“Please don’t spoil the movie with your own soundtrack.” Remember hearing this message before the beginning of a movie in a theater and how most people turn their devices on silent to watch the movie? The cost of the movie ticket is considerably less than the cost of medical education, but I wonder if learners consider this phenomenon when they walk into their classrooms. Is the habit of smartphones in our daily lives so engrained that we aren’t even aware of the distraction? Or is it that the learners get distracted unintentionally while they are looking for answers?

Recently, after giving several lectures to medical students and residents, I noted that most people in my audience checked their phones at some point. Noticeably, some attendees didn’t have their phones on silent and answered their phones while walking out of the lecture. People commonly check emails, browse the internet, and send text messages during lectures and meetings. Why are learners so distracted by technology, and what is its effect on learning?

I found a few papers on the effects of smartphones on learning:

• A 2013 study by Kuznekoff and Titsworth shows how mobile phone usage affects student learning. Researchers concluded that students who were not accessing their cell phones wrote down 62 percent more information in their notes, took more detailed notes, were able to recall more detailed information from the lecture, and scored a full letter grade and a half higher on a multiple choice test than those students who were actively using their cell phones.
• In another 2013 study by Sana et al., the investigators concluded that laptop multitasking hinders classroom learning for both users and nearby peers. The primary task was learning in the classroom, and the secondary task was completing unrelated online tasks. Notably, nearby peers scored even lower than the students who were multitasking.

Technology, of course, has pros and cons. Some of the pros: Most researchers in the education field talk about finding balance, wherein learners use technology to maximize their learning experience, form long-term memories, and acquire knowledge. Insight and awareness is always helpful and is the first step in technology etiquette. We also cannot disregard the value of technology in teaching (especially for disabled learners).

We need more research on this subject to examine positive and negative consequences, weigh the risks and benefits, and make an informed decision on the use of technology to maximize learning. What rules would you lay down for learners on the use of smartphones, tablets, and laptops if you were teaching in the classroom?

Kashif Shaikh is an internal medicine chief resident who blogs at Insights on Residency Training, a part of NEJM Journal Watch.

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