Using mobile phones on the job
Authors: Patricia Mechael, Ada Kwan, Sarah Struble
Publication date: 19 Apr 2012
Not only helpful for users in a clinical setting, but becoming increasingly popular for distance learning
Learning is not limited to the classroom, and in a profession where continuing education is necessary, consideration must be given to learning opportunities anytime and anywhere. The use of mobile technologies in health—mobile health (mHealth)—is gaining traction in health education and professional health worker training. Health professionals and students will be expected to incorporate mobile technologies in their day to day responsibilities, especially as mHealth platforms are being used to improve learning. With video, audio, and text features, as well as interactive learning applications, mobile platforms provide new ways to engage, reinforce, and augment material taught through traditional learning. Yet the practice of incorporating mobile learning (mLearning) into the education of health professionals is relatively new and rapidly evolving.
A study published in BMC Medical Education  assessed the use and acceptability of personal digital assistants (PDAs) equipped with learning resources given to 387 medical students through surveys, focus groups, and usage tracking data. The authors reported that technology benefited student learning in four ways: timely access to facts, consolidation of knowledge through repetition, a supplement rather than a replacement, and making use of wasted time. However, the study had pitfalls—for example, PDAs froze and, subsequently, students used them less. Additionally, using PDAs interrupted clinical interactions with patients and doctors, and negative feedback was received from teachers and patients. Investigators suggested that guidance on etiquette ought to be provided to alleviate these problems. They concluded that the barriers to adoption of using PDAs could and should be overcome.
This study showed that mobile devices can be used to reference facts or procedures in a clinical setting while helping learning through repetition. Although mHealth might not replace more traditional methods of learning and practising medicine, it might be an important supplement to them.
The benefits of mLearning are not limited to the users only. Mobile devices can improve professional health training, which can increase job satisfaction and retention rates of health workers. If applied properly, using mobile devices to support health professionals can mean better diagnosis and treatment and improved health outcomes while reducing costs related to training and information dissemination. Despite the potential suggested from early evidence, stronger evidence from rigorous evaluation is needed to include mLearning into and alongside broader mHealth efforts.
The MoMEd study represents a growing number of projects around the world that are adding evidence to how mobile devices can serve as a supplement and complement, rather than a replacement, to existing learning techniques.  A 2010 policy white paper that we published on the barriers and gaps in mHealth found that, in developing countries, health professionals were most commonly using mHealth strategies for distance learning—rural health workers would receive training materials, guidelines, and scientific papers that could be read on mobile phones. Several projects in the developing world mention that using mobile devices for education and training where minimum infrastructure exists is a cheaper and more widespread alternative than using computers.  The Millennium Village Project, with sites in 10 African countries, provides mobile phone based continuous education and refresher learning of protocols to community health workers. Although feedback is positive, the small storage capacity of the phones was a problem. In South Africa, AED-SATELLIFE created an electronic library that is accessible by mobile phone with more than 4500 pages of treatment guidelines, diagnostic tools, and more for hospital nurses. Along with improving the knowledge and information seeking behaviour of nurses, the project instilled confidence in nurses during clinical interactions.
A few years ago, it was a commonly held belief that mobile phones could be helpful in a clinical environment, and studies such as MoMEd are helping to make the case. Although the findings are useful, many studies do not have large enough sample sizes to determine true effects on cost effectiveness, work efficiency, or health outcomes.   The first step in moving towards more formally integrated mLearning programmes is developing this evidence with scientifically rigorous evaluations. As the field moves away from pilots to more widely recognised, large scale programmes based on evidence, the negative perception of using mobile phones in clinical settings should change. Meanwhile as this evidence accrues, it is critical that national policies and regulations support mHealth education applications, which would enable cost effective implementation of healthcare professional development and help mHealth become more sustainable and scalable.
Competing interests: None declared.
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Patricia Mechael executive director
mHealth Alliance, United Nations Foundation
Ada Kwan researcher National Institute of Public Health, Mexico
Sarah Struble programme associate mHealth Alliance, United Nations Foundation
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