Librarians' story of the PDA Service at the University of Queensland Rural Clinical School (Kaye...
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Librarians’ story of the PDA Service at the University of Queensland Rural Clinical School by Kaye Lasserre, William Chun & Lisa Kruesi NSW Health Libraries Forum Gosford 2007 Focus on the User Environment: Techniques and Technologies
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Kaye Lasserre, William Chun and Lisa Kruesi University of Queensland The University of Queensland Library and the School of Medicine conducted the first major Australian trial of Personal Digital Assistants' (PDAs) use by medical students at the Rural Clinical Schoolduring 2003 and 2004. The trial became an ongoing PDA Service from 2005, and its role in enhancing medical education has been demonstrated by continued funding and senior management support. The PDA Service has helped to provide key health information resources for students on rural placements. Adoption of the Service has addressed some of the equity issues caused by inadequate Information Communication and Technology (ICT) infrastructure beyond urban centres. Rural students' use of information at the point of care facilitates learning and establishes good practice for future clinical decision making. This presentation will discuss the Rural Clinical School Librarians' story about the implementation of the PDA Service, the lessons learnt and why it was a component of "An Integrated Package of Innovative Rural Medical Education:Enhancing Student Outcomes and Increasing the Rural Medical Workforce", 2006 Carrick Award Winner for Australian University Teaching.
Transcript of Librarians' story of the PDA Service at the University of Queensland Rural Clinical School (Kaye...
Librarians’ story of the PDA Service at the University of Queensland
Rural Clinical School by Kaye Lasserre, William Chun & Lisa Kruesi
NSW Health Libraries Forum Gosford 2007
Focus on the User Environment: Techniques and Technologies
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Abstract
Librarians’ story of the PDA Service at the University of Queensland Rural Clinical School
The University of Queensland Library and the School of Medicine conducted the first major Australian trial of Personal Digital Assistants' (PDAs) use by medical students at the Rural Clinical School during 2003 and 2004. The trial became an ongoing PDA Service from 2005, and its role in enhancing medical education has been demonstrated by continued funding and senior management support.
The PDA Service has helped to provide key health information resources for students on rural placements. Adoption of the Service has addressed some of the equity issues caused by inadequate Information Communication and Technology (ICT) infrastructure beyond urban centres. Rural students’ use of information at the point of care facilitates learning and establishes good practice for future clinical decision making. This presentation will discuss the Rural Clinical School Librarians' story about the implementation of the PDA Service, the lessons learnt and why it was a component of "An Integrated Package of Innovative Rural Medical Education: Enhancing Student Outcomes and Increasing the Rural Medical Workforce", 2006 Carrick Award Winner for Australian University Teaching.
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Outline
Background PDA Project - objectives and overview Key Findings PDA Service Lessons Learnt – issues and solutions Future
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UQ School of Medicine
Operates throughout Queensland Offers the postgraduate medical
(MBBS) program Clinical Schools provide
teaching, learning and research activities
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Rural Clinical School
Fourteen Rural Clinical
Schools in Australia University of
Queensland
Rural Clinical School
located at South West
and Central Queensland
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PDA Project Issues of access to information in rural and remote
areas
Successful PDA implementations
No significant trials in Australian medical schools
Funding opportunity arose
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Project Objectives Provide access to authoritative, evidence-based information to
medical students at their point of learning
Contribute to a positive rural medical education experience and address equity issues for students in remote or isolated areas and have limited access to information and technology infrastructure
Optimise the application of contemporary information and telecommunications technologies in healthcare education and to prepare students for the practicing medicine in 21st Century
Provide a platform for the University of Queensland, School of Medicine to evaluate and report on the applicability of this technology to the teaching and learning environment
Provide the University of Queensland, School of Medicine and the University Library with experience in the provision resources, training and support for PDAs
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Project Phase
March to December 2004 95 units distributed Participants - 3rd and 4th year
medical students and staffof the Rural Clinical School
Training and support byLibrarians
*trialed on three units or less
Project Resources MIMS for PDA (including MIMS Interact) Micromedex (drug information database) Textbooks
– Oxford handbook of clinical medicine– Oxford handbook of clinical specialties– Oxford concise medical dictionary
Archimedes (Clinical calculator) Clinical Evidence *UpToDate *Harrisons on Hand Adobe Acrobat and the Mobipocket readers Outlook contacts and academic calendar
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A day in the life of a medical A day in the life of a medical student using a PDAstudent using a PDA
MBBS 3, Rural Clinical School, Toowoomba
• Ward rounds – medicine• how to diagnose suspected rheumatoid arthritis• Oxford Handbook of Clinical Medicine
• Clinical question: endocervical swabs vs urinalysis• reminder to look up later
• What does xanthelasma mean and indicate?• Oxford Concise Medical Dictionary
• Drugs drugs drugs…losartan• Australian Medicines Handbook • precautions and interactions• dosages
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PDA Usage
Once a week or less
Several times a day Several times
a week
Once a day
Never use it
64%
14%10%
12%
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Use of Information Resources
0% 20% 40% 60% 80% 100%
Oxford ConciseMedical Dictionary
Archimedes medicalcalculator
MIMs on PDA
MIMs Interact onPDA
Oxford Handbook ofClinical Medicine
Oxford Handbook ofClinical Specialities
Useful
Very useful
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Perceived Value of Technology
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Access and EBM
Research indicates many clinical questions go unanswered
Lack of access to information a factor ‘Just in time’ education to keep up-to-date
with medical knowledge Use PDA to learn on the spot or record
questions for later study Integrate learning/CPD with daily clinical
work
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Access Enhances Learning
Do you think that access to the reference materials on the PDA contributes to your educational experience?
86% agreed
Value of learning in context “Yes. It can make clinical situations teaching moments when questions can be
explored with the clinician in combination with PDA resources”
“Access information quicker and still in the clinical context, therefore it is more relevant. I am more likely to look something up if I don’t have to remember to look it up later”
“Yes, definitely. It enables answers to some questions immediately – particularly for drug information or quick reminders of different diseases, so can better apply knowledge to that patient straight away”
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Organisation, IT and Equity
“I found the PDA very useful in terms of organisation. It’s probably the most organised I’ve been in the last three years…”
“Encouraging use of IT in clinical practice at a time when, as a student you are still working out a routine and are able to incorporate the use into your practice.”
“The nurses are all asking me for advice about drugs and don’t realise that the only reason that I can come up with answers is the PDA on my belt! Well, not always the only reason - but often!”
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Summary
PDAs, by optimising access to information support EBM and improve the performance
of a clinician enhance student learning by facilitating
learning in context
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PDA Service
Project became ongoing service in 2005 for permanent students
Focus changed in 2006 Distribution to 3rd year students doing Rural
Medicine Rotation Five rotations per year All 3rd year medical
students can try a PDA
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PDA Resources
The Oxford handbook of clinical medicine The Oxford concise medical dictionary Australian medicines handbook Australian College of Rural and Remote Medicine
(ACRRM) Clinical Guidelines Royal College of Pathologists of Australasia
(RCPA) Handbook Archimedes clinical calculator
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Use On Rural Rotation
Aust Med Handbook – Med Super asked me what were the normal dosages of an anti-elliptic and I was able to inform him using the PDA. He now wants to get some for his staff.
Medical dictionary – whilst in consultations with my preceptor so I didn’t interrupt, but could follow the case accurately.
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Hardware choice – why PDA and not laptop Characteristics needed
Operating System choice – why MS over Palm Past versus present and future
Information access Standalone Network
Lessons Learnt: Procurement
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Point of care and Reference/study Value/cost and Overlap User interface Licence issues
Palm docs (.pdb) – using eReader on Pocket PCs
Publishing for mobile devices
Lessons Learnt: Information Resources
25 Folder/HTML Transfer by card reader and not synchronization cable/dock (~40min)
Free resourceHTMLRCPARCPA Manual
Requires web access to install Installation from host - requires MS ActiveSync and
dock/IrDA(infrared)/Bluetooth
Free resourceSkyscapeSkyscapeArchimedes Medical Calculator
Requires registration for password/serial Installation from host - requires MS ActiveSync and
dock/IrDA(infrared)/Bluetooth Requires web access.
Free resource but required institutional licensing agreement with publisher
StandaloneMcGraw-HillDiagnosaurus
eBook on MobiPocket Little documentation – self discovery through trail and error Current editions now OUP on Skyscape
One off purchase One off / Annual update Nag screen
MobiPocketOUP-------------Franklin / Skyscape
Oxford Concise Medical Dictionary
eBook on MobiPocket Little documentation – self discovery through trial and error Current editions now OUP on Skyscape Older versions incompatible with current MobiPocket Reader
One off purchase One off / Annual update Nag screen
MobiPocketOUP-------------Franklin / Skyscape
Oxford Handbook of Clinical Specialties
Installation from host - requires MS ActiveSync and dock/IrDA (infrared)/Bluetooth
Requires web access to register.
One off / Annual update Nag screen
SkyscapeOUP-------------Skyscape
Oxford Handbook of Clinical Medicine
eBook on Vade Mecum Institutional membership to access downloads
Vade Mecum(Part of ACRRM
institutional Subscription)
ACRRM/
RRMEO
ACRRM/RRMEO Clinical Guidelines
CAB archive installation file (does not require installation of MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Free resourceMobiPocketMobiPocket-------------Amazon
MobiPocket Reader
Installation from host - requires MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Free resourceVade MecumCommunity open source project
Vade Mecum Reader
CAB archive installation file (does not require installation of MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Requires web access to register.
Annual SubscriptionStandaloneAMH----------HCN
Australian Medicines Handbook
InstallationLicensePlatform/Interface
Publisher----------Vendor
Resource
Folder/HTML Transfer by card reader and not synchronization cable/dock (~40min)
Free resourceHTMLRCPARCPA Manual
Requires web access to install Installation from host - requires MS ActiveSync and
dock/IrDA(infrared)/Bluetooth
Free resourceSkyscapeSkyscapeArchimedes Medical Calculator
Requires registration for password/serial Installation from host - requires MS ActiveSync and
dock/IrDA(infrared)/Bluetooth Requires web access.
Free resource but required institutional licensing agreement with publisher
StandaloneMcGraw-HillDiagnosaurus
eBook on MobiPocket Little documentation – self discovery through trail and error Current editions now OUP on Skyscape
One off purchase One off / Annual update Nag screen
MobiPocketOUP-------------Franklin / Skyscape
Oxford Concise Medical Dictionary
eBook on MobiPocket Little documentation – self discovery through trial and error Current editions now OUP on Skyscape Older versions incompatible with current MobiPocket Reader
One off purchase One off / Annual update Nag screen
MobiPocketOUP-------------Franklin / Skyscape
Oxford Handbook of Clinical Specialties
Installation from host - requires MS ActiveSync and dock/IrDA (infrared)/Bluetooth
Requires web access to register.
One off / Annual update Nag screen
SkyscapeOUP-------------Skyscape
Oxford Handbook of Clinical Medicine
eBook on Vade Mecum Institutional membership to access downloads
Vade Mecum(Part of ACRRM
institutional Subscription)
ACRRM/
RRMEO
ACRRM/RRMEO Clinical Guidelines
CAB archive installation file (does not require installation of MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Free resourceMobiPocketMobiPocket-------------Amazon
MobiPocket Reader
Installation from host - requires MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Free resourceVade MecumCommunity open source project
Vade Mecum Reader
CAB archive installation file (does not require installation of MS ActiveSync and dock/IrDA(infrared)/Bluetooth)
Requires web access to register.
Annual SubscriptionStandaloneAMH----------HCN
Australian Medicines Handbook
InstallationLicensePlatform/Interface
Publisher----------Vendor
Resource
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Initial set up and packaging: Create image – tasks, contacts Exceptions to initial load and Serials Registry edits – scroll bars, 802.11g…. Final image
Turnover process: Re-imaging, cleaning and other administrative tasks Hardware servicing Hiring students
Lessons Learnt: Roll-out and Maintenance
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Projection (MS Remote Display Control)
Target audience: No PDA exposure…….experienced users
Training aims:1. Familiarisation of the PDA and the information resources
2. Apply Adult Learning Principles to up the “personal motivation” to: want to take a PDA use the information resources on the PDA
Improve focus: Testimonials: to show value of PDA to previous students Role play examples: clinical usage scenario Work sheet: helps resource familiarisation
Lessons Learnt: Distribution and Training
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Support at a distance Phone/email support User re-imaging Exchange SD cards Faults and solutions log
Continuous improvement Return surveys
Resource selection Improve training
Fault reporting (Quality Control and Quality Assurance) Find more uses (Value adding) Faults and solutions log
Lessons Learnt: Support and Improvements
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Future
Stand alone versus Wireless Wide Area Network (WAN) resources
End of the road for pure PDAs? Move to:
– Convergence devices / Smartphones
– Tablets/Laptops Role of Librarians
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References
Ely JW, Osheroff JA, Ebell MH, Chambliss ML, Vinson DC, Stevermer JJ, Pifer EA.Obstacles to answering doctors’ questions about patient care with evidence: qualitative study. BMJ. 2002 Mar 23;324(7339):710
Green ML, Ruff TR. Why do residents fail to answer their clinical questions? A qualitative study of barriers to practicing evidence-based medicine. Acad Med. 2005 Feb;80(2):176-82
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Acknowledgements
Professor Peter Baker, Associate Professor Bruce Chater, Dr Di Eley, Ms Donna Georgeson, Ms Janelle Coe, Mr Keith Webster Mrs Janine Schmidt, Ms Heather Todd, Mr Andrew Heath, Ms Yasmin Childs, Mr Daryl Healing.
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Questions
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Further information
Kaye Lasserre– [email protected]
William Chun – [email protected]
Lisa Kruesi– [email protected]
