White coat pockets stuffed full of reference material is almost a prerequisite to being a medical student or intern, but new technology and the availability of apps for everything under the sun is quickly changing that.
A part of everyone’s clinical experience involves taking thorough, detailed histories and doing complete physical exams, at least in the early part of their training.
While well-seasoned doctors may be able to identify the key elements of a focused clinical history and exam, the necessity of first learning to take a complete H&P cannot be underestimated.
But, that’s a lot of information! How can you be sure you remember to ask everything? Enter – pocket reference cards and their tech-savvy counterpart, i-PocketCards from publisher Borm Bruckmeier
This little app packs a full H&P into bite-sized pieces by letting the user select from a table of contents or classic view to review basic information before meeting with a patient.
The interface is relatively user friendly and self-explanatory; by clicking on Table of Contents you’re taken to a page with options to view Preliminary Data, History, Review of Systems or Physical Exam Elements. Each of these expands into further categorized areas of the basic H&P. When you select the last tier you are taken to a screen with detailed information and a check-box system, allowing the user to easily identify if they have asked all the pertinent information.
The classic view is just that – a classic view of an H&P pocket card one might carry along in their white coat pocket for full H&P reference.
While the interface is easy on the eyes and simple to use, the utility of this app seems to be lacking. For me personally the app would be much more useful if it allowed for some type of input – even just a yes/no system would be more applicable. As it is currently, the app serves simply a check-box function to ensure that you’ve “asked all the right questions,” but doesn’t record any of the answers for transfer to a patient chart. Though the app does fulfill its function of a reference card adequately, it leaves much to be desired in the realm of actual clinical usefulness as far as interactivity goes.
Although the app lacks a bit clinically, it does include some good reference material, particularly for pulmonary and cardiovascular exams. Again, this is most useful for younger medical students who are just learning the techniques.
It also offers some good tables, such as these for nerve functions and reflex testing.
The one area of medical training I see this app being most useful is in the very early years of learning how to take H&Ps and very early clinical training. As a first year medical student I might have found the information in this app helpful in my early clinical experience classes for quick reference outside a patient room. However, even as a third year student I did not find myself opening this app on a regular basis, simply because I didn’t find myself needing access to this type of information clinically.
Typically, as you move through your clinical years and into actual practice you’re expected to be able to decide what information is relevant and elicit a relevant, focused H&P, rather than take a full-monty, ask-everything approach. So, while this app may serve a purpose in practices with physicians afforded the luxury of sitting down with patients for long periods and asking every question under the sun, it does not serve a practical purpose in most situations.
Junior medical students will find this one great for review before those first few detailed H&Ps they are required to take or before that first full-history OSCE they participate in, but otherwise the actual clinical utility seems to be lacking.
However, it is worth noting that the information is extensive and doesn’t seem to be lacking in any particular area. It is reliable and includes any and everything you may want to ask a patient. If you are ever in a situation where you need to take a full H&P and can’t seem to recall every little question, exam technique, or subject, this app would serve a good reference purpose.
- Easily accessible information with a simple to use interface, wealth of information related to H&P
- Good illustrations on auscultation and the like
- Accurate and reliable information
- Clinical usefulness is greatly lacking with almost no interactive functions in the app
- Serves only as a check-list reference app
- Would like to see at least an opportunity to record yes/no answers for transfer to patient charts
- While the premise of the app is promising and it definitely fulfills the function it advertises to, the usefulness is likely to disappoint those who frequently use clinical apps and are accustomed to those apps having impressive interactive functions that can’t be fulfilled by a simple photo or document stored on the device.