The Journal of the Norwegian Medical Association on iPad – doctors are changing their reading habits

Are Brean About the author
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Our journal is now printed on a new type of paper. At the same time, we are launching the iPad version. In combination, the changes represent the best of two worlds.

Photo: Einar Nilsen

«Can’t you decide what channel to watch!» I recently exclaimed to one of my teenage children, who was zapping incessantly between the TV channels, remote control in hand. «I look at them all,» was the laconic response from the normally rather bookish teenager. When my initial irritation has subsided I realised that the response was correct as well as wise: The digital generation’s media-use habits are adapted to the realities of the digital world. Whereas reading on paper invites a chronologically vertical reading process that proceeds from the first to the last page, modern media encourage another type of information-gathering – every page on the web contains links to other pages, other places and other topics. In this manner one can surf horizontally from place to place on the Internet as well as on TV, until the need for information has been fulfilled.

There are indications that the reading habits of doctors are changing in the same direction. When I was a student in the early 1990s, static textbooks represented the natural choice of a place to search for knowledge. If we wanted the most recent articles as well, a good librarian could provide paper copies within a few days. Today, the large medical search engines provide immediate access to a nearly unlimited number of articles. Nearly all of these contain links to other – and perhaps even more interesting – pages, articles and multimedia content, and so we can continue surfing. There is documentation to indicate that this is gradually changing the way we learn our skills. While the time that a researcher spent reading a scientific article remained virtually unchanged at 47 minutes until the mid-1990s, it later fell continuously to reach somewhat more than 30 minutes by 2009 (1). At the same time, the total time spent on reading has remained fairly stable. In other words, we read more medical articles than before, but spend less time on each of them. The analogy to the teenager in front of the TV does not seem far-fetched.

It is by no means certain that this development is unfortunate or undesirable. The new ways to collect information have obvious advantages, and doctors have always been quick to make use of innovations in information technology (2). This is essential, since collection and transfer of information are so crucial to provide appropriate treatment to individual patients, especially in a contemporary situation where medical axioms are changing more rapidly than ever before. In recent years, this journal has therefore started to make use of a growing number of channels and platforms, and the content is currently available on paper as well as online, as podcast, web-TV and on adapted smartphones. In addition, the editors devote much effort to disseminating the content through various social media on the web. Today, you can hardly surf the web for Norwegian health-related content without encountering articles from this journal in some form!

The launch of the iPad version of our journal is a natural consequence of all this. The so-called tablet computers – with the iPad as the first, and so far the most well-known among them – have assumed a leading role in determining how medical knowledge is disseminated (3). The iPad also has characteristics that render it especially well suited for use in the health services, and tablet computers have in many places been put to use in a variety of functions in practical, clinical medicine (4). In the development of the iPad version of this journal, it has been essential to exploit the characteristics that distinguish the iPad from other digital platforms. For example, the design has been adapted to the iPad, and not just transferred from the web-based or the paper-based version, as is the case with a number of other journals (5). By itself, this provides for a unique reading experience, when compared to the web issue as well as the printed one. You can also bookmark articles, build your own archive of articles and read them offline. In the articles you can highlight/underscore text, you can share the articles with others, and tailor the selection of articles to your particular area of interest. Pictures and video are also integrated into the content.

To coincide with the launch of the iPad version, this journal is introducing a new type of paper for the printed issue that you receive in your mail box or on your doormat. The simultaneous introduction of these two changes is no coincidence. While the iPad version has the advantage of being independent of paper, the new paper has a clear environmental profile – it has been produced close to our print shop to reduce transport distances, and we have by personal inspection confirmed that the production process is so environmentally friendly that the waste water coming out of the factory is drinkable. We have chosen a paper which will be perceived as a little coarser and as having a more palpable texture than the old one – in short, it will be perceived as even more distinctively «paper-like», and hopefully provide for a deeper and more three-dimensional reading experience. It thus signals more succinctly that this is another medium than its digital counterparts. On paper, the vertical reading process still applies – without any disturbing multimedia, links and extras. In this sense, the advantage of the paper version is the absence of the advantages of the iPad version. The two versions complement each other, and show that the modern doctor can, and should, happily engage in vertical as well as horizontal professional immersion, just as my digitally zapping teenager also can spend hours with a captivating paper book. Happy reading!

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