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Medical informatics.

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PubMed2002

A medical informatics curriculum for 21st century family practice residencies.

BACKGROUND AND OBJECTIVES: An informatics curriculum was developed by integrating evidence-based medicine, communication and behavioral sciences, patient education, and computer skills. Introduction of an electronic medical record (EMR) to our family practice center was a focal point of this training. Our objective was to measure whether the new curriculum improved our residents' informatics skills and computer knowledge. METHODS: Before and after institution of the curriculum, residents' self-rated skills and attitudes were measured with a questionnaire. They also took an objective test of informatics skills after the curriculum was implemented, and their scores were compared to scores from five other control residencies that did not use the curriculum. RESULTS: The curriculum, including use of the electronic record, was successfully implemented and tested. The curriculum improved residents' self-ratings of informatics knowledge and computer skills, but the objective test did not show a significant difference between programs. CONCLUSIONS: After implementation of a medical informatics curriculum, residents self-reported an improvement in computer and informatics skills. The objective measurement of knowledge did not demonstrate the benefit of our curriculum compared to other programs.

Computer Literacy↗
PubMed1995

Analysis of medical decision making: a cognitive perspective on medical informatics.

The improved support of complex medical decision making will require a greater understanding of the cognitive processes of physicians. Decision making in medicine often involves the careful weighing of uncertain and ill-structured information from various sources. In this paper a cognitive approach to analyzing complex intensive care decision making is outlined. The study described involved the presentation of case descriptions of systematically varied complexity, to two levels of physicians: intensive care residents (intermediates) and intensive care specialists (experts). Subjects were asked to "think aloud" in providing treatment and management decisions for the cases. The audiotaped protocols were then analyzed for the use of decision strategies and for key aspects of decision making. It was found that expert subjects tended to focus on developing a more refined situational analysis of the decision problem. The study results are being used in the design of a system for aiding physicians in making complex decisions in intensive care medicine.

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