Personal Digital Assistant Usage among Undergraduate Medical Students: Exploring Trends, Barriers, and the Advent of Smartphones*

Article excerpt

Personal digital assistant (PDA) use is widespread and now considered an essential part of medical practice [1, 2]. These devices, also known as handhelds, allow health professionals to find answers to clinical questions while at the patient's bedside, resulting in better patient safety and clinical outcomes [3]. However, it has been found that PDA users, especially medical students, often struggle to use these tools to their full potential [4-7]. Health sciences libraries have responded by providing resources and services such as the evaluation of PDA programs and devices, instruction sessions on effective PDA use, and even the provision of technical support [8, 9].

Most of the literature that can be used to inform library practices in this area only briefly describes PDA usage patterns [10, 11], the types of activities performed with a PDA, or the most popular programs used [2, 5, 7, 12-17]. Some studies go slightly further and examine barriers to handheld computing [6, 7, 14, 18]. While a multitude of case studies superficially describe PDA initiatives implemented by libraries [19-22], few studies empirically examine the services and resources provided for medical students who use PDAs [23]. Finally, little to nothing has been written on how the advent of the smartphone has affected PDA usage and users' behaviours and needs [24].

Since 2001, the John W. Scott Health Sciences Library at the University of Alberta (U of A) has been providing services and resources for those using PDAs. These services have met with some success and have been cited and commended by a number of authors [19, 25, 26]. In an area where so much innovation and change takes place, it is necessary for libraries to maintain relevance by routinely assessing services and implementing improvements. This paper describes a study that was developed to inform the U of A's current PDA initiatives and subsequently addresses some of the gaps identified in the current body of literature on this topic.


The main objectives of this study were to assess PDA usage and the resource needs of U of A undergraduate medical students. In particular, the following research questions informed development of the survey that was used:

1. Which devices and operating systems are the most popular?

2. Which library resources are the most used and desired?

3. What type of content and which format for instruction are preferred?

4. How do students' PDA and computer use differ from and/or complement each other?

5. Has the advent of the smartphone changed PDA usage?

The resulting data will guide library collection development and user instruction policies and practices.


After ethics approval was received, an online survey was distributed in February 2008 via an email discussion list to all 571 undergraduate medical students at the U of A (Appendix A, online only). The survey consisted of 19 questions and was designed to take between 10 and 15 minutes to complete. Questions related to the devices owned by students, their frequency of use, the ways students had learned to use their devices, the programs downloaded, and the types of library services desired by students.

Three hour-long focus groups were held with a total of seven students. Questions (Appendix B, online only) differed slightly from those asked in the survey. Participants were asked what were barriers to their handheld usage, how their use of PDAs differed from their use of computers, and what the library's role was in service provision. Feedback was also sought on the library's PDA resource page.


Unfortunately, only 81 responses out of a potential 571 were received, for a low survey response rate of about 14% and a margin of error of 10.1% (or confidence interval of +/-10.1%, 95% confidence level). Numbers were extremely low for students in their third and fourth years of education (4/127, 3. …