Use of handheld computers in medical education

AbstractBACKGROUND: Over the past decade, handheld computers (or personal digital assistants [PDAs]) have become a popular tool among medical trainees and physicians. Few comprehensive reviews of PDA use in medicine have been published. OBJECTIVE: We systematically reviewed the literature to (1) describe medical trainees’ use of PDAs for education or patient care, (2) catalog popular software applications, and (3) evaluate the impact of PDA use on patient care. DATA SOURCES: MEDLINE (1993 to 2004), medical education-related conference proceedings, and hand search of article bibliographies. REVIEW METHODS: We identified articles and abstracts that described the use of PDAs in medical education by trainees or educators. Reports presenting a qualitative or quantitative evaluation were included. RESULTS: Sixty-seven studies met inclusion criteria. Approximately 60% to 70% of medical students and residents use PDAs for educational purposes or patient care. Satisfaction was generally high and correlated with the level of handheld computer experience. Most of the studies included described PDA use for patient tracking and documentation. By contrast, trainees rated medical textbooks, medication references, and medical calculators as the most useful applications. Only 1 randomized trial with educational outcomes was found, demonstrating improved learning and application of evidence-based medicine with use of PDA-based decision support software. No articles reported the impact of PDA use on patient outcomes. CONCLUSION: Most medical trainees find handhelds useful in their medical education and patient care. Further studies are needed to evaluate how PDAs impact learning and clinical outcomes.

[1]  L Sullivan,et al.  Using personal digital assistants in a family medicine clerkship. , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[2]  Saju Joy,et al.  Personal Digital Assistant Use in Florida Obstetrics and Gynecology Residency Programs , 2004, Southern medical journal.

[3]  Medical schools and hospitals adopt handheld personal data assistants. , 2001, Health care strategic management.

[4]  Stephen E Lapinsky,et al.  Surgical procedure logging with use of a hand-held computer. , 2002, Canadian journal of surgery. Journal canadien de chirurgie.

[5]  A Cohrssen Tracking resident procedures needs accountability. , 1998, Family medicine.

[6]  Feisal A Adatia,et al.  "Palm reading": 1. Handheld hardware and operating systems. , 2002, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[7]  S. Engum Do you know your students' basic clinical skills exposure? , 2003, American journal of surgery.

[8]  Scott M. Strayer,et al.  Assessing medical residents' usage and perceived needs for personal digital assistants , 2004, Int. J. Medical Informatics.

[9]  Charlene R. Weir,et al.  Developing a taxonomy for research in adverse drug events: potholes and signposts , 2002, AMIA.

[10]  Peter D. Stetson,et al.  Application of Information Technology: PalmCIS: A Wireless Handheld Application for Satisfying Clinician Information Needs , 2004, J. Am. Medical Informatics Assoc..

[11]  Goutham Rao,et al.  Introduction of handheld computing to a family practice residency program. , 2002, The Journal of the American Board of Family Practice.

[12]  Joseph L. Kannry,et al.  Portable Digital Assistant Use in a Medicine Teaching Program , 2000, AMIA.

[13]  Todd K. Malan,et al.  HAND‐HELD COMPUTER OPERATING SYSTEM PROGRAM FOR COLLECTION OF RESIDENT EXPERIENCE DATA , 2000, Obstetrics and gynecology.

[14]  Joseph Finkelstein,et al.  Feasibility of a Palmtop-Based Interactive Education to Promote Patient Safety , 2003, AMIA.

[15]  Axel Ekkernkamp,et al.  Comparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial. , 2004, Journal of Bone and Joint Surgery. American volume.

[16]  N Chesanow Colleagues rate the leading software. , 2000, Medical economics.

[17]  R Garvin,et al.  Using handheld computers to document family practice resident procedure experience. , 2000, Family medicine.

[18]  Robert R McKenney The next level of distributed learning: the introduction of the personal digital assistant. , 2004, The Journal of oncology management : the official journal of the American College of Oncology Administrators.

[19]  Cynthia S. Gadd,et al.  Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry , 2001, AMIA.

[20]  Parvati Dev,et al.  Case Report: Audience Response Made Easy: Using Personal Digital Assistants as a Classroom Polling Tool , 2004, J. Am. Medical Informatics Assoc..

[21]  Christian Lovis,et al.  Understanding usage patterns of handheld computers in clinical practice , 2002, AMIA.

[22]  Robert W. Williams,et al.  The USU medical PDA initiative: the PDA as an educational tool , 2002, AMIA.

[23]  Leslie H Fall,et al.  Development of a Handheld Computer Documentation System to Enhance an Integrated Primary Care Clerkship , 2002, Academic medicine : journal of the Association of American Medical Colleges.

[24]  David W. Bates,et al.  Research Paper: Clinician Use of a Palmtop Drug Reference Guide , 2002, J. Am. Medical Informatics Assoc..

[25]  S. Lapinsky,et al.  Review Paper: Handheld Computing in Medicine , 2003, J. Am. Medical Informatics Assoc..

[26]  Walton Sumner,et al.  Family practice clerkship encounters documented with structured phrases on paper and hand-held computer logs , 2000, AMIA.

[27]  J. Marc Overhage,et al.  A comparison of a printed patient summary document with its electronic equivalent: early results , 2001, AMIA.

[28]  J. Luo,et al.  Portable Computing in Psychiatry , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[29]  Stuart M. Speedie,et al.  PDA support for outpatient clinical clerkships: mobile computing for medical education , 2001, AMIA.

[30]  R J Young,et al.  The potential role of IT in supporting the work of junior doctors. , 2000, Journal of the Royal College of Physicians of London.

[31]  K. Aaron,et al.  A call for papers , 1991, Transactions of the Kansas Academy of Science.

[32]  G. Leung,et al.  Randomised controlled trial of clinical decision support tools to improve learning of evidence based medicine in medical students , 2003, BMJ : British Medical Journal.

[33]  Documenting procedures and deliveries during family practice residency: a survey of graduates' experiences, preferences, and recommendations. , 2003, Family medicine.

[34]  David B Schubot,et al.  Personal digital assistants herald new approaches to teaching and evaluation in medical education. , 2003, WMJ : official publication of the State Medical Society of Wisconsin.

[35]  M. Irigoyen,et al.  Use of personal digital assistants to enhance educational evaluation in a primary care clerkship , 2002, Medical teacher.

[36]  D. Simpson,et al.  Personal digital assistant for "real time" assessment of women's health in the clinical years. , 2002, American journal of obstetrics and gynecology.

[37]  Walton Sumner Student documentation of multiple diagnoses in family practice patients using a handheld student encounter log , 2001, AMIA.

[38]  R A Greenes,et al.  The Constellation Project: experience and evaluation of personal digital assistants in the clinical environment. , 1995, Proceedings. Symposium on Computer Applications in Medical Care.

[39]  R. Brilla,et al.  Introducing New Technology: Handheld Computers and Drug Databases. A Comparison Between Two Residency Programs , 2004, Journal of Medical Systems.

[40]  Philippe L Bedard,et al.  "Palm reading": 2. Handheld software for physicians. , 2003, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[41]  D. Christakis,et al.  The effect of point-of-care personal digital assistant use on resident documentation discrepancies. , 2004, Pediatrics.

[42]  Ruth B. Greenberg Use of the personal digital assistant (PDA) in medical education , 2004, Medical education.

[43]  Jian Su,et al.  Evaluating a Digital Resident Diagnosis Log: Reasons for Limited Acceptance of a PDA Solution , 2003, AMIA.

[44]  Scott M. Strayer,et al.  Information Needs of Residents During Inpatient and Outpatient Rotations: Identifying Effective Personal Digital Assistant Applications , 2003, AMIA.

[45]  Michael L. Parchman,et al.  Research Paper: Handheld Computer Use in U.S. Family Practice Residency Programs , 2002, J. Am. Medical Informatics Assoc..

[46]  B. Beasley,et al.  Utility of Palmtop Computers in a Residency Program: A Pilot Study , 2002, Southern medical journal.

[47]  D. Christakis,et al.  Pediatricians' use of and attitudes about personal digital assistants. , 2004, Pediatrics.

[48]  Dario M Torre,et al.  Clinical and Educational Uses of Handheld Computers , 2003, Southern medical journal.

[49]  S G Bass Wireless computing. Medical students and mobile medicine. , 2000, M.D. computing : computers in medical practice.

[50]  S. Goldenberg,et al.  Implementation of a PDA based program to quantify urology resident in-training experience. , 2003, The Canadian journal of urology.

[51]  Alderson,et al.  Clinical experience of medical students in primary care: use of an electronic log in monitoring experience and in guiding education in the Cambridge Community Based Clinical Course , 1999, Medical education.

[52]  S B Bird,et al.  Emergency medicine resident patient care documentation using a hand-held computerized device. , 2001, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[53]  A L Helwig,et al.  Using palm‐top computers to improve students' evidence‐based decision making , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[54]  Aaron E. Carroll,et al.  Development of a Personal Digital Assistant (PDA) based client/server NICU patient data and charting system , 2001, AMIA.

[55]  Bill Briggs Pushing data out to PDAs. , 2002, Health data management.

[56]  Walton Sumner,et al.  Validation of electronic student encounter logs in an emergency medicine clerkship , 2002, AMIA.

[57]  Gabriel M Leung,et al.  Evaluation of a handheld clinical decision support tool for evidence‐based learning and practice in medical undergraduates , 2004, Medical education.

[58]  Jon O. Ebbert,et al.  Case Report: Survey Assessment of Personal Digital Assistant Use among Trainees and Attending Physicians , 2003, J. Am. Medical Informatics Assoc..

[59]  A. McAlearney,et al.  Doctors' experience with handheld computers in clinical practice: qualitative study , 2004, BMJ : British Medical Journal.

[60]  Khan M. Siddiqui,et al.  Nuclear cardiology patient tracking using a palm-based device: methods and clinician satisfaction. , 2002, Journal of digital imaging.

[61]  Resident procedure and resuscitation tracking using a palm computer , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[62]  Anil S Menon,et al.  Preparing doctors for bedside computing , 2003, The Lancet.

[63]  Alec Holt,et al.  Hand-held computers in healthcare: what software programs are available? , 2002, The New Zealand medical journal.

[64]  Moore Rh Use of a palmtop pocket computer to produce a customised logbook of surgical experience. , 1995 .

[65]  Michael H. Zaroukian,et al.  HANDHELD COMPUTING IN RESIDENT EDUCATION: BENEFITS, BARRIERS, AND CONSIDERATIONS , 2002 .

[66]  V K Mohl,et al.  Can palmtop computers improve the feasibility of research projects for FM faculty? , 1998, Family medicine.

[67]  R H Moore Use of a palmtop pocket computer to produce a customised logbook of surgical experience. , 1995, Annals of the Royal College of Surgeons of England.