Use of personal digital assistants (PDAs) in reflection on learning and practice

Introduction: As the use of personal digital assistants (PDAs) grows, the value of reflection of learning and practice draws increased attention from policymakers and evaluators. To learn more about the use of PDAs in practice and learning, the present study describes use of (1) PDAs in patient care and (2) a PDA version of the Virginia Board of Medicine Continuing Competency and Assessment Form (CCAF), a learning portfolio intended to encourage documentation of reflection on practice and medical education. Methods: A purposive sample of 10 practicing physicians (6 male, 7 primary care) was recruited from geographic regions throughout Virginia. Five participants were previous users of a PDA. Three sources of data were analyzed: (1) a questionnaire describing PDA usage, (2) transcripts from telephone interviews, and (3) CCAF written comments. A study team member installed the PDA system and conducted individualized training on the basis of current equipment, software, and skills of the learner. Telephone interviews were completed 4-6 months after training. Results: All physicians accessed the system after training. Use of the PDA was associated with the value of information for making clinical decisions. Information accessed by PDA was used not only for clinical decisions but also for patient education and for teaching medical students. Use of the CCAF prompted physicians to reflect on changes in clinical practice. Discussion: Training on the handheld equipment and applications should include assessment of systems connectivity and integration, access authority, existing skills, and previous use. Proponents of PDA use for clinical decisions should assure access to information that is useful to physicians for reflection on learning and practice.