Use of handheld computers in medical education. A systematic review
The use of Personal Digital Assistants (PDAs) has been shown to be a useful resource for physicians and other medical staff. There are mutilple applications for the use of PDAs in the medical community, including education, patient care, and reference referral.
The authors discuss the use of PDAs in medical care, their history, and the different products available. They then performed a systematic review of the literature with three main objectives: (1) provide an update for the medical community of the uses of PDAs in education, (2) provide a list of common and popular programs and references, and (3) evaluate the effect of PDA use on patient care. Methods: The first step was the searching of the literature. They searched OVID MEDLINE from 1993 to September 2004 use relevant keywords and PDA-related MeSH terms. A total of 1,616 articles were found on the database search. On the title and abstract review, 1,446 were excluded on the bases of no being relevant. Of the 170 potentially relevant articles, 114 were excluded on full text review. Another 10 were excluded based on the fact that they were review articles. This left 46 articles, which was increased to 67 articles and abstracts after the reference review (5 articles) and conference review (16 abstracts).
Many of the articles evaluated more than one area of PDA use. The typical areas of study were accessing electronic medical resources, tracking patients/procedures, billing, and prescription writing. Only 1 study compared attending vs. resident use of PDAs. As far as general attitudes toward the use of PDAs, increased experience with PDAs typically lead to improved satisfaction with them. Barriers among novice users of PDAs were also discussed. The general use of PDAs was also evaluated, showing variable rate of use and the demographics associated with use. In the areas of teaching and clinical education, the authors discuss the different uses in an educational setting and the specific applications used clinically. Patient care, documentation, and research uses were also addressed. Finally, patient outcome studies were shown to be significantly limited.
PDAs have developed into an important resource for physicians, with up to 70% of trainees currently using them. The most popular uses were reference databases and medical calculators. The majority of studies are noted to be more descriptive and lacking in meaningful outcome evaluations. Controlled studies are required to evaluated the impact of PDA use on (1) educational processes, (2) educational outcomes, (3) patient care processes, and (4) patient outcomes. Limitations included the databases searched, study types available, and the biases of the published research.
This article does a good overall review and synopsis of the clinical and educational uses of PDAs. The methods were solid and I feel the authors expanded the search by reviewing references and non-published studies by searching abstracts from conference presentations. The article gives a proficient overview of the typical uses of PDAs in multiple areas and a list of common applications used.