Presenter: John Sun, BS
Presented at Stanford Medicine X 2013 Conference, Sept. 27-29, 2013

 

john_sun
​Recently, there has been an increased interest in integrating mobile computing devices, such as the iPad, into medical education. Four months ago, the Stanford Anesthesia residency program provided mobile computing devices (iPad 3, Apple, Cupertino, CA) to 63 of their residents for the duration of their residency. A cross-sectional survey study was conducted in order to understand how these residents are using mobile computing devices for anesthesia education. Specifically, we sought to understand how often the residents were using the mobile computing devices, in what ways they were using the devices, and how this has impacted their anesthesia residency training.

Methods

iPad Information:
​We provided our residents with 64 GB wifi iPad 3s, which were preloaded with Anesthesiology Journal (Anesthesia & Analgesia, Anesthesiology), Crisis Code (an application to teach crisis management principles in the context of ACLS, iLarynx (a fiberoptic intubation simulator), ePocrates (a drug reference guide), ComunicatOR (an operating room translation application), StanMed (a Critical care medicine application) and Ether Mobile (a paging application).

Survey Design

After testing for reproducibility and clarity, we deployed our survey to our 63 anesthesia residents. The survey, hosted by http://www.surveymonkey.com, asked the residents questions about how they used the iPad for studying and residency tasks.
The survey included 9 open-ended questions, and 17 multiple-choice questions. We organized the questionnaire into three general domains:

  • General Information: We collected demographic information from the students such as gender and age, as well as  technical information such as previous experience with mobile technology.
  • iPad Usage : We collected information about when the residents were using the iPads, and how this affected their usage of computers.
  • iPad Application Information: We collected information about individual applications that we preloaded onto the iPad to determine their usefulness.

Data Analysis
After we received our results.we analyzed them using a mixed-method. The open-ended collected data was entered into NVivo 10 and the questions were analyzed using qualitative methods.

Results
90.2% of Stanford Anesthesia Residents agree or strongly agree that an iPad would enhance their ability to learn anesthesia. 85.7% of residents surveyed also agreed or strongly agreed that iPads were under-utilized in anesthesia education.

After receiving the iPad, 64.3% of our residents said that they were using their personal desktop computer less. In fact, in one of our open-ended questions, one of our residents said: “I love my iPad. It has made my laptop nearly useless”.
​When asked what frequency the residents used their iPad, 46.4% used them daily, 39.3% used them every other day, and the remaining 14.3% used them once a week.

The two main activities that the residents used the iPads for are E-mailing and reading medical books or papers. The places that the residents are using the iPad most often are at home, followed by inside the OR, and then inside coffee places. The main reason stated for using it at home was because the iPad was too big to carry with them at all times. One resident mentioned that, “the smaller the better for resident use. The less heavy and bulky my stuff is, the more likely I’m able to actually use it in the OR and carry it around with me”.

We also asked the residents how useful the iPad provided by Stanford was for specific activities. 85.7% of residents said that the iPads were useful or very useful for accessing medical papers and 95% said that the iPads were useful or very useful for studying. 71.4% thought the iPads were useful or very useful for clinical issues, and 54.3% thought the iPads were useful for watching a video of a procedure before entering the OR.

Out of the individual applications that we provided to the residents, the applications rated most useful were the books and journals. One of our residents stated: “[the iPad] has revolutionized access to texts and primary literature for studying and preparing everyday.”

Conclusions

Our survey has shown us that the  majority of our residents use their iPads almost daily, and that the iPads have been reported to be very useful for studying and accessing medical books and journals. As for the portability of the iPad, many of our residents reported that it was still too bulky to carry around in the operating room, but that it was an excellent resource for studying at home or outside of operating room clinical environment. However, residents did voice concerns that they would lose the iPad because of its small size and inability to securely store the device in the clinical environment. Future work in exploring the use of mobile computing devices may focus on implementation of the iPad Mini as a more portable option for in anesthesia medical education.