title: Educational impact of using smartphones for clinical communication on general medicine: more global, less local.
abstract: BACKGROUND
  Medical trainees increasingly use smartphones in their clinical work. Similar to other information technology implementations, smartphone use can result in unintended consequences. This study aimed to examine the impact of smartphone use for clinical communication on medical trainees' educational experiences.
  
  
  METHODS
  Qualitative research methodology using interview data, ethnographic data, and analysis of e-mail messages.
  
  
  METHODS
  We analyzed the interview transcripts, ethnographic data, and e-mails by applying a conceptual framework consisting of 5 educational domains.
  
  
  RESULTS
  Smartphone use increased connectedness and resulted in a high level of interruptions. These 2 factors impacted 3 discrete educational domains: supervision, teaching, and professionalism. Smartphone use increased connectedness to supervisors and may improve supervision, making it easier for supervisors to take over but can limit autonomy by reducing learner decision making. Teaching activities may be easier to coordinate, but smartphone use interrupted learners and reduced teaching effectiveness during these sessions. Finally, there may be professionalism issues in relation to how residents use smartphones during encounters with patients and health professionals and in teaching sessions.
  
  
  CONCLUSIONS
  We summarized the impact of a rapidly emerging information technology-smartphones-on the educational experience of medical trainees. Smartphone use increase connectedness and allow trainees to be more globally available for patient care but creates interruptions that cause trainees to be less present in their local interactions with staff during teaching sessions. Educators should be aware of these findings and need to develop curriculum to address the negative impacts of smartphone use in the clinical training environment.
authors.affiliation: Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada. robert.wu@uhn.on.ca
authors.forename: Robert C
authors.initials: RC
authors.lastname: Wu
authors.forename: Katina
authors.initials: K
authors.lastname: Tzanetos
authors.forename: Dante
authors.initials: D
authors.lastname: Morra
authors.forename: Sherman
authors.initials: S
authors.lastname: Quan
authors.forename: Vivian
authors.initials: V
authors.lastname: Lo
authors.forename: Brian M
authors.initials: BM
authors.lastname: Wong
mesh_terms: D040421:Cell Phone / Q000592:standards / Q000639:trends*; D003142:Communication; D004501:Education, Medical / Q000592:standards / Q000639:trends*; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards / Q000639:trends*; D007396:Internship and Residency / Q000592:standards / Q000639:trends*; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards / Q000639:trends; D013337:Students, Medical