Are personal digital assistants an acceptable incentive for rural community-based preceptors?

BACKGROUND AND OBJECTIVES This study's objective was to evaluate the acceptability, effect, and use of handheld computers (also known as personal digital assistants or PDAs) as a reward for undergraduate rural community-based family medicine preceptors. METHODS All rural, undergraduate family physician teachers who accepted an undergraduate student for a 1-month placement were offered the choice between a PDA that carried medical software or a monetary payment of an equivalent value. Approximately 1 year later, different surveys were sent to both groups of preceptors to collect data on their use of PDAs and computer technology. RESULTS The most commonly reported reason for choosing a PDA in lieu of payment was that it provided a good opportunity to learn about PDA technology. Of those who accepted a PDA, however, 10% had not yet used it, and another 44% of recipients had difficulty in getting started using the PDA. There were more reported problems with the software than the hardware. When surveyed 1 year later, those who received a PDA and were still using it reported satisfaction with the medical software, ranging from 31% for Epocrates qid to 71% for the 5-Minute Medical Consult. More than 90% of those using their PDA 1 year later reported that they used it in clinical settings, with 68% feeling their PDA had some or a significant effect on patient care. CONCLUSIONS Rural family physicians appeared to find PDAs an acceptable reward for teaching, based on the reported use and utility of their PDA, but many had technical difficulties. Recipients of the PDA reported using their PDA primarily in the clinical setting, with the feeling that the PDA had a positive effect on their patient care. Many users had difficulty with technical aspects of PDA use. To support PDA recipients, technical assistance should be provided.