Personal Digital Assistants Users Research Articles

The use of medical and drug information software programs for personal digital assistants among pharmacy students in a Malaysian pharmacy school

BackgroundThe use of medical and drug information software programs for Personal Digital Assistants (PDAs) is increasing. The technological advances in recent years may have prompted this increase. Many studies have been conducted in developed countries about the use of PDAs among health care professionals and medical and pharmacy students, but similar studies in developing countries are lacking. ObjectivesTo explore the use of medical software programs for PDA among pharmacy students in their clinical clerkships as well as barriers and facilitators to PDA use. MethodsA descriptive, cross-sectional, exploratory study was conducted. A 56-item face- and content-validated, self-administered, and anonymous questionnaire was distributed to the students in the third and fourth years of a pharmacy program at the International Islamic University Malaysia (IIUM). ResultsThe response rate was 84.8%. The majority of respondents reported using PDAs (64.1%) and medical/drug information software programs for PDAs (61.5%). Android was the operating system used by the majority of PDAs users (87.5%), and free download websites were the most used source for these programs (93.1%). Micromedex was the most commonly used software (66.7%). PDA cost is the major barrier to use (chosen as barrier by 77.8% of the non-users). ConclusionPharmacy students use medical software programs for PDAs for many clinical tasks and the devices were perceived positively by students who do not use PDAs. The acquisition of a PDA is the major determinant of medical software PDA programs use because of the availability of free versions of these software programs.

The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

BackgroundThere is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs) and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns.MethodsA survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC) facilities, and community organizations (home care and public health). The sample consisted of 710 participants (response rate 58%) at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%). A hierarchical regression model (HLM) was used to evaluate the effect of predictors from all levels simultaneously.ResultsThe Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001). Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative effect). Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative). ‘Organizational culture’ (positive), ‘breadth of device functions’ (positive), and ‘slack staff ‘(negative) were associated with frequency of Lexi/PEPID drug dictionary use.ConclusionAccess to PDAs and Tablet PCs supported nurses’ self-reported use of information resources. Several of the organizational context variables and one individual nurse variable explained variation in the frequency of information resource use.

Factors Affecting Acceptability and Usability of Technological Approaches to Diabetes Self-Management: A Case Study

This study explored the impact of personal digital assistant (PDA) features, users' perceptions, and other factors that may have hindered PDA acceptability and usability as technology advances in e-health diabetes self-management. An ongoing study on PDA usage is set within the context of the advancements of Web 2.0 for type 2 diabetes mellitus (T2DM) self-management e-interventions. Advancements in technology as it relates to the future of T2DM mobile applications are discussed as possible deterrents of PDA acceptability and usability. This case study illustrates the importance of addressing factors that may impede the adoption of electronic devices intended for sustained health behavior change. Recognizing the importance of individual perception within the context of rapid technological advancements is imperative for designing future health interventions. Incorporating electronic devices that individuals are more inclined to utilize, such as smartphones, as the platform for health interventions is a promising strategy to improve acceptability and usability, allowing researchers to more accurately assess the health benefits of self-management programs.

Accuracy and Efficiency of Novice Nurse Practitioners Using Personal Digital Assistants

To determine if using personal digital assistants (PDAs) increased accuracy and efficiency of clinical decisions made by novice nurse practitioners (NPs). Experimental with a repeated measures design. The study sample included 40 novice NPs. Data were collected from December 2003 to March 2004 following a stratified random assignment of the subjects to a textbook or PDA group. Participants identified appropriate laboratory value assessments, diagnosis, and medication decisions using the assigned resources when given two randomly administered clinical scenarios. Accuracy was determined by the correct response score to each clinical question. The completion of the scenario was timed by the investigator. Length of time necessary to answer each part of the scenario determined efficiency. Data analysis included mixed design repeated measures analysis of variance. There was a significant interaction and difference in accuracy in the laboratory analysis section of the case scenarios (F(1,38) = 21.256, p ≤ .001) in the PDA group when compared with the textbook group. There were no differences in accuracy by section. In three of six efficiency variables measured, the PDA users were significantly more efficient. In both laboratory values and one of the treatment sections, the PDA users were more efficient in determining an answer to the clinical questions. Accuracy of PDA users was equal to textbook users. The findings lend support to benefits for novice practitioners using PDAs when evaluating clinical situations, both in accessing certain correct information and doing this in a timely manner.

Doctors’ Concerns of PDAs in the Ward Round Situation

Healthcare professionals in hospital care increasingly use small-screen handheld computers. Studies that have investigated doctors' concerns about handheld usage have mainly focused on technical, organizational and performance issues. Very few have looked at the effects of Personal Digital Assistants (PDAs) on the interaction between physician and patient. The aim of this study was to explore the effects of PDA usage on the physicians' prescription work, their concerns about using it in point-of-care situations, and the effects on the patient-physician dialog. We used a qualitative and comparative approach where 14 physicians each carried out four simulated ward rounds in which they modified the medication of patient actors using a paper-based medical chart and three versions of a PDA-based system. We analyzed ward round video recordings, semi-structured interviews with the doctors, and focus group using approaches based on ethnomethodology and grounded theory. Physicians used PDA and paper differently. Physicians' actions, as well as their non-verbal communication, were less transparent and clear for the patient when using a PDA. Doctors were worried about distractions from the handheld device and about a negative impact on the physician-patient conversation. In general, physicians were more comfortable with paper, but preferred PDA because it offered an undo function and reduced the need to memorize drug names and dosages by providing concrete alternatives in the user interface. Despite the many benefits, PDA usage at the point-of-care comes with the increased risk of distractions for physicians and can cause a negative patient experience. Designers of point-of-care systems need to be aware of, and address, the problems with handhelds and learn from the attributes and access capabilities of paper charts.

The effect of Personal Digital Assistants in supporting the development of clinical reasoning in undergraduate nursing students: a systematic review

Background The objective of this review was to determine whether the use of Personal Digital Assistants (PDAs) would provide greater support in developing undergraduate nursing students' clinical reasoning, in comparison to more traditional resources such as textbooks. Search strategy The search strategy sought to identify published data from five electronic databases: CINAHL, Medline, Cochrane Library, Meditext and Scopus. Unpublished literature was also sought in digital dissertations, conference proceedings, relevant scholarly websites and reference lists. Selection criteria All undergraduate nursing students were considered eligible for inclusion. Types of interventions considered for this review were inclusive of all forms of PDAs and traditional resources. The research setting of this systematic review reflects the diversity of nursing practice, and includes the classroom, clinical or simulated environment. The process of clinical reasoning was defined by four outcome measures; alterations in theoretical nursing knowledge, clinical skills, problem solving and reflection. Assessment and extraction of data Studies of potential significance to the review were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Authorship of the studies was not concealed from the two reviewers. From the nine studies assessed for quality, only data from four studies were included in the review. Results Four published studies were included in the systematic review of literature. The designs of the studies included a nonrandomised quasi-experimental design, case control study, comparative descriptive design and a pre test post test mixed method study. Four outcomes were identified by the four included studies. These outcomes addressed possible effects of PDA usage on undergraduate nursing students' practice of medication administration, self-efficacy, anticipation to exercise professional nursing judgment and clinical reasoning. This systematic review provides evidence that the use of PDAs is able to improve nursing students' self-efficacy and accuracy in clinical situations that require direct and context-free answers, such as medication administration, but is not as supportive as textbooks in assisting students to apply this knowledge critically in decision making and problem solving. Implications for practice The use of PDAs by undergraduate nursing students can improve students' confidence in the often stressful clinical environment. This bears significance in contemporary nursing education where undergraduates are failing to maximise the clinical experience because of insufficient support or guidance from busy clinicians or supervisory staff. From these findings, PDAs are also beneficial in improving the accuracy and efficiency of medication administration in nursing students. However, the application of the knowledge provided by PDAs is not supported to be used critically in its application to decision making and problem solving. Nursing students need to be educated in methods to develop critical analysis in order to use these resources effectively. Implications for research This systematic review highlights the poor quantity of literature currently available in nursing and the subsequent need for primary quantitative studies examining the effect of PDAs in developing undergraduate nursing students' clinical reasoning skills.

The effect of Personal Digital Assistants in supporting the development of clinical reasoning in undergraduate nursing students: a systematic review.

The objective of this review was to determine whether the use of Personal Digital Assistants (PDAs) would provide greater support in developing undergraduate nursing students' clinical reasoning, in comparison to more traditional resources such as textbooks. The search strategy sought to identify published data from five electronic databases: CINAHL, Medline, Cochrane Library, Meditext and Scopus. Unpublished literature was also sought in digital dissertations, conference proceedings, relevant scholarly websites and reference lists. All undergraduate nursing students were considered eligible for inclusion. Types of interventions considered for this review were inclusive of all forms of PDAs and traditional resources. The research setting of this systematic review reflects the diversity of nursing practice, and includes the classroom, clinical or simulated environment. The process of clinical reasoning was defined by four outcome measures; alterations in theoretical nursing knowledge, clinical skills, problem solving and reflection. Studies of potential significance to the review were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Authorship of the studies was not concealed from the two reviewers. From the nine studies assessed for quality, only data from four studies were included in the review. Four published studies were included in the systematic review of literature. The designs of the studies included a nonrandomised quasi-experimental design, case control study, comparative descriptive design and a pre test post test mixed method study. Four outcomes were identified by the four included studies. These outcomes addressed possible effects of PDA usage on undergraduate nursing students' practice of medication administration, self-efficacy, anticipation to exercise professional nursing judgment and clinical reasoning.This systematic review provides evidence that the use of PDAs is able to improve nursing students' self-efficacy and accuracy in clinical situations that require direct and context-free answers, such as medication administration, but is not as supportive as textbooks in assisting students to apply this knowledge critically in decision making and problem solving. The use of PDAs by undergraduate nursing students can improve students' confidence in the often stressful clinical environment. This bears significance in contemporary nursing education where undergraduates are failing to maximise the clinical experience because of insufficient support or guidance from busy clinicians or supervisory staff. From these findings, PDAs are also beneficial in improving the accuracy and efficiency of medication administration in nursing students. However, the application of the knowledge provided by PDAs is not supported to be used critically in its application to decision making and problem solving. Nursing students need to be educated in methods to develop critical analysis in order to use these resources effectively. This systematic review highlights the poor quantity of literature currently available in nursing and the subsequent need for primary quantitative studies examining the effect of PDAs in developing undergraduate nursing students' clinical reasoning skills.

Posture Monitoring System for Context Awareness in Mobile Computing

The posture of a user is one of the contextual information that can be used for mobile applications and the treatment of idiopathic scoliosis. This paper describes a method for monitoring the posture of a user during operation of a mobile device in three activities such as sitting, standing, and walking. The user posture monitoring system (UPMS) proposed in this paper is based on two major technologies. The first involves a tilt-angle measurement algorithm (TAMA) using an accelerometer. Unlike most previous studies, it is based on a relative computation using the dot product from the time-series acceleration data. Because TAMA does not require a physical calibration by a user, it is more robust and accurate compared to other methods that rely on absolute computations. The second technology is an effective signal-processing method that eliminates the motion acceleration component of the accelerometer signal using a second-order Butterworth low-pass filter (SLPF). Because the posture of a user is only related to the gravity acceleration component, the motion acceleration components should be removed. The TAMA and UPMS are implemented on a personal digital assistant (PDA). They are evaluated to verify the possibility of application to a mobile device. Additionally, a posture-based intelligent control interface in context-aware computing that reacts to the posture of a PDA user is implemented on the PDA to complement the poor user interface (UI) of the mobile device, and its results are presented.

Personal digital assistant usage among undergraduate medical students: exploring trends, barriers, and the advent of smartphones

Personal digital assistant (PDA) use is widespread and now considered an essential part of medical practice [1, 2]. These devices, also known as handhelds, allow health professionals to find answers to clinical questions while at the patient's bedside, resulting in better patient safety and clinical outcomes [3]. However, it has been found that PDA users, especially medical students, often struggle to use these tools to their full potential [4–7]. Health sciences libraries have responded by providing resources and services such as the evaluation of PDA programs and devices, instruction sessions on effective PDA use, and even the provision of technical support [8, 9]. Most of the literature that can be used to inform library practices in this area only briefly describes PDA usage patterns [10, 11], the types of activities performed with a PDA, or the most popular programs used [2, 5, 7, 12–17]. Some studies go slightly further and examine barriers to handheld computing [6, 7, 14, 18]. While a multitude of case studies superficially describe PDA initiatives implemented by libraries [19–22], few studies empirically examine the services and resources provided for medical students who use PDAs [23]. Finally, little to nothing has been written on how the advent of the smartphone has affected PDA usage and users' behaviours and needs [24]. Since 2001, the John W. Scott Health Sciences Library at the University of Alberta (U of A) has been providing services and resources for those using PDAs. These services have met with some success and have been cited and commended by a number of authors [19, 25, 26]. In an area where so much innovation and change takes place, it is necessary for libraries to maintain relevance by routinely assessing services and implementing improvements. This paper describes a study that was developed to inform the U of A's current PDA initiatives and subsequently addresses some of the gaps identified in the current body of literature on this topic.

Supporting Evidence-Based Practice for Nurses through Information Technologies

To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes. The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies. The authors took place over a 12-month period. Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services (PARIHS) model guided the selection of variables for study. A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization, perceived quality of care, and on nurses' job satisfaction. The setting was 29 acute care, long-term care, home care, and correctional organizations in Ontario, Canada. The sample consisted of 488 frontline-nurses. Nurses most frequently consulted drug and medical reference information, Google, and Nursing PLUS. Overall, nurses were most satisfied with the Registered Nurses Association of Ontario (RNAO) BPGs and rated the RNAO BPGs as the easiest resource to use. Among the PDA and Tablet users, there was a significant improvement in research awareness/values, and in communication of research. There was also, for the PDA users only, a significant improvement over time in perceived quality of care and job satisfaction, but primarily in long-term care settings. It is feasible to provide nurses with access to evidence-based practice resources via mobile information technologies to reduce the barriers to research utilization.

The Prevalence of Use of Personal Digital Assistants (PDA) by Clinical Dietitians in Delaware Valley

ObjectiveThe first purpose of this study was to examine the prevalence of PDA use among clinical dietitians and identify the most commonly reported applications. Secondly, we aimed to establish the most commonly cited reasons for choosing not to use PDAs at work. Finally, we analyzed the influence of dietitian age and years of experience on their tendency to use a PDA at work.MethodsEmail invitations were sent to randomly selected 77 Clinical dietitians in the Delaware Valley. 40 of them responded by completed an online survey.ResultsForty percent of respondents reported use of a PDA compared with 60% of respondents who did not. Among the clinical dietitians using PDAs, 62.5% used nutrition assessment tools, such as diet assessment, 25% used nutrition reference tools, and 12.5% used medical dictionaries. Of the 60% of the dietitians who do not use PDAs for work, 33% reported they felt the PDA was not valuable for their work, 25% stated PDAs were too expensive, and 21% reported lack of knowledge in PDA operation. The proportion of PDA users to non users for this study was independent of age (p = 0.17) and years of experience (p = 0.90).ConclusionPDAs are valuable tools. However, the results of this study suggest that use of PDAs is not common among clinical dietitians. Age and years of clinical experience do not appear to influence the tendency to use PDAs, suggesting that employer attempts to integrate PDAs to the work place would be well received across the workforce.

PDA Usage by Japanese Resident Physicians Is Low

Personal digital assistants (PDAs) are in widespread use by resident physicians in many countries, reaching as high as 95% in some reports. Uses are varied and include clinical decision support and support of evidence-based practice. Utilization by resident doctors in Japan has not been characterized. This study was conducted to determine practice patterns of PDA use by Japanese resident physicians. A nationwide cohort survey study was distributed to all 1070 residency teaching programs in Japan. The survey included questions pertaining to use of PDAs in clinical practice. 1124 surveys were returned (response rate of approximately 75%). 297 (30.7%) respondents reported currently using PDAs, while 971 (86.4%) reported having used a PDA in the past. PDA users were more likely to be male (p <0.05), but no other significant differences were found when examining the following variables: age, training site (university hospital versus community teaching hospital), satisfaction with existing information technology access. Use of PDAs among Japanese resident physicians is much lower than their counterparts in other countries. In light of this, further research on patient outcomes in Japan and the impact of PDA usage on patient outcomes is urgently needed. If demonstrated to improve outcomes, barriers to adoption need to be identified and overcome.

A Business Model for Potential Customers Identification and Personalized Knowledge Provision of TSPs

Abstract Recently, enterprises have faced the pressure of industry transformation and high competency in the global market. In Taiwan, most small and medium sized enterprises (SMEs) cannot afford advanced R&D. In order to increase competency of SMEs, the technology and service providers (TSPs) play a critical role for innovative technology provision. Traditionally, the salesmen of TSPs have to evaluate the critical customers via trials and errors. In addition, although the personal digital assistant (PDA) has been widely used to promote business for its high mobility, the business information downloaded into PDA is actually rarely concerned. In order to increase efficiency and effectiveness of business promotion, this paper focuses on the development of a personal business information management (PBIM) model with four modules namely critical customer identification (CCI), potential customer identification (PCI), PDA user category determination (UCD) and PDA user busy level determination (UBD) for TSPs to identify potential customers and to provide personalized business information. A non-profit R&D institute in Taiwan is used to validate feasibility of the proposed modules via the developed PBIM platform. This paper presents a feasible PBIM approach for the TSPs to efficiently and systematically analyze the project history and PDA daily records for business outreach.

Educational effectiveness of a personal digital assistant-based geriatric assessment tool

Background: Although personal digital assistant use among residents is common, few outcomes-based studies have examined the impact of this technology on medical education.Aims: We evaluated the educational effectiveness of a personal digital assistant-based geriatric assessment tool.Methods: Internal medicine residents were enrolled as subjects. Personal digital assistant users were randomly assigned to receive or not receive a geriatric assessment tool for use on their device. Outcome measures included pretest/posttest performance and tabulation of geriatric functional issues on hospital dismissal summaries.Results: Seventy-two residents participated. Of these, 38 (53%) reported personal digital assistant use. Twenty were assigned to receive the geriatric assessment tool. Average change between pretest and posttest scores was highest for the group using the geriatric assessment tool on a personal digital assistant (2.8, P = 0.01). This group also had the highest average posttest score and the highest average number of geriatric functional issues identified on dismissal summaries, but neither value was significantly different from respective averages for the other study groups.Conclusions: Residents who used a personal digital assistant-based geriatric assessment tool demonstrated greater improvement in geriatric knowledge than peers who did not use this resource. Curricula adapted to this technology may prove useful in medical education.

Personal digital assistant use by nurse practitioners: A descriptive study

We sought to describe the prevalence and patterns of use of personal digital assistants (PDAs) among active nurse practitioners (NPs). A descriptive correlational survey was conducted among NPs in the United States (N = 126). Participants were randomly selected from members of the American Academy of Nurse Practitioners who had listed a practice site on their application. Sixty-four percent of participants used PDAs. A drug reference was reported to be the most useful and frequently installed application. A large majority of PDA users believed that PDA use supported clinical decision making (91%), promoted patient safety (89%), and increased productivity (75%). Sixty-two percent predicted that PDA use would change their practice within the next 5 years. As innovative PDA applications with potential to improve patient outcomes become increasingly available, handheld computer skills will be a fundamental practice competency. To prevent errors in clinical decision making with quick access to PDA reference materials, NPs must critically evaluate the legitimacy and worth of PDA software programs. There is a critical need to evaluate the effectiveness of PDA use in clinical settings and develop an evidence base to guide use of the PDA in solving clinical problems.

The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review.

BackgroundHealth care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications.ObjectiveThe aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care.MethodsThe literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen’s Model of System Acceptability as a theoretical framework in structuring and presenting the results.ResultsFrom the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen’s Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning.ConclusionsThis overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.

A personal digital assistant application (MobilDent) for dental fieldwork data collection, information management and database handling

To develop a personal digital assistant (PDA) application for oral health assessment fieldwork, including back-office and database systems (MobilDent). System design, construction and implementation of PDA, back-office and database systems. System requirements for MobilDent were collected, analysed and translated into system functions. User interfaces were implemented and system architecture was outlined. MobilDent was based on a platform with. NET (Microsoft) components, using an SQL Server 2005 (Microsoft) for data storage with Windows Mobile (Microsoft) operating system. The PDA devices were Dell Axim. System functions and user interfaces were specified for MobilDent. User interfaces for PDA, back-office and database systems were based on. NET programming. The PDA user interface was based on Windows suitable to a PDA display, whereas the back-office interface was designed for a normal-sized computer screen. A synchronisation module (MS Active Sync, Microsoft) was used to enable download of field data from PDA to the database. MobilDent is a feasible application for oral health assessment fieldwork, and the oral health assessment database may prove a valuable source for care planning, educational and research purposes. Further development of the MobilDent system will include wireless connectivity with download-on-demand technology.

Improving Diabetes Self-Care with a PDA in Ambulatory Care

Use of information technology in diabetes management has been shown to improve self-care. We determined whether enhancing type 2 diabetes (T2DM) self-care with a personal digital assistant (PDA) by patients in the ambulatory setting would improve glycemic control. A pretest/posttest intervention study was conducted in four family practice clinics in a large multispecialty group practice associated with an 186,000-member Health Maintenance Organization. Adults with T2DM and last measured glycosylated hemoglobin (HbA1c) of > or = 8.00% received one-on-one training on the use of a loaned PDA pre-installed with "Diabetes Pilot." Changes in HbA1c and other outcomes were assessed at 6 months from baseline for all participants and by participant-reported PDA use patterns, dichotomized into high PDA users (> or =3 days in past 7) and low PDA users (< 3 days). Of 43 subjects enrolled, 18 (41.90%) completed the 6-month intervention. Their mean HbA1c decreased 17.50% from 9.70% at baseline to 8.00%, a significant mean HbA1c change of -1.7% (95% CI = -2.60 to -0.90). The mean HbA1c change was higher among reported high PDA users (n = 9, mean difference = -1.90, 95% CI = -3.20 to -0.50) than among reported low PDA users (n = 9, mean difference = -1.50, 95% CI = -2.80 to -0.30). Significant increases were reported for the foot care and general diet subscales of the Summary of Diabetes Self-Care Activities from 3 to 6 months. Enhancing T2DM self-care by adults with a PDA was associated with significant reductions in HbA1c; the reductions were greater among reported high PDA users.

Utilization of Personal Digital Assistants (PDAS) by Pediatric and Emergency Medicine Residents

The objective of the present study was to investigate the current personal digital assistant (PDA) usage patterns of the residents and their interest in future PDA-based applications. A cross-sectional survey was conducted among the Pediatrics (Peds) and Emergency Medicine (EM) residents in an urban teaching hospital. Data points included level of training, specialty of training, experience of use of different PDA devices, use of current software applications, and interest in future applications. A total of 60/74 (81%) eligible residents participated in the study. Palm® (Palm Inc., Sunnyvale, CA) was the most commonly used operating system (82%). Among the PDA users, 82% reported using the device several times a day, and 16% used them a few times a week. The most commonly used applications included the simple calculator (81%), drug references (80%), medical calculators (75%), electronic textbooks (66%), and schedule and contact information (42%). In addition, residents showed interest in using PDA applications for procedure logs, patient tracking, and prescription writing. No significant differences were noted in the frequency and expertise of using PDAs between the Peds and EM residents ( p = 0.29). Our data show current trends of use of PDAs by Peds and EM residents and their interest for future applications.

Use of personal digital assistants (PDAs) in reflection on learning and practice

As the use of personal digital assistants (PDAs) grows, the value of reflection of learning and practice draws increased attention from policymakers and evaluators. To learn more about the use of PDAs in practice and learning, the present study describes use of (1) PDAs in patient care and (2) a PDA version of the Virginia Board of Medicine Continuing Competency and Assessment Form (CCAF), a learning portfolio intended to encourage documentation of reflection on practice and medical education. A purposive sample of 10 practicing physicians (6 male, 7 primary care) was recruited from geographic regions throughout Virginia. Five participants were previous users of a PDA. Three sources of data were analyzed: (1) a questionnaire describing PDA usage, (2) transcripts from telephone interviews, and (3) CCAF written comments. A study team member installed the PDA system and conducted individualized training on the basis of current equipment, software, and skills of the learner. Telephone interviews were completed 4-6 months after training. All physicians accessed the system after training. Use of the PDA was associated with the value of information for making clinical decisions. Information accessed by PDA was used not only for clinical decisions but also for patient education and for teaching medical students. Use of the CCAF prompted physicians to reflect on changes in clinical practice. Training on the handheld equipment and applications should include assessment of systems connectivity and integration, access authority, existing skills, and previous use. Proponents of PDA use for clinical decisions should assure access to information that is useful to physicians for reflection on learning and practice.