How an iPad is replacing medical textbooks

by Kal Shah

Kal Shah, a first year medical student at the University of California Irvine who recieved his undergraduate degree from UC Berkeley in Bioengineering, has given iMedicalApps the scoop on how the iPad is being used by himself and classmates.

He highlights how medical textbooks are being utilized, along with an app he feels is better at note taking than the popular iAnnotate.

I recently gave up my previous note-taking methods and adopted the iPad for all aspects of my education. Here are some brief examples of how I use it.

Textbooks

We have a lot of our textbooks provided to us, free of charge, via two main providers — Student Consult and VitalSource. They both have online accessibility so I view my textbooks through the Safari browser. VitalSource just came out with their Bookview app which lets me download their textbook to my iPad and view it through an app.  The speed of flipping pages and searching through the textbook are both much faster through their app than their online website access. The only downside to viewing our textbooks on the iPad (online or via the app) is that we can’t annotate them or highlight them. In a meeting we had with Lippincott’s (who uses VitalSource to distribute their textbooks electronically to us), we told them that the best thing they could do to improve the textbook app is give it highlighting and annotating functionality.

We also have another app called CourseSmart that has a couple of our textbooks on it, but we haven’t gotten to that part of our curriculum yet so can’t accurately give my experience using it.

A lot of my classmates still prefer the paper version of the textbooks — which I think is mainly because the paper versions allow us to “mark it up”. I personally prefer the electronic version because I’m not much of an “annotator” when it comes to textbooks, and carrying an iPad beats carrying 15-20 lbs worth of textbooks.

Taking Notes

I use an app called Noterize, which I prefer much more than iAnnotate. With Noterize, I can download my lecture slides directly from my dropbox folder. There is also an option to directly open a pdf or ppt file from a web address and download it to the app. I can quickly create a textbox to type notes, use the highligher, record audio or use a pen to handwrite notes.

But why is it better than iAnnotate?

1) The textbox can be a see-thru box and it stays open, unlike the textbox in iAnnonate which blocks a lot of the material on my slides or becomes a tiny icon when minimized. The textbox on Noterize is very much like the textbox you would find on MS Word.

2) Highlighting is a pain on iAnnotate — unless it recognizes what you want to highlight as “text,” it won’t let you highlight it. In Noterize, I can highlight anything I want, as if I really had a highlighter in my hand and I was applying yellow streaks all over my paper. It’s very much like a paintbrush tool, and applies a coat of light yellow over whatever I slide my finger across.

3) Noterize records audio and syncs it to your slides! I hit the mic record button and start taking notes, flipping slides, etc. Noterize records audio and keeps track of what slide I was on when the audio was coming in. So later, I can go back to a slide and re-listen to whatever was said when I was on that specific slide. It really beats listening to the lecture podcast and fishing out the parts you want to re-listen to.

4) Finally it’s easy to upload the annotated notes back into my dropbox, so I can view the annotated notes on my computer, or wherever else. The audio doesn’t get uploaded when uploading as a pdf. However, you do have the option of uploading your audio to your computer via iTunes — you end up with a folder full of audio files — kind of pointless. So to re-listen to audio, I use the app.

5) I can merge different pdf files. So what I do at the end of a certain professor’s slides from one day is insert the slides for the next day and so on. This way I have one big file with ALL of that professor’s slides, instead of having 4 different files for slides from lectures one through four. But that’s just personal preference.

Studying

There some flashcard making apps that I used to memorize a few of the biochemistry pathways and I know there are a lot more flashcard apps and other learning tools for anatomy and related subjects.  I most likely will use some them when I need to start studying for anatomy. There are even more apps for Step 1 – but that’s far on my periphery for now.

So, I hope this gives you an idea of how some of us here at UCI School of Medicine are using our iPads. Like Stanford, a lot of us are still attached to our computers for taking notes and studying, and some also prefer pen and paper. I personally, find the iPad more convenient and versatile.

Kal Shah is a medical student.

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  • paul

    man, if i could do it all over again with all this new technology…

    actually scratch that, i wouldn’t apply to medical school.

  • James

    There are some major drawbacks not mentioned here. First, the technology (iPad) costs extra money. Many of the books from Student Consult and other sites are online access only with the purchase of the actual textbook, granted you could sell the print version. Further, using the mentioned software and an iPad involves a learning curve. Many medical students are not tech-saavy and not willing to spend their limited time dealing with technology that seemingly adds little benefit to studying.

    Next, is the inherent reliability issues with any technology. You need to charge an iPad. You need to have WiFi access for many of the book sites, such as Student Consult. If you’re a 3rd of 4th year medical student that travels from hospital to hospital, WiFi may not be easy to find. Further, if your iPad fails for any reason (dropped, water damage, component malfunction) you no long have access to your study materials. Depending on the software/App used, you could even lose all your notes. If your iPad fails the day before an exam, how will you study?

    Lastly, if book publishers like VitalSource offer download versions of their books then they open themselves up to theft. No matter what format they attempt to use, someone will find a way to convert that into a common format (e.g. PDF). At that point, it is difficult to protect the product from theft.

    I would believe that flipping through a downloaded book on the iPad is faster than viewing it on the website (using the iPad). However, I doubt the iPad downloaded book beats any standard computer at speed. So, I feel there are many reasons why the iPad will not replace textbooks in medical school anytime soon.

    • http://www.imedicalapps.com iltifat

      Good points, the following are my responses to them:

      “First, the technology (iPad) costs extra money.”
      -Not really, for many paper based curriculums, such as Stanford’s who are using the iPad now, it saves them massive amounts to not print thousands of pages of paper. Also, most schools already have subscriptions with book publishers, even with actual textbooks.

      ” if your iPad fails for any reason (dropped, water damage, component malfunction) you no long have access to your study materials. ”
      -The iPad nicely backs up everything, even the material stored in your apps, when you connect your iPad to iTunes on your computers. So basically, you could chuck your iPad out the window in the rain, and you could use the school’s replacement iPad, connect it to your personal computer, and everything will be exactly how it was on your iPad. Can’t say the same for texts…

      “Lastly, if book publishers like VitalSource offer download versions of their books then they open themselves up to theft. No matter what format they attempt to use, someone will find a way to convert that into a common format (e.g. PDF). ”
      -This is a great point you made — textbook silos. But fears such as this will only hinder technology. iTunes has flourished b/c Apple has broken down those barriers, and now downloading online music is huge. So this can’t continue to the be excuse for textbook publishers — they need to find an alternative.

  • rswatkins

    Perfect example of good products selling themselves. Anyone think federal subsidies will be needed to get med students to use ipads?

  • http://thedocsquawk.com thedocsquawk

    Nothing the iPad does that computers didn’t already do except show it off in a glossy touchy package. Are doctors hailing the iPad as so useful in medicine because they can’t interface without a touchscreen or because they didn’t know what computers could already do?

    • http://www.imedicalapps.com iltifat

      There has never been a touch screen OS designed for a mobile platform. Sure, plenty of Windows “tablets” have been around forever — but it’s not exactly a tablet when the OS isn’t customized for touch. Thats the key differentiation. It’s not only the mobile form package, thats kind of been done before — it’s the new operating system — that has not been done in the same method or with such precision before.

    • pcp

      “Are doctors hailing the iPad as so useful in medicine because they can’t interface without a touchscreen or because they didn’t know what computers could already do?”

      Or because mouse/keyboard technology is primitive, outmoded, and inefficient in clinical settings?

  • http://futureoffamilymedicine.blogspot.com mdstudent31

    I remember starting out during non-clinical years with PBL and having the aid of computers, PDAs, smart phones, etc. when going through cases. A well-respected faculty member always made us put those things away when it came time to really formulate your own ideas about the integration of symptoms, psychosocial issues, diagnoses, treatment, and follow-up. How do we balance the use of these great tools with the cognitive skills we lose every time we lean on the “crutch” of technology to help our patients.

  • http://drpullen.com medical blog

    Does anyone know how prevalent this type of use is for undergraduate studies? More of us have kids in college than med school. It’s Christmas.

  • http://www.drgetulio.com.br Getúlio Bernardo Morato Filho

    I bought Noterize after reading this article and I have to say that I prefer using iAnnotate for reading .pdf files. Noterize is not more than a notepad that you can draw over the text.

    But Ipad has become an important tool for medical students and physicians. You can also use to improve the comunication with patients, explaining diseases and how to use medications.

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