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Thanks to technology advances and innovation, information is readily available, easily accessed, and ready for us to use in improving our knowledge base and patient care. If only we were disciplined enough to use our phones or tablets only for those purposes….The unintended consequences of innovative technologies are often unappreciated or unnoticed during daily activity because, like the technology itself, they happen quickly and without warning. Such is the case with technology’s effect on human attention.


Published 6/1/2013
Chad A. Krueger, MD

The Downside of Smartphones, Tablets, and Computers

New media provides a convenient excuse for distractions

The Internet and mobile devices have made accessing useful information easy and have exponentially increased our efficiency in locating, reading, and disseminating quality information, such as journal articles. Can you imagine going to a medical library and looking up a past issue of The Journal of Bone and Joint Surgery—American using an index, a card catalogue, and a step stool to reach the journal on the top shelf? I can’t.

Same goes for photocopying articles or pages from a book and putting them on a colleague’s desk or placing them in a file cabinet. Why would I do that? Much easier to download the articles or chapters as PDFs and save them to a thumb drive or send them via email.

Today, everything either originates or ends up online in one form or another. As a result, some residency programs are even providing each resident with a tablet. Add in a smartphone, a laptop, and a few nifty ‘apps’ and the possibilities for improving efficiency and education seem endless.

Texting and surfing the Internet during educational sessions can be distractions to learning.
Courtesy of Fuse\Thinkstock

With the advent of smartphones, tablets, and the ever-growing Internet, we always have a distraction readily at hand (pun intended). Finish a conversation about a potential research project and want to send a follow-up email? No problem. Just remembered that you were supposed to make dinner reservations? Easy fix. Curious about last night’s game score? Done. All of these tasks can be completed at any time with just a swipe of the finger. It’s no wonder that so many people text and drive despite knowing the deadly consequences; it’s simply too easy and seductive for many people to pass up.

It’s not all positive
Although we may all rush to get the latest device and discuss how technology can increase our knowledge and improve patient care, we need to recognize the negative effects that technology can have. For example, a longitudinal study of more than 150,000 junior high school students in North Carolina, published in 2010, found that students who received a computer part way through the study actually had a significant decrease in their grades. It was not that the students magically forgot how to study or somehow had less access to information; it was that they used the computer more as a toy than an educational device.

I think I am much more sophisticated than an eighth grader, but I doubt that I could resist the temptation to surf the Internet, check my email, or chat with my friends during a lecture much better than those students did. In fact, I’m probably worse now than I was in eighth grade because as my life becomes busier my brain is more easily distracted. I have a hard time not turning on my phone to see what has happened since I last checked 30 minutes ago.

An easy distraction
Therein lies the problem with our current fixation on technology: It easily, and consistently, distracts us from the present in many of our daily activities. Even during Instructional Course Lectures and symposia held during the AAOS annual meeting, a goodly percentage of attendees, who paid good money to attend, are on their phones, tablets, or computers.

That’s also true for other lectures, meetings and—despite the Academy’s admonition to “Decide to Drive”—all of the times we use our phones while driving or catch ourselves checking an email in the midst of a conversation with our significant others. Most people have literally become unable to separate themselves from technology—whether during an hour-long lecture or a 2-minute conversation. We seem content to ‘do’ something on our phones rather ‘be’ present during many of our daily interactions and activities.

All actions have an opportunity cost; spending time and energy on one activity prevents us from spending that time and energy on something else. Research has clearly shown that, just as we cannot be in two places at once, our brains cannot pay attention to multiple information sources simultaneously. Although we may think we can ‘get the idea’ of a presentation without actually paying attention to it, the reality is that we are more likely to misinterpret the information being presented. Human brains need context and association to formulate knowledge and both are compromised by continual disturbances.

Missing the point?
Annual meetings are highly regarded for many reasons, but the educational content they provide is often the reason most participants attend. This is the same educational content that can be missed because we are too busy on our phones or tablets to pay attention to what is being presented. That email will stay in an electronic inbox for an infinite period of time, but the information imparted from the speaker is finite.

Also worrisome is the thought that if technology’s distraction is strong enough to prevent us from listening to a world-renowned speaker during a special event such as the AAOS Annual Meeting, imagine what happens when we are in the comfy confines of our own institutions. How often do we check the day’s headlines during grand rounds or morning report? Distractions of just 15 minutes a week (probably a very conservative estimate) add up to almost 2 days’ worth of education missed during a 50-week year. And that is only during formal teaching periods. Distractions may be more pronounced and unnoticed during many ‘unofficial’ learning opportunities.

I challenge readers to put your phones and tablets away. Turn them off, leave them in your bag, and just listen to the presentations and educational events that you are attending. Rather than think about all of the other tasks you have on your plate, work on being mindful and fully engaged in your activity of choice. We can all benefit from an increased awareness of where our time, energy, and focus are being used, and the more we can control each, the more beneficial our efforts will be.

Technology never regresses; it will continue to grow rapidly and we will continue to find new and ‘better’ ways to use it to improve our own education and patient care. Although technology enhances education in many ways, there are probably an equal number of ways that it inhibits learning. Our challenge is to recognize those inhibitions and develop ways to limit their negative effects. Turning off the phone and being mindful during a lecture is just one small step in that direction.

Chad A. Krueger, MD, is a resident member of the AAOS. He can be reached at cak705@gmail.com