Just in time? Using QR codes for multi-professional learning in clinical practice

• Healthcare staff use and value high-yield, contextually relevant clinical information and guidelines.
• Smartphones and similar devices can be used to deliver such information, but require tools that link information resource.
• QR codes can provide a link between the real world and the related information on mobile devices like smartphones.
• The content must also be high-quality, at an appropriate level of complexity, and easy to read on a mobile device screen.
• Smartphone use by nurses, in particular, is still often viewed as inappropriate, even to support clinical practice.

Clinical guidelines and policies are widely available on the hospital intranet or from the internet, but can be difficult to access at the required time and place. Clinical staff with smartphones could use Quick Response (QR) codes for contemporaneous access to relevant information to support the Just in Time Learning (JIT-L) paradigm. There are several studies that advocate the use of smartphones to enhance learning amongst medical students and junior doctors in UK. However, these participants are already technologically orientated. There are limited studies that explore the use of smartphones in nursing practice. QR Codes were generated for each topic and positioned at relevant locations on a medical ward. Support and training were provided for staff. Website analytics and semi-structured interviews were performed to evaluate the efficacy, acceptability and feasibility of using QR codes to facilitate Just in Time learning. Use was intermittently high but not sustained. Thematic analysis of interviews revealed a positive assessment of the Just in Time learning paradigm and context-sensitive clinical information. However, there were notable barriers to acceptance, including usability of QR codes and appropriateness of smartphone use in a clinical environment. The use of Just in Time learning for education and reference may be beneficial to healthcare professionals. However, alternative methods of access for less technologically literate users and a change in culture of mobile device use in clinical areas may be needed.