Medical students hesitant to use clinical apps in healthcare settings for fear of being perceived as incompetent

Data on the frequency, type, popularity and perceptions of 11 common clinical apps used in the healthcare setting was collected from 731 medical students using an anonymous, 18-question Web-based survey in a cross-sectional study by Quant et al in the US.¹ The apps included in this survey were Epocrates, UpToDate, VisualDx, DynaMed, Diagnosaurus, Lexicomp, Eponymns, Medscape, Micromedex, WebMD, Wikipedia, and Google.

The most used apps were UpToDate and Epocrates. The most trustworthy apps were UpToDate, Epocrates, DynaMed, Micromedex, and Medscape. Most of the medical students think apps enhance their clinical knowledge (90%), save time (95%), improve care (87%) and diagnostic accuracy (78%). In fact, 23% think that these medical apps are even more reliable than textbooks, while 61% think they are at least as reliable. However, more than half of the medical students thought that they look less competent using apps in front of patients and colleagues. Interestly, more of the medical students in their third and fourth year with clinical experience think it’s ok to use apps in front of their patients, while fewer from first and second year without clinical experience think it’s ok. The ones with more clinical experience also think that using apps in front of patients shows that they care enough to check, while fewer preclinical students think this way.

A recent study from Australia supported the benefits of iPhone usage in acute care settings by both physicians and nurses.² In fact, in this study, the physicians were not concerned about being viewed as incompetent, while the nurses were. Based on the results from both studies, it seems that the less experienced or less specialized medical professionals are less confident about using apps and mobile phones in front of their patients and more concerned about being questioned on their knowledge and credibility. This mentality needs to change. It would be a waste of time and resources if clinical mobile apps and tools are not used despite their availability and accessibility, especially because it has been shown that accessing medical information at the point of care is beneficial for the clinical outcome.³ Clinical guidelines and recommendations are updated more quickly in online and digital resources, therefore referring to textbooks and pocket guides, which traditionally are perceived as more legitimate resources, may not be as beneficial.

What may help change this mentality is to learn about patients’ perception on medical staff using phones during a consult or in the clinical setting in general. Also, the interaction between the physician and the patient when mobile devices and clinical apps are used can be studied. For example, do physicians let patients know what they are doing with their phone? Is there anything visual that they can show the patient to explain their condition better? If the appropriate communications are paired with phone and clinical app usage, perhaps medical professionals will feel more comfortable using handy clinical apps to confirm and improve diagnosis without the fear of having their professionalism challenged.