Ranson Sonya L, Boothby John, Mazmanian Paul E, Alvanzo Anika
Simulation Center, Carilion Clinic, Roanoke, VA 24014, USA.
J Contin Educ Health Prof. 2007 Fall;27(4):227-33. doi: 10.1002/chp.142.
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.
随着个人数字助理（PDA）使用的增加，学习与实践反思的价值引起了政策制定者和评估者越来越多的关注。为了更多地了解PDA在实践和学习中的使用情况，本研究描述了（1）PDA在患者护理中的使用，以及（2）弗吉尼亚州医学委员会继续能力与评估表（CCAF）的PDA版本，这是一个旨在鼓励记录实践反思和医学教育的学习档案。
从弗吉尼亚州各地的地理区域招募了10名执业医师（6名男性，7名初级保健医师）作为有目的的样本。5名参与者以前使用过PDA。分析了三种数据来源：（1）一份描述PDA使用情况的问卷，（2）电话访谈的文字记录以及（3）CCAF的书面评论。一名研究团队成员安装了PDA系统，并根据学习者当前的设备、软件和技能进行了个性化培训。培训后4 - 6个月完成电话访谈。
所有医师在培训后都访问了该系统。PDA的使用与用于临床决策的信息价值相关。通过PDA获取的信息不仅用于临床决策，还用于患者教育和医学生教学。CCAF的使用促使医师反思临床实践中的变化。
对手持设备和应用程序的培训应包括对系统连接性和集成性、访问权限、现有技能以及先前使用情况的评估。支持将PDA用于临床决策的人应确保医师能够获取有助于其反思学习和实践的信息。
