A study of personal digital assistants to enhance undergraduate clinical nursing education

This study reports on personal digital assistants (PDAs) as a means to prepare nurse professionals who value and seek current information. An interdisciplinary team of nursing and library faculty, information technology and bookstore staff, students, and educational consultants developed this project. A pre-post and comparative group design of second-degree students in the accelerated and traditional baccalaureate nursing degree (BSN) options was used to examine students' information-seeking behaviors, and the effectiveness and cost of innovation strategies associated with incorporation of PDAs into students' clinical practice. Results of this study support PDAs as an effective student learning resource, especially for reference materials. The student group with PDAs had increasing numbers of questions associated with clinical situations and a greater recognition of the need to use current resources. Students made substantial use of their PDAs and health team members, while decreasing reliance on textbooks and clinical faculty. Students' use of and satisfaction with this technology is linked to access speed and readability. Providing faculty with PDAs is recommended to enhance their comfort with and incorporation of PDAs into clinical teaching.     

A survey of PDA use by palliative medicine practitioners

This paper describes the results of a Web survey on the use of personal digital assistants (PDAs) by physicians across Canada involved with the delivery of palliative medicine in different settings. Seventy-two physicians responded to the survey from April to July 2005. The survey revealed 58.3% of respondents currently use PDAs on a daily basis, mostly to organize their practice and to look up medical references. Some use their PDAs to store patient information and to access a central electronic patient record (EPR). In terms of potential PDA use in palliative medicine, six thematic areas are suggested: medical references, EPR, staying connected, personal productivity, clinical research, and issues/concerns. For implications, healthcare organizations should consider mobile technology as part of their information systems strategy. The feasibility of a portable EPR for palliative medicine should be explored, and an information-based approach can help advance palliative medicine research in Canada.     

Portable computers and applications in respiratory care

Personal digital assistants (PDAs) have had a tremendous impact in the clinical setting, as they have in business and education environments. This report explores the health care application of PDAs, compares available PDA devices and software, and discusses PDA use for tracking patients, documenting clinical procedures, medical education, research, and accessing medical reference material. This report aims to increase awareness among health care providers about the potential roles of PDAs and to encourage further evaluation of PDAs in respiratory care.     

Infusing PDA technology into nursing education

Use of the personal digital assistant (PDA) has been infused into the accelerated baccalaureate program at Duke University to help prepare nursing students for professional practice. The authors provide an overview of the use of PDAs in the classroom, laboratory, and clinical setting. Technical aspects of PDA infusion and steps to ensure regulatory compliance are explored. Benefits of PDA use by both faculty and students in the program and challenges met with the infusion of this technology are also described.     

Handheld computers in nursing education: PDA pilot project

Interest in the use and application of handheld technology at undergraduate and graduate nursing programs across the country is growing rapidly. Personal digital assistants (PDAs) are often referred to as a "peripheral brain" because they can save time, decrease errors, and simplify information retrieval at the point of care. In addition, research results support the notion that PDAs enhance nursing clinical education and are an effective student learning resource. However, most nursing programs lack the full range of technological resources to implement and provide ongoing support for handheld technology use by faculty and students. This article describes a 9-month pilot project for the initial use of PDAs by novice faculty and students at Simmons College.     

What nurses want: diffusion of an innovation

We investigated the usability of personal digital assistants (PDAs) to improve research utilization and timely access to electronic practice information to assist in clinical decisions. Nurses used a decision support tool on a PDA to collect point-of-care outcomes data. Follow-up interviews documented usability. Nurses liked the portability and size of the PDA, as well as ease of use of the PDA software. Electronic decision support tools at point of care have the potential to improve nurses' research utilization and quality of care.     

PDAs as cognitive aids for people with multiple sclerosis

OBJECTIVE: Cognitive impairment is a common symptom for people with multiple sclerosis (MS). This study evaluated the effects of an occupational therapy training protocol using personal digital assistants (PDAs) as assistive technology for people with cognitive impairment related to MS. METHODS: Twenty participants were trained to use PDAs by an occupational therapist. Assessments of functional performance were taken at the start of an 8-week pretreatment period, at the beginning and end of training, and 8 weeks after the conclusion of training. RESULTS: Participants demonstrated the ability to learn how to use basic PDA functions and retain learning for at least 8 weeks. Functional performance increased significantly with PDA use, and this gain was maintained at 8-week follow-up. CONCLUSION: This study provides evidence of an association between an intervention providing training in the use of a PDA and improvements in the everyday function of people with cognitive impairment related to MS.     

Back to the future: personal digital assistants in nursing education

This article provides an overview of the current state of the art for incorporating personal digital assistants (PDAs) into nursing education. The development of PDA technology and the lessons learned by educators integrating PDA technology into nursing curricula are described. The current cycle of PDA evolution is discussed and contrasted with a proposed model for maximizing the impact of PDAs on technological innovation in nursing education and practice.     

10 uses for personal digital assistants in home care

This article focuses how clinical staff can use personal digital assistants (PDAs) to become more organized, expand quick reference libraries, and have some fun! If you've been wondering if a PDA will help maximize your work efficiently, this article is for you!     

Evaluating students' attitudes to using PDAs in nursing clinicals at two schools

Funding from the University of Massachusetts president's office allowed two campuses of the University of Massachusetts system to offer nursing faculty and students PDAs containing medical/nursing databases for use during their clinical rotations. A study was designed to explore student's attitudes toward the use of PDAs in a clinical setting and to determine if the manner in which the technology was introduced affected the formation of these attitudes. During the fall and spring semesters of 2005 to 2006, both sites used and evaluated the effectiveness of PDAs at the point of care, but the clinical course, faculty experience with PDAs, and method and stage of introduction varied on each campus. The University library acted as the public point of access for borrowing and technical support of the PDAs. All students were asked to complete a 21-question survey that collected quantitative and qualitative data about their attitudes toward the use of PDAs at their clinical agency. Results of questionnaires relating to students attitudes to the PDA as a learning tool showed that there were differences in the student's perceptions and acceptance of the PDA as a learning tool. The results from the analysis of the data and suggestions for the possible reasons for the differences are explored.     

Use of mobile handheld computers in clinical nursing education

Personal digital assistants (PDAs) are increasingly in use in both clinical practice and nursing education as a method of providing timely access to resources at the point of care. This article describes the use of PDAs during the medical-surgical clinical component of a Bachelor of Nursing program in Australia. The aim of the study was to investigate whether PDAs would enhance students' pharmacological and clinical contextual knowledge and to identify issues associated with the use of PDAs in students' clinical experience. A mixed-method approach was used incorporating a quasi-experimental design with pretest and posttest of pharmacological knowledge and focus group discussions. Students using the PDAs demonstrated a moderate increase in their mean score, which was double the increase in the control group. Findings from the focus group discussions indicated that students found the PDAs easy to use and perceived their use as beneficial to their learning in the clinical area. This study provides support for the ongoing implementation of PDAs into nursing education.     

Procedure Documentation in Emergency Medicine Residencies: A Time of Change

Objectives: The purpose of this study was to identify the methods of procedure documentation (PD) used by emergency medicine residency programs and to ascertain the number of programs that are transitioning to a more advanced system. Methods: All 122 ACGME-approved allopathic emergency medicine programs were contacted by telephone in December 2001. Survey information was obtained from the program director, an attending physician, a resident, or the residency coordinator. Results: The response rate was 92.6%. Seventeen programs (15%) reported using multiple methods of PD, with only 8% utilizing a formal database. Fifty-five percent reported that PD was manual. One third of all programs utilized a Web-based system for PD, while 13% required the use of personal digital assistants (PDAs). Nearly one fifth of programs stated they were changing to another form of PD, with the majority of those changing to a PDA format. Fifteen percent of programs purchased PDAs for their residents, and a similar proportion reported that the PDA was used by "most or all" of their residents to document procedures. Nearly four times as many programs (64%) reported that "most or all" of their residents utilized PDAs for clinical purposes. Conclusions: PDAs are used by a majority of residents for clinical purposes, although fewer utilize this resource for PD. Although most emergency medicine residency programs still utilize a manual system for PD, many programs are in transition to a more technologically advanced method.     

Performance of drug-drug interaction software for personal digital assistants

BACKGROUND: Personal digital assistants (PDAs) allow healthcare professionals to check for potential drug-drug interactions (DDIs) at the point of care, reducing the need to consult traditional references. However, PDAs can only be as effective as the software programs they use. OBJECTIVE: To examine the ability of DDI software programs manufactured for Palm OS-compatible PDAs in detecting clinically important DDIs. METHODS: Eight PDA software programs were assessed for sensitivity, specificity, and positive and negative predictive values for 16 well-documented DDIs contained within 6 simulated patient profiles. RESULTS: Sensitivity of the software programs ranged from 0.81 to 1.0, specificity ranged from 0.52 to 1.0, positive predictive values ranged from 0.62 to 1.0, and negative predictive values ranged from 0.88 to 1.0. Five programs scored perfect sensitivity scores: DrugIx, ePocrates Rx, ePocrates Rx Pro, Lexi-Interact, and the Tarascon pocket Pharmacopoeia. Of these, the ePocrates programs scored the highest in specificity (0.9), while Lexi-Interact and the Tarascon pocket Pharmacopoeia scored considerably lower (0.52). MosbyIx was the only program to score a 1.0 in specificity; however, its sensitivity was just 0.81. CONCLUSIONS: ePocrates Rx and ePocrates Rx Pro scored greater than or equal to 90% in regard to both sensitivity and specificity, making them the most reliable in detecting the clinically relevant interactions studied without the distraction of detecting those of no clinical significance. In addition, ePocrates Rx is updated regularly and is easily accessible on the Internet at no cost.     

Personal Digital Assistants: A Review of Current and Potential Utilization Among Medical Residents

Background: Increases in the daily work load of medical residents, coupled with constraints on their work hours have made personal digital assistants (PDAs) an increasingly popular management resource. No comprehensive review of PDA utilization among medical residents has been published. Purpose: The purpose is to review and analyze current literature addressing PDA use by medical residents and to asses the future impact handheld computers may have on the daily practices of residents. Method: A systematic literature search was completed to identify publications that describe the use of PDAs by medical residents. Particular attention and priority was given to articles addressing patient care, information management, and educational outcomes. Results: The rate of PDA utilization has dramatically increased in the past decade. Today, 70% of residents report using a PDA daily. PDAs are most commonly used for referencing medication-prescribing guides, medical textbooks, patient documentation programs, and medical calculators. No articles have reported the impact of housestaff PDA use on educational or patient care outcomes. Conclusion: PDAs are perceived as a valuable resource by most medical residents. Further studies are necessary to confirm that daily PDA use by housestaff confers an educational, institutional, and patient care benefit.     

Compliance of Medical Students With Voluntary Use of Personal Data Assistants for Clerkship Assessments

Background: For several years, final-year students at McMaster University have been required to complete 10 mini-CEX type assessments per rotation. A similar system was being introduced at Ottawa. Purpose: To facilitate data capture, we decided to introduce a personal data assistant (PDA)-based system and evaluate its impact. Method: A randomized trial was designed to compare the acceptability of PDA and printed evaluation forms. The trial failed because of clerks' unwillingness to use PDAs. A focus group was held and user surveys were administered, chiefly by e-mail, to explore students' preference for printed forms. Results: Thirty percent of invited clerks (52/176) agreed to use a PDA; 6% (11; 21% of those agreeing) recorded one or more encounters; 2% (4) recorded at least the minimum number of evaluations required by their program. Most survey respondents expressed concerns related primarily to the relative inconvenience of PDAs compared to paper, a judgment reflecting the time required both to install required software and to become familiar with the software and data entry form, and to record information via the form. A minority were also concerned about assessors' willingness or ability to use PDA forms. Conclusion: Before asking students and clinical supervisors to use a PDA-based encounter-evaluation form in clerkship, planners should conduct a careful assessment of the advantages and disadvantages for students of the system they hope to implement. The prima facie greater convenience and efficiency of the PDA may actually be offset by workplace disincentives and inefficiencies in data recording, relative to the incentives and efficiencies associated with a system based on printed (paper) forms.     

Partners for NP education: the 1999 AANP preceptor and faculty survey

PURPOSE: To increase understanding of national trends in nurse practitioner (NP) clinical education, the Education Committee of the American Academy of Nurse Practitioners (AANP) conducted a survey at the 1999 National AANP Conference in Atlanta. DATA SOURCES: A convenience sample of preceptors (n = 87) and faculty (n = 42) out of the total attendance of 1,744 responded to a written questionnaire. CONCLUSIONS: Preceptor respondents provided data concerning the number of NP students supervised, influence of student supervision on productivity, and availability of incentives for precepting. Faculty reported placement and supervision issues, the extent of precepting in their clinical practice site, and recognition and support for this role. Faculty and preceptors disagreed about the types and number of incentives offered for accepting students as well as the congruence of clinical teaching activities and national teaching guidelines. Precepting did not appear to strongly influence preceptor productivity. External funding did not influence opportunities for clinical education. IMPLICATIONS FOR PRACTICE: In 1998, the graduates of NP programs rose by 15.8% and over half of all nursing students enrolled in graduate nursing programs were seeking a NP education. This increase in students may compromise the ability of schools of nursing to insure quality clinical education of NP students by increasing faculty workload and placing greater demands on expert preceptors in the community. Clinical education is also changing in light of changes in the health care system.