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Evaluating the impact of mobile technologies on the

student learning experience in health practice

Jill Taylor, Catherine Coates, Sara Eastburn, and Ieuan Ellis

Leeds Metropolitan University,

Practice education is a core element of all health care professional education
programmes and an essential component for registration to practice. Assessment
and Learning in Practice Settings (ALPS), a Centre for Excellence in Teaching &
Learning (CETL), is a collaborative project between 5 Higher Education
Institutions committed to delivering excellent assessment, learning and teaching
(ALT) opportunities across health and social care professions.

As an ALPS partner site, Leeds Met undertook a pilot project, involving pre-
registration dietetic and physiotherapy students, to deploy mobile technologies
into placement settings and to develop appropriate pedagogic approaches that
exploit the technology to deliver an enhanced student learning experience.

MediaBoard was used to set up web-based multimedia message boards.
Students and tutors contributed to the message boards by sending SMS (text),
MMS (text, picture, audio), from O2 XDA 2 mobile PDA/phones. This allowed
recording of immediate “real time” experiences within the placements setting and
exploited the features available on the mobile devices to record this information
in multimedia formats.

The students collected information as part of a multimedia blog including
information about observations and learning experiences, especially pivotal
incidents that support critical analysis of learning that underpins reflection. The
approach also gave them the opportunity to work collaboratively to support and
enhance inter-professional learning. Although the emphasis was on supporting
formative activities the data collected could be used as evidence in summative
assessment of some of the practice placement learning outcomes.

Key findings from the project evaluation are discussed such as learner and tutor
experiences, benefits to ALT, and issues associated with implementation such as
usability, connectivity, and the ethical and cultural change issues that arise. We
will suggest ways in which this technology could be utilised and embedded more
effectively in ALT strategy.
Practice education, Reflective practice, Mo-blogging, PDAs


The potential of personal digital assistants (PDAs) for learning and assessment is
of increasing interest to Health and Social Care Professions (Sauders and
Pellow, 2006) and the wider H.E. community (Smith, 2003; Anderson and
Blackwood, 2004). The use of handheld computers to facilitate practice
assessment is one of the key strategic aims of the ALPS CETL. Mobile
technologies are mainly being used for clinical rather than learning applications.
Previous studies in health settings have been undertaken mainly in the USA and
Australia and have focused on nurses (Miller, 2006), paramedics (Norman, 2005)
and doctors (Scheck McAlearney, 2004). These studies investigated the use of
PDAs to provide access to information and assessed the usability of the devices
for Health Care Professionals. Walton et al (2005) explored the perceptions of
health care students regarding the use of PDAs in the community. The students
showed a low level of awareness of the technology but placed great importance
on being able to access learning resources from the community. They have been
found to be an effective resource for students, especially for reference materials
(Miller et al, 2005). There are very few studies that have assessed the
effectiveness of PDAs for practice assessment and these have mainly involved
self assessment activities with medics (Engum, 2003; Bent et al, 2002) and
nurses (Kneebone et al, 2003). This study used physiotherapy and dietetics
students and aimed to evaluate the barriers and benefits of introducing PDAs for
reflective learning and for the collection of learning artifacts to support
constructionist pedagogies.


Twenty pre-registration M.Sc
Physiotherapy students and twelve B.Sc
hons Dietetics students were issued with
O2 XDA mini-s PDAs to support reflective
learning experiences during assessed
placement taking place in a wide range of
practice placement settings within NHS
Trusts in Yorkshire. University tutors and
link tutors were also provided with PDAs
to facilitate communication with the
students. MediaBoard is a flexible, web
based tool which enables the creation of
interactive learning tasks and projects. It
has been previously used successfully to
deliver a wide variety of educational
mobile pilots in a variety of educational settings (Savill-Smith, 2006). It was used
to set up Internet based multimedia message boards. A Mediaboard starts with a
central image which can be marked up into zones. Students are able to send in
comments, which can be text, audio, pictures or emails to a specific zone. Unlike
most traditional Internet message boards they can add their comments by
sending SMS (text) or MMS (picture, text and audio) from a mobile device. A
variety of mediaBoards were set up including the “Sites” board (Fig 1) which
provided the opportunity for interprofessional learning and collaborative working
to support reflective practice.

Individual and tutor boards were employed to log pivotal incidents and encourage
reflective practice. Learning artifacts posted by students were used for formative
and summative assessment in practice modules and contributed to the students
practice portfolios. The project was underpinned by hands on training sessions
for staff and students on the use of the PDA and mediaBoard. These were
complimented with online WebCT support materials and a IT helpdesk. Ethical
clearance was obtained from the Faculty ethics committee for the pilot and each
participating student completed an ethics proforma to ensure that no images
were taken of active clinical environments to preserve patient confidentiality.

A number of evaluation instruments were used to assess the experience of the
learners and practitioners including pre and post WebCT surveys, focus groups,
semi-structured interviews of staff, and mediaBoard staff and student issues


Students posted a variety of artifacts to their individual boards, for example,
images taken of procedures, X-rays and clinical resources (Fig. 2) and in addition
posted comments and reflections to tutors via the tutor boards.

Most students preferred entering text data using the slide out keyboard in
preference to handwriting recognition or the on screen keyboard.
Benefits for students

The main perceived benefits for
students were improved tutor
and peer support and better
access to information and
resources along with the ability
to record and reflect on their
clinical experiences in real time.
Students felt they were learning
a useful skill that could be
transferred and used in future
innovations (Fig. 3).

Students commented that:

“It’s useful as we had projects to
do together so we used it a lot
for that”

“Useful for contacting visiting
tutor at university whilst on placement”.

“Being able to take pictures during in-services (x-ray for example) acts as a
useful trigger for recalling information”.

“Good for recording data and evaluating and reflecting upon clinical experiences”

Issues for students
The issues encountered with using the technology in the practice placement
settings were ethical and cultural acceptance, finding time within hectic practice
placements to interact with the technology, and the technical problems that
arose. Students commented that:

“Obviously I had explained it to my supervisor but all the other staff, like
psychologists or occupational therapists were all looking at me as if to say
“What’s she doing on her mobile phone?”…..”

“Sometimes when I was getting shown something on a patient, then that would
have been useful but you can’t do it”.

“I think the mediaBoard could be very useful although I didn’t have time to use it”

“A bit bulky to carry around whilst in uniform”

“Couldn’t send video”.

The majority of students agreed they would be more motivated to post to the
mediaBoard if it counted towards the assessment.

Evaluation from tutors
Initial evaluation from tutors indicates that the PDAs and mediaBoard facilitates
communication however the tutors found the use of the PDAs challenging and
would have liked greater support and better training. The resistance to change
affected their engagement with the technology. However some acknowledged
the future potential of this approach for enhancing practice education. Tutors
commented that:

“A big cultural change but very interesting and potentially useful to support

“I can see that with more time and commitment I would use this more in the

“Personally I am not against them but I would need much more support/time to
learn how to use them”.
“Great way to access and support students directly when on placement”.

“Felt we are just at the start when the pilot ended. Would welcome development
for portfolios, reflective practice, web logs etc. Opportunities extended for peer
support and learning in practice setting”.


This initial pilot begins to address the benefits and issues involved in introducing
mobile technology to the practice environment and its ability to facilitate
pedagogical practices congruent with a constructionist educational philosophy as
proposed by Sotillo (2003). Our findings suggest that the impact of m-learning
would be facilitated if the technology is introduced early in the student life cycle to
encourage familiarity and develop cultural acceptance. A lesson we learned was
that we should be more directive with the task definition and embed the learning
activities firmly in the assessment strategy. In addition we would redesign the
training for students, tutors and practice educators to encourage more
experimentation to encourage acceptance and familiarity. A future challenge will
be to gain recognition from NHS Trusts, practice educators, and service users of
the PDA as the “modern notebook “for undertaking assessments and recording
clinical experiences in multimedia formats.


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