There were 47 responses to the survey, representing a 6% response rate (47/728). This was lower than hoped for but, due to the large volume of requests for information sent to medical students, not wholly unexpected. The male/female split of responses was 15: 32 (32%:64%) which is fairly representative of the demographics of the course, 4% declined to declare a gender.
All 47 respondants (100%) had both smart phone and computer ownership with 19 (40%) owning a tablet. This means that apps and electronic resources can be recommended without concern for lack of equality amongst students, an oft cited barrier in widening use of electronic pedagogical aids.
Students were asked to rate their frequency of utilisation of electronic resources. 37 of the respondants (79%) utilised them every day with no students reporting they never used them. There was a fairly even split as to whether these resources were accessed via a computer or a smart phone with only 1 utilising a tablet device. Of the smartphone users 32 (68%) used apps for learning whilst the remainder purely used the smartphone to access the Internet.
To give supervisors an insight as to what resources students were using, the students were asked to list the top five applications (apps) and top five websites that they used in relation to clinical learning. There were a total of 25 apps and 28 websites given by 31 and 45 responders respectively. Only 4 of the names given were on both the app and website list suggesting that, in most cases, students use apps and websites for different purposes. The highest cited apps were the British National Formulary (BNF), Medscape, Geeky Medics and Teach me anatomy. The highest used websites are shown in Figure 1. The remaining resources were a very diverse mix with often only 1 or 2 citations from students. All the top apps and websites were familiar to the authors but at least half weren’t highlighting a lack of awareness amongst faculty as to how students are accessing information. Of note the BNF was used both in website and app format but far more in app format and a surprising number quoted Wikipedia as one of the most used websites for information which is a worry considering the fact that a lot of the information on that site is unreferenced or subject to scrutiny.
Figure 1 - The top used websites by students by number of citations

Students were asked to state how they accessed information in a number of situations that arise on clinical placements: clinical calculators, clinical guidelines, medication queries, reviewing clinical sciences, reviewing medical conditions, revision questions and working with colleagues. Additionally, they were asked whether they accessed this information online, via an app, via both the aforementioned or via a book.
Results show that most resources are accessed online however there is a large variety across the subgroups (Figure 2). Medication queries have a much higher app utilisation than other scenarios supporting the results that demonstrated the BNF was one of the most utilized apps. Within each subgroup, except reviewing clinical sciences, there was a clear favorite website or app. MDCalc was the preferred clinical calculator, NICE website the preferred guideline resource, the BNF the key medication query resource, patient info the preferred site for reviewing a medical conditions, Pass medicine the preferred site for revision and Facebook the preferred platform for interacting with colleagues. We would have to consider whether there was a lack of clarity from students about what was being referred to regarding working with colleagues as we are aware that use of WhatsApp and Facebook are high amongst students working in tutor groups yet the use of apps represented only a small proportion of the responses to this question.
Figure 2 – The use of different technologies for specific tasks

Students were asked to comment on whether they had been recommended resources by: their tutor, other clinicians, other students or whether they found them via an internet/app store search. 44 (94%) students had used resources that had been recommended by other students with only 19 (40%) having had them recommended by a tutor. Notably 30 (64%) used resources that they found via a simple Internet search rather than any medical school tutor directed search strategy. A question linked to this also asked how students ensured the accuracy and quality of the information that they were sourcing found that many then check the information in books. Whether this represents the fact that many still see textbooks as important with the electronic resources as a mobile support or whether it represents a lack of confidence in the electronic resources is difficult to conclude.
Students were asked when they used electronic resources majority of students use them before and after patient encounters rather than during suggesting they are using e-resources to either prepare to ask the correct questions or reviewing information after the clinical encounter.
Finally students were asked whether they had had any feedback during placements about their use of electronic resources. There was quite an even split between positive and negative feedback. The main areas of positive feedback seemed to be around speed of access to clinical information, for example drug information:
“The partners in my recent GP practice were impressed by my use of the BNF app and website, and one asked me to download the app on her smartphone.”
Some students found that their supervisors were encouraging and suggested useful resources:
“lots of consultants happy for you to use smartphones for googling info while they dictate letters in clinic. One consultant encouraged it”
Lots of students commented that they perceived negative views and that it was considered to be rude to use a phone in front of a patient, even if it was for clinical information:
“many tutors are against pulling out your phone to e.g. look up a medicine but are fine with you pulling out a BNF but it’s the same thing”
“Yes - I like to make notes on my iPhone (e.g. between patients in clinic or between patients on ward rounds) rather than writing them down on paper as they are more accessible here (same reason I use my iPhone calendar rather than a diary). However, I can sense negative attitudes towards this from some healthcare professionals.”
Overall there was an overwhelming desire for supervisors to be more encouraging, for electronic device use to be more accepted and for faculty to recommend useful resources:
“It’d be nice if we could use electronic resources more on placement without being told off”
“should be more openly talked about, with good suggestions for resources from supervisors”