Jil Fairclough, Medical School Librarian Brighton & Sussex Medical School j.fairclough@bsms.ac.uk

1. Mobile Medical Education (MoMEd):Putting digital mobile resources in the hands of medical students – impact, lessons learnt and the future Jil Fairclough, Medical School Librarian Brighton & Sussex Medical School j.fairclough@bsms.ac.uk

2. Brighton & Sussex Medical School

3. The MoMEd project - Mobile Medical Education • Research and results – 2005 to present • The librarian/library role – how does that fit in? • The future – 2011 onwards - where are we going now?

4. GMC’s: Tomorrow’s Doctors (2009) expects doctors to be able to “use information effectively in a medical context” • “Access information sources and use the information in relation to patient care, health promotion, advice and information to patients, and research and education” • “Make effective use of computers and other information systems, including storing and retrieving information.”

5. Why mobile technology in medical training? BSMS, as a new medical school, wants students to become familiar with mobile technology and take advantage of the technology to explore innovative approaches to teaching and learning. The future of education lies in the adoption of technology, such as mobile and wireless, that connects people, unifies the education process and enhances learning. Dr John D. Halamka, Associate Dean, Harvard Medical School, 2002 Prof Jon Cohen, Dean of BSMS, 2003

6. In 2005, BSMS became the first UK medical school to introduce the widespread use of mobile devices to its students • Offered to all Year 3, 4, and 5 students (approx. 350 students) • Loaned PDA and software for free

7. What did we do? Supporting set-up, roll-out, maintenance, and training Dir. of Undergraduate Studies – Dr Inam Haq IT Manager – Mark Packer Librarian – Jil Fairclough Learning Technologist – Tim Vincent Divisional assistant IT Technicians x2 – Tim Lambert, Matthew Day Everyone! Clinical Research Fellow(s) – Dr JethinRafique, Dr Bethany Davies, Dr Anna Jones

8. Providing mobile hardware and software @ BSMS Module Handbook

9. Resources on the Dr Companion card • British National Formulary • Chemical Laboratory References • Classification of Surgical Operations & Procedures • Clinical Evidence • Cochrane Abstracts • DSM IV • ICD 10 • NICE Compilation Guidance • Netter Atlas of Human Anatomy • Evidence Based Medicine • Patient Organizations • Oxford Concise Medical Dictionary • Oxford Handbook of Emergency Medicine • Oxford Handbook of Clinical & Lab Investigation • Oxford Handbook of Clinical Medicine • Oxford Handbook of Clinical Surgery • Oxford Handbook of Practical Drug Therapy • Oxford Handbook of General Practice • Oxford Handbook of Medical Sciences

11. Useful mobile technology in the clinical setting A 45-year-old Bangladeshi gentleman is reviewed on the Coronary Care ward round. He was admitted 3 days previously and underwent primary angioplasty for a myocardial infarction. He has mild pulmonary oedema. The SHO is prescribing some ramipril. • The CCU consultant asks you • “What evidence is there for the use of ACE inhibitors in secondary prevention post MI?” • “And what dose is the SHO writing up?”

12. What is the impact of putting digital mobile information resources in the hands of medical students? How much do medical student really use mobile devices to access learning resources? What are the advantages and disadvantages of mobile devices in the clinical setting What is the impact on students’ learning? Mobile Medical Education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students: a mixed methods study. Bethany S Davies, Jethin Rafique, Tim R Vincent, Jil Fairclough, Mark H Packer, Richard Vincent and Inam Haq. BMC Medical Education 2012, 12:1 doi:10.1186/1472-6920-12-1 http://www.biomedcentral.com/1472-6920/12/1/abstract

13. Data collection Usage stats on server Focus groups Questionnaires

14. Results: Most popular resource Questionnaire Tracking

15. Analysis : Three major themes identified

16. Theme 1: Access to knowledge • Mobility • Immediacy • Speed of access • Two devices “The only thing is, you don’t have that many pockets. I would have my wallet in one pocket, my phone in another. I found it quite hard to carry [the PDA] around with me all the time.” “The whole two devices thing is my major gripe.”

17. Theme 2: Consolidation of knowledge • Quick reference information • Repetition • Better use of ‘wasted’ time • “It has enhanced [my knowledge] by reinforcing key points at point-of-need. If you want to know then-and-there, you can find it then-and-there. It’s just the memory jog you need to reinforce the point a bit more. It doesn’t mean you’re relying on the PDA – it just helps to reinforce and consolidate the knowledge a bit better.”

18. Theme 2: Consolidation of knowledge • Quick reference information • Repetition • Better use of ‘wasted’ time • “The more repetition I get, the more I’m able to look at something quickly – when I need to - the more it’s likely to stick. Because you can look and say ‘oh ok, that’s what it is again’” • “Initially, you may look at it three times and then after that you will become more confident in saying ‘yes I know this now’”

19. Theme 2: Consolidation of knowledge • Quick reference information • Repetition • Better use of ‘wasted’ time • “One of the drivers for me of using it might be more general is just my dislike of wasted time particularly during the day.” • “I agree. Actually, that’s one of the reasons I have started to use it a lot more. There and then when there isn’t anything to do you can make use of time.”

20. Theme 3: Change • Attitude, behaviour, approach • Resistance to change • Establishing change • “…if you remember to take it with you” • “I think it’s about adopting a different mentality.” • “I’m worried that the nurses or patients will think I am texting or emailing”

21. Theme 3: Change • Attitude, behaviour, approach • Resistance to change • Establishing change • “What changed your mind?” “Finding I did use the PDA and it did come in handy several times. It just makes life a bit easier.” • “...I have definitely got used to having that type of reference at my fingertips. I would definitely look into ways of continuing that.”

22. The future of MoMEd

23. The emergence of smartphones Apple becomes largest smartphone vendor BSMS becomes the first UK medical school to introduce the widespread use of PDAs to its students Apple announces sales of 4.7m iPhones First Android phone (G1) launches Smartphone sales make up 31% of 1.8bn devices sold globally Steve Jobs unveils the iPhone Apple launches iPad 2005 2006 2007 2008 2009 2010 2011 2012 2013

24. What do the students want?

25. iPhone pilot • 4 month trial (Nov-Feb) • 48 students with own iOS device • Novel logging to track usage • Contract to recording usage and research participation

26. Changing the model to information over technology Offered to all students in years 3-5 with their own device

27. What MoMEd provides now Year 3 Year 4 Year 5

28. Librarians/Library role • Resources knowledge • Publisher knowledge • Knowledge of usage of print/online resources • Teacher role

29. Thank you www.bsms.ac.uk Follow MoMEd on Twitter @bsms_momed