Technology as we all know has caused significant movement in medical education. In reality this was not a desire of our own as doctors, but was brought to us courtesy of the gaining popularity of technology use in everyday lives, from the rise of the internet, mobile devices, laptops, and social media. We then attempted to utilise this technology due to its abundance. And further attempted to enhance the academic validity of its use by linking its worth to educational theories. Interestingly many of these theories were developed at a time when technology did not exist.

Let us reflect on real life working habits and ask what do we observe as to the uses of technology by doctors. Let’s take the junior doctor as the first example. The junior doctor, as I and probably most people see them, use technology when battling the wards or in clinic where they are likely to search for information if they are unable to recall all the potential differentials or tests to order, or to access the latest evidence base for condition x or y. Instant messaging is popular. Groups for members of one’s team exist to provide updates on patients’ state, or to provide a notification of when or where the next teaching session may be. In real life, doctors in training resort to online question banks for exam preparation. Thousands of questions are available online and hence using these platforms is popular—after all passing exams is essential for progression. There are thousands of apps, but which apps are used in real life and why? One common utilisation as I see it are journal apps which allow for convenient access to evidence based material. Or it may be an app to a popular clinical textbook. For senior doctors the applications in real life working are similar—most likely access to the evidence base and for communication.

Of course observation may to some seem to be weak evidence, but real life working in the field counts for something. And research studies are often not fit for purpose. Studies often rely on a technology platform and assessing its merits in an artificial setting. And no doubt people will like or dislike its use. We can perform multiple studies this way without reaching an agreed way forward.

Surely we need to shift medical education to realism. Note how we actually use technology, as opposed to pushing applications to users in the hope that they take them on board. We need to ascertain the needs of learners first from a technology perspective and then problem solve accordingly.

Neel Sharma graduated from the University of Manchester and did his internal medicine training at The Royal London Hospital and Guy’s and St Thomas’ NHS Foundation Trust. Currently he is a gastroenterology trainee based in Singapore.

Competing interests: None declared.