When Policy Meets Practice: Medical Residents and the Governance of Smartphone Use for Communication in Clinical Settings

Background/Objectives: The use of personal smartphones by healthcare professionals in clinical settings has become a growing area of concern as practice may not consistently align with policy guidance. This study enhances our understanding of how and why medical residents are using smartphones to communicate patient healthcare information with other physicians in daily practice and provides insights into the role that institutional governance, policies, and structures play in the use of smartphones. Methods: This study used qualitative techniques to examine medical residents' use of smartphones to communicate healthcare-related information with colleagues. Additionally, a neo-institutional theory lens was applied to assess the role that regulative (guidelines/policies), normative (what peers/staff are doing), and cultural-cognitive (beliefs/perceptions) factors play in smartphone use by medical residents. Results: The results suggest that behaviour related to smartphone use is based primarily on normative and cultural-cognitive factors rather than regulative factors. Regulative elements around smartphone use play a smaller role in shaping behaviour, particularly when they: (1) lack clarity; (2) are not seen as credible/legitimate; or (3) are viewed as cumbersome and do not align with workflow needs. Conclusions: The implementation of future guidelines/policies should consider the use of mentorships throughout postgraduate medical training whereby staff physicians educate, model, and promote behaviour in accordance with the associated policies/guidelines.