Pulse
The iPad Project
Will the iPad be the next learning tool for medical students?
By Kim Kiser
Jake Wagner is studying neuroanatomy. Rather than reading a textbook or looking at a PowerPoint slide, he is using an iPad to turn an electronic image of the spinothalamic tract of the midbrain into a flash card with “pins” pointing out different parts and a list of questions he can use to quiz himself. Creating the flash card is a learning experience in itself, and once he’s finished with it, Wagner will review it while riding the bus to and from school. “I can go through this two or three times and have it memorized,” he says.
As a member of the first-year class at the University of Minnesota Medical School’s Duluth campus, Wagner is taking part in a study of how the iPad, Apple’s tablet that combines the functionality of a smartphone with the resolution of a laptop computer, can be used as a learning tool. The project was the idea of Jim Boulger, Ph.D., a professor of family medicine and community health and behavioral sciences, and a self-confessed Apple enthusiast.
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In addition to the University of Minnesota Duluth, Stanford Medical School and University of California Irvine School of Medicine require their first-year students to have iPads.
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Following the introduction of the iPad last year, Boulger started thinking about how it could be used for learning and for medical practice, and saw potential. “As an information holding and gathering device, there couldn’t be anything simpler,” he says. And with more than 65,000 apps now available, “it shows how quickly it’s catching on.” Boulger and Ruth Westra, D.O., M.P.H., who chairs the department of family medicine and community health on the Duluth campus, had received a $2.3 million Health Resources and Services Administration grant to fund efforts to increase the use of electronic learning in the medical school curriculum. They decided to use money from the grant to provide all 62 first-year students and faculty members with iPads. (This year’s class is the first of five to receive iPads.)
The idea is for faculty and students to experiment with how they can use the device for teaching and learning. “Rather than having students rely on textbooks, lectures, and PowerPoints, we’re trying to give them a tool that will engage them and give them immediate hands-on reinforcement,” Westra says.
Top Apps for Medical Students
The following are apps the first-year University of Minnesota Duluth medical students have found especially useful thus far:
Hello Baby – pregnancy calendar and neonatal development resource (free)
Epocrates – mobile drug reference (free)
Shots 2010 – the immunization schedule for children and adults (free)
Physical Exam Essentials HD – overview of patient physical exam ($2.99)
Medscape – medical news digest, drug reference database, interaction checker, and more (free)
MediMath Medical Calculator – 135 medical calculators and scoring tools ($4.99)
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Currently, students are able to download portions of courses or electronic learning modules onto the iPad. Those studying histology, for example, can view electronic slides on the screen, rather than in the lab. “The resolution is much better than with a microscope, and you can blow it up in terms of size and not lose detail,” says Boulger.
Students are also encouraged to try out different medical apps. One of the goals, Boulger says, is for the students to develop a list of their favorites. “We are trying to find the best ones that are free,” he says.
Boulger and Westra will survey students at the end of the year to find out how they are using the iPads. “This is an iterative process,” Boulger says For Wagner, whose iPad is his to keep, the device has become his primary tool for studying anatomy. (He considers it an adjunct to his laptop, which he prefers for looking up information because it’s faster.) In addition to creating his own flash cards, he purchased the Netter’s Anatomy Flash Cards app (it was $40, he says, but has been “worth its weight in gold.”) “At first, I was struggling,” he says, explaining that he found the old ways of studying to not be as effective. Having the iPad “saves me a lot of time and mental duress. I’m lucky to have it.”
New Role for Old Technology
A reliable old technology, ultrasonography, appears to be making a comeback. Used in radiology, cardiology, and obstetrics for decades, ultrasound is now being performed and interpreted by clinicians at the bedside, thanks to smaller devices (even handheld ones) that generate high-resolution images.
A recent New England Journal of Medicine article points out that ultrasound is now being used to ensure accuracy in placement of central lines; thoracentesis, paracentesis, and arthrocentesis; regional anesthesia; incising and draining abscesses; and lumbar puncture and biopsies. It’s used to help diagnose patients with hypotension, chest pain, and dyspnea. And using an approach known as FAST (focused assessment with sonography for trauma), it can pinpoint hemorrhage quickly in trauma patients, including those with suspected stroke.
With the increased availability of handheld devices, usage is expected to increase. Some predict that handheld devices will be the stethoscope of the future. Medical schools have begun to provide their students with portable ultrasound equipment to use during rotations. Mayo Medical School and the University of Minnesota Medical School, Duluth, are among those experimenting with handheld devices.
Sources: Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med 2011;364:749-57; Wittich CM, Montgomery SC, Neben MA, et al. Teaching cardiovascular anatomy to medical students by using a handheld ultrasound device. JAMA. 2002;288(9):1062-3.