J. Med. Internet Res. - Smartphones as multimodal communication devices to facilitate clinical knowledge processes: randomized controlled trial.

Tópicos

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Resumo

CKGROUND: Despite the widespread use and advancements of mobile technology that facilitate rich communication modes, there is little evidence demonstrating the value of smartphones for effective interclinician communication and knowledge processes.OBJECTIVE: The objective of this study was to determine the effects of different synchronous smartphone-based modes of communication, such as (1) speech only, (2) speech and images, and (3) speech, images, and image annotation (guided noticing) on the recall and transfer of visually and verbally represented medical knowledge.METHODS: The experiment was conducted from November 2011 to May 2012 at the University Hospital Basel (Switzerland) with 42 medical students in a master's program. 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. Participants were randomly assigned to 3 experimental conditions/groups. In group 1, the specialist provided verbal explanations (speech only). In group 2, the specialist provided verbal explanations and displayed the radiological image and the photographs to the participants (speech and images). In group 3, the specialist provided verbal explanations, displayed the radiological image and the photographs, and annotated the radiological image by drawing structures/angle elements (speech, images, and image annotation). 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.RESULTS: Data analysis by ANOVA found that participants in groups 2 and 3 (images used) evaluated the support provided by the specialist as significantly more positive than group 1, the speech-only group (group 1: mean 4.08, SD 0.90; group 2: mean 4.73, SD 0.59; group 3: mean 4.93, SD 0.25; F2,39=6.76, P=.003; partial (2)=0.26, 1-?=.90). 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). 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). No significant differences were observed between the groups regarding verbally represented medical knowledge.CONCLUSIONS: The results show (1) the value of annotation functions for digital and mobile technology for interclinician 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. This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice.

Resumo Limpo

ckground despit widespread use advanc mobil technolog facilit rich communic mode littl evid demonstr valu smartphon effect interclinician communic knowledg processesobject object studi determin effect differ synchron smartphonebas mode communic speech speech imag speech imag imag annot guid notic recal transfer visual verbal repres medic knowledgemethod experi conduct novemb may univers hospit basel switzerland medic student master program particip analyz standard case patient subcapit fractur fifth metacarp bone base radiolog imag photograph hand textual descript ask consult remot surgic specialist via smartphon particip random assign experiment conditionsgroup group specialist provid verbal explan speech group specialist provid verbal explan display radiolog imag photograph particip speech imag group specialist provid verbal explan display radiolog imag photograph annot radiolog imag draw structuresangl element speech imag imag annot assess knowledg recal particip ask write brief summari case verbal repres knowledg consult reanalyz diagnost imag visual repres knowledg assess knowledg transfer particip analyz similar case without specialist supportresult data analysi anova found particip group imag use evalu support provid specialist signific posit group speechon group group mean sd group mean sd group mean sd f p partial howev signific posit effect recal transfer visual repres medic knowledg observ smartphonebas communic involv combin speech imag imag annot group signific posit effect recal transfer visual repres knowledg group speech group speech imag signific differ observ group regard verbal repres medic knowledgeconclus result show valu annot function digit mobil technolog interclinician communic medic informat use guid notic integr speech imag imag annot lead signific improv knowledg gain visual repres knowledg particular valuabl situat involv complex visual subject matter typic clinic practic

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