Rebecca Dimond*, Cardiff University, Cardiff, United Kingdom Alison Bullock*, Cardiff University, Cardiff, United Kingdom Wendy Hardyman, Cardiff University, Cardiff, United Kingdom Mark Stacey, Wales Deanery, Cardiff University, Cardiff, United Kingdom Track: Research Presentation Topic: Digital Learning Presentation Type: Oral presentation Submission Type: Single Presentation Building: Mermaid Room: Room 3 - Upper River Room Date: 2013-09-23 02:00 PM – 03:30 PM Last modified: 2013-09-25

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Background: Transition from medical school to the workplace is associated with increased patient mortality and trainee anxiety as with limited knowledge and experience they manage escalating responsibility for patient care. In the context of information-explosion, mobile technology has potential to support junior doctors, providing ‘just-in-time’ information, at the bedside, so enhancing confidence and promoting safe and efficient patient care. The Wales Deanery-funded “iDoc” project provides trainee doctors in Wales with access to an internet-free searchable library of medical textbooks on their own smartphones.

Objective: The objective of the iDoc evaluation is to assess the value and impact of the initiative by gathering data on when, why and how the device is used and to what effect.

Methods: Trainees submit baseline and exit questionnaires and complete at least two case reports. Data are reported here from 2012/13, from 357 baseline questionnaires - 249 Foundation Year 1s (F1s) and 108 F2s - and their first 80 case reports. Baseline questionnaires collect data on frequency, type, usefulness and variation in use of workplace information sources, including mobile devices. Case reports are submitted on a pro forma and participants detail specific instances of use (including setting/context, problem or issue addressed, what happened, obstacles and reflections).

Results: At baseline, over 90% agreed that ready access to books on their smartphone lessened worries about increased responsibility. Information continued to be sought from colleagues: seniors, peers and other staff were consulted on a daily basis by 76%, 69% and 55% of our sample. However, these and other resources (hard-copy texts and ward-based computers) were not always available. Many indicated that they did not feel comfortable using a mobile device in front of seniors (31%) or patients (65%). If they did not know something during a consultation, most (70%) would not seek information with the patient present.

The case reports were classified by purpose. Most commonly, the smartphone library was used to check drug dosages. Thematic analysis revealed six main themes related to: just-in-time information, transition, discourse with colleagues, learning opportunities, patient care, and barriers. Access to information enhanced confidence and enabled trainees to better prepare for learning and discussion with seniors. iDoc enabled trainees to improve care quality by addressing gaps in knowledge, ensuring patients received timely, evidence-based treatment. Perceived barriers included colleagues and patients misinterpreting the purpose of smartphone use.

Conclusions: Although the context is one in which people-based resources are the most frequently used information sources, immediate access to a searchable mobile library of texts can enhance trainees’ learning in the workplace. This has important consequences for their wellbeing and standards of patient care. Interaction with colleagues is a central process of workplace learning and iDoc offers scope to make best use of people-based discussion. However, the application of mobile technology for learning in healthcare settings is complex and further work is needed to determine how to use technology most effectively, for patients and with patients.