The use of mobile devices to support learning in practice settings

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As mobile devices become ubiquitous, healthcare practitioners are exploring how using technological support in the workplace could advance their practice, communication and learning. This paper discusses findings from a research study funded by the Higher Education Academy (HEA) in the UK, which investigated how using iPads impacted on physiotherapy and occupational therapy students’ learning, reflective practice and communication with peers and tutors during placement cycles. Similar to research carried out amongst physicians in 2009, the students found that the devices collapse ‘time and space’, because they permit users to access data and resources when moving between patients, wards and clinics (Prgoment et al., 2009). The paper also discusses how students used the iPads to interact with other professionals and patients while in hospital and community settings, as well as the usability of the devices and associated apps for improving their learning (Clay, 2010). Apps were found to be good tools for documenting individual learning histories, engaging with learning objects and developing personalised structured education (Ifenthaler & Schweinbenz, 2013). The project adopted a participatory action research approach. Eighteen student participants used iPads during their placements in a variety of settings for a period of 5 – 10 weeks. The students were supported by visiting tutors and practice educators over an eight-month period. Interviews and focus groups were conducted with students, visiting tutors and practice educators to ascertain the utility and acceptance of the devices in practice settings. The Unified Theory of Acceptance and Use of Technology (UTAUT) model developed by Venkatesh, V. et al. (2003) is used to analyse the acceptability and efficiency of the devices in clinical settings. In particular, the research focuses on why user acceptance is challenged by established practitioners, and why healthcare settings have not adapted their environs and infrastructure so mobile devices can be used more readily by practitioners.

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The use of mobile devices to support learning in practice settings

  1. 1. The use of mobile devices to support learning in practice settings Lynn Clouder Arinola Adefila Nigel Williams Helen Bradley Lawrie Peck Steve Ball Imran Ali
  2. 2. Overview • Objectives • Rationale/Context • Methodology • Participants • Findings • Challenges
  3. 3. Project Objectives • To extend the evidence base on the impact of mobile learning on linking theory and practice, accessing timely knowledge and enhancing peer support to contribute to the development of students’ employability through enhancing their clinical reasoning capabilities on placement • To identify the challenges to using mobile devices to promote learning on placement. Including their acceptability with respect to professional/organizational culture • To identify whether students’ use of mobile technology reduces reliance on clinical educators and academic tutors responsible for facilitating learning and supporting students on placement, in terms of time spent on basic teaching and pastoral support respectively • To make recommendations for future health and social care professional education.
  4. 4. Rational PAPERLESS NHS DOCTOR - AHP DIVIDE DOCTORS DO THAT! NURSES, PHYSIOS, OTs etc
  5. 5. Methodology • Using participatory action research approach • Working with student co-researchers • Collaboration between Coventry and Derby Universities • Three phases of field work, placements took place between October 2012 and June 2013. 4 physiotherapists and 4 occupational therapists – 35 VT + 38 PEs • Using iPads during placement, preloaded with Apps. Passing them to the next group at the end of their placement. • Data collated through interviews and surveys from students, their educators and tutors.
  6. 6. Student Co-researchers OT Mental Health (early intervention) Mental Health (elderly) Hopsital Outpatient Community PT Mental Health (early intervention) Mental Health (elderly) Hopsital Outpatient Community Total – 35 placements 9 Occupational Therapy students - 1 placement each 9 Physiotherapy students - 3 placements each/ 2 for 1 student
  7. 7. Benefits FOR STUDY Immediacy – look up notes Check information Organization - folders FOR PRACTICE Show patients videos Take notes Use Apps to support
  8. 8. Some great Apps and resources
  9. 9. HEALTHCARE APPS 4 MILLION
  10. 10. Tasks/Treatment iPads were used for Setting Tasks Challenges Mental health (early intervention) Taking notes, showing pictures or playing games with patients Patient wanted to use it to browse the internet Mental Health (elderly) Taking notes, organising caseload, used in personal study time, researching conditions, researching equipment, researching NICE guidelines, showing patient pictures Patients with dementia often not interested. It would be useful to have specific Apps developed by Speech and Language therapists or organisations like MIND Hospital Taking notes, writing ideas, researching conditions, showing patients exercise, showing patients Xrays, showing patients apps, organising caseload Sometimes it is not use for several hours and there is no where to put it Outpatient Taking notes, researching conditions, showing patients exercise, showing patients Xrays, showing patients apps, organising caseload, used for organising EBP It is too expensive to use as a note book Community Taking notes, writing ideas, researching conditions, showing patients exercise, showing patients useful websites and resources, showing patients apps, organising caseload Wi-Fi access in remote areas – SAMBA did not work.
  11. 11. Benefits - performance Expectancy - Use in community, out patients and on some hospital wards Means of communication/interaction Note book/ Research tool/ For organising/Teaching aid Challenges - Difficulty/impossible to use in sync with Trust systems Getting Trust Wi-Fi/Fear of theft in busy, public spaces/Storage/Infection control issues Direct value to patients may be limited .Attitude of other clinicians - not seen as an aid/tool. Perception is “it is an add on” Social Influence - Pressure to show pragmatic use Concerns about patient safety(confidentiality) /Concerns around quality of care Facilitating ConditionsWi-Fi - connection with internet is possible Connection with Intranet highly desirable Supportive educators/Use by others, even other clinicians Useful Apps FACTORS THAT INFLUENCE USE BEHAVIOUR OF IN CLINICAL SETTINGS Behavioural Intention Dealing with clinical uncertainty Convenience Aid – teaching aid, communication aid Efficiency Interaction Storage cabinet – for files, documents Paperless NHS Communication tool Interaction Processor – for presentations Use behaviour Bag of new tools: research, organisatio n, video/camera function, syncing, pro viding patients with information and opportunities to learn some skills and care for themselves Gender No Evidence of gender bias Age Generational divide – some staff more amenable to try new ways of providing better outcomes for patients. Some staff prefer to stick to traditional methods Experience Evidence suggests this is linked to environment, personal use and opportunities to use similar equipment and technology Voluntariness of Use Easier to use in environments where the technology is encouraged.
  12. 12. Findings Mobile devices are ubiquitous and multifunctional and their use in clinical settings is gradually increasing. Mobile technology can collapse ‘time and space’ allowing access to data and resources when moving between patients(Prgoment et al., 2009). Very useful reference–demonstrates evidence based practice. You can use them to show patients diagrams about their condition or resources online. Goniometer App Dermatomes You can use them to take pictures and show patients exercises. Quick and handy! Collection of notes all together! They would be great in an out-patient setting (Visiting tutor)
  13. 13. Challenges • Attitudes • Apps – development of relevant ones profession specific • Risks to patients – infection? • Security concerns • Changes to practice • Access to Wi-Fi
  14. 14. REFERENCES Clay, C. (2010) Exploring the Use of Mobile Technologies for the Acquisition of Clinical Skills. Nurse Education Today, 31(6), 582-586. Black Book Rankings "The Year of the Big EHR Switch" Confirms Physicians Favor iPad and Mobile Applications http://www.blackbookrankings.com accessed July 2013 Garnett, B. M. & Jackson, C. (2006) A Mobile Clinical E-Portfolio for Nursing and Medical Students, Using Wireless Personal Digital Assistants (PDAs). Nurse Education Today 26(8), 647-654. Ifenthaler, D. and Schweinbenz, V. (2013) The Acceptance of Tablet-Pcs in Classroom Instruction: The Teachers’ Perspectives Computers in Human Behavior 29 (2013) 525–534 Kinash, S., Brand, J., Mathew, T. &Kordyban, R. (2011). Uncoupling Mobility and Learning: When One Does Not Guarantee the Other. In R. Kwan et al.(eds.), Enhancing Learning Through Technology – Education Unplugged:Mobile technologies and Web 2. Communications in Computer and Information Science 177, Springer, Berlin, pp. 342–350. Luanrattana, R., Than Win, K., Fulcher, J. and Iveson, D. (2012) Mobile Technology Use in Medical Education. Journal of Medical Systems, 31(1), 113-122. Marceglia, S., Bonacina, S., Zaccaria, V., Pagliari, C. and Pinciroli, F. How Might The IPad Change Healthcare? J R Soc Med 2012 105: 233 Murphy, G.D. 2011Post-PC devices: A Summary of Early Ipad Technology Adoption in Tertiary Environments. e-Journal of Business Education & Scholarship of Teaching Vol. 5, Iss. 1, 2011, pp: 18-32. ”http://www.ejbest.org” Norman, N. (2011) Mobile Learning for the NHS: Research Report. NHS South Central. Park, Y. (2011). A Pedagogical Framework for Mobile Learning: Categorizing Educational Applications of Mobile Technologies into Four Types. International Review of Research inOpen and Distance Learning, 12(2), 78-102. ETC

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