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
The use of mobile devices to support learning in practice settings
Aug 23, 2014
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.
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 Lynn Clouder
Arinola AdefilaNigel WilliamsHelen BradleyLawrie PeckSteve BallImran Ali
Overview
• Objectives• Rationale/Context• Methodology• Participants• Findings• Challenges
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.
Rational
PAPERLESS NHS DOCTOR - AHP DIVIDEDOCTORS DO THAT!
NURSES, PHYSIOS, OTs etc
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.
Student Co-researchersOT
Mental Health (early inter-vention)Mental Health (elderly)HopsitalOutpatientCommunity
PT
Mental Health (early in-tervention)Mental Health (elderly)HopsitalOutpatientCommunity
Total – 35 placements9 Occupational Therapy students - 1 placement each
9 Physiotherapy students - 3 placements each/ 2 for 1 student
Benefits
FOR STUDYImmediacy – look up notesCheck informationOrganization - foldersFOR PRACTICEShow patients videosTake notesUse Apps to support
Some great Apps and resources
HEALTHCARE APPS
4 MILLION
Tasks/Treatment iPads were used forSetting 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.
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 Conditions Wi-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, organisation, video/camera function, syncing, providing 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.
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)
Challenges
• Attitudes• Apps – development of relevant ones
profession specific• Risks to patients – infection?• Security concerns• Changes to practice• Access to Wi-Fi
REFERENCESClay, 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 accessedJuly 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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