The Impact of a Personal Digital Assistant (PDA) Case Log in a Medical Student Clerkship

Abstract

Background: Medical education literature emphasizes that reflection and self-audit are pivotal steps in learning and that personal digital assistants (PDAs) have potential as decision support tools. Description: The purpose was to examine the efficacy of PDA-based resources and patient-encounter logging systems among 3rd-year medical clerks during pediatrics rotations. Evaluation: Students in rotations were assigned to control (using paper-based logs and references) or intervention groups (using PDA-based logs and resources). Students completed pre- and postrotation Paediatrics Competency Surveys, participated in focus groups, and were compared on year-end examination grades. Use of PDA logs far outweighed that of paper logs (1,020 PDA logs and 87 paper logs). PDA logs were ranked significantly higher in enhancing learning and reflection than paper logs (t = 2.52, p < .01). PDA logs also facilitated specific learning experiences. Conclusion: PDA-based patient-encounter logs appear to be effective case documentation and reflection tools. The difference in number of logs between control and intervention groups demonstrates the utility of the PDA for “point-of-care” patient logging.

Funding support for this research was provided by the Teaching and Learning Enhancement Fund, University of British Columbia. Kent Haden, President, Resilience Software Inc; Steven Wong, Division of Continuing Medical Education Program Director, University of British Columbia; Bob Mack, Director, Rural Family Practice Program, University of British Columbia; Abhirami Gunasingam, Chris Steele, Zena Sharman, Damini Malhotra, Beverly Beckingham, and Lisa Wright, Researchers, Division of Continuing Medical Education, University of British Columbia. Thanks to Alex Wong, Third-Year Student Representative, Faculty of Medicine, University of British Columbia, and the 3rd-year paediatric clerks who gave their time and feedback to the study.

Notes

∗The PDA included the following resources: medical calculator, Five Minute Pediatric Consult, Pharmaceuticals Database, Growth Charts, and Redbook.

^†The clinical mark is produced from the evaluation of their 4-week inpatient work. The form used is standardized and used throughout the different clerkships. The evaluation itself is subjective.

^‡The OSCE is a six-station examination. Three of the stations are patient based. These include a physical examination station, a history-taking station, and a counseling station. These stations are different for each group but a score out of 20 is developed for each. The other three stations are written stations that include interpretation of X-rays, data, or pictures, all of which are provided with a clinical scenario.

∗Indicates significance.