"Bump": using a mobile app to enhance learning in simulation scenarios.

W e would like to share with your readers a novel approach to using a mobile application for the enhancement of a student simulation learning experience, which we have found useful. We offer an advanced elective course that combines an online learning module and high-fidelity human patient simulation (HPS) technology. This course has been previously described in more detail. Instructors use an adult learning approach having pharmacy students review Internetbased learning modules before class to understand current evidence-based drug treatments. Students are then engaged in real-life scenarios using HPS. A major goal of this course is to develop students’ critical thinking skills. During HPS cases, students receive a synopsis of the patient’s condition and are expected to use critical thinking to evaluate what additional information they need to develop a pharmacotherapy plan. Previously, facilitators used a couple of options to communicate the information requested by students including a simulated paper chart or verbal communication. The simulated paper chart has limitations: (1) All information is given to the students, and this may not necessarily require critically thinking about obtaining pertinent data. (2) The facilitator cannot easily evaluate the students’ thinking process supporting their treatment recommendations. The other approach for transferring relevant information to students involves facilitators providing requested information verbally. Although this allows facilitators to evaluate the students’ critical thinking process, it is time consuming for students to manually copy all information stated aloud, thus limiting the time available for active learning 1-hour HPS cases. Bump Technologies, Inc (Mountain View, CA) application for mobile devices was used to transfer requested information to students in a form that simulates using an electronic patient chart during the in-class cases. Each file was easily transferred to the student requesting the information by bumping or tapping the facilitator’s and the student’s electronic devices together. Facilitators designed the patient chart in separate JPEG files containing pertinent information (eg, medical history, allergies, laboratory results, chest radiograph). An example of a screenshot for laboratory values, culture results, and a chest radiograph that the student received is displayed in Figure 1. Visualization of the information is limited to the student requesting the Bump. Students used their own electronic devices, so a variety of devices were used. This application was chosen because it is easy to use, available to students for use with several brands of mobile smart devices or tablet devices, and free to download. Applying Bump technology further enhanced an active learning environment for students. Facilitators noticed that using Bump increased the opportunity for students to think critically in a stepwise fashion as students requested each piece of patient data, thus contributing to their learning. Challenges that arose included occasional Internet service interruption that prevented bumping and font size appearing small on large text files, making visibility on some handhelds difficult. We noticed that limiting the amount of text provided in each file corrected the problem. Students using tablet computers did not have visibility problems. Overall, use of Bump allowed students to (1) apply critical thinking processes that were obvious to the facilitator and (2) have more time for learning compared with other methods of transferring information.