusive about the student preference for device provision versus supporting a pre-owned device.

          Conclusion

          M-learning devices can have a positive impact on the learning experiences medical students during their clinical attachments. The results supported the feasibility of providing mLearning devices to support learning in the clinical environment. However, universal internet is a fundamental limitation to optimal device utilisation.

          Electronic supplementary material

          The online version of this article (10.1186/s12909-018-1264-5) contains supplementary material, which is available to authorized users.

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          Most cited references30

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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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            Mobile Medical Education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students - a mixed methods study

            Background Mobile technology is increasingly being used by clinicians to access up-to-date information for patient care. These offer learning opportunities in the clinical setting for medical students but the underlying pedagogic theories are not clear. A conceptual framework is needed to understand these further. Our initial questions were how the medical students used the technology, how it enabled them to learn and what theoretical underpinning supported the learning. Methods 387 medical students were provided with a personal digital assistant (PDA) loaded with medical resources for the duration of their clinical studies. Outcomes were assessed by a mixed-methods triangulation approach using qualitative and quantitative analysis of surveys, focus groups and usage tracking data. Results Learning occurred in context with timely access to key facts and through consolidation of knowledge via repetition. The PDA was an important addition to the learning ecology rather than a replacement. Contextual factors impacted on use both positively and negatively. Barriers included concerns of interrupting the clinical interaction and of negative responses from teachers and patients. Students preferred a future involving smartphone platforms. Conclusions This is the first study to describe the learning ecology and pedagogic basis behind the use of mobile learning technologies in a large cohort of undergraduate medical students in the clinical environment. We have developed a model for mobile learning in the clinical setting that shows how different theories contribute to its use taking into account positive and negative contextual factors. The lessons from this study are transferable internationally, to other health care professions and to the development of similar initiatives with newer technology such as smartphones or tablet computers.
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              ‘It's on my iPhone’: attitudes to the use of mobile computing devices in medical education, a mixed-methods study

              Objective The last decade has seen the introduction of new technology which has transformed many aspects of our culture, commerce, communication and education. This study examined how medical teachers and learners are using mobile computing devices such as the iPhone in medical education and practice, and how they envision them being used in the future. Design Semistructured interviews were conducted with medical students, residents and faculty to examine participants’ attitudes about the current and future use of mobile computing devices in medical education and practice. A thematic approach was used to summarise ideas and concepts expressed, and to develop an online survey. A mixed methods approach was used to integrate qualitative and quantitative findings. Setting and participants Medical students, residents and faculty at a large Canadian medical school in 2011. Results Interviews were conducted with 18 participants (10 students, 7 residents and 1 faculty member). Only 213 participants responded to the online survey (76 students, 65 residents and 41 faculty members). Over 85% of participants reported using a mobile-computing device. The main uses described for mobile devices related to information management, communication and time management. Advantages identified were portability, flexibility, access to multimedia and the ability to look up information quickly. Challenges identified included: superficial learning, not understanding how to find good learning resources, distraction, inappropriate use and concerns about access and privacy. Both medical students and physicians expressed the view that the use of these devices in medical education and practice will increase in the future. Conclusions This new technology offers the potential to enhance learning and patient care, but also has potential problems associated with its use. It is important for leadership in medical schools and healthcare organisations to set the agenda in this rapidly developing area to maximise the benefits of this powerful new technology while avoiding unintended consequences.
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                Author and article information

                Contributors
                thomas.chase@nhs.net
                adam.julius@nhs.net
                joht.chandan@nhs.net
                emily.powell@doctors.org.uk
                charles.hall@doctors.org.uk
                benedict.phillips@nhs.net
                ryan.burnett@nhslothian.scot.nhs.uk
                deborah.gill@ucl.ac.uk
                bimbi.fernando@nhs.net
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                27 June 2018
                27 June 2018
                2018
                : 18
                : 152
                Affiliations
                [1 ]ISNI 0000000121901201, GRID grid.83440.3b, University College London, ; Gower St, London, WC1E 6BT UK
                [2 ]ISNI 0000 0001 2108 8951, GRID grid.426467.5, Respiratory Medicine, , St Mary’s Hospital, ; Paddington, London, W2 1NY UK
                [3 ]ISNI 0000 0001 2177 007X, GRID grid.415490.d, General Surgery, , Queen Elizabeth Hospital Birmingham, ; Birmingham, B15 2TH UK
                [4 ]ISNI 0000 0004 0497 2835, GRID grid.428062.a, Medicine, , Chelsea and Westminster Hospital NHS Foundation Trust, ; London, SW10 9NH UK
                [5 ]ISNI 0000 0001 0738 5466, GRID grid.416041.6, The Royal London Hospital, ; Whitechapel road, London, E1 1BB UK
                [6 ]Guy’s and St Thomas’ Foundation Trust, Department of Nephrology and Transplantation, London, SE1 9RT UK
                [7 ]ISNI 0000 0001 0709 1919, GRID grid.418716.d, Royal Infirmary of Edinburgh, Medicine of the Elderly, ; Old Dalkeith Road, Edinburgh, EH16 4SA UK
                [8 ]ISNI 0000000121901201, GRID grid.83440.3b, Academic Centre for Medical Education, , University College London Medical School, ; London, UK
                [9 ]ISNI 0000 0001 0439 3380, GRID grid.437485.9, Royal Free London NHS Foundation Trust, Transplant Surgery, ; London, NW3 2QG UK
                Article
                1264
                10.1186/s12909-018-1264-5
                6020287
                29945579
                e87b8bb9-a891-47e1-bc01-acbbe6486ae3
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 January 2018
                : 20 June 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000765, University College London;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                electronic learning,medical students,learning and study skills,medical education
                Education
                electronic learning, medical students, learning and study skills, medical education

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