Mobile Medical Education (MoMEd): Putting digital mobile resources in the hands of medical students – impact, lessons learnt and the future Jil Fairclough, Medical School Librarian Brighton & Sussex Medical School

Brighton & Sussex Medical School

Research and results – 2005 to present The librarian/library role – how does that fit in? The future – 2011 onwards - where are we going now? The MoMEd project - Mobile Medical Education

GMC’s: Tomorrow’s Doctors (2009) expects doctors to be able to “use information effectively in a medical context” “Access information sources and use the information in relation to patient care, health promotion, advice and information to patients, and research and education” “Make effective use of computers and other information systems, including storing and retrieving information.”

Why mobile technology in medical training? The future of education lies in the adoption of technology, such as mobile and wireless, that connects people, unifies the education process and enhances learning. BSMS, as a new medical school, wants students to become familiar with mobile technology and take advantage of the technology to explore innovative approaches to teaching and learning. Dr John D. Halamka, Associate Dean, Harvard Medical School, 2002 Prof Jon Cohen, Dean of BSMS, 2003

In 2005, BSMS became the first UK medical school to introduce the widespread use of mobile devices to its students Offered to all Year 3, 4, and 5 students (approx. 350 students) Loaned PDA and software for free

What did we do? Supporting set-up, roll-out, maintenance, and training Dir. of Undergraduate Studies – Dr Inam Haq IT Manager – Mark Packer Librarian – Jil Fairclough Learning Technologist – Tim Vincent Everyone! Clinical Research Fellow(s) – Dr Jethin Rafique, Dr Bethany Davies, Dr Anna Jones Divisional assistant IT Technicians x2 – Tim Lambert, Matthew Day

Providing mobile hardware and

Resources on the Dr Companion card British National Formulary Chemical Laboratory References Classification of Surgical Operations & Procedures Clinical Evidence Cochrane Abstracts DSM IV ICD 10 NICE Compilation Guidance Netter Atlas of Human Anatomy Evidence Based Medicine Patient Organizations Oxford Concise Medical Dictionary Oxford Handbook of Emergency Medicine Oxford Handbook of Clinical & Lab Investigation Oxford Handbook of Clinical Medicine Oxford Handbook of Clinical Surgery Oxford Handbook of Practical Drug Therapy Oxford Handbook of General Practice Oxford Handbook of Medical Sciences

Useful mobile technology in the clinical setting The CCU consultant asks you “What evidence is there for the use of ACE inhibitors in secondary prevention post MI?” “And what dose is the SHO writing up?”

What is the impact of putting digital mobile information resources in the hands of medical students? How much do medical student really use mobile devices to access learning resources? What is the impact on students’ learning? What are the advantages and disadvantages of mobile devices in the clinical setting Mobile Medical Education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students: a mixed methods study. Bethany S Davies, Jethin Rafique, Tim R Vincent, Jil Fairclough, Mark H Packer, Richard Vincent and Inam Haq. BMC Medical Education 2012, 12:1 doi: /

Data collection Focus groupsQuestionnaires Usage stats on server

Results: Most popular resource Questionnaire Choose 3 most popular resources Votes BNF91 OH Clinical Medicine89 Medical dictionary22 Netter’s anatomy19 Tracking Most popular resource No. of uses OH Clinical Medicine3,385 BNF3,137 Medical dictionary1,867 OH General Practice791 OH Clinical Surgery884

Access to knowledge Consolidation of knowledge Need for change Analysis : Three major themes identified

Theme 1: Access to knowledge Mobility Immediacy Speed of access Two devices “The only thing is, you don’t have that many pockets. I would have my wallet in one pocket, my phone in another. I found it quite hard to carry [the PDA] around with me all the time.” “The whole two devices thing is my major gripe.” “The only thing is, you don’t have that many pockets. I would have my wallet in one pocket, my phone in another. I found it quite hard to carry [the PDA] around with me all the time.” “The whole two devices thing is my major gripe.”

Theme 2: Consolidation of knowledge Quick reference information Repetition Better use of ‘wasted’ time “It has enhanced [my knowledge] by reinforcing key points at point- of-need. If you want to know then-and-there, you can find it then-and-there. It’s just the memory jog you need to reinforce the point a bit more. It doesn’t mean you’re relying on the PDA – it just helps to reinforce and consolidate the knowledge a bit better.”

Theme 2: Consolidation of knowledge Quick reference information Repetition Better use of ‘wasted’ time “The more repetition I get, the more I’m able to look at something quickly – when I need to - the more it’s likely to stick. Because you can look and say ‘oh ok, that’s what it is again’” “Initially, you may look at it three times and then after that you will become more confident in saying ‘yes I know this now’” “The more repetition I get, the more I’m able to look at something quickly – when I need to - the more it’s likely to stick. Because you can look and say ‘oh ok, that’s what it is again’” “Initially, you may look at it three times and then after that you will become more confident in saying ‘yes I know this now’”

Theme 2: Consolidation of knowledge Quick reference information Repetition Better use of ‘wasted’ time “One of the drivers for me of using it might be more general is just my dislike of wasted time particularly during the day.” “I agree. Actually, that’s one of the reasons I have started to use it a lot more. There and then when there isn’t anything to do you can make use of time.” “One of the drivers for me of using it might be more general is just my dislike of wasted time particularly during the day.” “I agree. Actually, that’s one of the reasons I have started to use it a lot more. There and then when there isn’t anything to do you can make use of time.”

Theme 3: Change Attitude, behaviour, approach Resistance to change Establishing change “…if you remember to take it with you” “I think it’s about adopting a different mentality.” “I’m worried that the nurses or patients will think I am texting or ing” “…if you remember to take it with you” “I think it’s about adopting a different mentality.” “I’m worried that the nurses or patients will think I am texting or ing”

Theme 3: Change Attitude, behaviour, approach Resistance to change Establishing change “What changed your mind?” “Finding I did use the PDA and it did come in handy several times. It just makes life a bit easier.” “...I have definitely got used to having that type of reference at my fingertips. I would definitely look into ways of continuing that.” “What changed your mind?” “Finding I did use the PDA and it did come in handy several times. It just makes life a bit easier.” “...I have definitely got used to having that type of reference at my fingertips. I would definitely look into ways of continuing that.”

The future of MoMEd

The emergence of smartphones BSMS becomes the first UK medical school to introduce the widespread use of PDAs to its students Apple announces sales of 4.7m iPhones First Android phone (G1) launches Apple becomes largest smartphone vendor Smartphone sales make up 31% of 1.8bn devices sold globally Steve Jobs unveils the iPhone Apple launches iPad

What do the students want?

iPhone pilot 4 month trial (Nov-Feb) 48 students with own iOS device Novel logging to track usage Contract to recording usage and research participation

Changing the model to information over technology Offered to all students in years 3-5 with their own device

What MoMEd provides now Year 3 Year 4 Year 5

Librarians/Library role Resources knowledge Publisher knowledge Knowledge of usage of print/online resources Teacher role

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