...the whole point of using the PDA in pharmacy education and clinical practice is to compress a specialized professional library 'into this gizmo that weighs five ounces and fits in your pocket'...
On a recent afternoon in Samford's McWhorter School of Pharmacy, a student stopped by to schedule a meeting with Dean Joseph Dean. Dean and the student each produced wallet-size computers and, with a few strokes of a stylus, scheduled a meeting. The exchange was a measure of how thoroughly computer technology has infiltrated our daily lives, but it also represents a genuine revolution in pharmacy education.
The Personal Data Assistants (PDAs) the Dean and student used to arrange their schedules are capable of holding the contents of a small library–much more information than even the most diligent students could memorize and recall at will. “Pharmacy has developed into a knowledge profession, an information-driven profession,” Dean said. “It is impossible, now, for anyone to hold in his or her head everything he or she needs to know.” The PDA, Dean said, is “a peripheral brain at their fingertips,” and the focus of a remarkable investment by the school.
It Must Be For Everyone
Dean felt from the beginning that the school must provide students the technology it expected them to master and take with them into professional life. For the sake of compatibility and equal access to resources, he said, “it must be for everyone.” That required a substantial investment and a certain amount of trial and error in determining which of the various computer hardware formats would serve with equal utility in both the classroom and in clinical practice.
The school first turned to laptop computers, but the limited number of machines provided faculty in the mid-1990s proved to be too cumbersome in practice environments. “The PDA seemed to have the potential for overcoming that limitation,” Dean said. After initial research and experimentation confirmed the advantages of the technology, the school used a portion of a larger gift from Huntsville alumnus Bill Propst to purchase, direct from Palm, Inc., almost 500 PalmM500 and M515 model PDAs.
In spring 2001 all McWhorter School of Pharmacy faculty received PDAs and encouragement to experiment with them in classroom settings. The results were encouraging, and by fall of 2002 all students and faculty had the devices. Even school staff now have PDAs, making MSOP the only pharmacy school in the nation to be so completely equipped, according to Dean.
Pharmacy professor and resident technology expert John Sowell said some PDA models may hold more information or be more trouble-free than the one the school finally chose, but may also be too large to be convenient. He noted that no hardware can be all things to all people, and the school prefers a very small, straightforward device that doesn't allow users to simultaneously use a calculator function, check a drug database, check email and phone a friend.
Do-it-all machines aren't necessarily better, Sowell said, especially when they actually discourage use by making the technology physically burdensome. After all, the whole point of using the PDA in pharmacy education and clinical practice is to compress a specialized professional library “into this gizmo that weighs five ounces and fits in your pocket,” he said. Nevertheless, the grass sometimes seems greener on the other side of the technology fence, and the school decides year-to-year whether or not to stick with its current PDA model or try a new one. Allowing students to take their PDAs with them when they graduate not only eases their transition into practice, but also frees the school to make such changes. According to Sowell, a sudden, dramatic change of PDAs would be complicated by compatibility issues, but would not be impossible.
Sowell hopes some students will learn to create custom software programs that will make their PDAs even more useful and drive innovation in clinical applications of the technology. Finding pharmacy practitioners and students with programming interest and skill gets easier every year, he said, adding that McWhorter School of Pharmacy is planning to form a student organization to encourage interest in technology.
Not everyone is eager to embrace the new technology, however. At first, some students say, “I don't want my life tied down to that thing,” said Sowell. Noting a certain amount of technophobia, he said some students haven't figured out how to use the technology as efficiently and effectively as it could be used. “These are just standard learning curve things that the class will go through.” In any case, it seems the more the students use the devices, the more they like them. “Eighty-five percent of students will tell you that they don't know how they got along without it,” said Sowell.
In fact, according to pharmacy professor Renee DeHart, who has conducted a survey of faculty and students, 86.7 percent of third year student respondents said the PDAs have had a positive impact on their learning. That percentage dropped roughly ten points each for second year (76.8 percent) and first year (68.7percent) classes. Faculty, who bear the greatest responsibility for applying the technology in the classroom, brought up the rear in the survey, with 56.7 percent seeing a positive effect on learning and 33.3 percent still undecided about its effect.
Third year pharmacy student Maryam Farrokh Ryoo is among those who see the technology as a positive development. “It helped us a lot in finding quick information about the drugs and disease states while studying,” she said. Ryoo said that makes the technology “very precious and valuable.”
She does worry about the costs of keeping the data current, however. "It would be great if we could get a better price since we have to buy the updates every year as well." Currently, McWhorter School of Pharmacy students must purchase digital databases, dictionaries, guides and other software and software updates just as students at other pharmacy schools purchase mountains of textbooks. The school negotiated a volume discount for a school standard suite of PDA software, but the periodic updates are the students' responsibility.
The good news for students is that they can take advantage of at least some group discounts. For that reason, Sowell said, “I suspect that half the graduating class will want to update their software.” He said the school has the costs of technology in mind, and may eventually provide students with both hardware and at least some software, with the costs folded into tuition. Students likely would still be left to update software to suit their individual needs.
Not a Crutch
PDA software updates are no small concern, not only because of their expense, but because old drug data may be dangerous drug data. Sowell said software companies have a significant legal interest in making sure customers keep their databases up to date, though they vary in the way they offer such updates. Regardless of what form they take, the digital updates are the equivalent of receiving hard copy updates and snapping them into a four-inch thick binder like the one on Sowell's bookshelf. Sowell said the PDA, like that binder, is not a crutch for poor pharmacists, but rather is a personalized answer to the question, “what am I going to remember versus what am I going to look up?”. Sowell said that because pharmacy graduates will have different needs in practice, they must answer that question for themselves and apply the technology accordingly.
So, the old standby paper references aren't dead, though Sowell noted that every company that formerly published pharmaceutical guides and databases is moving into the digital field. He said he still values the giant binder, with its frequent paper updates, because it may have more current information from clinical trials. But he said the PDA more quickly reminds him of what is or isn't stored in his brain. He can then fill in the gaps with the hard copy. “If I were running a pharmacy, I would have that book and update it every month with hard copy,” Sowell said. “I would also have a PDA.” He said the benefits of the technology in a pharmacy setting–especially the linkage between clinical overviews, drug databases and interaction tables–are too great to ignore. “Digital is the way to go.”
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