Category Archives: Tutorials

RealWorld Orthopaedics and RealWorld Radiology

App: RealWord Orthopaedics and RealWorld Radiology
Cost: $9.99 / $2.99
Function: Enhancement


The RealWorld Orthopedics app provides the user with a library of radiographic images for common orthopedic concerns. Each series of case images is paired with a clinical scenario in a quiz format. The    answer grid outlines both visually and through a text description the precise abnormalities seen in the image.

Real World Radiology is a valuable tool to support the art and science of reading flat plate images for common primary care complaints. As with its counterpart above, case scenarios outline background clinical information to help the user determine the mechanism of injury or clinical signs and symptoms that accompany the images presented. The information is presented in quiz format and the answers highlight the specific radiological signs that lead to diagnosis.

These apps are useful when reviewing cases with learners and patients. They also provide a very helpful library of visual resources for simulation exercises and exam review purposes.

 

 

Heart Murmur Pro

App: Heart Murmur Pro – The Heart Sound Database
Cost: $2.99
Function: Enhancement


Heart Murmur Pro is an app that allows learners to hear a variety of pathological heart sounds, some of which they are unlikely to encounter on a regular basis in primary care. Aside from the pathological sound, there are two key features of this application that make it particularly valuable. The first is that there is a visual representation of the abnormal sound. The representation contains both location as compared to the S1 and S2, as well as characteristics of the sound such as crescendo or decrescendo. Providing both the visual and auditory data at the same time will simplify knowledge acquisition by the learner. The other key feature of this program is that it allows the user to move rapidly between an abnormal heart sound and entirely normal heart sounds. The ability to contrast the two types of sounds allows the learner to appreciate the differences between them. By functioning in this fashion, the application exploits the technological capability of the iPad to provide an educational experience that previously required a PC in order to accomplish.

 

MSK Injections

App: MSK Injections by Elsevier, Inc.
Cost: $29.99
Function: Enhancement


MSK Injections by Elsevier is a textbook application that has been enhanced to include a variety of video clips that provide detailed instructions on how to give injections (and aspirations). Each detailed video illustrates how to carry out the procedure that is described in the text. The text is enriched with further information related to indications for the procedure, possible complications, necessary equipment for procedure set up and handy instructions for follow up care for patients..

Where the video information used to be available on a collection of DVDs, now the physician has access to the information in one application. This is particularly useful as it does not require internet connectivity which  can often be an issue when care is provided in a rural setting or in the patient’s home.

As a teaching tool, residents can read about a procedure, and then watch the video before they perform the procedure. When used by faculty, it helps to standardize the foundational teaching around a specific procedure provided in the clinical setting.

 

McGraw-Hill Color Atlas of Family Medicine

App: McGraw-Hill Color Atlas of Family Medicine
Cost: $124.99
Function: Replaces existing resource


The McGraw-Hill Color Atlas of Family Medicine is an app that functions as a replacement for the physical textbook by the same name. While this type of replacement may at first appear to be a very limited exploitation of the technology, its format is superior to its hard cover counterpart as it permits rapid search options and is easily portable in and out of various clinical environments for in the moment bedside teaching.

This type of reference app is particularly useful because of the high quality colour images it has compiled for both common and less prevalent clinical conditions seen in Family Medicine. It is a wonderful supplement to learning when clinical opportunities are limited. For example, the following demonstration shows how the app may be used to highlight the diagnosis of Koplik spots when concerns over a potential measles outbreak was looming.

 

OtoSim Companion

App: OtoSim Companion
Cost: Free App ($4.99 to unlock)
Function: Enhances


Teaching ear examination in the clinical setting can be very challenging. The first problem is that it may be difficult to provide the learner with the opportunity to see all of the pathological entities that they might encounter in practice. The second problem is that most books present a complete picture of the tympanic membrane rather than the small segments that are often seen with the otoscope. There are stimulators that can be purchased to offer trainees a wide range of clinical content. However, the OtoSim Companion app for the iPad provides a cost effective alternative. By selecting an image and then having the learner examined the image through an ear speculum from approximately 10-15 cm away from the iPad screen, it is possible to simulate what they would actually see through an otoscope.

The OtoSim Companion app contains a series of images with descriptions that include both common presentations and conditions that occur rarely and as such are unlikely to be encountered by a trainee. The simulation allows learners to observe a much wider breadth of clinical material than they would be likely to see during their regular rotations.

The app itself is free, but the free version only contains a few sample chapters. The remaining chapters can be unlocked through an in-app purchase for $4.99.

Challenge Activity

In groups of two, one person open the OtoSim app and choose an image. The second person, using an ear spec, examine the image and determine what they are seeing.

SimulusDM

App: Simulus DM by Simation Medical Ltd.
Cost: free
Function: Provides something new


The SimulusDM App provides simulation around various diabetes treatment options for patients . It allows the user to select a patient from several patient profiles with diverse variable (type of DM, age, weight, past treatment and lab results etc.). Once a patient profile has been determined, the app user can modify the patient’s glycemic physiology through modifications in lifestyle choices and medications. The app will then provide a visual representation of the effects of the modification on blood sugar over the course of three months. . The app supplies information in both metric and US units.

Note that this app requires that you be connected to the Internet. It is memory intensive, so you may wish to close any apps you do not need before using this.

From a teaching point of view, one of the biggest benefits to this type of simulation app is that you can allow residents to make treatment decisions that you would not be feasible or appropriate in real time clinical settings. It allows residents to see the consequences of various management decisions and learn from their mistakes without risk to patients.

iPad User Manual

A common complaint amongst iPad users is the perceived lack of a ‘user manual’. Apple does make an iPad User Guide, conveniently available online for each release of the iOS (operating system). The manual is available in PDF format or as an eBook for iBooks, available for free in the iBooks Store.

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[tboot_button color=”primary” url=”http://manuals.info.apple.com/MANUALS/1000/MA1595/en_US/ipad_user_guide.pdf” title=”iPad User Guide for iOS 7.1 Software (PDF Version)” target=”blank”]iPad User Guide for iOS 7.1 Software (PDF Version)[/tboot_button]

[tboot_button color=”primary” url=”https://itunes.apple.com/ca/book/ipad-user-guide-for-ios-7.1/id709634245?mt=11″ title=”iPad User Guide for iOS 7.1 Software (iBooks Version)” target=”blank”]iPad User Guide for iOS 7.1 Software (iBooks Version)[/tboot_button]
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iCloud

By Rebecca J. Hogue & Madeleine Montpetit

iCloud is an umbrella term used for the various cloud-based services provided by Apple. iCloud services are integrated into all your Apple devices (iPhone, iPad, Mac). iCloud services are actively being developed and evolving, and as a result, new features are being delivered on a regular basis.

iCloud provides services that help to make your iPhone, iPad and laptop more secure. At a minimum, we strongly recommend that you enable iCloud for the Find My Phone functionality.

Please read the following article specifically addressing how you can make your iPhone and iPad more secure when using iCloud in the medical context: iPhones, iPads and HIPAA-Compliant Practice: Locking Down Your Apple Device.

In addition iCloud can be used  to synchronize some of your data from your iPad and iPhone to the cloud. When you enable iCloud on your device, you can configure iCloud synchronization for each type of data individually.

Which services you choose to use are up to you. This will depend on your personal strategy for backup and cloud-based synchronization services available. At a minimum, I highly recommend you turn on Find My Phone as it aligns with the HIPPA-Compliance Practice.

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As a general rule, before using any cloud-based application you should consider the security and privacy policy of the company providing the app. Most companies that provide cloud-based services provide an overview of their security and privacy policies on their websites.

For example, if you are concerned about the privacy and security of any of the data you choose to store in iCloud, review the iCloud security and privacy overview.

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Passwords abound in today’s internet enabled society. To make our internet use more secure, it is recommended that we use different passwords for each website we access. It quickly becomes impossible to remember all the passwords required to manage our internet use safely. Password Managers are software applications that were created specifically to allow you to securely store and conveniently retrieve your passwords, allowing you to implement unique random passwords for each website you use. In addition, some of the password manager tools allow you to securely store credit card numbers and other important information.

Recently Apple has introduced a new feature known as Keychain that provides password management services. This feature provides many of the same functions as some of the leading password managers; however, it only works on Apple products and software (e.g. iPhone, iPad, Mac, Safari).

If you are going to take the time to implement a password manager solution, at this time we recommend that you use a full service solution such as 1Password. Applications such as 1Password integrate with all mobile devices and all web browsers on both Mac and PC platforms. This means you only need to remember one password (make sure it is a good one) in order to access each of your unique website password.

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Find My Phone is an iCloud service that allows you to track the location of any iPhone, iPad, or Apple computer that is configured with the Find My Phone Service.

To configure the Find My Phone service on your iPad:

  1. Open the Settings app.
  2. Select iCloud.
  3. At the bottom of the list, ensure Find My Phone is selected.

If you have not enabled iCloud, you will need to first activate iCloud. Select Settings > iCloud and follow the prompts (see Managing your Apple ID).

The Find My Phone functions are activated by logging in the iCloud website (http://iCloud.com). After logging in, touch Find My Phone, then select a device from the My Devices list at the top center of the page. Once you select a device, the Find My Phone options are displayed.

FindMyPhone

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Shutting down your iPad

By Rebecca J. Hogue

There are two ways to shut down the iPad: (1) normal shutdown, and (2) force shutdown.

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normal shutdownUnder normal operations, you do not need to shutdown your iPad. However, if your iPad is operating slowly or a specific app is crashing or failing to load properly, you may wish to shutdown and restart your iPad. In addition, if you don’t expect to be using your iPad for an extended period  for example, a week while on vacation) , you may wish to shutdown the iPad to prevent the battery from draining.

To shutdown the iPad:

  1. Hold down the sleep/wake button until the slide to power off prompt appears.
  2. Touch and slide to power off.

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ForceShutdownIf while you are using your iPad, an app causes the device to lock up, and you are not able to close the app, you may need to force the iPad to power down. This type of force shutdown does not remove any data from your device, it simply powers down the iPad. You can then restart the iPad by holding the power button.

To force shutdown, hold both the sleep/wake button and the home button until the device powers off (about 3 seconds).

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