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. 2015 Nov 27;3(2):66–78. doi: 10.1002/nop2.37

Table 3.

Overview of the included studies (n = 20)

Reference/study design/setting Speciality/aim Study participants Results Only the findings relating to impact/outcome are reported
Quantitative (n = 17)
Carroll and Christakis (2004)
Survey
USA 		Paediatrics
To determine the percentage of paediatricians using PDAs and computers, to determine perceived strengths and weaknesses of PDAs and to explore characteristics associated with beliefs and use 		1185 paediatricians

  1. 35% of respondents currently use PDAs at work and 40% currently use PDAs for personal use.

  2. Of those using PDAs, the most commonly used apps were for drug reference (80%), personal scheduling (67%) and medical calculations (61%).

  3. Those using PDAs were more likely to believe that PDAs can decrease medical errors and increase efficiency.
De Groote and Doranski (2004)
Survey
USA 		Health sciences
To determine how PDAs are used on an academic health sciences campus to define the level of training and support the library can provide to the students and faculty 		352 medical residents and health sciences faculty

  1. Sixty‐one per cent of survey respondents used PDAs.

  2. The address book, date book and calculator were the most common uses reported for PDAs. Residents also reported a high use of drug databases on their PDAs.

  3. Most survey respondents indicated they would like to learn more about clinical resources for PDAs.
Flannigan and McAloon (2011)
Comparison study
UK 		Paediatric emergency
To compare the use of a drug calculator on a smartphone with use of the British National Formulary for Children (BNFC) for accuracy, speed and confidence of prescribing 		28 doctors and seven medical students in a paediatric department of a District General Hospital

  1. The drugs calculator on the smartphone was more accurate than the BNFC, with 28.6% of participants being able to correctly prescribe an inotropic infusion using the BNFC and 100% of participants being able to do so using the drugs calculator on the smartphone (P < 0.001).

  2. The smartphone calculator was 376% quicker than the BNFC with the mean time saved being 5 min and 17 s per participant (P < 0.001).

  3. Participants were more confident in their prescription when using the drugs calculator on the smartphone with a mean confidence score of 8.5/10 compared with 3.5/10 when using the BNFC (P < 0.001).
Franko and Tirrell (2012)
Survey
USA 		27 different specialties
To evaluate the use of smartphones and smartphone apps 		3306 providers (residents, fellows and physicians) at nation‐wide medical centres

  1. Greater than 85% of respondents used a smartphone.

  2. Over half of the respondents reported using apps in their clinical practice; the most commonly used app types were drug guides (79%), medical calculators (18%), coding and billing apps (4%) and pregnancy wheels (4%).

  3. The most frequently requested app types were text/reference materials (55%), classification/treatment algorithms (46%) and general medical knowledge (43%).
George et al. (2010)
Survey
USA 		Nursing
To describe the use of PDAs by undergraduate and graduate nursing students during their educational process 		48 nursing students in the undergraduate and graduate programmes

  1. More than 79% of the participants used their PDAs at least weekly, with almost 50% using them daily.

  2. 96% of the participants reported using their PDAs in the clinical environment. 67% using PDAs in the classroom and 56% using PDAs for personal use.

  3. The drug guide was the most frequently used app by students (98%), followed closely by the medical dictionary (83%).

  4. 71% of the participants indicated that PDA use improve their efficiency. 77% thought that using PDAs as a student would contribute to their future use of handheld technology. 100% indicated that they found PDAs to be an effective educational tool.
Greenfield (2007)
Non‐randomized quasi‐experimental study
USA 		Nursing
To determine whether nursing medication errors could be reduced and nursing care provided more efficiently using PDA technology. 		87 junior and senior undergraduate nursing students

  1. PDA (experimental) group answered the six questions (three medication administration calculations and three clinical decisions based on medication administration) with greater accuracy and speed than did the textbook (control) group.
Kenny et al. (2009)
Survey supported by interviews
Canada 		Nursing
To evaluate the potential of mobile learning in nursing practice education 		17 students in a nursing practice education course taught at the end of third year

  1. Participants reported positively on the usability of the mobile devices, finding them easy to learn, readily portable and the screen size sufficient for mobile specific programmes.

  2. However, they had difficulty with the wireless connectivity and, despite an initial orientation, did not have time to fully learn the devices in the context of a busy course.

  3. It is not clear if students can effectively use the social technology provided by such devices or if mobile learning can support interaction between instructors and learners in this context.
Khan et al. (2007)
Survey
USA 		Paediatric and emergency medicine
To investigate the current PDA usage patterns of the residents and their interest in future PDA‐based applications 		60 paediatrics and emergency medicine residents

  1. 82% of the PDA users reported using the device several times a day and 16% used them a few times a week.

  2. The most commonly used apps included the simple calculator (81%), drug references (80%), medical calculators (75%), electronic textbooks (66%) and schedule and contact information (42%). Residents showed interest in using PDA apps for procedure logs, patient tracking and prescription writing.

  3. No significant differences were noted in the frequency and expertise of using PDAs between the paediatric and emergency medicine residents (P = 0.29).
Maag (2006)
Survey
USA 		Nursing
To explore students’ satisfaction with the academic podcasts as an emerging mobile learning tool 		1st survey: 34 undergraduate and graduate nursing students
2nd: 33 undergraduate nursing students
3rd: 43 undergraduate and graduate nursing students

  1. The students were generally satisfied with the availability and use of educational podcasts.

  2. Podcasts assisted their learning and provided valuable learning experiences.
Miller et al. (2005)
Pre–post comparison study
USA 		Nursing
To report on PDAs as a means to prepare nurse professionals who value and seek current information 		58 second‐degree nursing student completing the pre‐intervention survey and 46 the postintervention survey

  1. Results of this study support PDAs as an effective student learning resource, especially for reference materials.

  2. The student group with PDAs had increasing numbers of questions associated with clinical situations and a greater recognition of the need to use current resources.

  3. Students made substantial use of their PDAs and health team members, while decreasing reliance on textbooks and clinical faculty.

  4. Students’ use of and satisfaction with this technology is linked to access speed and readability.
Morris et al. (2007)
Survey
USA 		Medicine
To understand PDA usage and training in family medicine residency education 		598 residents, fellows and full‐time physician faculty members

  1. Use of PDAs is common among residents (94%) and faculty (79%). A total of 96% of faculty and residents report stable or increasing frequency of use over time. The common barriers relate to lack of time, knowledge and formal education.

  2. A total of 52% of PDA users have received some formal training. The majority of users report being self‐taught. Faculty and residents prefer either small‐group or one‐on‐one settings with hands‐on, self‐directed, interactive formats for PDA training.
Ranson et al. (2007)
Case study
USA 		Primary care, nephrology, cardiology, emergency medicine, & endocrinology
To describe use of (1) PDAs in patient care and (2) a PDA version of a learning portfolio in reflection on practice and medical education 		10 practising physicians & specialists

  1. All physicians accessed the system after training.

  2. Information accessed by PDA was used for clinical decisions support, patient education and teaching medical students.

  3. Use of the PDA version learning portfolio prompted physicians to reflect on changes in clinical practice.
Rothschild et al. (2002)
Survey
USA 		Medicine
To evaluate the clinical contribution of a palmtop drug reference guide – ePocrates Rx 		946 randomly selected ePocrates Rx users

  1. Physicians reported that ePocrates Rx saves time during information retrieval, is easily incorporated into their usual workflow and improves drug‐related decision making

  2. They felt that it reduced the rate of preventable adverse drug events.
Stroud et al. (2005)
Survey
USA 		Nursing
To describe the prevalence and patterns of use of PDAs by nurse practitioner (NP) students and faculty, examine relationships between patterns of use of PDAs and demographic characteristics of NP students and faculty and describe patterns of use of PDAs that support evidence‐based practice (clinical scholarship) 		227 nurse practitioner students and faculty

  1. A total of 67% of the participants (N = 153) used PDAs. Use was higher among men (82%) than women (64%). On average, respondents who used a PDA had been using it just over a year (M = 13 months).

  2. Respondents reported using a PDA most days of the week (M = 5 days).

  3. The top three medical software programs identified by respondents as the most useful in clinical practice were ePocrates Rx (82%), Griffith's 5‐Minute Clinical Consult (26%) and MedCalc (22%).

  4. Use of the PDA clearly facilitated both student and faculty access to accurate and current knowledge. Most participants (96%) related that PDA use supported clinical decision making.
Stroud et al. (2009)
Survey
USA 		Nursing
To describe the prevalence and patterns of use of PDAs among active nurse practitioners 		126 nurse practitioners

  1. A total of 64% of participants used PDAs. A drug reference was reported to be the most useful and frequently installed application.

  2. A large majority of PDA users believed that PDA use supported clinical decision making (91%), promoted patient safety (89%) and increased productivity (75%).

  3. A total of 62% predicted that PDA use would change their practice within the next 5 years.
Tews et al. (2011)
Comparison study
USA 		Emergency medicine
To evaluate medical students’ case presentation performance and perception when using mobile learning technology in the emergency department 		22 fourth‐year medical students randomized to receive or not to receive instruction by using the iPod Touch video

  1. There was a statistically significant improvement in presentations, when the videos were viewed for the first time (P = 0.032).

  2. There was no difference when the presentations were summed for the entire rotation (P = 0.671).

  3. The reliable (alpha=0.97) survey indicated that the videos were a useful teaching tool and gave students more confidence in their presentations.
Walton et al. (2005)
Survey
UK 		Community health
To explore the potential for mobile technologies to give health students in the community access to learning resources 		49 students on the health visiting/community nursing/school nursing course

  1. Mobile technologies were mainly being used for clinical rather than learning applications.

  2. The students showed a low level of awareness of the various mobile technologies but placed great importance to accessing learning resources from the community.

  3. The most beneficial aspects of mobile technologies were seen as improved access to information, followed by improved contact with the university.
Qualitative ( n  =   3)
Fisher and Koren (2007)
Focus group
USA 		Nursing
To explore the perceptions of students lived experience using a PDA in clinical practice at the point of care in undergraduate nursing clinical education 		28 third and fourth year of nursing undergraduate students in four focus groups

  1. The integration of PDA technology into a clinical practicum was successful and positively viewed by the junior and senior students

  2. Six themes were identified: information resource; retaining information; clinical critical thinking; professional image; communication skills and quality of care.
Garrett and Jackson (2006)
Qualitative evaluation
Canada 		Nursing and medicine
To design, implement and evaluate a PDA‐based tool to support reflective learning in practice 		Six final year nurse practitioner students and four final year medical students

  1. The students on average used the apps for a total of 68 min per week.

  2. The PDAs were mainly used as electronic reference tools rather than data recording and communications devices.

  3. The use of PDAs was limited by the handwriting user interface.

  4. Although they acknowledged the value of professional reflection, the use of the guided reflection process was not regarded as a useful tool by the students.

  5. The value of the PDA to help prevent clinical isolation and support clinical learning was viewed positively.
Garrett and Klein (2008)
Qualitative interpretivist
Canada 		Nursing
To explore advanced practice nurses’ perceptions on the value of wireless PDA technologies to support their practice 		43 nurse practitioners, clinical nurse specialists completing survey, two focus groups of 12 nurse practitioner students (24 total) and four information technology managers participating individual interviews

  1. Wireless PDA's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses.

  2. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless communications.