Using PalmPilots as a Teaching Tool during a Primary Care Clerkship

Abstract

Objective: Expanding knowledge and compressed time mean that physicians must find new ways to keep information “at the tip of their fingers.” The Association of American Medical Colleges has challenged faculty to use technology in our teaching so that students will be able to use digitized information to guide their clinical and educational practices. Personal digital assistants (PDAs) are pocket-sized information-management tools that provide access anywhere, including ambulatory practice situations where personal computers are not immediately available. We issued PDAs to medical students and faculty as a pilot project to use them as teaching tools. Description: After orientation to a required rotation in primary ambulatory care, we gave two consecutive random sample groups of students (9/34 and 8/36) the Palm IIIX™ (Palm Computing, Inc., Santa Clara, CA, <www.palm.com>) with four megabytes of RAM. Students were taught to use the Palm IIIX™ and related software with a scavenger hunt to demonstrate various applications. In the context of patient care, the students were primed by faculty (who had been trained as part of a faculty development program) to use PalmPilot information before seeing a patient, in response to patient issues or questions in the examination room, or after patient contact to find further focused information. After each half-day session of clinic work, the students were asked to evaluate the extent to which the use of PDA technology in ambulatory care augmented their educational experience. The Palm IIIX™ included medical software (preventive guides, history and physical protocols, medications, pediatric dosage calculations, and others) from the Internet that was reviewed by seven faculty for relevance, accuracy, and utility in a primary care setting. Four viewer application software programs were purchased and used to read these public access files. A list of relevant Internet resources was added to the “memo pad” of the Palm IIIX™ (e.g., Centers for Disease Control, National Institutes of Health, and American College of Physicians Web sites) along with several PalmPilotRN Web sites. The calendar was used to give students ready access to schedules of clerkship core lectures. Discussion: The students' response was and continues to be overwhelmingly enthusiastic. Third-year medical students found that the software for drug selection, name, and dose was helpful. The Palm IIIX™ was also useful for focused medical problems, such as hyperkalemia, anemia differential diagnosis, and lower respiratory tract infections, and for preventive care guidelines. The PalmPilot has limitations. It has insufficient memory for large databases. The screen size is small, making reading of extended text difficult. There is a steep learning curve for both students and faculty, but we found it to be relatively short with adequate orientation. Inexpensive, portable, easy to use, PDAs are already used by faculty and many learners for information tracking and time management. With the addition of medical software, they can become quick, basic, medical informatic tools for third-year medical students. Medical students' enthusiasm for the use of the PalmPilot has led us to continue exploring their application in an ambulatory setting. Use for recording student/patient care experiences, local development of clerk-ship-specific PalmPilot material, and a more extensive list of potential Web sites for student reference will be pursued.