Using mobile technologies to give health students access to learning resources in the UK community setting Blackwell Publishing, Ltd.
Graham Walton*, Susan Childs† & Elizabeth Blenkinsopp‡, *Library, Loughborough University, †Information Society Research Community, Northumbria University, Newcastle upon Tyne, ‡Loughborough University, UK
Abstract Objectives: This article describes a project which explored the potential for mobile technologies to give health students in the community access to learning resources. The purpose included the need to identify possible barriers students could face in using mobile technologies. Another focus was to assess the students perceptions of the importance of being able to access learning resources in the community. Methods: This 1-year project used two main approaches for data collection. A review of the literature on mobile technologies in the health context was conducted. This was used in a systematic way to identify key issues and trends. The literature review was used to inform the design and production of a questionnaire. This was distributed to and completed by a group of community health students at Northumbria University, UK. The questionnaire was piloted and there was a 100% completion rate with 49 returned forms. Results: The literature review indicated that most mobile technology applications were occurring in the US. At the time of the review the most prevalent mobile technologies were PDAs, laptops, WAP phones and portable radios with use being concentrated around doctors in the acute sector. A range of advantages and disadvantages to the technology were discovered. Mobile technologies were mainly being used for clinical rather than learning applications. The students showed a low level of awareness of the technology but placed great importance to accessing learning resources from the community. Conclusions: Significant development and changes are taking place in mobile technologies. Since the data collection for this work was completed in 2004 podcasting and videocasting have become significant in mobile learning for health professionals. Librarians will need to address the relevance and implications of m-learning for their practice. Care and consideration needs to be given on the time and resources librarians allocate for the necessary development work around mobile technologies. Collaboration and partnership working will be most effective approach for librarians wishing to integrate their services with m-learning technologies.
Introduction Correspondence: Graham Walton, University Library, Loughborough University, Loughborough LE11 3TU, UK. E-mail:
[email protected]
The purpose of this paper is to explore the potential for mobile technologies to be used in
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accessing learning resources in the community setting. This work was funded by the NHSU and the Northumberland, Tyne and Wear NHS Strategic Heath Authority. Outcomes from a questionnaire with community health students at Northumbria University, UK will be used to explore future issues in the use of mobile technologies to support learning in the health professional and student. The concept has emerged in recent years of mobile-learning to represent learning which occurs where mobile technologies have a central role. In terms of differentiating between e-learning and m-learning some commentators1 see m-learning as being e-learning using mobile devices and wireless transmission. They also see m-learning as allowing learners to move away from the stand-alone computer, to interact with more devices with information being made accessible through a wireless connection to a server. Rapid developments of new technologies are impacting on all aspects of society (including learning), often with very little prior warning of their arrival. The project reviewed published literature up until 2004 but it should be acknowledged that new technologies have been developed in the interim. In terms of m-learning, podcasting has emerged as a major technology with applications in e-learning. Podcasting is a ‘method of publishing audio broadcasts via the Internet, allowing users to subscribe to a feed of new files (usually MP3s)’.2 Any digital audio player or computer audio-playing software can play podcasts. As a development it has had a major impact in 2005 for health professionals and students learning. For example, the USA ABC Radio National has a health section which lists on a daily basis various files which can be downloaded to a mobile device.3 In September 2005 it was possible to freely download audio broadcasts on such diverse areas as the link between stress and breast cancer, exercise and genotype and the benefits and harms of cancer screening. Indeed technology is advancing so quickly that already some commentators4 are indicating that podcasting is old technology and videocasting will replace it. Videocasting allows digital video files to be downloaded to portable devices. The US Department of Health and Human Services has the National Institutes of Health Website which
makes available videocasts.5 The challenge librarians face is how and whether to incorporate these new technologies, when it appears that the only guarantee will be that they will be quickly superseded by something else. Context Health care and the education and training of health professionals have been informed by developments in information and communication technologies (ICT) for a number of years. In the UK, the National Health Services framework for lifelong learning6 is underpinned by an e-learning strategy. E-learning enhances learning by ‘delivering content via the internet, intranet, video, and audioconferencing, E-mail, electronic discussion groups and CD-ROM.7 A further element for health professionals is the importance of Continuing Professional Development (CPD). CPD ensures that health professionals keep updated to meet the needs of patients, the health service and their own professional development. It includes the continuous acquisition of new knowledge, skills and attitudes to enable competent practice.8 The concept of lifelong learning is behind many of these pressures. ICT has been identified by Twigg and Miloff 9 as being important in supporting lifelong learning. Course materials can be offered independently of time and place. There is the increased flexibility of the internet at home, on campus and at work and there is more information on the web, either free or under institutional access agreements. During the 1990s, UK government policy (as in other Western countries) has strategically shifted responsibility and funding for health services from the acute sector towards primary care.10 Practitioners within the community setting have to also undertake their CPD but very often do not have access to the same level of learning opportunities as those in the acute sector. Given the policy agenda in Primary Care there is a pressing need to look to creative uses of technology to overcome these problems. A recent study11 of pre-registration health students showed that 92% attached great importance to having access to learning resources when they were on clinical placement. This work also highlighted issues around equity. Those students in the acute sector had much easier access to both a
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computer connected to the Internet and to physical learning resources than those students located in the community. Further importance to learning resource access can be attributed to the use of problem based learning in the curriculum and the increased emphasis on developing practitioners adept at evidence-based practice.12 The NHSU and the NHS Northumberland, Tyne and Wear Strategic Health Authority funded this study to explore the potential for mobile technologies to give practitioners and students access to learning resources in the community setting. The study took place in 2004 and was conducted by the Information Management Research Institute at Northumbria University. Students need to be able to access information that is delivered by systems that are effective, easy to use, focused on users’ needs and are robust. This project provided an opportunity to evaluate the effectiveness of different technologies. It would have wider significance, as increasingly individuals will expect to be able to learn at a time and place of their choosing. These include fixed locations, such as at a work base, university or home, as well as from non fixed points.
categories created. Appendix 1 details those references used for the review of the literature. This review should be considered within the context that it does not include material published after mid 2004. In a world of rapidly developing technologies, missing areas are present (e.g. podcasting and videocasting). In order to complete an information needs analysis of nurses within the primary care setting a questionnaire was developed (Appendix 2). The questionnaire was structured around the themes identified through undertaking the literature review. It was piloted and some minor changes were made. Research ethics approval was given by the Research Ethics Committee at Northumbria University’s School of Health, Social Work and Education. The student questionnaire was completed by all students on the health visiting/community nursing/school nursing course (49 in total). They completed it at the end of their 12 month course in 2004. The questionnaire was distributed and completed in the classroom. The original intention to have qualified nurses complete this questionnaire had to be jettisoned when problems around distribution became insurmountable. The questionnaire analysis was completed using SPSS.
Methodology A variety of data collection approaches were developed to ensure data were collected on the various aspects. A literature search was undertaken for articles on current research/developments in health care/training and mobile technologies published since 2000 on the following databases: (Cumulative Index to Nursing and Allied Health Literature), (Library and Information Science Abstracts) and (US National Library of Medicine bibliographic database). As a result of this search, 50 articles or reports were located. Each reference was assigned a unique numerical code for traceability and a template was devised in order to record the information. The template headings were as follows: code, publication year, document type, article details, geographical location, product, supplier/manufacturer, user group, applications, advantages/disadvantages, memorable quote, recommendations. An overview of this literature search was then produced, summarizing the reference findings under each of the template
Findings The 50 references identified in the literature review are detailed in Appendix 1. The outcomes from the review show that development and use has primarily been focused in the US (Table 1). It is also apparent that most commonly used mobile technology within the health context is the Personal Digital Assistant (PDA) (Table 2). In terms of the different professional groups that use mobile technologies Table 3 shows that use is concentrated around doctors in the acute sector. Less use is made by other health professionals. It is used to a lesser extent in learning and teaching Table 1 Geographical location of mobile technology use Initiatives based in USA
References (see Appendix 1)
Application of use
2,4 –6,8,10,19–21,27,28,31, 34 –36,43–45,48,49 1–4,8–10,19,24 –41,46
Development of software
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Using mobile technologies to access learning resources, Graham Walton et al. Table 2 Different types of mobile technologies Different type of mobile technology
References (see Appendix 1)
PDAs—personal digital assistants Laptops/compact PCs WAP (wireless application protocol) phones Portable radios Others
2,4–8,10,12,14–16,18–24,27,28,31,34–6,43–45,47–50 14,20,37,44 11,14 5,14 Pagers (44), telehealth applications (18), robots (43), digitally enhanced cordless telephony (13).
Table 3 Different health user groups of mobile technologies Health professional user group
References (see Appendix 1)
Medical staff Nurses and other health professionals Acute sector Community Undergraduate medical students (primarily in the hospital environment) Pre-registration nursing students
2,4–7,9,12,16–19,22,23,28–34,36–38,43–50 5,8,13–15,18,22,24,27,28,30,35,45,50 1,2,4,5,7,13,15–23,25,27–29,33–36,38,39,42–50 3,11,12,14,24,26,27,30,40,41,43,45,46 9,20,23–25,29,32,35,36,38,40,41,44,46 19,20,25,29,39
Table 4 Advantages and disadvantages of mobile technologies References (see Appendix 1) Advantages
Disadvantages
Information at point of care (19) Compact (2,19,22,27,34,37,49), Fast (1,2,7,11,14,22,27,28,33,36,39,45) Portable (3,20,22,28,31,47,49,50) Improved patient care (1,27,48), Better communication (5,28,40) Currency/immediacy of information (3,4,10–12,14,19,39,45–48,50), Reduction in prescribing errors/adverse drug events (2,3,6), Software free/cheap (4,29) and paper saving (17). Security (9,11,14,15,17,19,20,22,23,25,27,36,37,47,49) Confidentiality (9,20,36,46) Support (2,6,7,40) Small screen/keyboard (8,21–23,27,28,39,47,49,50) Battery life (15,17,20,48) Admin/technical costs (2,6,8,13,17,18,40) Interference (5,23) Limited memory (27,28,50) Limited transmission (5), Bandwidth/resolution issues (2) Protocol queries (14) Variable quality software (19,39).
and then more by undergraduate medical students than other student health groups. The potential of mobile technologies to meet the learning resource access needs of community
based nurses is shown in Table 4. The technology is seen to be compact, fast and portable but problems are attached to the levels of security, confidentiality and scalability of the hardware.
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Using mobile technologies to access learning resources, Graham Walton et al. Table 5 Clinical and learning applications of mobile technologies Clinical applications
Learning applications
Administrative functions (2,3,5,6,8,10,18–20,23–26,28,30,33–38,43,48) (scheduling, address book, calendar), Electronic textbooks (2–4,6,9,10,16,19–22,31,35–37,40,47,49), Prescription information (2,3,6,8–11,16,17,20,22–28,28,31,32,36,39,45,49,50) Medical calculators (2,3,4,9,16,20,23,25,34–37,43) E-prescribing (2,3,6,15–17,20,22,23,26–28,32,34,36,43,44,46,47,49) Photography (27,28,34,43,45,49) Internet (2,18–20,23,29,34–39,47,49) Memo (2,3,8,10,20,30,38,43) Integral Tel. (20,49) Medical records (2,16,27,42) Patient tracking (2,3,34,38,46) Other: intranet link (10), patient self-monitoring (10) voicemail (13), handwriting recognition (20,21,24), image capture (28). Internet (e.g. downloading searches) (2,10,15,18,19,22,23,27,33–36,38,39,43,45,47,49) Dictation (6,23,43,44,46,49) Evidence-based medicine tools (e.g. calculators) (25,40) In-house documentation system (track primary care students’ experiences in the community) (40,41) Other: database development (44) general study aid (20) tracking student assignments (8), beaming virtual handouts to a handheld users in a presentation setting (7), student record keeping (8), student evaluation (8) text messaging (23), connection to campus network (20), checklist for new skills, memo pad (students’ notes, used later for evaluation of student) (8), accessing reference materials (19).
Table 6 Barriers to accessing learning resources on placement
Barrier
% that strongly agree
% that agree
Difficulty in visiting the university library in person Difficulty in accessing electronically the university’s resources from clinical placement No access to a workplace library No access to workplace PC No access to Internet on clinical placement
23 26 35 33 31
53 17 16 10 14
There would appear to be currently wider clinical applications for mobile technologies than for learning applications (Table 5). In the clinical setting they are being used for administrative functions, electronic textbooks, prescription information and medical calculators. In terms of learning, the use appears to be concentrated around accessing the Internet, with a range of other experimental applications. The abbreviations used below are: SA = Strongly agree, A = Agree, D = Disagree, SD = Strongly Disagree. There was correlation with the study on health students and learning resources where it was found that they gave a high level of importance to learning resources access.12 These students also felt that access to learning resources whilst on
placement is viewed as very important (84% SA, 14% A). Table 6 indicates the students’ perceptions of the various barriers. Awareness of university facilities and availability of home equipment, however, is good. 78% disagreed or strongly disagreed with the statement about their not being aware of how to access the university’s resources by remote means. 90% disagreed or strongly disagreed that they had no access to a PC with Internet access at home. 75% disagreed or strongly disagreed that they did not use e-mail for studies. Students were also asked about their use of individual resources for their studies. Electronic resources are ranked highly. These could in the future be provided via mobile technologies. Table 7 is a
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Using mobile technologies to access learning resources, Graham Walton et al. Table 7 Ranked list of important learning resources and services
Learning resource
% that strongly agree
% that agree
E-journals Databases Internet Printed journals Study space Books Physical library Help in using learning resources
74 67 67 65 61 55 55 51
26 31 29 33 33 45 37 43
ranked list of important learning resources and resources established from the questionnaire Students were asked about their awareness of facilities provided by the university to access learning resources at a distance. They were also asked to indicate which of these services they had used. (see Table 8) There was a high level of awareness as well as a high level of use of these services. It is interesting to note that students had higher levels of awareness than use. The questionnaire also explored both the students’ awareness of the various mobile technologies and
their levels of use (Table 9). (Note: VAw = Very Aware, Aw = Aware, NS = Not Sure, NAw = Not Aware). Use of mobile technologies is minimal, except for laptops and WAP mobile phones, but even this is not above a third of the respondents. The potential for mobile technologies was examined for training and study purposes and the results are include in Table 10. Regarding students’ views on the use of mobile technologies for training/study purposes the most beneficial aspects of mobile technologies were seen as improved access to information, followed by improved contact with the university. The perceived limitations of mobile technologies were also investigated with the students (Table 11). The need for training was the highest ranked limitation, followed by security issues. Limitations of individual devices caused less concern; however, this should be placed in the context of the low practical experience of the respondents of such technologies. Students were asked how the use of mobile technologies could be improved. The most favoured improvement was access to a PC at work, closely followed by training and technical support. This should be linked to the finding that about a third of respondents do not have access to a workplace PC on clinical placement for their studies.
Table 8 Student awareness levels of university services to enable distance access and levels of use
Distance access service
% of students aware of service
% of students that used service
Access to course materials and documents from any off-campus networked PC Off-campus access to electronic journals Access to university software and my personal files from any off-campus networked PC Off-campus access to databases Web-access to my e-mail box from any off-campus networked PC Posting books and photocopies to my workplace/home
98 94 94 86 78 51
80 88 71 86 61 18
Table 9 Student awareness of mobile technologies and levels of use services to enable distance access and levels of use
Mobile technology
% of students not aware of service
% of students not sure of technology
% of students that used technology
Lap top/notebook WAP mobile phone Two-way pager Two-way radio Personal Digital Assistant Tablet PC
43 59 68 74 81 86
8 15 13 11 11 10
33 18 0 0 2 2
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Using mobile technologies to access learning resources, Graham Walton et al. Table 10 Students views on the use of mobile technologies for learning and training Application of the mobile technology for learning and teaching
% of students that strongly agree application is valuable
% of students that agree application is valuable
Providing current information Improving ability to study Providing immediate access to information Providing increased contact with place of study Increasing contact with lecturers increasing contact with other students Increasing contact with clinical supervisors
45 39 39 35 28 25 18
48 59 54 60 57 63 42
Table 11 Students views on the limitations of mobile technologies for learning and training Limitation of the mobile technology for learning and teaching
% of students that strongly agree
% of students that agree
Need for training Electronic security Physical security Concerns over confidentiality Poor ability to connect to networks Slow data exchange with networks Device interfering with other electronic equipment PDAs—small keyboard PDAs—usability of keyboard PDAs—limited memory PDAs—small screen PDAs—limited battery life Laptops—need to carry around extra equipment Laptops—heavy weight of device Laptops—poor portability of device
46 42 40 38 30 21 21 21 19 16 16 15 15 11 8
48 58 56 58 57 58 48 46 54 63 55 67 50 33 42
Discussion A feature of this project has been the variety and range of data collected. This has enabled new perspectives to be developed on the interface between hardware, software and learning processes for those involved in delivering health care. It is useful to reflect on how the questionnaire illustrates the nature of the students’ learning. Great importance is attached to access to the library and to learning resources when they are on placement. They have a high level of awareness of the range of resources and services available to them. The questionnaire results also show that the students make high use of electronic services and a low level use of such services as postal delivery of books and journals. At the same time there are significant barriers to them gaining effective access to learning resources when in the community. Physically visiting the Library is difficult and there are problems in
limited availability of networked computers. All these findings would indicate that they would benefit from some technology that they can easily use to use such sources as database, e-journals and the Internet. At a theoretical level, mobile technologies such as PDAs are ideal for meeting these needs. When considering the mobile technology literature and product development, significant trends also emerge. Mobile technology (like many other ICT areas) is very turbulent, showing rapid and major developments. These include increased integration of applications into a single mobile unit, wider availability of wireless technology and the removal of connectivity problems. It would appear that most development work is taking place in the US. Within the health sector, most applications are for the clinical applications. Where mobile technologies are being used in the education and training setting they are primarily for medical students.
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The questionnaire results show that at the time of the survey, students had both a low level of awareness of mobile technologies and a low level of ownership. Their expectation was that the mobile technology should give them the same level of access as a computer on the University campus. They had a pressing need to be able to access databases/e-journals and other source material off campus. Training was seen as very important if they were to be effective in using such technologies. The outcomes of this study pose some real challenges for the health librarian. At one level there are significant groups of health students and clinicians who would benefit from library and information services being delivered via mobile technologies. There would have to be major development work to enable easy and effective access to these services via the technology. At the same time there has to be a sense of reality that many of these possible users are not aware of the technology or do not have access to the hardware. In these times of financial constraints, it is questionable whether librarians can justify the work in supplying mobile technology specific services when the level of uptake is likely to be low. An understanding of the principles of innovation and diffusion13 of new ideas and practices will help the librarian decide when and when not to invest valuable development time and money. Conclusion Mobile technologies are not yet in a position to be significant in allowing nursing students remote access to learning resources. The reasons for this are varied and include low level of student awareness, limited relevance of software and limitations in the hardware. At the same time, the technology has great potential to meet the needs of these students. They attach importance to remote access to learning resources and are already make high level use of electronic learning resources. A greater understanding needs to be developed around how and when these students access learning resources when they are on placement. This intelligence will allow the use of the technology to be developed in the best way to meet their needs. M-learning undoubtedly will be supported by health library and information services. This area of learning does present an example of where collaborative
practice and project work is necessary. There are various other groups who will perceive m-learning development as part of their role including learning technologists, academics and IT specialists. None of these groups can independently carry out all the necessary actions to deliver m-learning. The responsibility lies with these groups and the health librarian to establish effective co-operative practices so that the health m-learner can learn as easily as possible. Key Messages Implications for Policy • New learning technologies will emerge where the librarian will have to decide whether they need incorporating in services. • There will continue to be a variable uptake of e-learning technologies within the difference health professional groupings. • Health professionals and students need access to learning resources in the community. Significant barriers exist include physical access to material as well as access to a computer. Implications for Practice • Librarians have a crucial training role with health professionals and students in the community as they begin to use new electronic learning resources. • Health professionals and students attach great value to e-journals and electronic databases because of their isolation from physical libraries. References 1 Hoppe, H. U., Joiner, R., Milrad, M. & Sharples, M. Guest editorial: wireless and mobile technologies in education, Journal of Computer Assisted Learning 2002, 19, 255–259. 2 Wikipedia. Podcasting. 2005. Available at: http://en.wikipedia.org/wiki/Podcasting 3 ABC Radio National. The Health Report. Available at: http://www.abc.net.au/rn/talks/8.30/helthrpt/ 4 Anon. Is Video-Casting The Next Big Thing? Move Over Podcasting. Available at: http://www.masternewmedia.org/ news/2005/02/18/is_videocasting_the_next_big.htm 5 National Institutes of Health. Video sessions Available at: http://videocast.nih.gov/ 6 Department of Health. Working Together—Learning Together: a framework for lifelong learning in the NHS. London: Department of Health, 2001. Available at: www.doh.gov.uk/lifelonglearning
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Appendix 1. References used for the review of the literature 1. Rothschild, J., Lee, T. H., Bae, T. and Bates, D. W. Clinician use of a palmtop drug reference guide. Journal of the American Medical Informatics Association, 2002, 9, 223–229. 2. Fischer, S., Stewart, T. E., Mehta, S., Wax, R. and Lapinsky, S. E. (2003). Handheld computing in medicine 2003 Journal of the American Medical Informatics Association, 10, 139–149. 3. Criswell, D. F. and Parchman, M. L. Handheld computer use in U.S. family practice residency programs 2002 Journal of the American Medical Informatics Association, 9, 80–86. 4. Lewis, M. Evidence-based-medicine tools for your palm-top computer 2003 Family practice management, 10, 73–74, 78–79. 5. Quittenton, A. Improving productivity through the use of portable radios 2002 Orthopaedic Nursing, 21, 67–72.
6. Porn, L. M. and Patrick, K. Mobile computing acceptance grows as applications evolve 2002 Healthcare Financial Management, 56, 66–68, 70. 7. Topps, D. Virtual handouts for handheld computers 2002 Medical Education, 36, 1101. 8. Lehman, K. Clinical instructors’ use of handheld computers for student recordkeeping and evaluation 2003 Journal of Nurse Education, 42, 41–42. 9. Nesbitt, T. S. Equipping primary care physicians for the digital age 2002 Western Journal of Medicine, 176, 116–120. 10. Suszka-Hilbrandt, S. Handheld computing: the next technology frontier for school nurses, 2001 Journal of School Nursing, 17, 98–102. 11. Brazier, D., Campbell, J. and Irving, M. M-care —mobile access to primary care patient information at the point of care 2001, 18, 23–25. 12. Top Drawer Handyvaid brings Ayurveda to the masses 2003 CIN: Computers, Informatics, Nursing, 21, 68–69. 13. Burkill, G. Outwardly mobile 2000 Health Service Journal, 110 Special Report 16 Mar: 4–5. 14. Dudman J. Health service in our hands 2000 Health Service Journal 110 Supplement Oct 26, 4–5. 15. Kitney, R. Increasing mobility and improving decision-making with wireless technology 2002 British Journal of Healthcare Computing and Information Management, 19, 31–32. 16. Ostergarard, P. Bluetooth: connecting the mobile workforce 2002 British Journal of Healthcare Computing and Information Management, 19, 58–59. 17. Paul, R., Curtis, C. and Paul, P. The future’s bright, the future’s mobile 2001 British Journal of Healthcare Computing and Information Management, 18, 26–27. 18. Fairclough, J. New methods of delivering information to patients and clinicians held 9 June 2003 at the British Library, London. CILIP 2003 Health Libraries Group Newsletter, 20, 16–17. 19. Rios, G. R. Technology and e-health advancements 2004 Reference Services Review, 32, 16– 20. 20. Smith, T. Personal digital assistants (PDAs) in further and higher education 2003 TechLearn Briefing, 1–15.
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21. Malter, D. E. and Davis, T. J. Data collection and ‘real-time’ learning using handheld computers 2003 Applied Occupational and Environmental Hygiene, 18, 321–330. 22. Peterson, M. F. Adapting a hospital library service for wireless delivery. 2001 Online Information Proceedings, 4–6 Dec, 163–167. 23. Waegemann, C. P. and Tessier, C. Documentation goes wireless: a look at mobile healthcare computing devices 2002 Journal of AHIMA, 73, 36–39. 24. Rao, G. Introduction of handheld computing to a family practice residency program 2002 Journal of the American Board of Family Practice, 15. 25. Stoddard, M. J. Handhelds in the health sciences library 2001 Medical Reference Services Quarterly, 20, 75–82. 26. Stevens, L. A year of slow but steady progress for the Internet 2001. Medicine on the Net, 7, 1–4. 27. Stevens, L. PDA-ville Medicine on the Net 2002, 8, 1–6. 28. Adams, E. J. Popular PDAs 2003 Medicine on the Net, 9, 1–5. 29. Crowell, K. and Shaw-Kokot, J. Extending the hand of knowledge: promoting mobile technologies 2003 Medical Reference Services Quarterly, 22, 1–9. 30. Morgen, E. B. Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library 2003 Medical Reference Services Quarterly, 22, 11–19. 31. Beattie, J. W. Web-based PDA downloads for clinical practice guidelines and decision support tools 2003 Medical Reference Services Quarterly, 22, 57–64. 32. Usatine, R. Teaching and practicing medicine with handheld computers 2002. Family Medicine, 34, 719–720. 33. d’Hemecourt, P. Assistance in the palm of your hand. 2001 Healthcare Informatics, 18, 102–103. 34. Fowler, D. R., Stolworthy, Y. and Thomas, C. J. Issues in clinical trials management. Using PDAs to enhance clinical research site operations 2003. Research Practitioner, 4, 144–149. 35. Beasley, B. W. Utility of palmtop computers in a residency program: a pilot study. 2002 Southern Medical Journal, 95, 207–211.
36. Torre, D. M. Clinical and educational uses of handheld computers 2003. Southern Medical Journal, 96, 996–999. 37. McGowan, J. and Sidlofsky, M. Medical and health applications for PDAs. 2002 Bibliotheca Medica Canadiana, 23, 128–130. 38. Smith, R. Adapting a new technology to the academic medical library: personal digital assistants 2002 Journal of the Medical Library Association, 90, 93–94. 39. Scordo, K. A. and Yeager, S. Use of personal digital assistants with acute care nurse practitioner students 2003 AACN Clinical Issues, 14, 350–362. 40. Pipas, C. F. et al. Development of a handheld computer documentation system to enhance integrated primary care clerkship 2002 Academic Medicine, 77, 600–609. 41. Carney, P. A. et al. An analysis of students’ clinical experiences in an integrated primary care clerkship 2002 Academic Medicine, 77, 681–687. 42. Zytkowski, M. E. Nursing informatics: the key to unlocking contemporary nursing practice 2003. AACN Clinical Issues, 14, 271–281. 43. Newbold, S. K. New uses for wireless technology 2003 Nursing Management IT Solutions, 22–23, 32. 44. Moore, M. E., Shaw-Kokot, J. and Garrison, J. A. Informatics education: mobile technology forums. 2002 Medical Reference Services Quarterly, 21, 75–79. 45. Tachakra, S. et al. Mobile e-health: the unwired evolution of telemedicine. 2003 Telemedicine Journal and e-Health, 9, 247–257. 46. Whitsed, N. Learning and teaching. 2003 Health Information and Libraries Journal, 20, 119–123. 47. Peterson, M. Library service delivery via hand-held computers—the right information at the point of care. 2004 Health Information and Libraries Journal, 21, 52–56. 48. McAlearney, A. S., Schweikhart, S. B. and Medow, M. A. Doctors’ experience with handheld computers in clinical practice: qualitative study. 2004 British Medical Journal, 328, 1162–1166. 49. Al-Ubaydli, M. Handheld computers 2004. British Medical Journal, 328, 1181–1184. 50. Ovid Technologies Survey on handheld computers, Ovid 2004.
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Appendix 2. Questionnaire Mobile Technologies: remote access to the knowledge base and learning resources by nurses and nursing students in the community: phase 1: issues, applications and developments Questionnaire Survey 1. Your organisation details Please tick one category ONLY
GP Practice Community health centre HE institution FE institution Other ( please specify)
2. Your professional details Please tick one category ONLY
Nursing student Practice nurse Community nurse Community psychiatric nurse Other ( please specify)
3. Your study details Please tick ALL that apply
I’m studying for my first professional qualification, e.g. B.Sc. Nursing I’m studying for my continuing professional development (CPD) I’m studying full time I’m studying part time I am currently not studying
4. Access to learning resources—your views on the findings from the HENSAL project Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement
Access to learning resources whilst on placement is important to me Distance access to the university’s learning resources is important for my studies I have difficulty in visiting the university’s Learning Resources Centre/Library in person I am not aware of how to access the university’s learning resources by distance means
I strongly I agree I disagree I strongly agree disagree
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I have difficulty in accessing electronically the university’s learning resources from my workplace I do not have access to a workplace library for my studies I do not have access to a workplace PC for my studies I do not have access to the Internet at work for my studies I do not use e-mail for my studies
5. Use of individual resources for your studies- your views on the findings from the HENSAL project Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement I strongly agree Access to books is important to me Access to printed journals is important to me Access to electronic journals is important to me Access to databases is important to me Access to the Internet is important to me Access to study space is important to me Access to help in using learning resources is important to me
I agree I disagree I strongly disagree
6. Awareness of facilities provided by your university to access learning resources at a distance Please tick ALL that you are aware of Posting books and photocopies to my workplace/home Off-campus access to databases Off-campus access to electronic journals Access to course materials and documents from any off-campus networked PC e.g. Blackboard Access to university software and my personal files from any off-campus networked PC e.g. Desktop anywhere Web-access to my e-mail box from any off-campus networked PC Loan of lap tops Other (please specify)
7. Use of facilities provided by your university to access learning resources at a distance Please tick ALL that you have used for your studies Posting books and photocopies to my workplace/home Off-campus access to databases Off-campus access to electronic journals Access to course materials and documents from any off-campus networked PC e.g. Blackboard Access to university software and my personal files from any off-campus networked PC e.g. Desktop anywhere Web-access to my e-mail box from any off-campus networked PC Loan of lap tops Other (please specify)
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8. Are you aware of the mobile technologies named? Please tick ONE of the four options ‘Very aware’, ‘Aware’, ‘Not sure’, ‘Not aware’ for EACH of the mobile technologies named below Personal digital assistant (PDA) Tablet PC Two-way radio WAP mobile phone (wireless application protocol) Lap top/notebook Two-way pager Other ( please specify)
Very aware
Aware
Not sure
Not aware
9. Do you currently use any form of mobile technology? Please tick ALL that apply
Personal digital assistant (PDA) Two-way radio WAP mobile phone (wireless application protocol) Lap top/notebook Two-way pager Other ( please specify)
10. Do you currently own any form of mobile technology? Please tick ALL that apply
Personal digital assistant (PDA) Two-way radio WAP mobile phone (wireless application protocol) Lap top/notebook Two-way pager Other (please specify)
11. Your views on the use of mobile technologies for training/study purposes Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement
It gives me current information It provides me with increased contact with my place of study It increases my contact with other students It increases my contact with my lecturers It increases my contact with my clinical supervisors
I strongly agree
I agree I disagree I strongly disagree
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It gives me immediate access to information It improves my ability to study Any other views ( please specify)
12. What applications would you like to use through mobile technologies? Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement I strongly agree Word processing Calendar Internet access Mobile phone Database access Intranet access Docking to PC Electronic textbooks Any other applications ( please specify)
I agree
I disagree
I strongly agree
13. Your views on the limitations of mobile technologies Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement I strongly agree Need for training to use device Physical security e.g. loss of device Electronic security e.g. unauthorized taping into device Concerns over confidentiality of personal information Poor ability to connect to networks Slow data exchange with networks Device interferes with other electronic equipment Laptops—heavy weight of device Laptops—poor portability of device Laptops—need to carry around extra equipment e.g. mouse and power supply Personal digital assistants—small screen Personal digital assistants—small keyboard Personal digital assistants—usability of keyboard Personal digital assistants—limited memory Personal digital assistants—limited battery life Any other limitations ( please specify)
I agree I disagree I strongly agree
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14. Your views on how to improve the use of mobile technologies Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement
If I had training on how to use mobile technologies effectively If I had access to a PC at work, to exchange data between the PC and the device If I had a PC at home, to exchange data between the PC and the device If I received technical support to use mobile technologies Any other improvements ( please specify)
I strongly agree
I agree
I disagree
I strongly disagree
15. Briefly, do you have any other comments about mobile technologies?
16. Your views on other methods to support the ‘mobile student’ Please tick ONE of the four options ‘I strongly agree’, ‘I agree’, ‘I disagree’, ‘I strongly disagree’ for EACH statement
Posting books and photocopies to my workplace/home Off-campus access to databases Off-campus access to electronic journals Access to course materials and documents from any off-campus networked PC e.g. Blackboard Access to university software and my personal files from any off-campus networked PC e.g. Desktop anywhere Web-access to my e-mail box from any off-campus networked PC Any other methods ( please specify)
I strongly agree
I agree I disagree I strongly disagree
17. Any other comments ( please specify)
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