ORIGINAL PAPER M-learning: mobile phones’ appropriateness and potential for the training of laboratory technicians in limited-resource settings Livia Bellina & Eduardo Missoni Received: 20 July 2011 /Accepted: 28 September 2011 /Published online: 8 October 2011 # IUPESM and Springer-Verlag 2011 Abstract As previously demonstrated, m-phones can be easily used, without any adapter, to photograph and send images from a microscope. The objective of the current study was to test the appropriateness and educational potential of this mobile diagnosis approach with health workers in limited-resource settings, such as health units in Uganda, Bangladesh and Afghanistan. A total of 61 lab technicians were trained in basic lab skills and in using the m-phone to capture microscopic images and send them to distant Reference Centers for a second opinion. Structured pre-test interviews were used to define parameters such as health workers’ sex and age, duty station, schooling, experience in the laboratory, access to internet and availability to and use of m-phones. Images from the microscope were also uploaded on the available computers and shared on the screen to facilitate group discussions and comparisons with reference images. Standard instructions were then elaborated and tested with totally inexperienced people. Results showed that use of integrated camera m- phones was widespread. Mobile Messaging Service (MMS) was commonly accessible, however, not used. Neither m- microscopy, nor clinical use of m-phones was previously known among local health workers. A standard written procedure, without any additional verbal instruction, was enough to easily learn to take pictures of the microscope samples, even for the most inexperienced person. The possibility to share images on the m-phone and/or a computer screen, and the group discussions proved to be phenomenal educational tools. Keywords m-health . m-learning . Mobile phones . Telemicroscopy . Health workers training . Mobile diagnosis 1 Background Among the impediments toward universal coverage, the 2010 World Health Report highlighted the inefficient and inequitable use of resources and proposed a number of solutions including: get the most out of technologies and health services, motivate health workers and improve primary diagnosis accuracy by reducing medical errors [1]. In most cases these three solutions must go together. Technologies, for example, to be effective, must not only be appropriate, adequately taking into account the local context, but must also rely on motivated and skilled health workers. Providing isolated health workers with engaging training and a supportive second opinion may contribute both to their motivation and to correct diagnosis and treatment. Regarding mobile phone-based (m-phones) telemicro- scopy, it has been shown that modern, camera-integrated mobile phones with any resolution above 0.8 megapixel, can be easily used without any adaptor or device, to photograph and send images from a microscope to a reference center for a remote second opinion. It has also been argued that this approach could significantly increase training opportunities and diagnostics’ quality while lowering costs [2]. Thus, we decided to test the method in limited-resource settings, such as rural areas in Uganda, Bangladesh and L. Bellina (*) Mobilediagnosis, via G.Sciuti 180, 90144 Palermo, Italy e-mail: liviabellina@gmail.com E. Missoni Global Health and Development Area, CERGAS, Bocconi University, via Roentgen 1, 20136 Milano, Italy Health Technol. (2011) 1:93–97 DOI 10.1007/s12553-011-0008-x