Smartphones are well known for providing plentiful distractions, but otolaryngology residents, and even and those who have left their training days far behind, are using smartphone apps to navigate work/study life and make more efficient use of their time.
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January 2023
In general, I think online education is quickly surpassing the traditional enduring formats as it is more current, readily available, and easily accessible. —Sonya Malekzadeh, MD
Sonya Malekzadeh, MD, residency program director at the Georgetown University School of Medicine in Washington, D.C., and American Academy of Otolaryngology–Head and Neck Surgery education coordinator, was involved with the development of Academy Q, an otolaryngology knowledge assessment program that’s now available in the OTO Logic portion of the academy’s website. “In general, I think online education is quickly surpassing the traditional enduring formats as it is more current, readily available, and easily accessible,” she said. Academy Q was the first otolaryngology online self-assessment program and was vetted by multiple committees of expert specialists.
Although these types of apps can be useful, they can also cause some unexpected distractions. “At the University of Colorado, the hospitals have designated a feature called Secure Chat as the primary mode of communication about consults and inpatient questions,” said residency program director Cristina Cabrera-Muffly, MD. “This means residents are constantly getting messages through their EPIC mobile app (Haiku). Seeing residents on phones has led to some miscommunication with faculty, who perceived the resident was on their phone rather than paying attention,” said Dr. Cabrera-Muffly. In fact, the resident was answering the nearly 50 messages that nurses and support staff send them throughout the day.
They also had to slightly change their rotations so that a junior resident is assigned to consults and floor management only instead of being assigned to a clinic at the same time, since the messages are so disruptive to their learning experience.
Johnathan D. McGinn, MD, residency program director at Penn State Hershey Medical Center, said he and his colleagues do find residents using their phones frequently, but almost always it’s using the device to do work-related tasks like checking the electronic health record or using a HIPAA-compliant messaging tool with colleagues and peers regarding patient care. “We do exclude phone use during educational conferences to allow for resident focus on the learning and avoid distractions,” he said.
On balance, however, most believe the utility of apps can outweigh the distractions, particularly given that the technology is native to younger generations of physicians. Below are some apps that otolaryngologists and otolaryngology trainees are using to make their education and work lives easier.
Editor’s Note: This list is representative of some of the apps available to healthcare personnel at the time of publication. It should not be relied upon as recommending or promoting any particular app or developer, and the authors, society, and publisher accept no legal responsibility for any errors or omissions, and make no warranty, express or implied, with respect to material contained herein. Readers are encouraged to perform their own due diligence on any apps being considered for download.
Resident/Physician Training Apps
ENT Essentials
This interactive, symptom-based app is aimed at residents early in residency and mid-level providers specializing in otolaryngology. It has up-to-date text divided into sections covering the ear, face, nose, larynx, head and neck, and sleep medicine/pediatric ENT and written by multiple otolaryngologist authors. Each chapter is linked to multiple-choice questions for review.
Developer: Jaypee Brothers Medical Publishers
Operating System: iOS and Android
Cost/Subscription: Free; in-app purchases
ENT Instruments
This app lists the surgical instruments that are used in otolaryngology, offering images and descriptions to assist residents and medical students in examinations and clinical experience. The list is arranged under headings (otology, rhinology, laryngology, and miscellaneous). More instrument descriptions are added on a continuing basis.
Developer: Balasubramanian Thiagarajan
Operating System: Android
Cost/Subscription: Free
ENT Residency
This online learning program for otolaryngologists uses video-based education, hand-drawn diagrams for practice, images, and topical flow charts to make complex, intricate concepts easy to understand and remember. Mock written exams are available for all topics, as well as previous years’ test questions from a variety of universities. The app includes courses for theory and clinical aspects of otolaryngology residency.
Developer: Education Mobile Media
Operating System: Android
Cost/Subscription: Free; in-app purchases
Headmirror’s OtoRecall
Content in this free flash card app is geared toward clinical review and uses repetition and active recall to optimize learning and memory on a variety of otolaryngology topics. Users have access to thousands of questions covering every otolaryngology subspecialty, and new questions are added frequently through updates.
Developer: Headmirror
Operating System: iOS and Android
Cost/Subscription: Free
KJ Lee’s Essential Otolaryngology, 12th Edition
Full coverage from the book that spans the entire discipline, featuring an at-aglance review. The app features 300 board review questions, clinical pearls, more than 240 illustrations and photographs, and more than 100 tables. The 12th edition has been expanded to 60 chapters. Users can create notes and bookmarks, and no internet connection is required after download to access the information.
Developer: Usatine & Erickson Media
Operating System: iOS, Android
Cost/Subscription: $109.99 one-time charge
LearnENT
LearnENT is the official educational app of the Canadian Society of Otolaryngology–Head and Neck Surgery. The collaborative app offers detailed classification systems, a comprehensive list of otolaryngology eponyms, diagnostic criteria and interactive case studies for disorders, cancer staging information, a review of anatomical structures, and a history and physical exam section that includes video examples, overviews of important steps, common mistakes, common visual diagnoses, and quizzes to monitor understanding.
Developer: Scott Kohlert
Operating System: iOS
Cost/Subscription: Free
Netter’s Anatomy Flash Cards
This full-color flash card deck comes with numbered labels and hidden answers, concise comments, and clinical notes. Cards are separated into various anatomical groups, including head and neck. The information is arranged sequentially, and no internet connection is required after the initial download.
Developer: Skyscape Medpresso Inc
Operating System: iOS and Android
Cost/Subscription: Free; in-app purchases
Otolaryngology Exam StudyToken
This study app bases its information on the American Board of Otolaryngology (ABOto) training in the field of head and neck surgery. A bank of 100 questions each on a variety of otolaryngology specialty and subspecialty topics can prepare users for the ABOto board certification.
Developer: StudyToken
Operating System: Android
Cost/Subscription: Free; in-app purchases
SIMPL
The System for Improving and Measuring Procedural Learning (SIMPL) app allows faculty and residents to evaluate surgical proficiency after every procedure performed. Each evaluation consists of three questions (the degree of guidance required, intraoperative performance, and the complexity of the procedure). Included is the option to dictate formative feedback. Aggregated evaluation data are accessible to faculty to see how much experience a resident has with any given procedure or group of procedures.
Developer: Procedural Learning and Safety Collaborative, Inc.
Operating System: iOS
Cost/Subscription: Free
Reference/Medical Knowledge Apps
Current Dx Tx Otolaryngology
This reference app spans the entire spectrum of otolaryngology topics, with sections on basic science, facial plastic surgery, head and neck surgery, laryngology, rhinology, pediatric otolaryngology, otology, and neurotology. Information is organized by anatomic region and includes general considerations, pathogenesis, prevention, clinical findings, differential diagnosis and treatment, and medical and surgical management of disorders. There is a clinician’s guide and a radiology chapter. No internet connection is needed after the initial download.
Developer: Skyscape Medpresso Inc.
Operating System: iOS and Android
Cost/Subscription: Free trial; subscription required
Essential Anatomy 5
This immersive 3D app features more than 8,200 structures of both male and female models, with 11 systems shown (skin, skeletal, muscles, connective tissue, veins, arteries, nerves, respiratory, digestive, urogenital, and lymphatic, plus the brain and heart), Structures can be viewed in isolation and from any angle. Users can place customized pins with notes anywhere on the 3D model, and certain structures can be sliced through using a 3D plane tool. Audio pronunciation and Latin nomenclature is available for all structures, quizzes are in the app, and images can be shared through social media and email.
Developer: 3D4Medical from Elsevier
Operating System: iOS and Android
Cost/Subscription: $14.99 (Android), $19.99 (iOS) one-time payment
frequENTcy
Access the podcasts from the American Academy of Otolaryngology–Head and Neck Surgery. This app provides complete access to frequENTcy, with additional features that include streaming access, an archived back catalog, playback resume when interrupted by a call, bonus content, PDFs and wallpapers, and contact methods (call, email, web, Facebook, and Twitter) for the show.
Developer: American Academy of Otolaryngology–Head and Neck Surgery Foundation Inc.
Operating System: iOS and Android
Cost/Subscription: Free
Medscape
The Medscape app offers medical news and commentary by specialty, as well as drug and disease information, relevant professional education, and CME/CE activities. Medscape Decision Point combines evidence-based treatment options with trusted expert commentary. In addition, there are podcasts and more than 400 medical calculators grouped by specialty, a drug interaction checker, a pill identifier, and access to the Consult network for physicians and medical students. Access requires a Medscape website account.
Developer: WebMD, LLC
Operating System: iOS and Android
Cost/Subscription: Free
PubMed Hub
This app provides access to and a comprehensive data search of scientific research published on PubMed. Abstracts for research with author names are available in the app; full text can also be shown when available on PubMed or users will be redirected to the publishing journal. Each article shows its Journal Impact Factor, and articles can be shared through social media.
Developer: Omelette, Inc.
Operating System: iOS and Android
Cost/Subscription: Free; in-app purchases
The Washington Manual (WashMnl) Otolaryngology Survival Guide
Prepared by Washington University house staff and faculty, this survival guide provides essential information for interns, including an overview of the residency, a breakdown of common floor calls, consults, and emergency room calls, a typical daily routine, examination of the head and neck, and information on otology, rhinosinusitis, surgical treatment of thyroid and parathyroid disease, antimicrobial therapy, and pediatric otolaryngology. Content includes algorithms, useful formulas, patient notes, top work-ups, common calls and complaints, key points on most common problems, essentials of what not to miss and when to refer/call for help.
Developer: Skyscape Medpresso Inc.
Operating System: Android
Cost/Subscription: Free; in-app purchases
Diagnostic Apps
Diagnosaurus DDx
This quick-reference tool helps healthcare professionals quickly perform differential diagnosis at the point of care. There are more than 1,000 diagnoses organized by organ system, symptom or disease, and a See Related DDx feature within each entry offers alternative diagnoses for consideration. Users can highlight and create custom notes within entries.
Developer: Unbound Medicine, Inc.
Operating System: iOS and Android
Cost/Subscription: Free; in-app purchases
Epocrates
Epocrates allows users to identify superbugs in their communities and make more accurate point-of-care prescribing decisions to treat bacterial infections. Drug prescribing and safety, adult/pediatric dosing, adverse reactions, drug interaction, contraindication, and pharmacology information for thousands of brand name, generic, and over-the-counter drugs is included. CME and CE credits are available through articles, videos, podcasts and more based on specialty. COVID-19 resources and news are also included.
Developer: Epocrates, Inc.
Operating System: iOS and Android
Cost/Subscription: Free; in-app purchases
Mobile Airway Card
This reference tool was designed for residents, fellows, and attending physicians in pediatric otolaryngology to help calculate the percentage of obstruction in an airway. The app gives the sizes of tracheotomy tubes, provides examples of a normal airway, and can help with balloon dilation sizing.
Developer: Joseph Alward
Operating System: iOS and Android
Cost/Subscription: Free
Skyscape Lab Values Mobile App
Skyscape Lab offers information on what a given laboratory test is, its clinical significance, what a high or low value might mean, and how the test can aid in patient diagnosis and treatment. Tests covered include blood chemistry, nasal testing, and sputum testing. Information is edited by a practicing clinician and updated every four to six weeks. Users can leave rich text notes in entries.
Developer: Skyscape Medpresso Inc.
Operating System: iOS and Android
Cost/Subscription: Subscription required ($49.99)
UpToDate
Registrants and individual subscribers can answer their clinical questions anytime, anywhere. This clinical decision support resource offers evidence-based clinical information, including drug topics and recommendations that clinicians rely on at the point of care. Users can easily search clinical topics by specialty. Users can bookmark topics, use mobile-optimized medical calculators, and print or email topics/graphics to patients and colleagues.
Developer: Wolters Kluwer Health | UpToDate
Operating System: iOS and Android
Cost/Subscription: Individual or institutional subscription required
Social/Sharing/Wellness Apps
ACGME AWARE
Developed by the Accreditation Council for Graduate Medical Education, this app was developed to outfit physicians and others providing patient care tools to help identify opportunities to improve their well-being and strategies for promoting resilience. The app features a series of videos, information, and linked resources for better wellness.
Developer: Accreditation Council for Graduate Medical Education
Operating System: iOS and Android
Cost/Subscription: Free
MedShr
This secure, private community allows users to connect with thousands of verified doctors, healthcare professionals, and medical students to share knowledge and information, including ECGs, scans, X-rays, and patient photos and videos, and discuss relevant medical cases with colleagues by specialty and at all grades. Users can connect to individuals and groups in their specialty to keep up to date on their latest cases, techniques, and research. The app also makes it easy to request continuing professional development credits for each case shared.
Developer: MedShr
Operating System: iOS and Android
Cost/Subscription: Free
Renée Bacher is a freelance medical writer based in Louisiana. Amy E. Hamaker is the editor of ENTtoday.
YouTube Learning
There’s a resource for those with an interest in otology who prefer video education to app learning. Olivia Kalmanson, MD, a PGY4 otolaryngology resident at the University of Colorado Anschutz Medical Campus in Aurora, has created the YouTube channel OTOlivia. “The ‘Endoscopic Tour of the Middle Ear’ video has gotten a lot of traction and benefits a wide variety of ENT trainees,” she said. You can view that video at https://youtu.be/GHH9qrbpcO0.
Do Doctors Really Use Apps?
There are hundreds of apps for healthcare practitioners available today. But do practitioners actually use them? Several studies say that they do.
A 2021 study examined the use of an app in helping to improve medical student and resident confidence in approaching common otolaryngology scenarios. A cohort of students and residents at Blackpool Victoria Hospital in Australia were asked to rate their confidence in five common ENT scenarios both before and after being granted access to a locally developed otolaryngology application. Results showed that residents’ and medical students’ confidence scores increased by an average of 148% and 124%, respectively (Morecambe Bay Medical Journal. October 1, 2021. doi:10.48037/mbmj.v8i11.1330).
Not only are apps helpful to students and residents, but they can also be helpful to clinicians. A 2012 study found that more than half of the respondents reported using apps during patient interactions, with the most commonly used app type being drug guides (79%), medical calculators, (18%), and coding and billing apps (4%) (J Med Syst. 2012;36:3135–3139). The most frequently requested app types by respondents were textbook/reference materials (55%), classification/treatment algorithms (46%), and general medical knowledge (43%).
Although it’s true that the number of smartphone and tablet apps have increased dramatically over the last few years, it’s important to trust the developer and source of the information. A 2022 study found that the actual involvement of otolaryngologists in app development is still rare (Indian J Otolaryngol Head Neck Surg. 2022;74:58–62).