Abstract 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.

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. Overview
• Objectives
• Rationale/Context
• Methodology
• Participants
• Findings
• Challenges

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. Rational
PAPERLESS NHS DOCTOR - AHP DIVIDE
DOCTORS DO THAT!
NURSES, PHYSIOS, OTs etc

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. 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. Benefits
FOR STUDY
Immediacy – look up notes
Check information
Organization - folders
FOR PRACTICE
Show patients videos
Take notes
Use Apps to support

8. Some great Apps and resources

9. HEALTHCARE APPS
4 MILLION

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. 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. 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. Challenges
• Attitudes
• Apps – development of relevant ones
profession specific
• Risks to patients – infection?
• Security concerns
• Changes to practice
• Access to Wi-Fi

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