Smartphones found effective for multimodal inter-clinician communication

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A randomized controlled trial comparing different synchronous smartphone-based communication modes found them to be multimodal communication devices that can effectively support clinical knowledge processes, according to study in the Journal of Medical Internet Research.

The objective of the Swiss study was to determine the effects of different synchronous smartphone-based modes of communication, such as speech only, speech and images, as well as speech, images, and image annotation (guided noticing) of visually and verbally represented medical knowledge. Forty-two medical students in a master's program at the University Hospital Basel in Switzerland participated in the study. 

All participants analyzed a standardized case (a patient with a subcapital fracture of the fifth metacarpal bone) based on a radiological image, photographs of the hand, and textual descriptions, and were asked to consult a remote surgical specialist via a smartphone. The medical students were randomly assigned to three groups.

To assess knowledge recall, participants were asked to write brief summaries of the case (verbally represented knowledge) after the consultation and to re-analyze the diagnostic images (visually represented knowledge). To assess knowledge transfer, participants analyzed a similar case without specialist support.

Participants in groups 2 and 3 (images used) evaluated the support provided by the specialist as significantly more positive than group 1 (speech-only group), reports the article. "However, significant positive effects on the recall and transfer of visually represented medical knowledge were only observed when the smartphone-based communication involved the combination of speech, images, and image annotation (group 3)," state the authors. 

The study found that there were no significant positive effects on the recall and transfer of visually represented knowledge between group 1 (speech only) and group 2 (speech and images). In addition, no significant differences were observed between the groups regarding verbally represented medical knowledge.

"The results show (1) the value of annotation functions for digital and mobile technology for inter-clinician communication and medical informatics, and (2) the use of guided noticing (the integration of speech, images, and image annotation) leads to significantly improved knowledge gains for visually represented knowledge," conclude the authors. "This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice."

In the U.K., the University of Leeds School of Medicine was the first in that country to outfit all of its medical students with iPhones to record case notes while rounding in the hospital, keep electronic copies of reference materials, and stay current with medical guidelines. Not surprisingly, last year an online survey of medical students in the U.K. showed 79 percent owned a smartphone.

In related news, a recent study of third-year German medical students found that mobile augmented reality can significantly increase the attractiveness of mobile learning applications in medical education, compared to traditional textbook learning.

To learn more:
- read the study in JMIR

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