Wendy Hardyman , Mark Stacey , Alison Bullock, Sophie Carter-Ingram and Lesley Pugsley .

1. Health Sciences and Practice &Medicine Dentistry and Veterinary MedicineHigher Education Academy Subject Centres eLearning in Health 2011 conference collaboration, sharing and sustainability in the current environment The iDoc project: Using smartphone technology with trainee doctors across Wales Wendy Hardyman, Mark Stacey, Alison Bullock, Sophie Carter-Ingram and Lesley Pugsley.

2. Overview • Why the iDoc project? • What is the iDoc project? • How is the iDoc project being evaluated? • What do we know so far? • iDoc as a resource in clinical practice. • Key messages • Lessons learned from running iDoc

3. Learning outcomes • Recognise the potential of mobile technologies to support and enhance the work-based learning of trainee doctors, their teaching and patient care • Understand the role of mobile technologies within the wider context of other workplace information sources • Appreciate the need for evaluation of mobile technology enhanced learning in the workplace

4. Why iDoc? • Volume of information required for practice • Patient safety • Shorter working hours (EWT) • Transition from medical student to ‘doctor’ • Need for ‘just-in-time’ reliable medical information • Smartphones as an information resource • Limited evaluation in healthcare workplace settings

5. What is iDoc?

6. How is the iDoc project being evaluated? • iDoc evaluation explores the value of the device and its impact on learning in the workplace within the broader context of use of information sources at work: • Research ethics approval obtained • Information seeking practice survey (FY2) • Baseline, follow-up, exit questionnaires • Case reports • Follow-up interviews/focus group discussions

7. What do we know so far? (1) • Based on 88 baseline questionnaires: • Male (58%), Female (42%) • Foundation Year 1 (49%), Foundation Year 2 (24%),Other (27%) • Resources used to access information in the workplace on a daily basis: • Seniors (83%) • Peers (56%) • Other staff medical/nursing team (55%) • Internet (39%) • Hardcopy texts/journals (36%) • Electronic textbooks/journals via mobile device (13%) • Electronic textbooks/journals via PC (10%) • Lecture notes (1%)

8. What do we know so far? (2) When additionally asked which was preferred choice of information source in the workplace from resource list: • Seniors (1st choice) • Books/Journals (2nd choice) • Internet (3rd choice)

9. Why seniors? “My seniors are excellent and very knowledgeable and usually with me.” “ Easily available, much quicker than looking it up elsewhere, slow internet, knowledgeable.”

10. Why hard copy books/journals? “Good range of material, easy to use, familiar with format, small enough to be portable.” “ In my pocket!”

11. Why internet? • “ Easy access, helpful during evenings and weekends when no seniors around.” • “ Easy access; rapid, most likely to be up to date.”

12. When would a mobile device be useful? As an undergraduate? F1? F2? Other? • F1 level selected by majority (55%) across all respondent training grades Why? • F1 responses overall (n=43)to this question identified main themes below: • Increased responsibility/independence/less support • Lack of knowledge/skills • Lack of experience • Need for quick answers • Need most help

13. What they said about F1s? “ It is the 1st point at which we are expected to know answers, often on our own, with senior support not always available, so we have less answers at this stage with our limited knowledge.” “It would be useful at all times, however, F1 is the unique stage between learning and responsibility.” “ Very important that F1s have access to resources to confirm and double check their knowledge, as they are only newly qualified and still learning a great deal on the job.” “Transition from medical student to junior doctor.”

14. What else did they say? “Learning can be more effective if you can look something up at the time.” “ Expected to be more independent by this time a lot of knowledge learnt for finals has been forgotten.” “ You’ll never know everything (lifelong learning in medicine).” “ Evidence based medicine and lifelong learning are essential throughout a doctors career.”

15. iDoc as a resource in clinical practice • iDoc participants asked to submit case reports detailing their experiences of using the iDoc device in clinical practice, for example, where the device has enabled “just-in-time” learning or been a vital information resource. • Small number of case reports submitted so far to be rolled out to whole project • Themes identified from case reports submitted • iDoc: Clinical Practice • iDoc: Teaching and Learning • iDoc: Wider Applications and future developments

16. The unusual case of a rash • Setting/context • Problem/issue addressed • What happened? • Reflections

17. Key messages • Seniors are the main resource that trainees consult on a daily basis for help • F1 level seen by trainees as the best stage at which to give a mobile device containing medical information • Potential of this type of technology to make a difference in terms of treating patients • Potential of this type of technology to make a difference in terms of how trainees learn

18. Lessons learned from running iDoc • FREE isn’t everything! • Trainees view of technology • Be responsive to changing demands of the project • Snowball effect- build on interest • Clever marketing?! Limited availability • Embrace your participants- what is in it for them?

19. Further information Reference Morgan M, Pugsley L, Bullock A, Phillips S, Stacey M (2010) Evaluating trainee doctors’ educational use of a personal digital assistant: a pilot study. British Journal of Hospital Medicine 71 (8):461-464. Contact Details Wendy Hardyman hardymanw@cardiff.ac.uk www.cardiff.ac.uk/curemede