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PubMed2000

Milliseconds matter: an introduction to microstrategies and to their use in describing and predicting interactive behavior.

Interactive behavior is constrained by the design of the artifacts available (e.g., a mouse and button) as well as by the ways in which elementary cognitive, perceptual, and motor operations can be combined. Any 2 basic activities, for example, (a) moving to and (b) clicking on a button, can be combined to yield a limited number of microstrategies. The results of an experimental study suggest that alternative microstrategies can be deployed that shave milliseconds from routine interactive behavior. Data from a usability study are used to explore the potential of microstrategies for (a) bracketing the range of individual performance, (b) profiling individual differences, and (c) diagnosing mismatches between expected and obtained performance. These 2 studies support the arguments that the microstrategies deployed can be sensitive to small features of an interface and that task analyses at the millisecond level can inform design.

Adult↗
PubMed2003

The adaptive user: an investigation into the cognitive and task constraints on the generation of new methods.

When people use a computer application, they have the opportunity to adapt the methods or strategies that they deploy to better fit the demands of the task. In Experiment 1, we demonstrated that the generation of methods is limited by, but not entirely prevented by, the reduced opportunity that is associated with the iterative nature of typical computer-based tasks. In Experiment 2, we demonstrated that the cognitive demands associated with task-related problem solving delay, but do not prevent, the generation of more efficient device strategies. We argue that people are rather good at adapting device strategies to task demands and that previously reported arguments to the contrary are premature.

Adolescent↗
PubMed1998

Computer-assisted learning and the general dental practitioner.

Computer-assisted learning is an acceptable form of education for general dental practitioners. Critical assessment of program structure and content is required if the maximum benefits of the medium are to be obtained. There is a need for information technology support for general dental practitioners to allow them to make best use of the programs.

Adult↗
PubMed1994

The evolution of undergraduate medical informatics programmes.

This article summarizes developments in the teaching of medical informatics to undergraduate health care professionals. Whilst clinical schools are adopting quite different approaches to informatics education and training, there seem to be a number of common factors shaping educational policies and the resultant programmes. Different professional schools face similar problems in relation to resources and staff development. At the same time, examination of different syllabuses suggests the existence of divergent models as to what medical informatics should encompass, as well as different views as to what elements of the domain should be included in preliminary or undergraduate courses. The relevance of these trends to health libraries is briefly considered.

Attitude to Computers↗
PubMed1997

Advisory Committee on Dangerous Pathogens (ACDP). Seminar on microbiological risk assessment, 28 January 1997.

Microbiological risk assessment is an area of growing importance and significant potential, where the underlying science, software systems and databases are developing to the point of real and useful application. It is also an area where the developing science is posing as many questions as it is presenting answers. Key issues emerging from the day included: the need for more sophisticated management of uncertainty, which is much more relevant to microbiological risk analysis than to other applications; the need for global surveillance systems with better compatibility and appropriate peer review; considered assessment of the impact of new molecular-based diagnostic and screening techniques; the explosion of relevant information available, particularly on the Internet, which makes computer literacy essential both to professionals and 'laymen'; and the appearance of software systems which are either tailored for microbiological application or have the potential for this use. The closely associated issues of risk communication and perception also emerged as being vital to the effective application of microbiological risk management to public health issues. Overall, the majority of participants considered the event to have been valuable and stimulating and thought that it would lead to improvements in the use of microbiological risk assessment. The Advisory Committee on Dangerous Pathogens is committed to taking this topic forward and will be both taking up the messages from this seminar and encouraging development of suitable databases and software systems.

Bacterial Infections↗
PubMed2004

'Rage against the machine?': nurses' and midwives' experiences of using Computerized Patient Information Systems for clinical information.

BACKGROUND: Computerized Patient Information Systems (CPIS) are used increasingly in health care, yet few studies have asked clinicians to describe their experiences of using these systems and what they mean to their practice and patient care. AIMS AND OBJECTIVES: The aim of this study was to explore clinical nurses' and midwives' perceptions and understandings of computerized information systems in everyday practice. The objective was to provide a detailed and faithful account of clinicians' experiences of using such systems. DESIGN: A qualitative design was used, based upon interpretive phenomenology. METHODS: A total of 13 focus groups involving 53 practitioners was conducted in hospitals across five Australian states with nurses and midwives from a wide range of practice settings. The participants ranged from Level 1 RNs to Clinical Nurse Consultants and nurses with an IT project management role. RESULTS: This study focuses specifically on clinicians' experiences of using CPIS to manage clinical information. Clinicians' experiences were characterized by digital disappointment rather than electronic efficiencies. Clinicians reported generally that computerization had neither enhanced their clinical practice nor patient care, nor had it improved patient outcomes. CONCLUSIONS: Participants' experiences were predominantly negative and mostly critical of CPIS and their: perceived inability to capture 'real nursing', difficulty in use, incompatibilities, non-responsiveness and irrelevance to patient care and meaningful clinical outcomes. RELEVANCE TO CLINICAL PRACTICE: Technological 'solutions' to health care problems are endlessly seductive and easily entrance policy and decision makers. Computerization will continue to impact upon clinical practice and cannot be wished away. Today's computerized systems may have been developed with scant regard for clinician end-users. A crucial issue facing everyone in health informatics is how point-of-care systems can be developed in ways that involve clinicians meaningfully and which recognize and respond to the complexity and subtlety of the world of nursing and midwifery practice.

Attitude of Health Personnel↗
PubMed1999

Why? What? and How? IT provision for medical students in general practice.

OBJECTIVES: The aim of this paper is to discuss the increasing use of computers in undergraduate medical education and explore the why, what and how of providing IT facilities to undergraduate medical students when they are on placement in general practice. Adequate computing facilities are usually available within hospitals and medical schools, however, major changes are taking place in undergraduate education resulting in more teaching being undertaken in the community. Students will therefore need access to comparable facilities whilst in primary care settings in order for their training not to be compromised. SETTING: This paper describes one initiative addressing this need: the University Linked Practices (ULP) project in the Department of General Practice and Primary Care at St. Bartholomew's and the Royal London School of Medicine and Dentistry. DESIGN: We discuss the ways in which computers are currently being used in medical education and discuss some of the merits and drawbacks that are associated with this increasing drive to computerization.

Computer Literacy↗
PubMed2003

Effectiveness of training health professionals in literature search skills using electronic health databases--a critical appraisal.

The objective was to assess the effect on health professionals' skills of one to eight hours literature search and retrieval training from electronic health databases. We searched: Cochrane library (2002; Issue 3), MEDLINE (1977-2002/5), EMBASE (1980-2002/7); CINAHL (1982-2002/5); ASSIA (1982-2002/7), BNI (1994-2002/5), ERIC (1985-2002/6); LISA (1969--current), NRR (2002, Issue 2), the world-wide-web and references. The selection criteria consisted of randomised controlled trials, controlled before and after, and controlled cohort studies in comparison with no training. The intervention had to be one to eight hours training in literature search and retrieval skills for health professionals. The outcome was the effect on health professionals' literature search and retrieval skill levels measured through reliable instruments. For data collection and ana-lysis, one reviewer extracted data and assessed the quality of the studies and the second reviewer checked it. The results indicate that there is some evidence of positive impact on health professionals' skill levels in literature searching and they find the training useful. In conclusion, the size of the positive effect is debatable as only three small and methodologically weak studies met the inclusion criteria and out of those only two showed the positive effect.

Computer Literacy↗
PubMed2003

Trends in the use of cameras and computer technology among dermatologists in New York City 2001-2002.

BACKGROUND: Photography and computers can enhance dermatologic visit documentation and care. OBJECTIVE: To determine dermatologists' use of cameras and computers. METHODS: We surveyed computer and camera use during the Dermatologic Society of Greater New York's meetings in January 2001 and 2002. RESULTS: Approximately 75% of dermatologists can use computers. Between 2001 and 2002, 35-mm film camera use by attending and resident dermatologists fell from 60% to 47% and 43% to 32%, respectively, and digital camera increased from 25% to 38% and 35% to 59%, respectively. Approximately 50% of dermatologists use instant cameras. Approximately 15% of dermatologists use no camera. Most find images useful; however, medical dermatologists usually image only interesting patients, and dermatologic surgeons image almost all patients. Approximately 15% of dermatologist used electronic medical records (EMRs). CONCLUSION: Computers and cameras are widely used but have not changed dermatologic practice. Images are not used to track skin disease or integrated with EMRs nor are EMRs widely used, probably because of difficulty of use and limited computer literacy. Where images appear to add value, for example, for preoperative and postoperative documentation among dermatologic surgeons, camera use is common, suggesting that utility drives technology adoption.

Confidentiality↗
PubMed2001

Computer-based patient record systems.

OBJECTIVES: To provide oncology nurses with an overview of computer-based patient record (CPR) systems, a key infrastructure requirement in information management that is essential to maintaining a scientific basis for health care. DATA SOURCES: Published articles, research studies, and review articles pertaining to CPR systems. CONCLUSIONS: Progress in hardware development, software applications, and interfaces combine to bring us multimedia patient record systems. Many obstacles have been overcome as standards have emerged and technologies conform to those standards. However, there has been limited success in implementation of such systems. Early acceptance of structured data and problem-oriented documentation set the framework for charting in the electronic record. IMPLICATIONS FOR NURSING PRACTICE: Oncology clinicians and cancer patients alike will realize greater efficiencies and increased quality in health care when the CPR is fully implemented.

Attitude to Computers↗
PubMed2000

The Internet: a practical example of the use of new technology in the assessment of vancomycin use in pediatrics. The Pediatric Prevention Network.

BACKGROUND: The rapid emergence of both new infections and new technologies has revolutionized health care during the past 50 years. Increased use of the Internet has enabled health care professionals to educate, interact, and collaborate throughout the world in ways never before possible. Increased use of vancomycin has been associated with the emergence of organisms with decreased susceptibility to vancomycin, such as Enterococcus and staphylococcal species. The purpose of this article is to describe our experience using Internet technology to assess vancomycin use at children's hospitals in the United States. METHODS: A Web-based evaluation was developed and distributed on the Internet to 57 Pediatric Prevention Network hospitals. The evaluation was structured to collect summary statistics on vancomycin use and admissions data by service for 1997 and 1998. RESULTS: Twenty-four hospitals were able to provide archived vancomycin use and patient admissions data; completed evaluations were returned from 15 hospitals (62.5% response rate). Personnel at 6 (40%) hospitals completed the evaluation directly on the Internet. CONCLUSIONS: In our study, Internet technology facilitated a more efficient evaluation of vancomycin use, but fewer than half of the personnel at Pediatric Prevention Network hospitals completed the evaluation directly on the Internet. It is unclear whether personnel at these hospitals were limited in Internet access, support, or understanding. Efforts should be directed to educate health care personnel on the advantages of the Internet. Furthermore, many of the pharmacy databases used in our assessment were not standardized across hospitals nor systematically validated. Understanding that limitations still remain-within the source of the data studied, the health care system sampled, and the Internet tools available-is essential because the Internet offers health care professionals today a tool both to protect patients and to improve quality throughout the world.

Attitude to Computers↗
PubMed2002

The contribution of apparent and inherent usability to a user's satisfaction in a searching and browsing task on the Web.

Previous research found that apparent and inherent usability had big influences on user's acceptance of computer systems. This research extended these findings to the area of user's satisfaction. The study investigated the impact of inherent and apparent usability on user's satisfaction of Web page designs while the two main tasks on the World Wide Web, searching and browsing, were performed. The results indicated that inherent usability was the main factor contributing to user's satisfaction in both searching and browsing. General principles and specific recommendations for the design and evaluation of Web page designs are derived from these findings.

Adult↗
PubMed1991

Cognitive representations, control, and understanding of complex systems: a field study focusing on components of users' mental models and expert/novice differences.

Users' mental models of systems are frequently asserted to be important in their interactions with those systems. Although there are few explicit definitions of mental models in the literature, mental models are assumed to be important and researchers have seemed to accept and understand the concept intuitively. In our research, we have extracted three themes from the definitions of mental models including: (1) the relations among features or components of a system; (2) the capability of the mental model to aid in the control of the system; and (3) the capability of the mental model to enhance the user's understanding of the system. The relationships among the components of users' mental models, including procedural and declarative knowledge, perceptions of the use of system features, and the relations among the similarity of use of system features, were investigated in a field study. Trained and untrained novice users of a new business phone system rated the similarity of use of nine standard features on the phone. These ratings were used to derive cognitive representations of the relations among the system features. Users' ratings of features on univariate scales about the use of the features and scores obtained on a test of procedural knowledge were related to these representations. The two novice groups' mental models were similar except for the perception of one feature; it was more accurately depicted in the trained users' representation than those who did not attend a training programme. Two types of experts' similarity of use ratings were evaluated to determine an 'appropriate' representation of the use of the system features; this was then compared to the novices'. This comparison suggested that there were deficiencies in the mental models of novices. Designing training programmes and instructional aids for systems using the discrepancies between novices' and experts' mental models are discussed.

Adult↗
PubMedDate not supplied

An evaluation method of computer usability based on human-to-computer information transmission model.

This paper proposes a new evaluation and prediction method for computer usability. This method is based on our two previously proposed information transmission measures created from a human-to-computer information transmission model. The model has three information transmission levels: the device, software, and task content levels. Two measures, called the device independent information measure (DI) and the computer independent information measure (CI), defined on the software and task content levels respectively, are given as the amount of information transmitted. Two information transmission rates are defined as DI/T and CI/T, where T is the task completion time: the device independent information transmission rate (RDI), and the computer independent information transmission rate (RCI). The method utilizes the RDI and RCI rates to evaluate relatively the usability of software and device operations on different computer systems. Experiments using three different systems, in this case a graphical information input task, confirm that the method offers an efficient way of determining computer usability.

Computer Literacy↗
PubMed1994

Ageing, computer-based task performance, and stress: issues and challenges.

An emerging problem that encompasses both traditional ergonomic as well as macroergonomic concerns involves assessing the potential implications of computer-based tasks for older workers. An increasing older workforce and the influx of computer technology into a wide variety of work settings has motivated both a re-examination of the literature concerning ageing and work performance and research that more directly addresses the computer-interactive task domain. In this paper, we overview this literature and raise a number of crucial issues concerning potential age differences in performance and stress associated with computer-based tasks. Underlying our discussion throughout is the intention of identifying the challenges that await interested practitioners and researchers.

Adult↗
PubMed1995

Improving interface quality: an investigation of human-computer interaction task learning.

User learning is of critical importance in evaluating interface usability (and in turn interface quality). The focus of this research in on interface learnability, where a stochastic model represents the learning process required for successful completion of human-computer interaction tasks. The parameter used to quantify learning is a learning rate. Of interest here is the validation of learning rate as a measure of interface quality. Learning rate was validated against two traditional measures of interface quality: task completion time, and error frequency. SuperCard, a Macintosh project utility, provided an empirical learning environment in which 32 participants learned 16 fundamental SuperCard tasks. Results of correlation analyses suggested the usefulness of learning rate as an indicator of interface quality. Our learning rate analysis identified four tasks presenting learning difficulties. (Analysis of task completion times identified two of these four tasks, and error frequency analysis identified one). Learning rate data captured all of the information available from the two traditional interface quality measures and identified two tasks disregarded by them. Incorporating learning rates in the interface evaluation process precludes time-intensive video tape analysis typically required by more traditional interface quality measures.

Adult↗
PubMed2002

Twelve tips for the development of electronic study guides.

With recent advances in technology, electronic study guides are becoming extraordinary management, learning and assessment tools in the teaching-learning process, replacing printed study guides. The educational advantages they offer are listed here. During the elaboration of an electronic study guide, there are important issues to consider, such as the student's capabilities in the use of electronic media, the type of software to be used, proper authorizations and accessibility, the inclusion of all information and links needed, as well as a clear explanation on the use of the software. This paper offers twelve useful tips for the development of electronic study guides.

Adult↗