PITCH: A systematic review of smart device technology in medical education.

Problem

Smart device technology (SDT) has rapidly grown over the past decade, allowing users to run applications (apps) that enable its utilisation as a tool in medical education. Findings of studies investigating the role(s) of SDT in undergraduate (UG) medical education are conflicting. We conducted a systematic review to evaluate the role(s) and utility of SDT as a tool for delivering medical education.

Approach

Systematic review of SDT as a tool for delivering UG medical education. Medline, Psych info, ERIC, EMBASE, CINHAL, BEI, ASSIA were searched for English-language articles until the 5th August 2016. Studies were included if they investigated SDT and/or apps to support learning and/or assessment in UG medical education and reported outcomes evaluating SDT implementation. Two reviewers selected studies and extracted data (study characteristics, SDT used, comparator and outcomes for SDT to improve knowledge, skills and/or attitudes). Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Findings were narratively synthesised.

Findings

Searches identified 1,329 studies of which 111 were reviewed in full. 19 studies (three RCTs; 16 cohort studies) were included in final analyses. Study quality was high for most (n=15) studies. 10 studies reported outcomes for knowledge acquisition from SDT (all cohort studies); 16 studies reported attitudinal outcomes from using SDT (2 RCTs, 14 cohort studies); 6 studies reported outcomes for clinical skills acquisition from SDT (2 RCTs, 4 cohort studies).

Most studies found positive attitudinal findings that supported the implementation of SDT within UG medical education; good access to resources, ease of use and greater confidence were common reported themes. However, internet connectivity, appropriateness of using SDT in clinical environments and loss of interaction with educators were cited as negative aspects of using SDT. Findings suggest SDT may improve clinical skills acquisition and improve the frequency of skills assessments undertaken but few studies had control groups to enable meaningful comparisons to usual practice to be made. The findings from studies of knowledge acquisition from SDT were conflicting.

Consequences

The preponderance of evidence suggests SDT is well received by students in UG medical education, providing easier access to and utilisation of medical information. There is some evidence suggesting SDT could be used to facilitate clinical skills acquisition. However, there were conflicting findings from this review about the utility of SDT as a tool to improve knowledge acquisition within the UG medical curriculum.

With the rapidly evolving market of SDT, medical schools could use this technology to improve engagement of students with the UG medical curriculum. However, further research is needed to investigate the role and effectiveness of SDT as a tool to improve knowledge and clinical skills acquisition in UG medical education. With an expanding primary care curriculum SDT may have important role in delivering this.