O uso do smartphone durante a prática clínica : estimativa do potencial de distração entre internos de medicina e confecção de cartilha para preceptores

Abstract

The use of smartphones has become widespread in clinical practice among health professionals. Doctors and medical students have been using their devices to improve patient care by means of apps and programs to search for articles and treatments, as well as to share data and exchange information aiming for speed and efficiency in diagnoses and care. The benefits of mobile devices are well known in the literature, but so are the harms caused by their abusive use and distraction factors, which can undermine clinical practice and the relationship between health professionals and their patients. This dissertation analyzed medical internship setting, a period in which medical students undergo supervised practical training, lasting an average of two years and contribuing to the improvement of the knowledge acquired by interns throughout medical course, before starting their professional careers. During this period, students have the opportunity to train skills in the main areas of medicine, to make decisions about the specialty they will follow and to learn how to manage medicines clinical diagnoses and care for patients in general. Inicially, a literature review was carried out to identify the subject’s state of art, presented in the chapter concerning to theoretical framework. Next, a cross-sectional, descriptive observational study was conducted, presented in Chapter 3. The aim of this study was to investigate patterns of smartphone use and their potential distracting factor during case discussions and medical care among medical interns, as well as students' perceptions of possible harmful effects. This is a cross-sectional, descriptive observational study. Data was collected using online questionnaires in two private Brazilian medical schools. The instrument consisted of the student's socio-demographic information as well as questions about the pattern of smartphone use and its influence on clinical practice, in addition to information about the student's perception of colleagues and teachers. A data’s descriptive analysis was carried out. It was observed that the students assume that they make frequent use of smartphones during clinical practice, mainly for patient-related purposes. Participants reported greater intensity and frequency of use by colleagues, relating it to distraction and loss of important information. They agree that policies restricting the use of cell phones during clinical practice should be established by educational institutions, and that this use can also affect professional exercise. Finally, the study proposes a booklet, to be used by coordinators, supervisors and preceptors of medical internships, presenting the main uses of cell phones for doctors, a summary of the evidence on the benefits of smartphones’s uses in teaching medical students, the most commonly identified risks and suggestions for actions to mitigate possible problems.