Saturday, May 28, 2011

Why Medical School Needs to be Taught with Mobile Apps

Medical students in their third and fourth years, like the doctors they are emulating, are mobile. So too must be the content of their education.

Many (most?) knowledge workers today exercise their knowledge at a desk in front of a computer. However, the medical world is mobile, requiring answers and decisions on the go.

The old-fashioned method of having knowledge on hand was to learn it, to memorize it. Once it's stuck in your head, it can go anywhere. But now, with mobile devices, it simply need not be memorized to have the knowledge on hand, literally.

So what about medical education?

Think about the current model of medical education for a moment- it mobilizes information simply by stuffing groups of the best and brightest into memorization sweatshops (with an odd emphasis on competition). Once in their heads, students can take that info with them around on the hospital floors for the second two years. The sedentary classroom is used because it was the most efficient way to mobilize information.

That's no longer true. Today, that info can be mobilized with mobile apps. (My favorite example is Dr. Joshua Steinberg's ABG Eval)

If we want to revolutionize medical education (or at least help it try to keep up with innovation in healthcare) I propose we make as much of the medical school curriculum as we can mobile without using the sweatshop model.

It has to happen in medical education in particular because it's a knowledge profession that moves.


12 comments:

moviedoc said...

Follow twitter.com/behavenet to learn a behavioral health care term every day, and on their birthdays, something about related notable people. A daily psychiatric drug may be next. What do you think?

David Doherty, 3G Doctor said...

Hi Aaron,

This is already happening in the worlds leading medical schools and the early results suggest it is having the impact you are suggest.

I have no doubt that in the future using a smartphone in a medical exam will be as commonplace as it is for maths students to use a calculator.

Check out the initiative that started in Leeds last year:

http://mhealthinsight.com/2010/09/28/university-gives-medical-students-smartphones-loaded-with-key-medical-text-books/

UK Universities are currently signing deals for iPads, Samsung Galaxy Tabs and BlackBerry Playbooks for next term... then it'll get really interesting:

http://mhealthinsight.com/2011/05/18/mhealth-changing-the-way-people-really-learn/

astupple said...

Wow, great links. It really is moving.

Hopefully administrators will bite sooner rather than later.

Anonymous said...

Interesting,
But-Do you get to use mobile apps on exams? If not there is still a need to memorize. Furthermore a few observations
1 Many do sit and "exercise knowledge" in front of a computer but many *produce* knowledge in said exercise. You appeared to refer to pure consumption of medical information with apps. Big difference.
2 Don't underestimate the power of your mind. One's memory is a very efficient way to carry around medical information
3 "memorization sweatshop" ...is really that bad? I kinda enjoyed the experience and the competition. It brought out the best in me.
4 I don't know of any suitable mobile *lab* apps. Virtual reality may replace the lab someday but not today.
5 Reliance on references is inversely proportional to fund of knowledge.
6 you may have inadvertently made the case for tech savvy computer science students replacing med students
7 Be careful what you wish for, I foresee computers replacing doctors as medical knowledge is digitalized. IBM's Dr Watson is already as good as any 2nd year med student.
-Jon, MD

Dial Doctors said...

I believe that mobile apps are already used in most settings but there's something about memorizing that sticks with doctors.

While you may argue that I'm a psychologist and don't know much about it, my sister is currently a 2nd year resident and she uses both. I asked her why and she says no Ipad can beat her brain. Although she has relied on mobile apps she still believes her instinct is usually beats any machine.

Being a great health practitioner implies knowing how to use this information wisely. While your brain's hard drive may not be as organized, your instincts will lead you in the right direction. Only way to develop that is through memorization.

Use mobile apps but develop a doctor’s brain through learning everything even if it gets lost through the cracks. It may come in handy some day.

astupple said...

Anonymous: Greatly appreciate your input!

1- I definitely didn't mean to imply pure consumption with apps, hence the reference to Dr. Joshua Steinberg's ABG Eval app- it teaches how to evaluate ABG's rather than just calculating the answer as most others do.
2- Definitely! I'm only speaking of the useless-to-memorize. I'd be interested in a debate about what is still worthwhile. Basically, I see educators' job as developing/supplying the memory-replacing tools where appropriate.
3- Agreed- I loved memorize sonnets. Not so much trade names for drugs. Is there something beyond personal preference here?
4- Not sure what you mean here, again I refer to ABG Eval.
5- I used to agree. Now, I most respect opinions grounded in referenced facts. I say this as a self-acknowledged windbag.
6- Scary thought, indeed. One of the things that most struck me this year was that residents on the floors were most effective sitting at the computer terminal, watching the results come back and placing orders. I think this speaks directly to the future of the profession; a great topic in itself.
7- Right? I wrote a brief post on why I disagree here: http://adjacentpossiblemed.blogspot.com/2011/02/i-for-one-welcome-our-new-computer.html
And finally, regarding your first point, why not use them on exams? We use calculators in math class.

Dr. Jon, thank you very much for taking the time to engage!

-Aaron

moviedoc said...

This isn't really an either/or question. Exposure to that info will leave memory traces, esp. when repeated. Agree with access in exams which should be testing for more subtle skills that memorization.

astupple said...

Dial Doctors,

Agreed, things that your brain beats don't beat your brain.

For everything else, I prefer tools.

Like, if I can twist the cap off a bottle with my bare hands, I don't bother with a can opener. Likewise, if I'm a hematologist and I work with blood gases and the clotting cascade all day, I'm not going to rely on a mobile app any time soon.

But if a bottle came along with an even simpler cap system- say a soft push-button opener that was ergonomically integrated into the shape of the bottle, I'd use that. And if a mobile app was made so sophisticated that it integrated with the EMR and processed all of my hematology data in a dynamic and visually appealing format, I might go for that too.

Basically, I'm just saying that sophisticated web apps are ideal for medicine. Just because it's an answer on a mobile phone doesn't in ANY way mean it's superior, an important distinction. These apps are the most primitive of primitive now- they've only existed as a concept for what, three or four years?

Thanks for your input!

-Aaron

astupple said...

Moviedoc,

Agreed, hence I again refer to Dr. Steinberg's ABG Eval app. It gives the operator an answer, but in a pedagogical way that etches the process into the mind, with the goal that the user won't actually need the app anymore!

And yes, definitely not an either/or issue.

These tools do what all tools have done- they don't make us obsolete, they free up time for us to do even MORE amazing stuff.

Appreciate your comment.

-Aaron

moviedoc said...

"they free up time for us to do even MORE amazing stuff."

WOW. You mean like filling out disability forms and calling in prior authorizations??!!

astupple said...

Haha!

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