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Technology on its own doesn't help much
Resident Impressions of the Clinical Utility and Educational Value of the iPad Skomorowski M. et al. Journal of Mobile Technology in Medicine 2013; 2: 21-26.
Reviewed by Patricia McBurney


What is the study question?
What are residents' perceptions of iPad use both for patient care and medical education, and is there a difference between those in medical versus surgical disciplines?s

How was the study done?
In 2011-12,119 residents across all of the residencies at a community hospital in Ohio were issued an iPad that could connect with hospital electronic patient care systems, and asked to use it for patient care and educational activities over the course of the year as they saw fit. At the end of the year they were surveyed about how useful the iPad was for patient care and educational activities. Responses were grouped for analysis into two groups: often/always and never/rarely/sometimes and medical residents' responses were compared to those of surgical residents using Chi-square tests.

What were the results?
One hundred two of 119 (86%) residents completed the survey. Only 14.7% reported using the iPad on rounds, 21.6% reported using the iPad between rounds for clinical care, and 30.4% reported using it between rounds to read/research. However, more residents reported using the iPad outside of the hospital-57.8% percent to read/research and 37.3% for clinical care. There were differences in responses between specialties: medical residents were more positive in their perceptions of the iPad's value, with 41.7% (vs. 6.7% of surgical, p< .0001) stating that iPads had educational value on rounds, and 38.9% noting value of the iPad as an EBM tool (vs. 16.7%, surgical, p=.037). Residents reported issues with WiFi/connectivity (28%), ease of log-in (11.8&), and use for note writing (12.7%).

What are the implications of these findings?
In this study, the residents did not clearly value the iPad as a clinical rounding or educational tool. There were differences between medical and surgical specialty residents' perceptions. Medical schools and graduate medical training programs should make sure the environment is right for iPads before mandating or purchasing these tablets for trainees.

Editor's note: In this study, residents were given iPads and told to use them as they liked; no education seems to have been done on how the new technology might best improve workflow, and no patient care or educational processes seem to have been changed to make best use of residents with iPads. Not surprisingly, the residents' impressions were not overwhelmingly positive. This reinforces the point that it is not new technology itself that is useful, but the thoughtful and careful planning and implementation of that technology to achieve specific workplace goals (LL).

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