MacLeod Anna, Fournier Cathy
Division of Medical Education, Nova Scotia, Dalhousie University, Halifax, Canada.
BMJ Simul Technol Enhanc Learn. 2017 Jul 6;3(3):99-105. doi: 10.1136/bmjstel-2016-000185. eCollection 2017.
The practice of medicine involves, among other things, managing ambiguity, interpreting context and making decisions in the face of uncertainty. These uncertainties, amplified for learners, can be negotiated in a variety of ways; however, the promise, efficiency and availability of mobile technologies and clinical decision supports make these tools an appealing way to manage ambiguity.Mobile technologies are becoming increasingly prevalent in medical education and in the practice of medicine. Because of this, we explored how the use of mobile technologies is influencing residents' experiences of graduate medical education.
We conducted an 18-month qualitative investigation to explore this issue. Our research was conceptually and theoretically framed in sociomaterial studies of professional learning. Specifically, our methods included logging of technology use and related reflexive writing by residents (n=10), interviews with residents (n=12) and interviews with faculty (n=6).
We identified three challenges for graduate medical education related to mobile technology use: (1) efficiency versus critical thinking; (2) patient context versus evidence-based medicine and (3) home/work-life balance.
In this digital age, decontextualised knowledge is readily available. Our data indicate that rather than access to accurate knowledge, the more pressing challenge for medical educators is managing how, when and why learners choose to access that information.
医学实践包括处理模糊性、解读情境以及在面对不确定性时做出决策等诸多方面。这些不确定性对于学习者来说更为突出，可以通过多种方式来应对；然而，移动技术的前景、效率和可用性以及临床决策支持使得这些工具成为处理模糊性的一种有吸引力的方式。移动技术在医学教育和医学实践中越来越普遍。因此，我们探讨了移动技术的使用如何影响住院医师的毕业后医学教育体验。
我们进行了为期18个月的定性调查以探究这个问题。我们的研究在专业学习的社会物质研究中进行了概念和理论框架的构建。具体而言，我们的方法包括记录住院医师（n = 10）的技术使用情况和相关的反思性写作、对住院医师（n = 12）的访谈以及对教师（n = 6）的访谈。
我们确定了与移动技术使用相关的毕业后医学教育面临的三个挑战：（1）效率与批判性思维；（2）患者情境与循证医学；（3）家庭/工作与生活的平衡。
在这个数字时代，脱离情境的知识很容易获取。我们的数据表明，对于医学教育工作者来说，更紧迫的挑战不是获取准确的知识，而是管理学习者如何、何时以及为何选择获取这些信息。
