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The medical curriculum in the Federal Republic of Germany (FRG) is regulated by federal legislation. Medical informatics is part of this curriculum and is therefore taught by all 27 medical faculties in the FRG, 24 of which have related departments. The teaching situation in general and the specific approach at the author's department are described.
The authors have developed a curriculum in medical informatics that focuses on practical problems in clinical medicine, rather than on the details of informatics technologies. Their development of this human-centered curriculum was guided by the identification of six key clinical challenges that must be addressed by practitioners in the near future and by an examination of the failures of past informatics efforts to make a significant difference in the everyday practice of clinical medicine. Principles of human factors engineering--the body of knowledge about those human abilities, limitations, and characteristics that are relevant to design--are an essential part of this curriculum. Human factors engineering also provides the necessary perspective, as well as the concrete knowledge and methods, that can enable practitioners to properly evaluate their clinical information needs, weight the merits of proposed technology-based solutions, and understand their own inherent performance limitations.
OBJECTIVES: Computers are widely used for data management in clinical trials in the developed countries, unlike in developing countries. Dependable systems are vital for data management, and medical decision making in clinical research. Monitoring and evaluation of data management is critical. In this paper we describe database structures and procedures of systems used to implement, coordinate, and sustain data management in Africa. We outline major lessons, challenges and successes achieved, and recommendations to improve medical informatics application in biomedical research in sub-Saharan Africa. METHODS: A consortium of experienced research units at five sites in Africa in studying children with disease formed a new clinical trials network, Severe Malaria in African Children. In December 2000, the network introduced an observational study involving these hospital-based sites. After prototyping, relational database management systems were implemented for data entry and verification, data submission and quality assurance monitoring. RESULTS: Between 2000 and 2005, 25,858 patients were enrolled. Failure to meet data submission deadline and data entry errors correlated positively (correlation coefficient, r = 0.82), with more errors occurring when data was submitted late. Data submission lateness correlated inversely with hospital admissions (r = -0.62). CONCLUSIONS: Developing and sustaining dependable DBMS, ongoing modifications to optimize data management is crucial for clinical studies. Monitoring and communication systems are vital in multi-center networks for good data management. Data timeliness is associated with data quality and hospital admissions.
AIM: Standardization of education process and almost every aspect of life in EU moved the authors of this paper to evaluate medical informatics education at medical schools in Bosnia and Herzegovina. A very complex political structure and existence of two entities, one district and ten cantons in the Federation of Bosnia and Herzegovina caused great differences in the curricula, teaching methods and quality of acquired knowledge among medical schools in the country. Also, on the example of the teaching process at the Medical School, University of Sarajevo, the authors propose a future united and integrated system in the area. METHOD: Method of the study is descriptive, comparing education in medical informatics at five B&H medical schools. Over 500 students answered questionnaires designed at medical schools in Sarajevo and Tuzla. The questions tackled the contents of the subject of medical informatics, the possibility of acquiring knowledge from both practical and theoretic lessons, "good" and "bad" sides of the curricula as well as students' computer literacy. RESULTS: The subject of medical informatics is being taught in at least 3-4 different ways. Medical schools in Banja Luka and Foca/Srbinje are under a strong influence of the University of Belgrade, Serbia and Montenegro; the teaching staff in Mostar are from Croatia; the University of Tuzla has its own way; and Medical School in Sarajevo maintains high quality values and principles. Things and events that distinguish the Medical School, University of Sarajevo is the fact that it is the only medical school in Bosnia and Herzegovina which has a web site of of the Department of Medical Informatics, organized a number of events including a distance learning course, and has a highly competent teaching staff. Medical School in Sarajevo is the oldest medical school in Bosnia and Herzegovina established in 1944. As a required subject, medical informatics was introduced in the academic year 1992/1993, and it is the only medical school in Bosnia and Herzegovina where medical informatics is taught in two semesters, second and eleventh. DISCUSSION: Three important areas are discussed: the quality of education in secondary schools should be improved; the lack of multimedia equipment, good LAN, high-speed connection to Internet and well organized web design, and issues related to maintenance of equipment; and students should have free access to computer rooms to enable them to extend their knowledge in spare time; general information about health system should be available to students to allow them to require the role and importance of medical informatics in "real life". Naturally, we raise the question of unique and systematic medical informatics education in the whole country, irrespective of entities, nationality or religion of students. CONCLUSION: Medical informatics education at Medical School, University of Sarajevo, is based on the same concept as on prestigious universities all over the world and in accordance with recommendations of the working groups on education of EFMI and IMIA. Other medical schools in Bosnia and Herzegovina should employ the same methodology and system of work in order to have standardized education in medical informatics and to achieve high quality in education. To enable us to follow the European and global achievements in this area, the power of fact should predominate in the education system as well as in the health system.
The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics / medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware. The IMIA recommendations centre on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in health care (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree). To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http://www.imia.org/wg1).
1. CURRICULUM DESCRIPTION. Twenty years ago, our faculty organized several lessons in a physiology course to inform students about computers. Recently, new courses in informatics were established. In their first year, students take a compulsory course (15 hours=h) of basic computer science (computers databases, networking, and basic non-medical computer software). A special elective course in medical informatics (30h) can be taken in the 4th year (about 20% of students pass tis course). This course includes the following lessons: computers in medicine (2h), scientific information (4h), classification in medicine (2h- including ICD, SNOMED etc.), computer support of clinical decision (2h-calculation principles with demonstration), artificial intelligence (2h), statistical software (2h), hospital information systems (2h), software for practitioners (2h), biosignal and image analysis (4th), computers in pharmacology (2h), computer simulation (2h), support of metabolic care (2h-consultations, risk calculations), and laboratory information systems (2h). The same course, though slightly differences, is used for paramedical students (occupational therapy, health education, and nursing). Medical technology was established in a three year curriculum courses in the 1st year include common courses in electronic devices (60 h), computers and programming (120 h), biophysics (90 h), biomechanics (30 h), and different medical courses (500 h). For the 2nd and 3rd year, 75% of the courses (700 h per year) are technical e.g., medical devices, information systems, signal and picture analysis, laboratory technique, and data protection. 2. CONCLUSION AND PERSPECTIVES. Students of medicine, and some paramedical studies, are able to use computer in their profession after having taken these courses. Bachelors of medical technology find application in biomedical research, hospitals, and medical technology firms.
The importance of informatics training within a health sciences program is well recognized and is being implemented on an increasing scale. At Chicago Medical School (CMS), the Informatics program incorporates information technology at every stage of medical education. First-year students are offered an elective in computer topics that concentrate on basic computer literacy. Second-year students learn information management such as entry and information retrieval skills. For example, during the Introduction to Clinical Medicine course, the student is exposed to the Intelligent Medical Record-Entry (IMR-E), allowing the student to enter and organize information gathered from patient encounters. In the third year, students in the Internal Medicine rotation at Norwalk Hospital use Macintosh power books to enter and manage their patients. Patient data gathered by the student are stored in a local server in Norwalk Hospital. In the final year, we teach students the role of informatics in clinical decision making. The present senior class at CMS has been exposed to the power of medical informatics tools for several years. The use of these informatics tools at the point of care is stressed.
The advances of health informatics over the last 50 years are briefly sketched to reveal the pervasiveness of their applications in health and health care. The relations to research in health informatics and health are pointed out. From this perspective it is argued that the evolution of consumer health informatics in the last decade has had a profound impact on the practice of medicine, on patient-physician relations and, hence, on the requirements for medical education. The different access to information and how it is used in educational environments will also dramatically affect how curricula are structured both at undergraduate and postgraduate levels. The impact of health informatics on medical education is further elaborated, and the requirements on infrastructure in support of this education are detailed. This infrastructure goes beyond instructional laboratories and includes academic units for medical informatics and, most importantly perhaps, funding resources and adjudication capacity for health informatics research and their integration into the Canadian research organization and the new Canadian Institutes of Health Research.
As medical schools incorporate medical informatics into their curriculum the problems of implementation arise. Because there are no standards regarding a medical informatics curriculum, medical schools are implementing the subjects in various ways. A survey was undertaken to amass an overview of the medical informatics curriculum nationally. Of the responding schools, most have aspects of medical informatics incorporated into current courses and utilize existing faculty. Literature searching, clinical decision-making, and Internet are the basic topics in the current curricula. The trend is for medical informatics to be incorporated throughout all four years of medical school. Barriers are the difficulties in faculty training, and slow implementation.
OBJECTIVE: As an international organization with the missions to promote informatics in health care and biomedical research, advance international cooperation, stimulate research, development and education, and disseminate and exchange information, the International Medical Informatics Association (IMIA) must be constantly cognizant of new developments in medical informatics and address the challenges to the discipline. From an international organization standpoint, it perceives three major challenges viz. the Identity, Organizational and Leadership challenges. METHOD: This paper attempts to identify and discuss these challenges and to offer ways to overcome them through the activities of an international organization for medical informatics. RESULTS AND CONCLUSION: From an international organization standpoint, IMIA can help overcome these organizational challenges by ensuring strong leadership throughout its echelon, actively promoting its goals and objectives worldwide through its national and institutional members as well as its regional groups and encouraging strategic partnerships between its many Working Groups and Special Interest Group on Nursing with other international organizations and industry to further promote the awareness and the perception of the relevance of medical informatics to health and medicine by the international community.
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The teaching of medical informatics is of importance for students in medicine and health care, realizing that they will be the health professionals of the future. Training in medical informatics is also of value for practicing clinicians who are overwhelmed by the avalanche of systems that are available on the market. Some examples of operational systems are presented here to indicate that health care has changed dramatically over the last decades. This paper intends to contribute to the drafting of IMIA guidelines for teaching medical informatics by (1) reporting on the experience at the Faculty of Medicine and Health Sciences of the Erasmus University Rotterdam as part of the curriculum, (2) reporting on the implementation of guidelines for teaching medical informatics in The Netherlands since these guidelines were drafted in 1986, and (3) by introducing the teaching material contained in the new Handbook of Medical Informatics and on its Web site.
The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware. The IMIA recommendations centre on educational needs for healthcare professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in healthcare (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for healthcare professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, healthcare management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree). To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http:www.imia.org/wg1).
The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.
In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.
The medical informatics curriculum at University of Heidelberg/School of Technology Heilbronn started in 1972 as a specialized university curriculum. In this paper, we report on 20 years of experience and the evolution of this educational approach with respect to structure and content of the curriculum. We emphasize that this evolution parallels the development of medical informatics to a medical discipline in its own right, with distinct application domains and specific methodological approaches. Based on our experience and on recommendations from the national and international community, we describe and discuss the features of the curriculum.
In this paper author discussed about experiences of implementing curriculum of education of Medical informatics on biomedical faculties in Sarajevo. Theoretical and practical part of education process, according to new curriculum, during 6 years period of studying at Faculty of medicine in Sarajevo, is hold within the second semester and consists of 30 hours. At Faculty of Dental Medicine in Sarajevo, education is hold in the fourth semester, and consists of 45 hours. At Higher Medical School in Sarajevo, education is also hold in the fourth semester, and consists of 30 hours of theoretical and 30 hours of practical hours as well. Curriculum of Medical Informatics is identical at all these three institutions. Faculty of Dental Medicine education process points out dental informatics, and Higher Medical School devotes more time in education on nursing informatics.