Todd Vandenbark and Norah M. Airth-Kindree
Northwest Regional Instructional Technology Showcase,
3
E with Learning Technology: Efficiency, Effectiveness and Engagement
University of Wisconsin- Stout, February 2013
Learning Technology Development Council (LTDC) , UW System
Mobile Apps in Nursing: effective evaluation and use
Objectives:
• Students will research, use and clinically evaluate relevant mobile medical
applications (“apps”) from a nursing perspective.
• Students will develop and practice skills in presenting their evaluations in concise
and descriptive terms.
Structure:
1. Preceding class: Students will be assigned to teams of 3 people.
2. Each team will be assigned an app to evaluate, and a worksheet with questions to
answer in this process.
3. Bring your worksheet to class on January 30, where teams will be provided with
iPads allowing you to try out and evaluate your assigned app for approximately 30
minutes.
4. Based on the results of your research on, and use of the app, each team will then
give a short, 3-­‐5 minute on the app. A brief Q&A by peers (1-­‐2 minutes) may follow
depending on interest and time.
5. As a team, fill out and submit a single worksheet, complete with all group members’
names, and the name of the app you evaluated.
You will be graded for your presentation and worksheet on the following scale:
Grading rubric (scale of 1-­‐5)
Evaluation
Grade
Provided a concise and thorough presentation of their evaluation using basic
examples, demonstrating a broad understanding of the app and its application in
a clinical setting. Presentation was informative and kept the class’ interest.
5
Provided an adequate overview of their app, touching on half of the evaluation
criteria or less. Presentation was mildly interesting to the class.
3
Provided a reasonable overview of their app, touching on more than half of the
evaluation criteria. Presentation was informative and kept the class’ interest.
Provided a partial overview, including a few of the areas of evaluation.
Presentation was mildly interesting to the class.
Presentation clearly based only on immediate experience with the app, and
demonstrating a lack of advanced research and preparation.
(continued on next page)
4
2
1
Basic evaluation criteria
Use the following criteria as a guide in developing a 3-­‐5 minute overview of your group’s
assigned app.
When using mobile applications for research or reference, you will want to tailor the
evaluation criteria to meet your own needs. However, there are some basic guidelines that
can be taken into consideration. The following list presents some of the most basic
evaluation criteria. Not all criteria will apply to every app.
Focus
Suggested questions to ask
Authority of
source
•
•
•
•
•
•
Accuracy,
Objectivity and
Currency
•
•
•
•
Organization
•
•
•
•
•
Purpose
Compare with
other sources
Usability and
Applicability
Who is responsible for the content of this app?
What are the author's/contributors credentials?
Is there an organizational sponsor?
Developed by an educational institution? A business?
What is the reputation of the sponsor or developer?
Is there contact information, such as a publisher or email address?
Who is sponsoring the app?
Does author affiliation influence the views presented?
Is there a political, cultural, or religious perspective?
Are there advertisements on the app? How often is the information
updated?
Is the information well organized?
Is the app searchable?
Is there an index or table of contents?
Is the app reliable (does it work)?
Is there an easy-­‐to-­‐find “Help” feature?
• Who is the intended audience?
• Is the purpose to inform or persuade?
• Is the information promotional?
• Are other sources better (books, periodicals, etc.)?
• Is the app free, or is there a fee?
• Can the information be more easily obtained from another source?
• Is the app easy to use?
• How useful is the information for your purpose?
Apps for review
Group #
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Name
STAT Growth Charts by Austin Physician Productivity, LLC
Diagnosaurus by Unbound Medicine, Inc.
Medical Spanish by Mavro
Manual of Nursing by Current Clinical Strategies Publishing
Lexicomp by Lexi-­‐Comp (lexi.com)
Nursing Reference Center by EBSCO Publishing
Relief Central by Unbound Medicine
Shots by STFM by Group on Immunization Education of the Society of
Teachers of Family Medicine
iTriage: by Healthagen LLC
MyMedList by the National Library of Medicine (NLM)
Medscape by Medscape.com
Epocrates by Epocrates
Journal of Public Health Management and Practice by Wolters Kluwer
Health Lippincott Williams & Wilkins
Lexicomp by Lexi-­‐Comp
Flu Tracker by Anouk Stein, M.D.
My Fitness Pal by MyFitnessPal.com.
Drug Interactions by Micromedex
Drug information by Micromedex
IV Compatibility by Micromedex
LactMed by the National Library of Medicine (NLM)
WebMD by WebMD.com
Cancer.net mobile by Cancer.net
(worksheet on following page)
Group members:
Group App evaluation
Group #
Use the following criteria (Honisett, 2012) as a guide to develop a summary of your groups’
evaluation of the assigned app. The following list presents some of the most basic
evaluation criteria. Bullet points may be used for the first 6 items. Formal writing is
required for the summary. Evaluation is due to the D2L drop box one week following the
in-­‐class app activity. Submit 1 paper for your group please.
Focus
1. Authority of
source
2. Accuracy,
Objectivity and
Currency
3. Organization
4. Purpose
5. Compare with
other sources
6. Usability and
Applicability
One-­‐two paragraph
summary of app
(Bottom line: would
you recommend this
app to a colleague –
why or why not?)
Group Evaluation of
App
Self-­‐intro’s
1
Outline
• Background and overview
• Mobile technology in nursing practice today
• Integrating mobile devices into nursing course
• Demo testing and evaluating an app, explain
evaluation criteria
• Q&A
2
I’d like to begin by talking about three areas:
•  Use of mobile and other tech in learning
•  mHealth
•  Digital literacy
3
•  “Changes in technology conBnue to alter possibiliBes for learning and create new
challenges for pedagogy. Over the last two decades, colleges and universiBes
adapted and responded to the Internet, email, chat and instant messaging, course
management soIware, podcasts, personal digital assistants (PDAs), and much
more.“
•  ProjecBons suggest that by 2015 mobile devices will represent 80% of traffic
accessing the Internet, far surpassing current desktop use.
4
•  With each iteraBon of new devices, such as the iPad in 2010, many in academia
have experimented with them to both enhance learning and collaboraBon, and as
a quick reference tool. Example:
•  Librarian in Chicago I met @ LITA got a grant to use iPads with eBooks
instead of textbooks in a couple of social sciences classes for a couple of
semesters.
•  Rossing et al at IUPUI recently published a study to explore students’
percepBons of learning and engagement that may occur as a result of in-­‐
class iPad use. 209 students across seven disciplines parBcipated in in-­‐class
acBviBes involving iPads from 1-­‐7 Bmes, and then provided qualitaBve and
quanBtaBve feedback on the experience.
5
•  Their responses included both posiBve and negaBve a`tudes towards the
impressive availability of informaBon that mobile technology provided.
•  They also indicated that using the iPads provided:
•  Greater interacBon and collaboraBon opportuniBes
•  A novel learning tool and environment that allowed for different learning
paces
•  Allowed for becer parBcipaBon across learning styles (touch, sight, etc.)
•  A device containing a variety of tools in an easy-­‐to-­‐use design (for many)
•  Yet this endeavor was not without its challenges:
•  iPad as a shared resource limited how proficient students could become,
especially for those who found the interface confusing and difficult to use.
Which highlighted the digital divide, even between college students.
•  ConnecBvity and reliability of the apps
•  Time for training on the devices meant less Bme on subject instrucBon.
6
Succeeding with mobile:
•  Acclimate to devices
•  Repeated use and/or lending
•  Structure acBviBes with a clear purpose, or students will driI to distracBng
alternaBves
•  Minimize the amount of typing as the keyboard interface is challenging for some.
•  InsBtuBon must commit to high quality wireless infrastructure if this is to succeed.
7
The Btle of this talk refers to “mHealth” which, at is core, is using mobile technology
to improve the pracBce of medicine and public health. App development in this area
is one of the fastest growing, ranging across a variety of areas:
•  In poorer corners of the world:
•  Oxford University along with a group of South African researchers have
developed a kit to turn a low-­‐cost mobile phone into a stethoscope that
allows paBents “to record and analyse their own heart sounds using a
mobile phone microphone. PaBents then send the recordings to medics
who can remotely monitor their condiBon”
•  Study tested accuracy of ECG readings sent using a cellphone camera from
remote areas of Turkey to a medical research university.
•  A recent simulaBon study in Stockholm, Sweden, demonstrated how an alert
system using mobile posiBoning can get trained lay emergency responders to the
site of an out-­‐of-­‐hospital cardiac arrest up to 56% faster than the nearest
ambulance, based on historical data.
•  Reference app for consumers for medicaBon safety during pregnancy.
•  Studies have been conducted on whether texBng and social media used via mobile
phones can help with smoking cessaBon, prevenBng teenage depression, and
paBent compliance with medicaBon or diabetes regimens, most with posiBve
results.
8
As a librarian, my focus is on the topic of informaBon literacy, which is basically:
•  Knowing when more informaBon is needed,
•  What is needed and where to look, and, most importantly,
•  How to evaluate what you find.
A new term has arisen in the literature, that of “digital literacy”, which is the ability to
criBcally evaluate and effecBvely use technology to create new content.
While working at EHSL, med students were being provided with the opportuniBes to
not only learn about mobile technology, but also how to criBcally evaluate its
applicaBon as part of mobile medicine, or mHealth.
•  Check out Palm PDAs, then iPod touch, now iPads
•  Experiment with installed apps,
•  In a reflecBve learning exercise, give a short presentaBon to peers on their
findings.
9
mHealth in Nursing Education
MOBILE HEALTH IN NURSING
10
My informal survey of nursing educaBon literature turned up only a few areas of
focus for using mobile technology:
•  Mobile devices as reference tools for clinical work
•  Mobile tech and how its use can enhance or undermine the classroom experience
and learning.
But no examples of nursing students or pracBBoners criBcally evaluaBng these tools
as I saw being used in UT.
AIer giving a brownbag presentaBon on apps for Nursing, Norah invited me to
collaborate on a unit for her class.
11
Cell phone use was banned in hospitals in 2006 due to the radio frequency
interference that can be caused by turning cell phones off and on. Use of cell phones
was considered unsafe in hospitals, with concerns that the radio frequencies would
interfere with paBent monitoring equipment such cardiac monitors. This is no longer
the case and cell phones are frequently used within the acute care se`ng, though
largely by paBents or visitors instead of hospital personnel. In addiBon, the Smart
Phone has now been added to the basic cell phone, replacing the Palm pilots
(personal digital devices) of about a decade ago.
12
In Norah’s informal conversaBons with pracBcing nurses in acute care (i.e. hospitals,
Urgent Care), locally, there is currently no apparent need for the use of apps since
computers with internet access are located both inside and outside of paBent rooms.
Neither local hospitals supply floor nurses with smart phones during shiI work.
Hospitals subscribe to soIware programs that provide knowledge at the Point of care
(POC).
Likewise in the community se`ng, public health nurses (PHN’s) at the local City-­‐
County Health Department, mobile apps are currently not in use. Recently the PHN’s
started to use texBng as a method of reaching clients for appointment reminders or
to communicate needed informaBon to clients. Smart phones are not issued by the
agency at this point.
13
Nurses who use apps in acute care se`ngs locally do so with their own smart
phones. One app menBoned by a colleague is Micromedex as a drug reference. Since
there is no access to a computer in the medicaBon room, the nurse uses her app as
she searches for informaBon on new medicaBons or uses that app in the paBent
room if the paBent requires teaching.
Advanced pracBce nurses, such as Nurse pracBBoners I have spoken with use apps
such as Prescriber lecer and Epocrates Premium. Epocrates Premium is sort of a
“knowledge suite” and has mulBple apps such as Drug InformaBon, OTC MedicaBons,
AlternaBve MedicaBons, InteracBon Checking, Pill IdenBfier, Disease InformaBon,
Guidelines & Reference Lists, Calculators, PaBent EducaBon, Formulary InformaBon
and Clinical Updates. A 2 year subscripBon costs $169.
14
InteresBngly enough, conversaBon with a Labor & Delivery nurse revealed that while
the nurses are not using apps at POC in acute care se`ngs, the paBents are. PaBents
are using apps for recording all kinds of important informaBon. For example, the
iTunes Baby Nursing app lets you keep track of breasqeeding, pumping, tracking the
# of wet/dirty diapers, weight, growth measurements and hours of sleep for your
new born. It has a Bmer funcBon and allows you to add photos. All this informaBon
is invaluable to a first Bme mother. Apps such as Pregnancy (SPROUT), show high-­‐
quality 3D renders of a developing baby through the three trimesters that auto-­‐
update weekly based on the due date. There are also many health and fitness apps
for personal use as well from Weight Watchers, to exercise plans to blood pressure
recording.
15
iPads in a Nursing Course
Nursing within Systems:
Application and Analysis
Norah M Airth-Kindree,DNP, RN
Assistant Professor, College of
Nursing and Health Science, UW­
Eau Claire.
16
Norah teaches within the CollaboraBve Nursing Program where registered nurses
who have earned an associate degree in nursing (ADN) from a technical college
return to complete their Bachelor of Science in Nursing (BSN) degree. This program is
expanding; likely due to research which has shown that paBents cared for by
bachelor-­‐prepared nurses have becer health outcomes. Coupled with the InsBtute
of Medicine’s “Future of Nursing” 2010 report which called for an increase in the
number of BSN-­‐prepared nurses (from 50% to 80% in 2020), along with becer paBent
outcomes, health care systems are looking to hire more BSN-­‐prepared RN’s. Locally,
Mayo Clinic Health Systems has announced that ADN nurses must return to nursing
school and complete their BSN within 6 years of hire or they will no longer be an
employee.
At UW-­‐ Eau Claire, the capstone course Norah teaches, enBtled Nursing within
Systems: Analysis and Applica7on is the class taken just prior to graduaBon. The 4-­‐
credit course is composed of both a didacBc and clinical component. Though the
clinical is strictly a community/ public health focus as ADN-­‐prepared nurses are not
exposed to public health content, the didacBc porBon seeks to meet objecBves that
encourage life-­‐long learning. These objecBves specifically are to
Evaluate the effecBveness of client care and management of nursing care delivery.
Demonstrate leadership in program development or coordinaBon of care in public
17
Demonstrate evaluaBng an app
18
Structure:
Preceding class: Students assigned to teams of 3 people.
Each team assigned an app to evaluate, and a worksheet with quesBons to answer in
this process.
Bring your worksheet to class on January 30, where teams will be provided with iPads
allowing you to try out and evaluate your assigned app for approximately 30 minutes.
Based on the results of your research on, and use of the app, each team will then give
a short, 3-­‐5 minute on the app. A brief Q&A by peers (1-­‐2 minutes) may follow
depending on interest and Bme.
As a team, fill out and submit a single worksheet, complete with all group members’
names, and the name of the app you evaluated.
19
Your thoughts?
Q&A
20
Thank you!
• Feedback form:
http://bit.ly/XY9w4o
If you would like a link
to this slideshow, our
references or other
information, please
provide your name &
email in the "Other
comments" section.
Photo: HikingArtist.com via Compfight
21
References
• mHealth- Wikipedia,the free encyclopedia.
(n.d.). Retrieved January 23, 2013,from
http://en.wikipedia.org/wiki/MHealth
• Rossing, J.P.,Miller, W. M., Cecil,A. K., &
Stamper,S. E. (2012). ilearning: The future of
higher education? Student perceptions on
learning with mobile tablets.Journal of the
Scholarship of Teaching & Learning, 12(2), 1-
26.
22