I would like to talk about a project we under took at the Eccles Health Sciences Library  to integrate Palm devices into the School of Medicine curriculum. This will be a case study – outlining the process we undertook to make the use of this tool in the curriculum a reality.

The opportunity came to us from Dr. Grant Cannon, who is the overall course master for a course titled Topics In Medicine. Over the past 7 years we have worked with Dr. Cannon to teach evidence-based searching skills to the medical students during their Ob/Gyn rotation and he wondered if we would be interested in working with the Pediatric rotation, possibly using handheld devices. We of course jumped at the chance.

The first step in this process was to start planning. We had meetings starting in March of 2003. We talked about ways the devices could potentially be used in the rotation; we needed to select a specific device. Nancy Lombardo, our Systems Librarian, did most of the initial investigation into the model. We selected the Tungsten C, with wireless capability and LOTS of memory. We established a timeline and agreed to start the course in the first week of July 2003. As we talked about ways the devices could be used, we also identified appropriate software applications – a few of the more pediatric oriented programs were Kidometer, Red Book (related to pediatric infectious diseases and is considered their bible) and PedsBase, a resource of pediatric disease conditions. We also needed to find funding for these $500 devices and some of the fee-based software.

Nancy and Dr. Cannon applied for funding. We needed 15 student devices, 6 devices for pediatric faculty and 8 devices for Eccles Library faculty. In total the project, to this point, has cost $16,567.

Next in the process, and appealing to my practical nature, we approached the course content. Working with Drs. Cannon and Maloney, we established specific goals and objectives. There are 5 2-hour sessions over a six week period. Session 1 is the building your Palm session. The students, who’s skill levels with these devices range from novice to expert, are given the opportunity to download applications (we have them do Acrobat Reader and a drug resource, ePocrates), and practice enter basis address and calendar functions and them beaming their business card to the instructors. During Session 2 the students present an evaluation of an assigned application and then for Session 3, they find a new application  and again present an evaluative review to their peers. Sessions 4 and 5 related to evidence-based searching and evaluating research articles. The intent is to use the ebm tools on the handheld devices.

Our colleague John Bramble took the lead in resolving many of the technical issues related to this project. John worked diligently with the staff at the American Academy of Pediatrics to resolve the licensing issues related to the use of the Red Book, a fairly expensive program. They seemed very unsure how to deal with our need to reload the application at the beginning of each rotation. John developed a checkout and loan agreement form and staff were trained to check out the devices on the circulation system. We needed to be careful to account for all the various pieces – like the stylus and the usb cable. And at the end of each rotation, we needed to hard reset the devices to ensure that any private information the students added to the Palm was removed before the start of the next rotation.

The most significant challenge remains the amount of time and energy to prepare the devices for the first session of each rotation. Easily we spend 8 to 10 man hours on this. The skill level of the library faculty ranged from novice to expert and some of us were not comfortable with instructing students how to use the devices, when we were learning as well.. We established regular training sessions, once a week for one hour. This was an opportunity for use to learn more about the devices, improve our skill base and increase our comfort level. Some students came to the class with their own handheld devices – Pocket PC’s or Sony Clio’s, etc. And some students wanted to use their own devices rather than check out one we were providing. So we are still working with that one. In addition, there is no standard for application installation. Some apps are more difficult than others to download; and the process can be time consuming and frustrating. Over the course of the program, we have discarded some applications and added others – this based on usability and expressed preferences from faculty and students. And then there have been issued with damage to the devices – we have had three screens broken and one device was dropped into water (possibly a toilet) and have had to be returned and fixed. We haven’t had a lost device yet, and we hope we don’t have to deal with that one.

The students are issued a Palm for their 6 week pediatric rotation. Library faculty instruct the students in device basics – how to use the calendar, address book, etc. We also get the more experienced students to coach the less experienced students and we encourage peer to peer teaching of device applications. The pediatric faculty provide needed context and content expertise, and practical instruction in using certain applications and they provide instruction in evidence-based searching.

Overall, the experience has been valuable to the library faculty and to the students. Our most significant outcome is that we have exhibited leadership in promoting the use of leading edge technologies in the School of Medicine curriculum.

Overall, the experience has been valuable to the library faculty and to the students. Our most significant outcome is that we have exhibited leadership in promoting the use of leading edge technologies in the School of Medicine curriculum.