iPad Application Research Articles

Enhancing Reading Comprehension with Student-Centered iPad Applications

Reading comprehension, or understanding the author’s message, is a critical component of teaching literacy (Hougen and Smartt 2012). Student-centered activities using the iPad with the goal of improving reading comprehension in a fifth-grade classroom were implemented for this action research study. University teacher candidates guided fifth-grade students in completing the iPad reading comprehension activities. Findings indicate that the fifth-grade students increased their reading achievement scores to a statistically significant degree during the period of this study. These students also reported more enjoyment and understanding of reading. The university teacher candidates who participated also expressed that they gained valuable experience as they worked on a technology-enhanced learning experience with actual students. This study suggests that student-centered reading comprehension activities on the iPad can lead to better student achievement in reading comprehension.

Multilingual and multimodal composition at school: ScribJab in action

ABSTRACTIn this article, we explain how recent research on multilingualism, multilingual education, and multimodality informs our thinking about the use of ScribJab, a multilingual iPad application and website (ScribJab.com), which enables users to compose, illustrate, and narrate stories in two languages. Drawing on excerpts from ethnographic observations in two schools, we recount how students and teachers took up ScribJab and illustrate how the tool's design was linked with and contradicted teachers' and schools’ stated and enacted language policies, ideas about assessment, and understandings of multimodality. We conclude by arguing that the ecology of the classrooms was materially altered by ScribJab and further changes are required to make multilingual pedagogies, multimodal composition, and their assessment more commonplace in schools. We propose that future work on multilingual and multimodal education may need to consider more than the human aspects of classroom life.

Effect of In-water SCUBA Diving Activities on Response Time in Recreational Divers

The purpose of this study was to examine the relationship between the performance of in-water scuba diving training activities and simple motor response time. Twenty-four students enrolled in a scuba course had their motor response times measured before and after a one hour training session. Pre- and post-dive response times were measured using an iPad application. Additionally, students were asked to complete a dive history questionnaire to determine their diving experience and health history. Statistical analysis indicated a significant training effect on response time in the recreational scuba divers F (1.00, 23.00) p =.033. The results of this study suggest that basic in-water scuba training activities may improve one's ability to elicit quicker movement responses and lead to faster cognitive processing.

A Parent-Implemented, Technology-Mediated Approach to Increasing Self-Management Homework Skills in Middle School Students with Autism

ABSTRACTStudents with Autism Spectrum Disorder (ASD) in secondary school settings (i.e., grades 6-12) typically struggle with multiple academic challenges. Critics have noted that secondary schools traditionally have not been particularly effective in helping students with ASD develop self-determination (e.g., self-management) skills, which are considered pre-requisites to success in academics. Thus, there is a significant need for increased parent-professional collaboration in secondary schools. This study examined the effectiveness of coaching parents to implement a technology-mediated (e.g., iPad) approach to increasing the homework-related self-management skills for mathematics of five middle school students with ASD. Results indicate that these five students significantly increased their math homework self-management skills as a consequence of effectively using iPad applications when coached by their parents.

Midclerkship feedback in the surgical clerkship: the “Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills” application utilizing learner self-assessment

BackgroundThe Liaison Committee on Medical Education requires midclerkship formative (low stakes) feedback to students regarding their clinical skills. Student self-assessment is not commonly incorporated into this evaluation. We sought to determine the feasibility of collecting and comparing student self-assessment with that of their preceptors using an iPad application. These student self-ratings and preceptor ratings are jointly created and reviewed as part of a face-to-face midclerkship feedback session. MethodsUsing our iPad application for Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills (“PRIMES”), students answer 6 questions based on their self-assessment of performance at midclerkship. Each skill is rated on a 3-point scale (beginning, competent, and strong) with specific behavioral anchors. The faculty preceptors then complete the same PRIMES form during the face-to-face meeting. The application displays a comparison of the 2 sets of ratings, facilitating a discussion to determine individualized learning objectives for the second half of the clerkship. ResultsA total of 209 student–preceptor pairs completed PRIMES ratings. On average, student–preceptor ratings were in agreement for 38% of the time. Agreement between students and preceptors was highest for Professionalism (70%) and lowest for Procedural Skills (22%). On average, 60% of student–preceptor ratings did not agree. Students rated themselves lower than preceptors 52% of the time, while only 8% of students rated themselves higher than their preceptors' ratings (this difference is significant at the P value <.05 level). ConclusionsThis study demonstrates the value of using the PRIMES framework to incorporate surgery clerkship students' self-assessment into formative face-to-face midclerkship feedback sessions with their preceptors with the goal to improve performance during the second half of the clerkship.

Employing mobile technology to improve language skills of young students with language-based disabilities

ABSTRACTThis exploratory study investigated the effects of a language building iPad application on the language skills (i.e., receptive vocabulary, expressive vocabulary, and sentence formation) of young students with language-based disabilities. The study utilized a pre-test–post-test control group design. Students in the treatment group used the iPad language building application, Language Builder, for 30 minutes a day. Participants were 31 first-grade to third-grade students with identified language-based disabilities. Students were assigned to two groups for the 8-week intervention. Data indicated that students in the treatment group made significantly greater gains in the area of sentence formation than the control group. Results revealed no significant difference between the two groups in the areas of expressive and receptive vocabulary. A short intervention of using Language Builder via the iPad may increase the sentence formation skills of young students with language delays. Additionally, discussion regarding the usefulness of iPad applications in education is presented.

Plastic surgery telehealth consultation expedites Emergency Department treatment

Plastic surgery is a field that is particularly amenable to a telehealth milieu, as visual exam and radiographs guide proper diagnosis and management. The goals of this study were to evaluate telehealth feedback executed through an iPad app for plastic surgery-related consultations. A Quality Assurance/Quality Improvement (QA/QI) study was conducted over a 1-month period during which patients with hand injuries, facial injuries, or acute wounds presenting to the Emergency Department (ED) of a level-one trauma centre and university hospital were monitored. The study utilized a commercial iPad application through which up to four images and a brief history could be sent to a remote Plastic Surgery Educator (PSE) for evaluation. The PSE would respond with best practice information, references and videos to assist ED point-of-care providers. During the 1-month period of this study, there were 42 ED consultations for plastic surgical conditions. There was a highly significant difference in overall mean response time between consultants and PSEs (48.3 minutes vs. 8.9 minutes respectively, p < 0.001). The agreement between PSEs and consultants regarding patient assessment and care was 85.7% for in-person consultations and 100% for phone consultations. In four cases of telephone consultations, the ED providers placed splints incorrectly on hand-injured patients. Our results show that telehealth consultations to a remote plastic surgeon based on digital images and a brief history were able to produce timely and accurate responses in an emergency care facility. This design may have significant impact in rural areas, underserved populations, or regions abroad.

Effectiveness of iPad apps on visual-motor skills among children with special needs between 4y0m–7y11m

Aims: The aim of this randomized controlled trial was to assess the effectiveness of interventions using iPad applications compared to traditional occupational therapy on visual-motor integration (VMI) in school-aged children with poor VMI skills.Methods: Twenty children aged 4y0m to 7y11m with poor VMI skills were randomly assigned to the experimental group (interventions using iPad apps targeting VMI skills) or control group (traditional occupational therapy intervention sessions targeting VMI skills). The intervention phase consisted of two 40-min sessions per week, over a period of 10 weeks. Participants were required to attend a minimum of 8 and a maximum of 12 sessions. The subjects were tested using the Beery-VMI and the visual-motor subscale of the M-FUN, at baseline and follow-up.Results: Results from a 2-way mixed design ANOVA yielded significant results for the main effect of time for the M-FUN total raw score, as well as in the subscales Amazing Mazes, Hidden Forks, Go Fishing and VM Behavior. However, gains did not differ between intervention types over time. No significant results were found for the Beery-VMI.Conclusions: This study supports the need for further research into the use of iPads for the development of VMI skills in the pediatric population.Implications for RehabilitationThis is the first study to look at the use of iPads with school-aged children with poor visual-motor skills.There is limited literature related to the use of iPads in pediatric occupational therapy, while they are increasingly being used in practice.When compared to the traditional occupational therapy interventions, participants in the iPad intervention appeared to be more interested, engaged and motivated to participate in the therapy sessions.Using iPad apps as an adjunct to therapy in intervention could be effective in improving VMI skills over time.

Knitting Patterns

Large software conglomerates like Trimble and Autodesk provide consumers with suites of software that perform many functions within the design and construction process. Communicating with software outside of the suite can be highly problematic as file types and communication protocols are proprietary and closed within that software family - the antithesis of interoperability). This is in stark contrast with emerging trends in consumer computing, where we find a rich ecosystem of devices and services facilitating a period of intense innovation. This paper documents original research that aims to implement communication beyond specific software suites and test, to what extent, wider software ecosystems revolving around open standards might be implemented within the design and construction domain. Our first test case—an agent-based dynamic simulation combining natural and built environmental components—is deployed to explore the city as a multitude of interrelated natural and built patterns. We analyze the role this simulation might play in managing the complexities of rebuilding a sustainable urban environment after the devastating earthquake in Christchurch, New Zealand. The second test case deploys an iPad application to communicate with a BIM model - exploring the development of a mobile application and methodology for openly communicating outside of the intended software family. Through these case studies we begin to identify ways to leverage emergent device and data ecosystems and representations for ‘knitting' devices and services together in innovative ways to advance design and construction processes.

Visual acuity and contrast sensitivity screening with a new iPad application

We present a new iPad application (app) for a fast assessment of Visual Acuity (VA) and Contrast Sensitivity (CS) whose reliability and agreement was evaluated versus a commercial screening device (Optec 6500). The measurement of VA was programmed in the app in accordance with the Amblyopia Treatment Study protocol. The CS was measured with sinusoidal gratings of four different spatial frequencies: 3, 6, 12 and 18cpd at the same contrast values of the Functional Acuity Contrast Test (FACT) included in the Optec 6500. Forty-five healthy subjects with monocular corrected visual acuities better than 0.2 logMAR participated in the agreement study. Bland-Altman analyses were performed to assess the agreement and Deming regressions to calculate Mean Differences (MDs) and Limits of Agreement (LoAs). Coefficients of reliability were 0.15 logMAR for our method and 0.17 logMAR for the ETDRS testing protocol. For testing the CS, our test showed no statistically significant differences compared with the FACT at any spatial frequency (p>0.05). The MDs were lower than 0.05 log units for all spatial frequencies.

A Single-Subject Study of a Technology-Based Self-Monitoring Intervention

Students with ADHD often struggle with self-regulation skills. One strategy demonstrating considerable success in helping these students regulate their behavior is self-monitoring. Although there is an abundance of research on self-monitoring, research on the use of technology for self-monitoring is only beginning to emerge. The primary goal of this single-subject study was to examine the effects of an iPad application (SCORE IT) for self-monitoring on the behavior of three fifth-grade students with or at risk for ADHD who were exhibiting low rates of academic engagement in a general education environment. A secondary goal was to gain an in-depth understanding of the teacher’s perceptions of the feasibility and value of the intervention. Overall, the SCORE IT intervention resulted in substantial improvements in academic engagement, and teacher perceptions of the feasibility and worth of the intervention were reported as highly favorable. Limitations and future directions for research are discussed.

Electronic physiologic and subjective data acquisition in home-dwelling heart failure patients: An assessment of patient use and perception of usability

BackgroundThe current approach to the outpatient management of heart failure involves patients recollecting what has happened to them since their last clinic visit. But patients’ recollection of their symptoms may not be sufficiently accurate to optimally manage their disease. Most of what is known about heart failure is related to patients’ diurnal symptoms and activities. Some mobile electronic technologies can operate continuously to collect data from the time patients go to bed until they get up in the morning. We were therefore interested to evaluate if patients would use a system of selected patient-facing devices to collect physiologic and subjective state data in and around the patients’ period of sleep, and if there were differences in device use and perceptions of usability at the device level MethodsThis descriptive observational study of home-dwelling patients with heart failure, between 21 and 90 years of age, enrolled in an outpatient heart failure clinic was conducted between December 2014 and June 2015. Patients received five devices, namely, body weight scale, blood pressure device, an iPad-based subjective states assessment, pulse oximeter, and actigraph, to collect their physiologic (body weight, blood pressure, heart rate, blood oxygen saturation, and physical activity) and subjective state data (symptoms and subjective states) at home for the next six consecutive nights. Use was defined as the ratio of observed use over expected use, where 1.0 is observed equals expected. Usability was determined by the overall System Usability Scale score. ResultsParticipants were 39 clinical heart failure patients, mean age 68.1 (SD, 12.3), 72% male, 62% African American. The ratio of observed over expected use for the body weight scale, blood pressure device, iPad application, pulse oximeter and actigraph was 0.8, 1.0, 1.1, 0.9, and 1.9, respectively. The mean overall System Usability Scale score for each device were 84.5, 89.7, 85.7, 87.6, and 85.2, respectively. ConclusionsPatients were able to use all of the devices and they rated the usability of all the devices higher than expected. Our study provides support for at-home patient-collected physiologic and subjective state data. To our knowledge, this is the first study to assess the use and usability of electronic objective and subjective data collection devices in heart failure patients’ homes overnight.

How Do Residents Spend Their Shift Time? A Time and Motion Study With a Particular Focus on the Use of Computers.

To understand how much time residents spend using computers compared with other activities, and what residents use computers for. This time and motion study was conducted in June and July 2010 at NewYork-Presbyterian/Columbia University Medical Center with seven residents (first-, second-, and third-year) on the general medicine service. An experienced observer shadowed residents during a single day shift, captured all their activities using an iPad application, and took field notes. The activities were captured using a validated taxonomy of clinical activities, expanded to describe computer-based activities with a greater level of detail. Residents spent 364.5 minutes (50.6%) of their shift time using computers, compared with 67.8 minutes (9.4%) interacting with patients. In addition, they spent 292.3 minutes (40.6%) talking with others in person, 186.0 minutes (25.8%) handling paper notes, 79.7 minutes (11.1%) in rounds, 80.0 minutes (11.1%) walking or waiting, and 54.0 minutes (7.5%) talking on the phone. Residents spent 685 minutes (59.6%) multitasking. Computer-based documentation activities amounted to 189.9 minutes (52.1%) of all computer-based activities time, with 128.7 minutes (35.3%) spent writing notes and 27.3 minutes (7.5%) reading notes composed by others. The study showed that residents spent considerably more time interacting with computers (over 50% of their shift time) than in direct contact with patients (less than 10% of their shift time). Some of this may be due to an increasing reliance on computing systems for access to patient data, further exacerbated by inefficiencies in the design of the electronic health record.

Somatic and inclusive practice perspectives on developing an iPad application for choreography

Abstract The article offers insight into somatic perspectives that have informed the design of a software application for the iPad. Entitled formXtended, the app is designed to extend the compositional imaginations of users, by engaging them in choreographic tasks that integrate movement, sound and image. The project sought to develop an approach to software design that engaged with principles of inclusion and accessibility for disabled and non-disabled users. The article offers insight into some of the questions and issues addressed by the team in their endeavour to create inclusive app-based activities. The discussion articulates how somatic principles informed both app design stage and in the testing phase with young people, which led to further refinements in the app design. The somatic dimensions of the formXtended project are situated within a larger and more complex collaboration between arts organization, dancedigital, software company, Moviestorm and research partner, University of Bedfordshire.

Using the PyMOL application to reinforce visual understanding of protein structure

Visualization of chemical concepts can be challenging for many students. This is arguably a critical skill for beginning studentsof biochemistry to develop, since new information is often presented visually in the form of textbook figures. It is recommended thatvisual literacy beexplicitly taught in the classroom rather than assuming that students will develop this skill on their own. The activitydescribed here isdesigned to assist students in their development of understanding of basic representations of protein three-dimensional structure as well as various types of ligands (small molecules, ions) through the use of the iPad application PyMOL. It has been used as a laboratory exercise but can also be used in a typical 50-minute class period with a portion of the activity assigned as homework. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(5):433-437, 2016.

Development and Reliability of a Novel iPad-based Application to Rapidly Assess Body Image

PURPOSE: To improve upon our current assessment of a person’s body image/shape by embracing more modern digital technologies rather than relying on traditional hand-drawn line-based (figural) images or silhouettes. These traditional methods typically only consider an endomorphy-ectomorphy continuum with no mesomorphy component. METHODS: We have developed a novel iPad application that uses a wide array of >45 male and female somatotype photographs that allows more comprehensive estimates of body-image dissatisfaction than figural images/silhouettes. We piloted the iPad application with 20 adults who rated their ‘perceived’ and ‘desired’ body images from the somatotype photographs (>3 days between tests). RESULTS: Reliability correlation coefficients were determined for ‘perceived’ endomorphy r = 0.91 (68% identical), and ‘desired’ endomorphy r = 0.78 (85% identical); ‘perceived’ mesomorphy r = 0.81 (70% identical), and ‘desired’ mesomorphy r = 0.93 (65% identical); plus ‘perceived’ ectomorphy r = 0.88 (61% identical), and ‘desired’ ectomorphy r = 0.88 (70% identical). Overall, on re-test, 45% chose the identical ‘perceived’ somatotype and 50% the identical ‘desired’ somatotype. CONCLUSIONS: This novel iPad application introduces a revolutionary new and reliable method of assessing both perceived and desired body image. It also uniquely and simultaneously assesses body fat, muscle and leaness using realistic quasi-3D images. Developments of this rapid, portable and digital application may provide health care professionals with an enhanced tool for assessing body image and dealing with body image disorders. Funding: Hong Kong University’s Knowledge Exchange Fund and Seed Funding Programme #201411159144. J.E. Lindsay Carter Kinanthropometry Clinic and Archive New Zealand funding programme #KAPHK1.

Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

The feasibility of remote reading of coronary CT examinations on tablet computers has not been evaluated. The purpose of this study is to evaluate the accuracy of coronary CT angiography reading using an iPad compared to standard 3D workstations. Fifty coronary CT angiography exams, including a spectrum of coronary artery disease and anatomic variants, were reviewed. Coronary CT angiography exams were interpreted by two readers independently on an iPad application (Siemens Webviewer) and a clinical 3D workstation at sessions 2weeks apart. Studies were scored per vessel for severity of stenosis on a 0-3 scale (0 none, 1 <50%, 2 ≥50-69%, 3 ≥70%). Coronary anomalies were recorded. A consensus read by two experienced cardiac imagers was used as the reference standard. Level of agreement with the reference for iPad and 3D workstations was compared. Multivariate logistic regression was used to analyze the relationship between agreement and display type and to adjust for inter-reader differences. For both readers, there was no significant difference in agreement with the reference standard for per-vessel stenosis scores using either the 3D workstation or the iPad. In a multivariable logistic regression analysis including reader, workstation, and vessel as co-variates, there was no significant association between workstation type or reader and agreement with the reference standard (p > 0.05). Both readers identified 100% of coronary anomalies using each technique. Reading of coronary CT angiography examinations on the iPad had no influence on stenosis assessment compared to the standard clinical workstation.

DO IPAD APPLICATONS HELP STUDENTS WITH DEVELOPMENTAL DISABILITIES IMPROVE LIFE-READINESS SKILLS?

Students with developmental disabilities often struggle with life-readiness skills (e.g., literacy skills such as reading and writing, task completion, and communication), which also help prepare students for the workplace. Assistive technology tools offer these students a means to do better in these areas. In this action-research study, we provided students with developmental disabilities (N=9) who were transitioning out of secondary school with iPad applications (apps) that could help them improve their life-readiness skills. The Common Core State Standards’ overall objective is students’ college and career readiness by the end of secondary school. While collecting qualitative and quantitative data across the 2012-2013 academic years, a group of educators worked with the students and their parents to help them learn and apply the iPad apps for life-readiness skills. The results indicated that all students improved in life-readiness skills. Ideas for future research as well as limitations of this study are also discussed.

Educational Videos: An Effective Tool to Improve Training in Interventional Breast Procedures

PurposeUsing the iPad application Explain Everything™, the authors created a “how to” video for stereotactic breast core biopsy to enhance their breast imaging curriculum. The objective was to show that video integration into residency training enhances resident learning. MethodsA pretest was provided to all 40 radiology residents (postgraduate years 2-5) at the authors’ institution. The test included 20 questions on the video content, 15 similarly framed control questions on material that was not included in the video, and four demographic questions. Questions were randomly ordered, and trainees were not informed that both types of questions were included. Residents were given one week to watch the 20-minute video before completing a posttest that included the same 35 content questions presented in a different order. Three logistical questions were also included. Results for the video and the control questions were analyzed separately and compared. ResultsThirty of 40 residents (75%) participated (6-9 residents each year). The average scores for the video and control pretest were 7.7 of 20 (38.5%) and 7.8 of 15 (52%) and for the posttest were 13.8 of 20 (69%) and 7.8 of 15 (52%), respectively. This corresponds to a 30.7% mean improvement on the video-content questions compared with a 0% improvement for the control test (P < .001). Similar improvement was seen across all four postgraduate years and on an individual level. ConclusionsThis instructional video added significantly to resident learning in the short term. Further study on the long-term role of educational videos in radiology residency training seems warranted.

Social networks of HIV-positive women and their association with social support and depression symptoms

ABSTRACTSocial support is important to the mental health and well-being of HIV-positive women. Limited information exists about the specific structure and composition of HIV-positive women’s support networks or associations of these network properties with mental health outcomes. In this pilot study, the authors examine whether support network characteristics were associated with depressive symptoms. Survey and network data were collected from HIV-positive women (N = 46) via a web-based survey and an iPad application in August 2012. Data were analyzed using multivariate linear regression models in SAS. Depressive symptoms were positively associated with a greater number of doctors in a woman’s network; having more HIV-positive network members was associated with less symptom reporting. Women who reported more individuals who could care for them had more family support. Those who reported feeling loved were less likely to report disclosure stigma. This work highlighted that detailed social network data can increase our understanding of social support so as to identify interventions to support the mental health of HIV-positive women. Most significant is the ongoing need for support from peers.