Should you equip your radiology residents with iPads? The answer is an unequivocal yes, according to a group from Boston, who found there were multiple benefits to using iPads and other mobile devices. However, residency programs should have a long-term vision for mobile-based education, they wrote in the October American Journal of Roentgenology.
Radiology programs across the U.S. are purchasing iPads and other mobile devices for their residents. But many programs don't have a solid understanding of how a mobile device can enhance the learning environment, according to Dr. Harprit Bedi and Dr. Edgar Yucel, both from Tufts Medical Center. Bedi and Yucel offered ideas for how to incorporate mobile-device technology into resident education (AJR, October 2013, Vol. 201:4, pp. 704-709).
"At the most basic level, the device will allow residents to read journals and textbooks in a more convenient manner," they wrote. "But how will this device change what we actually do on a day-to-day basis? Can it truly enhance the educational experience of our residents? Can it make our lives as administrators and directors easier? Can it provide us a new and exciting avenue to be creative, imaginative, and visionary? Yes. Yes. Yes."
The Tufts Medical Center department of radiology gave iPads to its 22 residents in 2011, using an alumnus donation to purchase each tablet computer and resident "book funds" for subsequent purchases, Bedi and Yucel wrote. Before the devices were distributed, residents were given short surveys on their study habits, and they signed user agreements outlining basic rules (they were required to have the iPads at work and keep them accessible for most of the day). After six months, the residents were given the same survey again.
"Not only did the proportion of learning they did through electronic resources dominate the overall time studying, but the total amount of time spent studying also increased," Bedi and Yucel wrote.
Improving administration
Having residents use mobile devices improves the administration of the residency program in five concrete ways, according to the authors:
Documentation -- Tablet computers allow the program to use sharing software such as Dropbox to distribute the residency handbook, goals and objectives for each rotation, and explanations of core skills to be developed.
Note-taking -- Residents can more easily take notes and keep procedure logs. Some of the programs available include Evernote, Ramki Noteshelf, and Notes Plus.
Calendars -- Shared calendars can be created and maintained, with links to suggested reading material and/or videos of lectures.
Communication -- Group texting applications allow for messages to all residents, rather than individually paging, calling, or emailing them.
Evaluations -- Program administrators can embed links in the shared calendar that allow residents to complete evaluations.
Enhancing education
There's no doubt that mobile devices can be a distraction during conferences or even while residents are interacting with clinicians or patients, Bedi and Yucel noted. But that doesn't mean they shouldn't be used.
"The solution is to use the strength of mobile devices to integrate them into and thereby enhance the learning environment," they wrote.
The authors listed a number of ways in which mobile devices can improve resident education:
Electronic study resources -- The iPad and other mobile devices allow residents to take advantage of resources such as textbooks, electronic journals, educational websites, podcasts, and mobile applications.
Lectures -- Traditionally, residents listen to lectures given by senior physicians -- a "teacher-centered" model, according to Bedi and Yucel. Mobile devices promote a learner-centered education, prompting residents to get more involved in the lectures and explore deeper levels of understanding.
Image interpretation -- At Tufts, the radiology residency program uses a free application called BaiBoard, which allows a group to interact with an image together, projected on their individual iPads. "The entire group can be involved in the case," the authors wrote.
Video capture -- The audio and/or video of lectures can be captured and uploaded later on YouTube or iTunes.
Attendance -- Rather than using a sign-up sheet to monitor attendance, the Wi-Fi connection could identify which iPads have entered the local network, proving a time stamp of when the user joined the conference and keeping a log of each device.
Sharing curricula -- Radiology programs could collaborate and create open-source platforms to share lectures and cases via iTunes U or Moodle.
Case-based learning -- Mobile devices are useful for small, case-based learning sessions.
Teaching modules -- At Tufts, Bedi and Yucel are creating eight- to 20-minute teaching modules on various topics, which residents can access at appropriate moments in the curriculum cycle.
A few things to keep in mind
When incorporating mobile devices into resident education, it's important to keep in mind a few key points, including how the devices will be funded, how they will be technically supported, and how data will be kept secure.
The Tufts radiology department plans to use resident book funds for future purchases, and it buys Apple's extended warranty with each device, which includes three years of overall support. As for security, Tufts uses Good as its mobile security platform, and all users receive a security policy agreement that they must accept.
"When an individual accepts that policy on a device, he or she is allowed access to the information delineated in that policy, such as data in PACS applications, in electronic charts, and on the hospital intranet," Bedi and Yucel wrote. "This allows the information technology department to have control over those portions of the devices delineated in the policy -- that is, anything to do with patient information. If the device were lost or stolen, the information technology department could remotely wipe that portion of the device while leaving intact other personalized information not included on the policy."
Like it or not, mobile technology is rapidly becoming a key part of healthcare training and delivery, the authors concluded.
"We must have a vision of how these technologies can improve the educational experience of our residents," they wrote.
