iPhone apps for medical students

chanste

Hi everyone,

Was just wondering if anyone has come across any decent applications on the iPhone for helping with medical training.

I suppose the BNF would be useful though that's very expensive > €60.

Netter's flash cards would probably be cool but I only bough the actual cards last week and feel like I couldn't justify buying them on this too.

There is a lot of free stuff about the heart and imaging but a lot of them look kinda crappy.

I just got my iPhone this week so anything to help me feel like it was justified will be greatly appreciated :-)

mrmeindl

chanste wrote: »

Hi everyone,

Was just wondering if anyone has come across any decent applications on the iPhone for helping with medical training.

I suppose the BNF would be useful though that's very expensive > €60.

Netter's flash cards would probably be cool but I only bough the actual cards last week and feel like I couldn't justify buying them on this too.

There is a lot of free stuff about the heart and imaging but a lot of them look kinda crappy.

I just got my iPhone this week so anything to help me feel like it was justified will be greatly appreciated :-)

Jailbreak it and you'll get a lot of the apps for free.

toomevara

http://www.yorkshirepost.co.uk/news/Iphone-application-helps-cut-risk.6033184.jp

A Neurotic

toomevara wrote: »

http://www.yorkshirepost.co.uk/news/Iphone-application-helps-cut-risk.6033184.jp

Robot doctors ahoy...

toomevara

A Neurotic wrote: »

Robot doctors ahoy...

Who'd notice the difference......:D

tech77

chanste wrote: »

Hi everyone,

Was just wondering if anyone has come across any decent applications on the iPhone for helping with medical training.

I suppose the BNF would be useful though that's very expensive > €60.

Netter's flash cards would probably be cool but I only bough the actual cards last week and feel like I couldn't justify buying them on this too.

There is a lot of free stuff about the heart and imaging but a lot of them look kinda crappy.

I just got my iPhone this week so anything to help me feel like it was justified will be greatly appreciated :-)

AFAIK, the emedicine site (good extensive collection of articles on medical conditions/causes/path/dx/tx etc in most specialties) has an iphone app.

Piste

There's an app to use your iphone as a stethoscope!

Sitric

There is an App which uses the iphone to record ECGs

The Merck Manual is available, don't know how much it costs though.

The Duke of Moral Hazard

These are great anatomical reference apps, Irish company too:


http://www.youtube.com/watch?v=yirlKi03gpw

Chunky Monkey

Prognosis is really good (and free). If I had a smartphone I'd get that definitely.

mardybumbum

I got an iphone myself a few weeks ago and I found some of the apps really good.

I have Medscape, NEJM, Micromedex, Kaplan Qbank, Eponyms, Epocrates and Lippincotts Anatomy Q and A.

They are the only ones that I'm interested in anyway. I know someone in my class who has his jailbroken and has all the oxford handbooks on it. I'm not arsed jailbreaking mine and I prefer to read paper editions anyway.

Dropbox is great as well. I used it to import all my paeds lectures onto my phone so I can read them on the train, or when I'm not arsed getting off the couch and turning on my laptop.

tiredcity

I can second the Dropbox recommendation 'cause I throw all my notes in there so if the house burns down or something I CAN STILL STUDY! #medschoolpriorities

I also love a flashcard program called Anki. The desktop version is free but the app is 20 euro. Considering how much I use it, it's worth many times that. Medscape is great if you're cornered in a ward somewhere and someone's telling you to go take a classic history of some rare disease that you've never heard of cause you're only a first year.

take everything

Merck manual on the Skyscape app (iOS and Android).
Basically just download the Skyscape app and there's every medical book you can think of here.
Bit expensive admittedly (if you decide to pay for them).

Chunky Monkey

Medscape (Emedicine) is incredible! Forget wikipedia, that site is teaching me medicine.

The_B_Man

Hope its OK to post this but, I've actually written a med student app for android phones, in collaboration with some docs from Ireland and the UK. I did the Programming part and they did the medical stuff. It's my first medical app so have a look and go easy on me Medical Student MCQ App

Thanks.

candlegrease

The_B_Man wrote: »

Hope its OK to post this but, I've actually written a med student app for android phones, in collaboration with some docs from Ireland and the UK. I did the Programming part and they did the medical stuff. It's my first medical app so have a look and go easy on me Medical Student MCQ App

Thanks.

That actually looks like a great app, but personally €4 would be a lot for me to spend on one app.

mardybumbum

The_B_Man wrote: »

Hope its OK to post this but, I've actually written a med student app for android phones, in collaboration with some docs from Ireland and the UK. I did the Programming part and they did the medical stuff. It's my first medical app so have a look and go easy on me Medical Student MCQ App

Thanks.

Myself and a friend do the exact same thing.
We send each other a question a day and I find it's a pretty good way to learn. I think I probably learn more from composing a question then actually answering his. Afraid I don't have an android phone however.

Edit: Also, I learned something new. I would have imagined beta agonists would be used well before oral steroids.

sam34

The_B_Man wrote: »

Hope its OK to post this but, I've actually written a med student app for android phones, in collaboration with some docs from Ireland and the UK. I did the Programming part and they did the medical stuff. It's my first medical app so have a look and go easy on me Medical Student MCQ App

Thanks.

candlegrease wrote: »

That actually looks like a great app, but personally €4 would be a lot for me to spend on one app.

at €4 i'd say you're being very optimistic, tbh

The_B_Man

candlegrease wrote: »

That actually looks like a great app, but personally €4 would be a lot for me to spend on one app.

sam34 wrote: »

at €4 i'd say you're being very optimistic, tbh

Yeah, fair points. But for that 4 euro I had to get 3 very busy senior doctors to write 365 questions for no upfront payment, as well as getting them to proof read the questions that the other docs wrote. So it was a difficult project to get started, as it's not easy to get doctors who have a lot of experience with final year medical students and where they tend to go wrong in exams.

The_B_Man

I spoke to the other guys on this project and they agreed to drop the price.

Anyone care to recommend a price that they think is reasonable?

tiredcity

You seem to have it at 2 euro now which seems very reasonable, at least til you get it a bit more established! If you're going to add to the question bank over time then perhaps a higher price would be accepted more willingly. I've an iphone but otherwise I'd buy it.

The_B_Man

tiredcity wrote: »

You seem to have it at 2 euro now which seems very reasonable, at least til you get it a bit more established! If you're going to add to the question bank over time then perhaps a higher price would be accepted more willingly. I've an iphone but otherwise I'd buy it.

Thats a good point actually.
When we started writing the questions, for convenience, I made a small website for the Docs to write the questions. When they clicked the "Add" button, it would add those questions to the database. This is the same database we use in the app.

Inside the app itself, there is an "UPDATE" button, which connects to the site and downloads the latest database containing questions and answers.

Perhaps I should update the app description to include that in it.

Cheers.

chanste

Sounds good. I'd say the €4 sounds reasonable.

Also I think it makes sense to do it on android or even windows phone (I've an ipod touch myself though) because the itunes store is saturated with so many medical apps at that price rance for so many kinds of things I think it would be hard for a newcomer to establish themselves (Purely subjective impression).

Best of luck with it anyway!

Sid_Justice

seems grossly simple, get a mcq question bank, which there are many, and charge people to view one question a day. i don't see the value in this at all.

The_B_Man

I don't know where you're getting free question banks, Sid. It may not be your thing, which is fair enough. But in terms of value, I've had to get 3 senior doctors to write 365 questions with explanations (sometimes very lengthy explanations-see the newest screenshot I've added), and they're costing about 0.54c per question with explanation. I can't do much more for you on value.

Sid_Justice

Well I would be suspicious about the originality of the questions. They're obviously high yield, so the concept of the question must be in print else where, perhaps with different phrasing. I must have a gander at a MCQ book to see if I can find any.

I'd also be pretty disappointed with the first question on croup if I got it in an exam.

I would imagine first line treatment of mild croup is just humifidification and more moderate or severe croup treated with both corticosteroids and nebulised adrenaline. I've never actually worked in a hospital so if that's what an 'senior doctor' says I presume it's true.

The_B_Man

Sid_Justice wrote: »

Well I would be suspicious about the originality of the questions. They're obviously high yield, so the concept of the question must be in print else where, perhaps with different phrasing. I must have a gander at a MCQ book to see if I can find any.

I'd also be pretty disappointed with the first question on croup if I got it in an exam.

I would imagine first line treatment of mild croup is just humifidification and more moderate or severe croup treated with both corticosteroids and nebulised adrenaline. I've never actually worked in a hospital so if that's what an 'senior doctor' says I presume it's true.

I can assure you, the questions are all 100% original.

Regards your diagnosis, I don't know much about the medical side of things, as I do the programming side of things, but I've sent a link to this thread to one of the Doctors (a paediatrician) and he was kind enough to do up a lengthy reply, which I'll just paste directly in here:

Hi,

Thanks for sending me that link. We specifically chose a question on croup because less than 50% of medical students in their clinical years answer questions on the topic well. They often confuse it with asthma.

These questions are not designed to be exam questions, in that they don't represent all types of questions on the exam. They are revision aids. Though it would be a perfectly reasonable question in a clinical exam. But the EMQs and the scenario-based questions that we're working on will be designed to replicate exam questions.

The student's reply shows the lack of understanding about croup. The question referred to the first line treatment of croup. The majority of cases of croup need nothing more than steroids. Nebulised adrenaline is in no way a "first line" treatment option for croup, in the same way that aminophylline is not your first-line option for a child who has an asthma attack.

All of the studies on humidification in croup (and those studies are up to RCT level) show no benefit. Humidification is not recommended by any paediatricians in Ireland.

But, it's good feedback, it shows we've chosen questions that students don't have a good knowledge of.

As for the comment about the originality of the questions, I don't really know what to say about that. As you know, these questions took us a significant amount of time to create. Though I would imagine croup as a topic has come up somewhere in a textbook if he's going to spend his weekend searching for similar questions.

I'm also not sure why he's put "senior doctor" in inverted commas. You'll always get people who want to knock you for doing something like this. My advice is to ignore him.

Kind regards.

Perhaps you might consider purchasing the app, as it may be helpful to you in your exams?

Sid_Justice

Thanks for sending me that link. We specifically chose a question on croup because less than 50% of medical students in their clinical years answer questions on the topic well. They often confuse it with asthma.

So who wrote the question, experienced doctors or experienced examiners? Both? Where did they get 50% of students? Are they attached to a university? Do the university know they're using statistics garnered from students for their personal business?

These questions are not designed to be exam questions, in that they don't represent all types of questions on the exam...Though it would be a perfectly reasonable question in a clinical exam

.

This is fairly incomprehensible. My criticism that it was a poorly worded exam question but the author defends it by saying it's not designed to be exam question, despite it being a perfectly good exam question. They obviously want their pie and want to eat it.

The student's reply shows the lack of understanding about croup.

I'll quote from two sources that are readily available online



Principles of Airway Management By Brendan T. Finucane, Albert H. Santora, Ban C. H. Tsui

MILD CROUP — Children with mild symptoms, defined by a Westley croup score of ≤2, should be treated symptomatically with humidity, fever reduction, and oral fluids. Many such children can be managed by phone, provided that none of the criteria for further evaluation described above are present.

For children with moderate stridor at rest and moderate retractions, or more severe symptoms, we recommend nebulized epinephrine in addition to dexamethasone:

Approach to the management of croup Author Charles R Woods, MD, MS (uptodate article)

But, it's good feedback, it shows we've chosen questions that students don't have a good knowledge of.

Again, I'd have to question this persons reasoning. One person criticises their question for being ambiguous and represents alternative reasoning for deriving different answers and they shout back "the person has poor knowledge". If I had poor knowledge surely I would have just guessed the wrong answer, rather I challenged their conclusion. Obviously I'm wrong, but it wasn't a lack of knowledge, it was lack of clinical experience. Perhaps in the rush to write their reply the author didn't have time to look up the term knowledge in the dictionary and misused it.

As for the comment about the originality of the questions, I don't really know what to say about that. As you know, these questions took us a significant amount of time to create. Though I would imagine croup as a topic has come up somewhere in a textbook if he's going to spend his weekend searching for similar questions.

How does this sound to a neutral? To me this sounds incredibly arrogant and incredibly naive. It took a long time to create, ergo they're unique? It would take me a long time to copy a van Gogh painting, would it be unique? No it wouldn't. The fact that this person proclaims to be knowledgeable about what students do and don't know but readily admits they have no knowledge of what's in the textbook gives me the impression they're a waffler.

I'm also not sure why he's put "senior doctor" in inverted commas. You'll always get people who want to knock you for doing something like this. My advice is to ignore him.

Senior doctor are in inverted commas cause that's an expression you used to describe the authors. What's a senior doctor? A SHO? A clinician with teaching experience? Someone that's 3 years out of college? Someone who isn't a junior /intern doctor?

I'm not trying to know you for 'doing something like this' I'm knocking you because it's my impression it's just a question bank in android format.

You asked for feedback (in a way) and I gave you some. I didn't say you had to care, I'm not, nor will be a customer.

Perhaps you might consider purchasing the app, as it may be helpful to you in your exams?

I'm preclinical so the questions are mostly irrelevant to me. But I'd rather just look in a book rather than get 1 question a day.

The_B_Man

Thanks for the feedback, Sid. If you, or anyone else, have any more feedback on the Android side of it, eg colour scheme, layout, feature requests, I'd be grateful to hear it.

This email should clear everything up.

Cheers.

Hi, thanks for sending me the latest link!

I guess there's a few issues here:

All question authors are experienced clinicians and 2 are experienced examining students.

The exam questions are not designed to replicate every type of exam question in every university. They are based on the finals format in some universities, but MCQs may not be used in all medical schools. Therefore, their primary purpose is revision, as we cannot tell every student that this type of question will appear on their paper. They would all make reasonable finals questions, though, as long as the uni uses MCQs.

With regard to croup, the student has got poor knowledge, regardless of what he seems to think. He has googled to try and support his claim and has found something from Canada. I'm not sure why that particular author talks about using humidifications "even though it's not supported by evidence" but that's not normal practice in Canada, for that very reason.

See the following links for some Canadian guidelines:

http://www.google.ie/url?sa=t&rct=j&q=croup+guidelines+canada&source=web&cd=9&ved=0CFsQFjAI&url=http%3A%2F%2Fwww.childhealthbc.ca%2Fguidelines%2Fcategory%2F5-croup%3Fdownload%3D13%253Acroup-guideline&ei=0jisTpqyAcayhAe8t9HoDw&usg=AFQjCNFpV9nfsyZ0UjSztIN69lFDgYQtVQ&sig2=tfb8SjxlEBLHrJPT5_Q6NQ&cad=rja

Those are the guidelines from British Columbia, which say " Mist tents, wanes, or steamers are not effective and should not be used".

These ones are used in Alberta:

http://www.albertadoctors.org/bcm/ama/ama-website.nsf/AllDoc/87256DB000705C3F87256E05005534E2/$File/CROUP.PDF

They state that: "Mist therapy is not recommended".


In Ireland and the UK we tend to use local guidelines.

The Scots have put theirs up online and say:

"What is not helpful?
Antibiotics: most croup is viral, and antibiotics are of no benefit.
Humidity: no evidence for benefit from steam or humidity, and risk of scalding." That can be found at http://www.clinicalguidelines.scot.nhs.uk/Primary%20Care%20Handbook%20with%20Updates%20nov04.pdf

Most are not online. but you won't find anyone in Ireland using humidification, since the publication of this paper:

Neto GM, Kentab O, Klassen TP, Osmond MH. A randomized controlled trial of mist in the acute treatment of moderate croup. Academic Emerg Med 2002;9:873–9.

Not an amazing paper, but this and one or 2 more like it all suggest no effect. On the other hand, there is no paper suggesting benefit. The cochrane group also found no benefit, though suggested more research.

So, we can put the mist/humidification thing to bed. It does not get used routinely in Ireland or the UK or North America. The only time you might not give a steroid is where cough is the only symptom. Most of these patients get dexamethosone, as it's hard to predict the course of the illness in the A+E. However, UK and Irish guidelines virtually all endorse the use of dexamethasoe for all cases of croup.
It's not a lack of clinical experience that stops people knowing this. It's a lack of knowledge too ,as this stuff should be taught pre-clinically.Medical students should know this before they hit the wards.

To clarify the "van Gogh issue". The reason the questions took so long to write is because of their originality and because we took a long time writing explanation.

To address the other point, of course it's a question bank on an android. They're questions we wrote with explanations we wrote.

Kind regards,

Chunky Monkey

Our entire course is based around four 125 MCQ exams a year so that app would be incredibly popular here.

You only have it on iphone? You should have an android app!! http://www.bbc.co.uk/news/business-15489523

I don't have a smartphone (yet) but if I did, I probably would buy an MCQ app at €4 considering how expensive some sites are such as Onexamination and Passmedicine.

Not sure I like the one question a day thing for €4 though. Bear in mind that apps like Prognosis, which provide one case a week, are free so it would probably be better to provide all questions at the same time if you need to charge for it.

Chunky Monkey

Oh it is Android, apologies