A library mobile device deployment to enhance the medical student experience in a rural longitudinal integrated clerkship
DOI:
https://doi.org/10.5195/jmla.2019.442Keywords:
Mobile Devices, iPad Minis, Rural Medicine, Medical Students, Surveys, Journaling, Technology Acceptance ModelAbstract
Objective: Investigators implemented the Rural Information Connection (RIC) project, a library-initiated deployment of iPad Mini 3s for third-year medical students who were enrolled in a seven-month rural longitudinal integrated clerkship (LIC) rotation. The research aims were to determine if devices preloaded with high-quality mobile health apps enhanced the experience and increased access to and awareness of mobile health information resources for the enrolled project participants.
Methods: Nine participants enrolled in this mixed methods research project. Pre- and post-survey and structured learning journals (SLJs) were used for data collection on device and app use. Descriptive statistics and thematic coding analysis included data from seven pre-surveys, nine post-surveys, and sixty-four SLJ prompts. The validated Technology Acceptance Model instrument was also incorporated to gauge the devices’ integration into the participants’ workflow.
Results: The investigation indicated that the iPad Mini 3 and resources were utilized and integrated at varying levels in the participants’ workflow. Reported use of health information apps suggests a preference for broad-based information sources rather than specific or specialized information resources. Participants performed several tasks on the device, including seeking background information, educating patients, and managing rotation schedules. Participant reflections indicated positive experiences utilizing the device and health information resources, which enhanced their rural LIC rotations.
Conclusions: The research analysis demonstrates the information-seeking behavior of medical students immersed in a rural environment and indicates an acceptance of mobile technology into the workflow of participants in this project. Mobile device deployments offer great opportunities for librarians to design innovative programming in medical education.References
Anderson C, Henner T, Burkey J. Tablet computers in support of rural and frontier clinical practice. Int J Med Inform. 2013 Nov;82(11):1046–58. DOI: http://dx.doi.org/10.1016/j.ijmedinf.2013.08.006.
Eldredge JD, Hall LJ, McElfresh KR, Warner TD, Stromberg TL, Trost J, Jelinek DA. Rural providers’ access to online resources: a randomized controlled trial. J Med Libr Assoc. 2016 Jan;104(1):33–41. DOI: http://dx.doi.org/10.3163/1536-5050.104.1.005.
National Rural Health Association. About rural health care [Internet]. Leawood, KS: The Association; 2017 [cited 11 Aug 2017]. <https://www.ruralhealthweb.org/about-nrha/about-rural-health-care>.
Health Resources and Services Administration, US Department of Health and Human Services. Rural health information hub (RHIhub) [Internet]. Grand Forks, ND: The Department [cited 7 Aug 2017]. <https://www.ruralhealthinfo.org/>.
Schmitz D. Rural practice: graduate medical education for [position paper]. Leawood, KS: American Academy of Family Physicians; 2013.
Nuss MA, Hill JR, Cervero RM, Gaines JK, Middendorf BF. Real-time use of the iPad by third-year medical students for clinical decision support and learning: a mixed methods study. J Community Hosp Intern Med Perspect. 2014 Sep 29;4(4):10.3402/jchimp.v4.25184. DOI: http://dx.doi.org/10.3402/jchimp.v4.25184.
Alegria DAH, Boscardin C, Poncelet A, Mayfield C, Wamsley M. Using tablets to support self-regulated learning in a longitudinal integrated clerkship. Med Educ Online. 2014 Mar 12;19(1):23638. DOI: http://dx.doi.org/10.3402/meo.v19.23638.
Federal Communications Commission. Broadband progress report: significant improvements but Digital Divide persists [news release]. Washington, DC: The Commission; 2016.
Brassil E, Gunn B, Shenoy AM, Blanchard R. Unanswered clinical questions: a survey of specialists and primary care providers. J Med Libr Assoc. 2017 Jan;105(1):4–11. DOI: http://dx.doi.org/10.5195/jmla.2017.101.
Clarke MA, Belden JL, Koopman RJ, Steege LM, Moore JL, Canfield SM, Kim MS. Information needs and information-seeking behaviour analysis of primary care physicians and nurses: a literature review. Health Inf Libr J. 2013 Sep;30(3):178–90. DOI: http://dx.doi.org/10.1111/hir.12036.
Barnett J. Rural student physician program summary. Peoria, IL: University of Illinois College of Medicine at Peoria; 2013–2014.
Healthcare Information and Management Systems Society Analytics. Essentials brief: 2017 mobile study [Internet]. Healthcare Information and Management Systems Society Analytics; 2017 [cited 2 Nov 2018]. <http://www.himssanalytics.org/research/essentials-brief-2017-mobile-study>.
Baumgart DC, Wende I, Grittner U. Tablet computer enhanced training improves internal medicine exam performance. PLoS ONE. 2017 Apr 3;12(4):e0172827. DOI: http://dx.doi.org/10.1371/journal.pone.0172827.
Lazarus L, Sookrajh R, Satyapal KS. Tablet technology in medical education in South Africa: a mixed methods study. BMJ Open. 2017 Jul 31;7(7):e013871. DOI: http://dx.doi.org/10.1136/bmjopen-2016-013871.
Riss R, Manguvo A, Quaintance J, Radhi M, Dycoco M. iPad usage and impact on pediatric medical students’ learning and patient care. J Mob Technol Med. 2016;5(1):19. DOI: http://dx.doi.org/10.7309/jmtm.5.1.4.
Youm J, Wiechmann W. Medical student use of the iPad in the clerkship curriculum. Clin Teach. 2015 Dec;12(6):378–83. DOI: http://dx.doi.org/10.1111/tct.12381.
Friederichs H, Marschall B, Weissenstein A. Practicing evidence based medicine at the bedside: a randomized controlled pilot study in undergraduate medical students assessing the practicality of tablets, smartphones, and computers in clinical life. BMC Med Inform Decis Mak. 2014 Dec 5;14:113. DOI: http://dx.doi.org/10.1186/s12911-014-0113-7.
Gillum S, Chiplock A. How to build successful iPad programs in health science libraries: a tale of two libraries. J Electron Resour Med Libr. 2014;11(1):29–38. DOI: http://dx.doi.org/10.1080/15424065.2014.876580.
Davies BS, Rafique J, Vincent TR, Fairclough J, Packer MH, Vincent R, Haq I. Mobile medical education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students - a mixed methods study. BMC Med Educ. 2012 Jan 12;12:1. DOI: http://dx.doi.org/10.1186/1472-6920-12-1.
Khalifian S, Markman T, Sampognaro P, Mitchell S, Weeks S, Dattilo J. Medical student appraisal: searching on smartphones. Appl Clin Inform. 2012 Feb 6;4(1):53–60. DOI: http://dx.doi.org/10.4338/ACI-2012-10-CR-0047.
Mi M, Wu W, Qiu M, Zhang Y, Wu L, Li J. Use of mobile devices to access resources among health professions students: a systematic review. Med Ref Serv Q. 2016 Jan;35(1):64–82. DOI: http://dx.doi.org/10.1080/02763869.2016.1117290.
Shurtz S, Sewell R, Halling TD, McKay B, Pepper C. Assessment of an iPad loan program in an academic medical library: a case study. Med Ref Serv Q. 2015;34(3):265–81. DOI: http://dx.doi.org/10.1080/02763869.2015.1019743.
Stokes A, Light J, Haines LL. Library support of mobile resources during clinical clerkships. Med Ref Serv Q. 2014;33(2):179–94. DOI: http://dx.doi.org/10.1080/02763869.2014.897519.
Lombardo NT, Honisett A. One tool for many tasks: integrating iPads into the third-year learning experience. Med Ref Serv Q. 2014;33(1):17–28. DOI: http://dx.doi.org/10.1080/02763869.2014.866445.
Wallace RL, Woodward NJ, Clamon TS. A mixed-methods analysis of a library-based hand-held intervention with rural clinicians. Health Inf Libr J. 2014 Sep;31(3):215–26. DOI: http://dx.doi.org/10.1111/hir.12076.
Capdarest-Arest NA. Implementing a tablet circulation program on a shoestring. J Med Libr Assoc. 2013 Jul;101(3):220–4. DOI: http://dx.doi.org/10.3163/1536-5050.101.3.013.
Gomes A, Abate L. Rethinking our mobility: supporting our patrons where they live. Med Ref Serv Q. 2012;31(2):140–9. DOI: http://dx.doi.org/10.1080/02763869.2012.670574.
Consortium of Longitudinal Integrated Clerkships. CLIC overview [Internet]. The Consortium; 2018 [cited 10 May 2018]. <http://www.clicmeded.com/>.
Johnson EM. Rural student physician program: home [Internet]. Chicago, IL: University Library, University of Illinois at Chicago; 2017 [cited 6 Nov 2017]. <https://researchguides.uic.edu/RSPP>.
Moon JA. Learning journals: a handbook for reflective practice and professional development. London, UK, and New York, NY: Routledge; 2006.
Qualtrics. Provo, UT: Qualtrics; 2017.
Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. Manag Inf Syst Q. 1989 Sep;13(3):319–40.
Liang H, Xue Y, Byrd TA. PDA usage in healthcare professionals: testing an extended technology acceptance model. Int J Mobile Commun. 2003 Oct;1(4):372–89.
Park SY, Nam M, Cha S. University students’ behavioral intention to use mobile learning: evaluating the technology acceptance model. Br J Educ Technol. 2012 Jul;43(4):592–605.
Teo T. A path analysis of pre-service teachers’ attitudes to computer use: applying and extending the technology acceptance model in an educational context. Interact Learn Environ. 2010;18(1):65–79.
Abu-Dalbouh HM. A questionnaire approach based on the technology acceptance model for mobile tracking on patient progress applications. J Comput Sci. 2013;9(6):763–70.
Holden RJ, Karsh BT. The technology acceptance model: its past and its future in health care. J Biomed Inform. 2010 Feb;43(1):159–72.
Zhang H, Cocosila M, Archer N. Factors of adoption of mobile information technology by homecare nurses: a technology acceptance model 2 approach. Comput Inform Nurs. 2010 Jan–Feb;28(1):49–56. DOI: http://dx.doi.org/10.1097/NCN.0b013e3181c0474a.
Aggelidis VP, Chatzoglou PD. Using a modified technology acceptance model in hospitals. Int J Med Inf. 2009 Feb;78(2):115–26.
Hu PJ, Chau PY, Sheng ORL, Tam KY. Examining the technology acceptance model using physician acceptance of telemedicine technology. J Manag Inf Syst. 1999;16(2):91–112.
King WR, He J. A meta-analysis of the technology acceptance model. Inf Manag. 2006 Sep;43(6):740–55. DOI: http://dx.doi.org/10.1016/j.im.2006.05.003.
IBM. IBM SPSS Statistics for Windows. 22nd ed. Armonk, NY: IBM; 2013.
UpToDate. UpToDate. 3.0.0 ed. Wolters Kluwer Health; 2018.
WebMD Health. Medscape. 5.10.2 ed. WebMD; 2017.
Google. YouTube. 13.01.5 ed. Google; 2017.
Centers for Disease Control and Prevention. CDC. 2.4.2 ed. Centers for Disease Control and Prevention; 2017.
EBSCO Publishing. DynaMed Mobile. 1.0.1 ed. EBSCO Information Services; 2017.
MD Aware. MDCalc medical calculator. MD Aware; 2017.
Aptus Health I. Omnio medical reference. Univadis; 2017.
Ellaway R. The informal and hidden curricula of mobile device use in medical education. Med Teach. 2014 Jan;36(1):89–91. DOI: http://dx.doi.org/10.3109/0142159X.2014.862426.
Boruff JT, Storie D. Mobile devices in medicine: a survey of how medical students, residents, and faculty use smartphones and other mobile devices to find information. J Med Libr Assoc. 2014 Jan;102(1):22–30. DOI: http://dx.doi.org/10.3163/1536-5050.102.1.006.
Boruff JT, Bilodeau E. Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study. J Med Libr Assoc. 2012 Jan;100(1):55–60. DOI: http://dx.doi.org/10.3163/1536-5050.100.1.010.
3D4Medical.com. Essential anatomy 5. 5.0.6 ed. 3D4Medical.com; 2014.
Drugs.com. Pill identifier by Drugs.com. 2.74th ed. Drugsite Trust; 2017.
Markman TM, Sampognaro PJ, Mitchell SL, Weeks SR, Khalifian S, Dattilo JR. Medical student appraisal: applications for bedside patient education. Appl Clinl Inform. 2013 Apr 24;4(2):201–11. DOI: http://dx.doi.org/10.4338/ACI-2013-01-R-0007.
Citrix. Citrix receiver. Fort Lauderdale, FL: Citrix Systems; 2017.
Association of American Medical Colleges. Core entrustable professional activities for entering residency: toolkits for the 13 core EPAs. Washington, DC: The Association; 2017.
Barnett S, Jones SC, Caton T, Iverson D, Bennett S, Robinson L. Implementing a virtual community of practice for family physician training: a mixed-methods case study. J Med Internet Res. 2014 Mar 12;16(3):e83. DOI: http://dx.doi.org/10.2196/jmir.3083.
Apple I. Apple configurator 2. 2.5th ed. Cupertino, CA: Apple; 2017.
Deutsch K, Gaines JK, Hill JR, Nuss MA. iPad experience during clinical rotations from seven medical schools in the United States: lessons learned. Med Teach. 2016 Nov;38(11):1152–6.
