Why is a medical school justifying tablet provision with excuses about the environment and saving money?

“complete digital access to all course materials, including slides. Paper-based course materials will be eliminated… …the entire preclinical curriculum will be loaded onto the iPad for first- and second-year medical student… …For third- and fourth-year students, materials will be downloaded according to their individual concentrations… …Students will be provided apps that enable them to highlight or annotate curricular materials… …in addition, updates and revisions to lectures can be immediately synced to the iPad… …third- and fourth-year medical students will be able to use their iPads to manage Electronic Protected Health Information related to their clinical responsibilities”

As Yale School of Medicine issues iPad 2’s to all medical students they’ve issued this press release that I think completely misses the point that it is critical that medical schools are adequately preparing future Doctors for the connected careers that they are entering into.

In 2011 I would have hoped that the needle had moved far enough that we would be hearing justification from the medical schools who are NOT deploying the latest digital resources with their students but the excuses featuring in this press release have me very surprised:

Reduce Expenses and save paper

Yale’s iPad initiative started as a way to improve curriculum, reduce expenses and save paper… …We recognized that we were spending a lot of money on curriculum materials that our students were not always using and that the format of the materials was not the most conducive for learning… …We had a lot of of paper that had to be recycled, which was expensive and not very green, so we started wondering if there was a better way to do this

Obviously it’s another good point but why on earth is saving paper a priority? When these Doctors qualify and refuse to receive the usual high quality glossy printed sales literature (“just give me the digital version please!”) they’ll probably save this quantity of paper pulp in their first working week.

No mention of video

the solution was the iPad. In addition to saving money and paper the iPad’s high-resolution touchscreen adds a “vibrant new dimension” to the student learning experience. “Up until this point we’d given students the entire curriculum on black-and-white copy paper. On the iPad, all those images are still there — but in the appropriate colors. This is especially great for courses like anatomy, pathology, and histology, and for examining histological tissue slices and images generated in MRI, CT and other diagnostic imaging modalities

It’s depressing to think that today in central London the only place I’m 100% certain that I could find a VHS cassette would be in a medical school. An iPad isn’t just replacing paper it’s adding clinical content, video and community. Rather than that pile of paper being substituted by an iPad in the press release isn’t this much closer to what’s actually happening at Yale:


The cost for each iPad 2 (64 GB WiFi/3G capable) plus keyboard and apps is approximately $900, slightly less than what the school was spending for each student for paper curriculum materials in the first two years alone. But since the iPad will be used through all four years of a student’s medical education, the school expects to enjoy long-term savings in the delivery of curricular materials, as it supports the University’s policy of sustainable practices

Why is this decision being justified on the basis of cost? In 2 years time smart connected devices will be as invaluable to the work of a Doctor as a stethoscope (if convergence hasn’t already consigned them to the history books too). To put the $900 expense in context: pn it’s own the standard “books and supplies” estimate for the first 2 years at Yale is $3,000 and the estimated total cost of attending the program is more than $136,000 (and already also requires a laptop computer purchase).

Let innovation commence!

Ending on a positive note (because asides from this rather unnecessary justification this is after all another very positive mHealth development) as with most things in mHealth the real lessons and innovation will come from doing:

1) How long do you think it will be before every lecture is being recorded and attached to the lecture notes?

10 minutes into the first lecture? I’m willing to bet that a student sitting in the front row downloads a recorder app onto her iPad and works out how to attach the file as a podcast to the college provided slide deck.

2) How long before students realise that buying physical copies of their approved text books is pointless?

I expect sales of the approved Mobile Medical Libary content to exceed physical book purchases before the first year is out. If you are looking for retail space next to medical schools this will be a good time because the bricks and mortar book shops are going to probably be first to notice this very abrupt shift to digital.

3) How long before students are making and uploading their own video content?

With an iPad 2 about their person the entire time I’d be surprised if students aren’t creating their own clinical skills videos inside the first week. Imagine how cool a video of yourself similar to the following Ace Medicine video (but obviously using the most up to date terminology/technology eg. a fetal ultrasound monitor) would be as a revision tool?

4) How long before this creates a new thriving after-market for lecture notes?

In Medical School you could always seem to find an entrepreneurial grade A student that was selling her old text books and lecture notes to someone entering the year below. Imagine what’s going to be possible in a couple of years time?

Can you imagine how attractive this tablet created content would be to a medical school lecturer or student in the Democratic Republic of Congo? Although I’m sure that rather than a little cash over the table in the common room it’ll be more likely to be a PayPal or Google Checkout transfer…

Imagine the legacy that Yale Medical School could provide to the world by sharing these rapidly advancing digital modules freely as healthcare educational tools? Imagine how that would contrast with the mHealth innovation efforts that we’ve seen at Harvard?

About David Doherty

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