Nursing Educator

How to use an iPad 2 to teach handheld nursing applications

2012-01-30T09:45:00.000-05:00

I have been a long time advocate of using handheld computers as a reference resource during nursing clinical all the way back to the days of the Palm computer. Ever since then one of the most difficult tasks has been how to teach using the software with students. The difficulty is that it is hard to display to a group what is appearing on a small screen such as an Apple iPod Touch.

The original iPad released in 2010 had some video out capability but it was limited by the software. Developers needed to add code to software to let it be displayed, and very few did. The iPad 2 eliminated this restriction by providing a mirror display capability. In a mirror display whatever you see on the iPad will also be displayed on the external monitor. Unfortunately, there are still some considerations for nursing faculty hoping to show their students software in operation.

The iPad 2 mirror display requires a HDMI-capable monitor, an iPod-to-HDMI adapter (called the Apple Digital AV Adapter), and a HDMI cable. The adapter is available in the Apple Store and HDMI cables are easy to find, but many nursing programs do not yet have HDMI-capable displays.

Apple Digital AV Adapter

Most computer monitors and LCD projectors that are now ubiquitous in classrooms do not have HDMI capability. HDMI creates a digital "handshake" between the monitor and the device to limit copying. It is on every flat screen screen television sold in the last few years.

For nursing faculty this means we must push for the acquisition of HDMI-capable displays. They are a good investment as we migrate to high-definition instructional videos using Blu-Ray players it will be useful more than just handheld computer teaching.

When hooking up the iPad 2 to the adapter be sure to also plug in the power connector as you will run out of battery power very quickly without it. I also recommend you get a very long HDMI cable. They are available in many lengths but I suggest at least 12-foot. The most common 6-foot cords will not leave you much room to get into an area appropriate for pointing out what students will see on the monitor.

Some other tips:
• Software designed for the iPhone will display as an iPhone shaped rectangular screen. Use the 2X button to enlarge the display.

• Use the Orientation Lock next to the volume button to keep the screen from shifting from vertical to horizontal as you move the iPad.

• Have students follow along as you demonstrate a capability of the software. Then ask them to call out something they would like to do and then demonstrate that. Give students other tasks to do, such a look up a med or procedure, then see who is having difficulty. Ask a student who is able to do the task come up and demonstrate to the class.

• This advice will also work with the Apple iPhone 4S released in the summer of 2011.

Do you have any other tips or advice?

Apple's Education Initiative and Nursing Education

2012-01-20T10:25:00.001-05:00

Apple's Education Event announced yesterday brings some exciting opportunities to nursing educators. The event introduced three new things:

iTunes U: A course management system that works through iTunes. It lets faculty manage courses and post content.
iBooks 2: The next generation of iBooks for the iOS devices (iPod Touch, iPhone, and iPad). It adds new navigation, highlighting, interactivity, study cards, tap word glossary.
iBooks Author: Mac software that enables educators to write their own interactive textbooks.

The addition of iBooks Author has the greatest potential effect for nursing faculty. Imagine writing and publishing your own textbook that your students can download directly to an iPad. Self-publishing has not been a big factor in nursing academia but the advent of e-books is stimulating a change. I can foresee faculty creating their own books that will illustrate important concepts in nursing using video, audio, and links to Internet resources.

This new option also creates new questions about student purchases of technology and e-books, who owns the book, and who gets paid for the work. I recommend you view the Apple video and see where you think nursing education can go with this.

NLN Webinar on Curricula Implications of Informatics and Social Networking

2012-01-16T10:43:00.003-05:00

Here's a blatant advertisement for an upcoming webinar series by the NLN called Curricula Implications: Informatics and Social Networking. This is a three-part series on teaching electronic health records, integrating informatics into the curriculum, and the implications of social networking in nursing education.
A webinar is a one-hour audio/video conference you watch from any computer connected to the Internet. There is a question and answer period at the end. This webinar consists of three one-hour sessions held on Monday afternoons in February.
I am going to be teaching part of the session on the curricular implications of social networking. I hope you can join in.

4 Technology Issues for Nursing Educators in 2012

2012-01-09T09:45:00.000-05:00

As we begin a new year nursing educators face many challenges. What are some of the technology issues of interest to all those who teach nurses?

Need to incorporate electronic health records (EHR) into the curriculum. Documentation has long been taught but faculty now need to address how EHRs affect assessment and evaluation of patients. Additionally, students are entering clinical sites with a need to quickly adapt to various EHRs. Faculty must consider how to teach the principles of EHRs.
Need to assure access to EHRs by students and faculty. In the past, no hospital would think to deny student access to the patient charts but with the advent of EHRs some hospitals are now doing that. Nursing administrators or staff development people who are faculty liaisons must understand that they must push back when an IT person declines student access to an EHR. Faculty must be clear about learning needs, how they fit the mission of the hospital, and that IT should not be in charge of nursing education.
Need to plan how social media fits into your nursing program. While nursing students are heavily involved with Facebook and Twitter, how many nursing faculty even understand what they are? Remember when e-mail arrived and some faculty struggled to change the way they communicated? That is happening again with social networking. Nursing programs will need clear guidelines on how to use these media for external marketing and internal communication.
Need to evaluate your nursing program's use of technology to enhance learning. Technologies that have strong pedagogical advantages are available to faculty at lower cost and are easier to use. Make 2012 the year you investigate how to use Wikis, Blogs, Podcasts, Photo sharing, and Social networking.

Nursing graduate competencies in technology in 2012

2011-12-05T13:17:00.001-05:00

While it's obvious our graduates are entering a practice world that increasingly uses technology, it is less clear how students are being prepared for such practice. Nearly all nursing faculty had their basic education at a time without desktop computers, electronic health records, and handheld computers. Faculty are expected to have clinical expertise in their specialty but how many nursing schools expect their faculty to have technological expertise? Most faculty develop their skills through experiences in their clinical sites or by attending conferences, but is that enough?

Accrediting agencies at both the nursing level and the general higher education level are expecting graduates to have skills in technology. Nursing has a long history of constant revision with curriculum. You curriculum revisions of 2012 need to focus on these areas:

1. What are the expected technology competencies of our graduates?

2. Are our faculty prepared to teach students how to use these technologies?

The answers to those questions will require debate, a commitment to financial resources, and faculty development. Those questions will not be quickly answered. It will take a great deal of short and long term planning. What is your department doing to answer these questions?

4 Gift Ideas for Nursing Students this Holiday Season

2011-11-27T13:39:00.001-05:00

Nursing educators are heading into the final days of the fall semester at most schools. I like to give my students gift ideas that they could use to make their student lives easier. I suggest they pass them on to their parents and relatives. Here are my top 3 suggestion for the 2011 holiday season:

1. Monochrome Laser Printer: So many students tell me their printer is broken or out of ink, or that the school's printer is broken or being used by too many others. A black and white laser printer can be had for under $100. Even though toner cartridges cost around $60 students fail to realize that the cost per pages is only pennies, print quality is superior to inkjet, they're fast, and the toner never goes dry like an inkjet cartridge.

2. Apple iPod Touch: At $200 this is a great tool for students. No monthly fees, hundreds of healthcare applications (with many of them free), and lots of other non-academic uses including a camera, calendar, calculator, and iPod make it the best deal in the electronics store.

3. Apple iPad 2: If their parents have a bigger budget the iPad WiFi has all the benefits of the Touch and works well as an e-reader. The 3G model has monthly fees to access the Internet but has no contract.

4. All those too rich for your blood? How about a LED Penlight? They are very bright and last hours longer than the old-fashioned lights. They start around $7.

I hope you all have a good end of the semester. Stay calm. It will be all over soon.

Is the Amazon Kindle Fire useful to nursing educators?

2011-11-15T14:13:00.001-05:00

This week Amazon releases its latest member of the Kindle e-reader family, the Kindle Fire. On its surface it looks like smaller (7" vs 10") and cheaper ($200 vs $500) Apple iPad but there are differences that nursing educators need to consider.

First, some details about the Fire. It is tablet computer running an Amazon version of the Android operating system. It's primary purpose is to connect with the Amazon universe of books and shopping. It also has a web browser, an e-mail reader, and built-in links to Amazon's Android App Store. Early reports are that it does these things well and has an easy-to-read screen not unlike the iPad's. Unlike the iPad, the Fire has no Bluetooth, microphone, camera, or GPS. The Fire also has no automatic ability to read PDF files unless you first e-mail them to the device.

For nursing educators the Fire still may be an option. Before committing to the Fire be sure that the applications you want are available. While many Android healthcare apps are available many are not yet on the Amazon App Store. There are also far fewer healthcare apps for Android than for the iOS devices (i.e., iPhone, iPad, & iPod Touch). This means more support issue for faculty who are want students to get specific applications. To me, the inability to directly read PDF files is also a killer. Getting students to e-mail themselves a PDF you've assigned seems like a tech support nightmare.

So the Fire may have some specific applications for educators, and its price is attractive, but its limitations seem too great for use in a nursing classroom or clinical setting.

5 Tips for Poster Presenters

2011-11-08T16:16:00.005-05:00

I just got back from a conference and enjoyed many of the posters but I also was frustrated that so many educators fail to meet the needs of their audience. Here are some tips:

1. Minimize the text, Maximize the images. Why are so many posters practically a copy of their manuscript? Pick out the most important points and print only those. Use images, flowcharts, or charts to illustrate concepts. I should be able to tell what you did in a few seconds, remember there are lots of other posters I have yet to see.

2. Provide a handout with more detail. You're frustrated that you have so little on the poster? Make copies of the detailed description of your presentation. Use a small font and two columns and you can fit all the text onto one page.

3. Give clear contact information. Put your more than your name on the poster. Give us your email address so we can contact you for more information later. Put contact information on your handouts too.

4. Put the title of your study on a sticker and put it on the back of your business cards. If you want more people interested in your work a business card is great, but when I get home how will I remember what you did? If I have the title on the back of your business card I will remember what you did and know how to get in touch with you.

5. When you are standing by the poster during the poster session, engage those who walk by. The purpose of a research conference is to share research. This is not the time to avoid eye contact with people walking by. We all came from far distances to be there, engage us with some small talk, ask about our interests. We both may learn something.

The iPad at 1 year old: Its Effect on Nursing Education

2011-04-04T10:45:00.000-04:00

The Apple iPad was released a year ago today. I waited in a line and bought one sight unseen. In that time it has changed the computing in ways that are well documented. It is, as Steve Jobs described, a Post-PC device. Its ability to bring multimedia to your hand in a small form factor but with a large screen and a touch interface brought new opportunities to nurse educators. So where do we stand a year later?

As of today the App Store lists 1001 paid and 435 free iPad apps in their Medical category. Also keep in mind that nearly all the other thousands of apps written for the iPod Touch and iPhone will also run on the iPad (although in a enlarged display of the iPhone screen). Just as in the early days of the Palm handheld computers the majority of apps are geared to physicians, although many can be of interest to nursing students. For example, there are many apps to help learn anatomy. The iPad is particularly well suited to this with its big bright screen.

A search of "nursing" in the iPad Medical category shows 37 applications. The modal type in this list are NCLEX-RN preparation apps. Also available are some reference texts such as dictionaries. Among the major nursing suite apps none have been released for the iPad yet. It is a big investment for organizations such as Skyscape and Unbound Medicine to expand into the iPad market, and it is a scary prospect for them when there is little evidence of many nursing schools requiring an iPad. This chicken and egg dilemma has been at the heart of every technological advance.

Another area I am waiting for is the availability of nursing textbooks in iBooks form. This will be the "killer app" for the iPad in nursing education. My students tell me if they would love to carry all their books in an iPad. One of the biggest hassles of being a nursing student is the nearly one hundred pounds of textbooks they need to study. Being able to take their books to any place on campus and to the clinical area would be a big advance.

Keep in mind that the iPad is currently great at viewing pdf files in the iBooks app. I have been distributing my handouts in pdf form. They can be viewed on many platforms but the iPad is a great way to carry and read them.

So one year later the iPad has yet to fulfill its promise for nursing education but things are improving. The availability of the second generation, greater awareness of what the iPad can do, and the availability of thousands of apps that didn't even exist a year ago point to a bright future.

Educational Technology is expensive, but can we afford NOT to use it?

2011-04-01T09:45:00.001-04:00

I have been talking with nurse educators for years about different technologies that enhance learning. In the 1980s just having access to a computer was considered an achievement. Later I spoke about the uses of applications such as PowerPoint and how they helped organize a lecture. In the 1990s we talked about the coming of the Internet and how we could use it in nursing education. At all these phases there was always the complaint that it was 1) too expensive for the nursing school, 2) too expensive for students to buy, and 3) was not necessary because the old way of teaching was just fine. In all those cases the arguments were forgotten and now the technologies are considered a required part of nursing education.

Today I hear the same arguments about the use of handheld technologies; and my answer is the same. If the technologies have advantages over the old methods, and can help us create better nurses, then we can't afford not use the new tools.

Of course the reality is that money can be scarce with a nursing department, students will complain about spending anything on their education, and faculty are reluctant to spend money on new technology for themselves. Here are some points to consider:

1. Education is, and has always, been expensive. I am sure many nursing faculty reading this feel they are paid less than they are worth. Does anyone think that if we hired cheaper but less qualified faculty that the quality of the graduate would improve? There is an expression "you get what you pay for". If faculty sit still and not incorporate technologies that would improve the quality of the graduate then we will get what we pay for.

2. Students will always complain about spending money. Nursing textbooks cost thousands of dollars over the course of a curriculum but we don't tell students "that's OK, these books are optional". All of the healthcare-related reference texts are available in electronic form. If it is to the students' advantage to have the references wherever they are clinically then we should not feel bad about complaints of having to buy an iPod Touch to carry them.

3. Commitment to spending has to come from the top. Nursing schools that have most successfully incorporated technologies such as high-fidelity simulation or handheld computers had administrators who were committed to using the technologies. It takes administration support to help find the financing, commit a portion of the budget to such spending, and bring the more reluctant faculty along into new ways of teaching.

In upcoming blogs I will discuss some ways to pragmatically address these points in nursing education. I welcome your opinions.

3 Reasons Nurse Educators should require iPads and iPod Touch devices

2011-03-28T11:55:00.000-04:00

A commenter to an older post just asked a very good question about the cost of incorporating devices such as an Apple iPad into nursing education. So is it a good idea to add an additional expense to nursing education by requiring the use of a handheld device such as an iPhone, iPod Touch, or iPad? This is a question I hear a lot when speaking about the advantages of these technologies. Here is why I think it is worth it to have students use these technologies today:

1. They change the way students learn and apply information. Traditionally students learned nursing by buying textbooks, listening to lectures, and taking a multiple-choice exam. Moving to a handheld delivery system is not just making books available in electronic form. The change brings a change to the way students learn. In the classroom the teacher can move from presenting facts to giving lessons on how to apply knowledge. There is too much information to know it all but knowing how to find and use information quickly is really what nurses need to do in the 21st Century.

2. They provide a media delivery device directly to the student. Currently most students have to go to a library or a computer lab to view media that contribute to their learning. For example, to learn a procedure students once had to view a film strip or 16 mm film, later they watched a video tape or DVD. With a handheld device the video can be viewed wherever the student is. Right now there are nursing programs developing mini-videos of procedures that students can review just before going into a client's room.

3. They help faculty use proven pedagogies to improve learning. Educators have known for years that multi-media enhances learning. Steve Jobs calls the iPad a "post-PC" device. It gives students the ability to have audio, video, web-based apps, and clinical apps all in one device. This means that it is more than just a portable media delivery system but a whole new way to teach students how to use information p.r.n.

Apple iPad 2 Digital AV Adapter biggest advance for educators

2011-03-03T09:13:00.003-05:00

The announcement of the iPad 2 brought improvements in speed and weight and adds cameras. Those are great but lost in most accounts is the biggest feature for nurse educators, the ability to display apps on an external display. Apple is now offering a Digital AV Adapter for $39. On the iPad 2 this adapter creates a mirror output of the iPad's screen on a flat screen TV that has HDMI. This is a huge step for educators because now all apps can be shown to a classroom in real time on a real iOS device. Nurse educators can teach how to use clinical software in a way never before possible. Up until now only applications with the external-output code could be displayed. Faculty can now walk students through the options of their clinical applications.

Apple Digital AV Adapter

This adapter is not just for the new iPad. It will work with the iPod Touch 4th generation, the iPhone 4, and the original iPad (in 720p not 1080i).

Some caveats: The mirroring capability will only work with the new iPad 2. It is not yet clear what can be displayed on the other devices (my guess is just software with the external-output code). You will also need either an HDMI display or a way to convert your HDMI signal to DVI or VGA. DVI, which is used by most modern computer monitors can be displayed with a simple converter/adapter. To use VGA, which most projection LCDs use, requires an additional adapter such as the one available from HP. The reason for the HDMI requirement is due to the ability of HDMI to retain copy protection for videos.

Apple is promoting the iPad as a tool for educators at all levels. The AV adapter will really help nurse educators teach students how to use any of the hundreds of healthcare-related apps that are available for the iPhone and iPad. The adapter should be available on March 11 in the USA.

How iPhone 4 Affects Nursing Education

2010-06-29T12:49:00.000-04:00

The iPhone and iPod Touch have now been available with downloadable healthcare software for two years. The number of applications of interest to nursing faculty has expanded to nearly 1000 applications (out of the over 200,000 applications) in the Apple App Store. Apple has now combined the operating system for iPads, iPhones, and iPod Touches into the iOS. This will help developers create software for all the devices, all of which have nursing education implications.

The introduction of the iPhone 4 adds to the versatility of the Apple devices in education. The biggest change to the phone from an educators perspective is the much improved display. The iPhone 4 has the twice the resolution of the old phone. It is now much easier to read even very tiny text on the screen. For nursing educators this means students can read health-related texts and web pages with much more ease. The free iBooks app allows the importation of pdf files. Faculty could distribute course syllabi, class notes, or supplemental readings in an easily transportable form.

In addition to the great display the iPhone 4 has improved still and video camera capability, a front facing camera for video chat, and a much faster processor. I recommend you get a demonstration of the new phone if you are in the market. I predict that Apple will also be updating their iPod Touch in the coming months to take advantage of the display and processing improvements. All the more reason to consider adding a handheld computer to the nursing curriculum.

One Month as a Nurse Educator with an iPad

2010-05-03T11:26:00.000-04:00

One month ago I stood in line to pick up my reserved 16-gig WiFi iPad. So what is the state of the iPad as it pertains to nursing education? How does it compare clinically and educationally to the iPhone? I have taken both the iPad and the 3G iPhone to my clinical site, and the University where I work, and found that each has its advantages and disadvantages. Here they are:

Internet Access: Winner- iPad. As long as you are within WiFi, and I am at the hospital, the University, and most other public places I visit, the Internet browsing experience is much faster and easier to use than on an iPhone. I have long been unable to use Flash on the iPhone and it hasn't made much difference in my browsing.

E-Mail: Winner- iPad. The mail application is especially nice in the landscape mode. I can see my e-mail accounts, easily and quickly open messages, and manage those messages much faster than on the iPhone.

Reading: Winner- iPad. I never owned an e-reader such as a Kindle so reading e-books has been a new experience. So far I love it. The ability to change font size, bookmark, and see full color illustrations has been very helpful. I am reading more now than before as I can quickly read a few pages without having to carry every book.

Clinical Applications: Winner- iPhone. While the iPad's size makes for easy viewing it is also too big to carry around in an inpatient hospital setting. The iPad doesn't fit in a scrub pocket or lab coat so that means carrying around with my other papers. Another issue is that there are few clinical apps so far that take advantage of the iPad's features. Most of my iPad apps are just iPhone apps at 2X size. The iPhone is still the fastest way to quickly find clinical information. On the other hand, finding and reading a journal article is far better on the iPad.

So my final grade for the iPad is: Incomplete but showing great potential. It does a lot of things very well right now. When nursing textbooks designed for the iPad become available it will really make the use of paper texts a thing of the past. We also need to see clinical applications that can really take advantage of the larger screen.

5 Must Haves for Apple iPad Nursing e-books

2010-03-25T20:26:00.001-04:00

With release of the Apple iPad around the corner there have yet been any announcements about the availability of nursing texts. The iPad has great potential as a replacement for paper textbooks, but iPad nursing texts need to be more than electronic versions of the old. Here are some features that publishers need to include to make e-reader books better learning tools for nursing students:
1. Hypertext within the book. Keywords and links to other portions of the text would enable the reader to jump around the book and find the other relevant sections with ease. For example, in a section on care of a patient in a cast could link to another section on neurovascular assessment. Additionally, every word in the index should link to the respective section.

2. Large images. Currently, images in textbooks are limited in size due to space limitations. E-Books have no space limitations. Images should be enlargeable to the size of the e-reader screen. This would allow students to get much better images to study. Thinks of the detail for skin conditions, retinas, or cell images.

3. Embedded video. Textbooks have been limited to still images, until now. Procedures, communication examples, or animated processes should be embedded within the text.

4. Relevant Internet Links. While recent texts have included websites, e-books can actually link to those sites. The Apple iPad has Wi-Fi or, in some models, 3G network access. Nursing students should be able to instantly visit any sites listed. Links could also go to data that changes frequently such as daily morbidity statistics.

5. Embedded audio. Like images and video there are also sounds such as lung, heart, and bowel sounds that could be included. Additionally, image great lecturers including audio to help students learn difficult subjects.

It is time for nursing publishers, and nurse authors, to begin to think "outside the covers". What other things do you think nursing e-books should have?

Clinical guidelines for use of electronic devices

2010-03-18T08:42:00.001-04:00

Any of you teaching clinical have seen that nearly every student comes to clinical with at least a cell phone. Many now have iPhones or Blackberry devices loaded with clinical software. It has long been standard practice that students are not to engage in personal business while functioning as a nursing student in the clinical setting. New technologies now obligate nursing faculty to be more explicit in directing the proper use of these devices.

Some agencies and nursing schools have proposed banning mobile devices altogether. This is unwise as important clinical software is now available for these devices. Faculty should be encouraging the use of new technologies and applying the latest information when conducting patient care.

Here are some guidelines to establish with students. These should be put into your syllabus to clarify your expectations:

1. Protect patient privacy: Students may not use cameras to take pictures of patients. Healthcare data that identifies a patient is not to be removed, or transmitted, from the clinical site. Lab values and other assessments can be stored as long as no patient names or identifying numbers are connected to the data.

2. Professional conduct: Students are not permitted to engage in personal business while performing as a clinical student without faculty permission. This includes voice calls, texting, or Internet browsing for nonclinical information.

iPad will help teach use of iPhone apps

2010-02-13T18:06:00.001-05:00

One of the difficult things about implementing an iPhone or iPod Touch device for nursing students is showing them the screen in action. If you are savvy enough to download the iPhone SDK and run the iPhone Simulator it is possible, but well beyond the skills of most nursing faculty. When demonstrating software the best thing to have is a real time projected display of the teacher's computer. The iPhone has no video out so your only option, after the Simulator, is to use a video camera. Not a very elegant solution.

The Apple iPad removes that obstacle. The iPad has a video out report (which requires an adapter) that will let faculty display the screen. The iPhone software will run on the iPad in either original size or double sized. We will have to wait to see how good this looks. So, if you are teaching the use of iPhone apps for your nursing students I suggest buying an iPad with a video out adapter.

Apple iPad will change the nursing textbook business

2010-01-29T10:33:00.001-05:00

The announcement of Apple's iPad has been widely discussed this week. While it is unclear how successful the iPad will be nurse educators should begin to consider how it may be used in teaching and learning. The iPad is basically a large iPod Touch. With its larger 9.7" diagonal screen it offers much more room for reading.

A shortcoming of the iPod Touch and iPhone for students is difficulty in using them as e-readers. The iPad takes the e-reader concept pioneered by the Amazon Kindle and brings it new Apple shine. Full color, high-resolution, and even a three-dimensional look to pages make the iPad the first device that could replace a paper textbook. Students who have all their text in the iPad can have their whole library with them, but without the sore back from carrying large texts.

I quizzed my clinical group about their interest in have such as device to carry their books. Nearly all of them thought it would be great. They want books that have highlighting, bookmarking, and automatic updating. They tell me that they often have to drag their books to quiet places to study and would welcome something so portable.

So for nurse educators, we need to keep talking with publishers about their plans for a digital version of their textbooks. A big advantage for publisher is that they can inexpensively distribute evaluation copies of their texts. Nursing departments should invest in a least one iPad and test it out as books become available.

Software Links for iPhone of interest to Nurse Educators

2009-10-08T16:15:00.002-04:00

One of the frustrations of the iTunes Store is the number of supposed "Medical" apps that are not designed for healthcare providers or students. The folks at SoftwareAdvice.com, a commercial site that is paid for through vendor links, offers a great page highlighting some of the best medical software out there for iPhone and iPod Touch. Out of the over 1500 medical apps they determined only about half were actually of use to professionals. I mostly agree with their list. Also be sure to check out the spreadsheet of the over 700 medical apps. It's a great tool for finding apps you never knew about.

NANDA: Suicide by Greed?

2009-04-17T23:32:00.003-04:00

I was sent a document by NANDA-I outlining their fees for use their diagnostic labels in publications. I was stunned by the fees. For example, just to create a list of terms is $250. But wait, there's more. If you want to create a textbook using the diagnoses be prepared to fork over anywhere from $3500 to $65,000! These numbers do not even include their use in software. I asked last summer for the cost and was quoted $3000 plus $2.50 for every copy of the program sold.

Nursing is in great danger of being left behind as electronic health records go online. We need a way to communicate what we do. While many have complained about the circuitous language and downright silly labels of some NANDA nursing diagnoses, they at least provide a common language for documentation until something better is developed.

If NANDA-I and Wiley-Blackwell Publishing insist on taking this usurious tack then we should let NANDA-I diagnoses die a quick death. Many of the terms they use could be challenged as in the public domain. Only a list of diagnoses and definitions that are in the public domain will provide us with the common language that can be used freely for practice, documentation, research, and billing.

NLN Nursing Education Summit 2009

2009-03-27T14:35:00.000-04:00

Be sure to save the dates of September 23 to 26 for a trip to Philadelphia and the NLN Education Summit. I have attended nearly every one for the past few years and find them very valuable. It is a great opportunity to hear about advancements and issues in nursing education from across the USA. It is always good to meet fellow nurse educators facing the same issues you do. I often find new ways of thinking about a problem that helps me in my teaching. Issues of admission, classroom instruction, clinical instruction, special students, and community involvement are just some of the topics you are bound to hear about. Hope to see you in Philly!

Palm OS: RIP

2009-02-13T16:54:00.000-05:00

Palm has announced the end of development of its PalmOS, or operating system. They are opting for a web-based system and hoping to survive in the shadow of the Apple iPhone and RIM Blackberry. The are moving to their Palm "Pre" smartphone that requires network access to operate.

It has been frustrating for nurse educators that the current PalmOS has been unchanged since 2004. That is an eternity in personal computing. The future of small PalmOS devices that have been popular with nurses such as the E2 and Tx is more uncertain than ever. Considering the huge processing, graphics, and memory advantages of the Apple iPod Touch, let alone the easy installation of applications through iTunes, it was clear the end of Palm as a clinical choice was near. Nurse educators considering adopting the Palm should do a careful consideration of price, value, and support ease before making a decision.

Nursing Central from Unbound Medicine

2009-01-26T09:17:00.002-05:00

Unbound Medicine has released Nursing Central for the iPhone and iPod Touch. It offers the Davis Drug Guide, Lab and Diagnostic Tests, Diseases and Disorders reference, and Taber's Medical Dictionary. There is also a Medline Journal citation and abstract explorer. The Nursing Central app is offered free on iTunes but unlike Skyscape it has no free references for download. However, unlike Skyscape the references will reside on the iPhone or iPod Touch and continue to work after the subscription period of one year. During that year you have unlimited free updates.

The Nursing Central titles stick much closer to Apple Guidelines for the user interface. The Skyscape titles look more like Palm apps. Performance is good and I had no crashes. The user interface is pretty intuitive as the icons are clear about their purpose. Even the front page icons for each title are beautifully rendered. One shortcoming is that some titles in appendices get truncated due the use of large font sizes. I hope that is corrected in an update.

One issue for faculty is the cost. The only package offered is a $159 subscription. I look at this as $40 for each of the reference titles plus the Medline search tool for free. That is a reasonable price per title when compared to the print editions. The biggest benefit is that the reference titles continue work after the subscription. As of today Unbound Medicine is the only company offering this. Skyscape, Epocrates, Lexi-Comp and Pepid all shut down at the end.

Installation is easy but requires installing the app on the Apple device and then paying for the subscription online. Once the username and password are entered the titles begin to download. Be sure you are in a WiFi area when loading.

Overall, Nursing Central brings nursing educators to a point where we no longer need to recommend the use of a Palm or Windows Mobile device for clinical references. With the addition of some of the free and inexpensive medical formula tools, assessment guides, and learning aids available in the Apple App Store we now have a powerful handheld computer for clinical use.

My Skyscape: First iPod Touch Medical Reference App

2008-10-22T16:52:00.004-04:00

The iPhone could never become truly a handheld computer for the healthcare community until the reference applications could reside on the device. Web-based versions that accessed the database wirelessly have been available but are slow and awkward to use. Now Skyscape has brought their vast selection of titles to the iPhone.

They have done it by making a free portal application My Skyscape available on iTunes. Enter your Skyscape account info and you can then download purchased titles to your iPhone or iPod Touch. They are also giving away some basic titles including their Archimedes medical formula and reference guide.

The current titles appear to follow the basic layout of the Palm OS titles but with some size changes to take advantage of the iPhone's larger screen. Control is easy with a finger and it is a pleasure not to use a stylus.

I tried to buy a title but the app would not let me register. A Skyscape support person tells me it will be one to two weeks before titles will be able to be downloaded. In the meantime you can access the web-based version of purchased titles.

Skyscape has drawn first blood in the medical reference wars. The creation of a portal removes the hassle for Skyscape of putting each title on iTunes. It also lets them keep their subscription model. The portal also lets you keep all your titles under one home page icon. So go ahead and try it, just remember you'll need to wait a bit until you can buy new titles.

For nurse educators the availability of the Skyscape library really makes the iPod Touch the handheld computer to consider first. The ease of installation, use of iTunes for synchronization, and the ability to wirelessly install applications opens a new day in the use of handheld computers in clinical nursing education.

The Handheld Computer to Beat for Nurses: Apple iPod Touch

2008-10-04T16:05:00.001-04:00

Apple has updated the iPod Touch , adding a speaker, improving battery life, and allowing the addition of third party applications. All at a lower price. An 8 GB Touch is now $229 making it a better bargain than any Palm OS or Windows Mobile device. The ability to show video, browse the Internet with a full-fledged browser, and use healthcare-related applications make it more versatile than any previous handheld.

The iTunes App Store has thousands of applications. The number of useful healthcare apps is still small but growing quickly. Expect to see the classic reference titles for sale soon.

For nurse educators considering which handheld to recommend to students, the iPod Touch must be seriously considered. It provides a powerful computer that will serve students well past graduation. The fact that it is also an iPod only helps make it an easier sale to students.