|Year : 2015 | Volume
| Issue : 1 | Page : 34-38
Clinical and academic uses of smartphones among medical residents
Muhammad Haseeb1, Mir T Altaf2, Aneet Kour3, Firdous Ahmed2, Alamgir Jahan1, Arpan Bijyal1
1 Department of Orthopaedics, Jammu and Kashmir Health Services, Jammu and Kashmir 180001, India
2 Medical Officer, Jammu and Kashmir Health Services, Jammu and Kashmir 180001, India
3 Department of Anesthesiology, Government Medical College, Jammu 180001, India
|Date of Web Publication||30-Sep-2015|
208-B, Boys PG Hostel, Government Medical College, Jammu 180001, Jammu and Kashmir
Source of Support: Nil, Conflict of Interest: None declared.
Background and Objective: A smartphone is a cellular phone with an integrated computer that enables it to perform a wide array of tasks in addition to its primary purpose. Technological growth has been paralleled by a similar rise in the capabilities of modern day smartphones. And they have found their way into medical education as well as practice. iOS and Android based phones constitute the bulk of the smartphones. Together with their associated applications (apps), these devices have become an indispensable tool for the medical resident and practicing physician. The aim of this study is to make an objective assessment of the status of smartphones as a learning aid and practice tool among medical residents. Materials and Methods: The study was conducted on post-graduate trainees in the largest teaching hospital in Jammu province. The residents were approached in the hospital and requested to fill a pre-formulated questionnaire. 90 residents from different specialities were approached over a period of seven days. Results: 80% of the interviewees said they possessed a smartphone. The percentage was lower in first year trainees and highest in third year trainees. Android and iOS based phones were the devices most commonly used. 90% of those with smartphones said they used it for clinical or academic purposes in the hospital. Conclusion: A fairly large percentage of medical residents own smartphones. Most of them use these for clinical and academic purposes. Online resources and pre-installed apps are the two common resources accessed. There is a need for improving the credibility of online resources, and development of more medical apps for smartphones.
Keywords: Android, apps, iPhone, resident, smartphone
|How to cite this article:|
Haseeb M, Altaf MT, Kour A, Ahmed F, Jahan A, Bijyal A. Clinical and academic uses of smartphones among medical residents. Digit Med 2015;1:34-8
| Introduction|| |
Smartphones today are undoubtedly among the most selling electronic gadgets. A smartphone is a cellular phone with an integrated computer capable of performing a broad array of tasks, including running various downloadable applications (apps), which were conventionally not associated with a cellular phone. With the multitude of abilities, the present day smartphones have high-resolution cameras, internet and high speed wireless connectivity, and multimedia capability. With introduction of low-cost models, smartphones have evolved from luxury to essential need in general population and in particular the educated class. The medical community likewise is no exception; in fact practicing doctors and medical students are the highest percentage of smartphone users among any single community., Although smartphones existed as early as 1992, it was not until the development of the Palm and Blackberry in 2001 and 2002, respectively, that consumers began to use mobile devices capable of wireless information services and web-browsing. By today's standard, however, introduction of the iPhone by Apple in 2007 marked the birth of the smartphone.
A smartphone is defined by its manufacturer or the operating system it uses. Apples's iOS, Android by Google, Windows by Microsoft and Blackberry account for the majority of smartphone interfaces currently in use. All the leading models offer good quality cameras and efficient internet access. In addition, all these platforms are backed by an arsenal of downloadable apps that increase the versatility and productivity of the phone several fold. We sought to research the status of the smartphone among medical residents (post-graduate trainees), and find out how much, if at all, it contributed in their professional training.
| Materials and Methods|| |
We conducted this study on postgraduate trainees of Government Medical College, Jammu. Ethical approval was sought from the institutional committee. In order to utilize the time and effort efficiently, it was decided to approach the residents posted, by rotation, in the emergency department of the hospital everyday for one week. In this way, we met a new team from each specialty every day, and after one week gathered data from most of the residents working in the clinical departments of the hospital. We did not include residents from non-clinical departments because very few of them were posted in the emergency department. We did not include some specialties that are run in a separate hospital. The study was thus carried out on residents in internal medicine, general surgery, orthopedics, radiodiagnosis, ophthalmology and otolaryngology (ENT).
A questionnaire was formulated which would identify the incidence of smartphone use among the residents, and also bring out the importance they attach to the different aspects of its daily use [Appendix 1 [Additional file 1] ]. For the purpose of clarity, a 'smartphone' was defined as a cellphone with features including a camera, internet connectivity and availability of downloadable apps. For the purpose of this study, phones devoid of one of these features were not considered as smartphones. Further, tablets were excluded to avoid issues of comparability and disparities with the definition, although they were capable of most of the functions offered by smartphones.
Using these methods, residents-on-duty were approached directly. After introduction, the nature and purpose of the study was explained to them. Informed consent was obtained, and the questionnaire was then administered to each participant. Each took two to three minutes to complete the form. The forms were then preserved for analysis. During the short conversation with each participant, any additional views on the topic that were not covered in the questionnaire were also noted. This procedure was followed for a period of one week, at the end of which, ninety (90) questionnaires had been filled and signed.
| Results|| |
Of the 90 residents, 72 were males and 18 were females. Among these residents, 31 were first year trainees (PGY1), 30 were second year trainees (PGY2), and 29 were third year trainees (PGY3). The specialty wise distribution is given in [Table 1]. Out of 31 residents, 19 PGY1s owned a smartphone, which is 61.3%. In the second year, 26 trainees owned the smartphones, i.e. 86.66%. In the third year, the usage of smartphone by the residents increased to 93.10% (27 out of 29) [Figure 1]. Overall, 72 residents out of the total 90 owned a smartphone (80%).
|Table 1: Distribution of participating residents as per specialty, year of training and sex|
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|Figure 1: Bar diagram showing distribution of smartphones as per year of training|
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Out of seventy-two (72), fifty-one (51) had Android devices (70.83%), thirteen (13) had iPhones (18.05%) and eight (8) residents used smartphones running other operating systems including Windows and Blackberry [Figure 2].
|Figure 2: Pie diagram showing distribution of smartphone platform (OS used)|
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All those owning smartphones (100%) said they carry it regularly to their place of work. Out of 72 residents, 65 said they use it for clinical/academic purposes in the hospital (90%). Of the 65 residents, 50 said that they use it everyday for this purpose (77%), and 15 said they use it for this purpose less than everyday but at least once a week.
Forty residents out of 65, who used their smartphone for clinical/academic purposes, said they consulted through their device 'frequently' before performing/assisting in an invasive procedure (61.53%). Twenty-three (23) said they consulted it 'occasionally' (35.38%). Only two said they did not consult it at all (3%).
Thirty-eight residents said they used online resources more frequently than pre-installed apps (58.46%). Twenty-seven said they used pre-installed apps more. Twelve of these 27 were iPhone users [Figure 3]. Of the apps, those most frequently listed were 'iReader' by the android users and 'CHM Reader' by iOS users. Both of them are software that enable users to open e-versions of standard medical texts. Other top listed apps included medical calculators, normal lab values, drug dosage guides, basic anatomy modules and clinical examination apps.
|Figure 3: Types of resources used by 65 residents who used their smartphone for clinical/academic purposes|
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All (100%) of the sixty-five said that they find the camera in their phone 'very useful'. Most of them during the course of the conversation said, it was way more convenient to take clinical photographs for research or academic purposes with their phones than carry a separate camera for the same.
Sixty-one (61) out of sixty-five (65) said they feel better equipped to deal with medical situations knowing they have a quick reference at hand, if ever they need it (93.84%). When asked if they feel that smartphone use in medical practice/education has pitfalls, only two (3%) said 'yes'. They expressed their concerns over the credibility of data in medical apps, but could not cite any examples. One said that the devices were a disturbance especially during inpatient rounds.
Despite all the advantages of smartphones, all (100%) of the medical residents said that conventional bound textbooks were superior to e-books.
| Discussion|| |
Smartphones have revolutionized the way we access information. This has perhaps been most useful to the scientific community, which includes medical professionals. There is no denying the fact that constant reading is the only way to continue being a quality healthcare professional. For residents, it is the only way to 'start' being one. We all love our medical texts and references. But, one thing that gives trouble to most of us is their bulk. And then comes the technology.
Our study was intended to be an objective assessment of the impact of availability of digitized medical knowledge to the practicing physician and the student. It might be assumed that digitally available medical knowledge has made life easy for the medical professional. Our objective was to gather evidence on this utility. We chose smartphones because of their omnipresence and accessibility, and their evolution, recently into fully performing computers. Add to that the vast number of medical applications designed specifically for these devices.
Eighty percent of medical residents we interviewed possessed a smartphone. A breakdown of this proportion revealed that a smartphone was owned by 61.3%first year residents, 86.66% second year and 93.10% third year residents. This increase might be attributed to both the increased purchasing power of the resident with time and their feeling of the need for a smartphone with the advantages it offers. Although not documented in the questionnaire, our interaction with the interviewees suggested the latter. Franko and Tirrell  reported that over 85% of the providers working in Accreditation Council for Graduate Medical Education (ACGME) training programs used a smartphone, and 70% of the residents used it for clinical purposes.
In our survey, Android-based smartphones topped the list of devices owned followed by Apple phones. This is in contrast to some previously published articles on this topic.,, Very few had devices other than these. Out of 13 residents, 12 with Apple iPhones said that they used pre-installed medical apps more often than online resources. Android users by far were more dependent on online resources, reflecting the abundant availability of good medical applications in Apple's App Store. Nevertheless, the most common pre-installed apps used by all residents were e-book reader software. This clearly demonstrates how much importance every medical resident attaches to his texts, and how eager he/she is to have all his/her texts at hand all the time. Medical publishers should probably take note of this and explore the option of bringing out 'phone' versions of leading texts for the ease of the majority readers. Even though the reading experience on a phone was no match for that of a conventional bound book, in our survey, the effortless access to multiple references provided by a smartphone cannot be neglected.
A camera in a smartphone only adds to its already broad utility, as it deducts another 'essential need' from a medical resident's expense. This was concurred upon by all residents who possessed a smartphone. Ozdalga et al. also agreed that interesting and educational patient physical findings are better documented with the use of the smartphone's camera.
Wallace et al. reported that smartphone usage in 90% of the residents was questioned, and the most commonly used phone was the iPhone. The participants listed a number portability of advantages associated with the use of smartphones: portability fast access to information on the internet, efficient use of time, flexible communications, powerful applications and access to multimedia resources. Ninety-five percent of the residents said that the smartphones had a 'positive educational effect' for them, and 55% of them used their phones more than once per day to 'look stuff up'. They also cited potential disadvantages as encouragement of 'superficial learning', credibility of the information accessed and distraction in classrooms and clinics.
Summing up, most smartphone users in our study felt more secure in practice with their device in their pocket. It gave them fast access to reliable medical information when needed. Memorizing lab values, classifications, scoring systems, etc. became easier. Similarly, surgical residents could easily go over the steps of any procedure shortly before. Instant access to the latest advances in medicine is also now literally in your hand. However, the use of such devices for learning is not without concern. The validity of the information available online and that provided in the apps must be verified independently by the user.,,,
Our study may be limited by a small sample size and non-inclusion of residents of all specialties in the survey.
| Conclusion|| |
The utility of smartphones to trainee doctors cannot be over-emphasized. Medical residents find this tool indispensable in their learning and practice. The variety of apps available still needs improvement, and ways of making standard texts more 'available' on the phone need to be devised. Quality control of the information accessed also needs to be addressed.
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[Figure 1], [Figure 2], [Figure 3]