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PubMed1992

An analysis of transaction logs to evaluate the educational needs of end users.

End users at the University of Southern California (USC) have free access to the last ten years of MEDLINE through a local online system known as USCInfo. Librarians at USC Norris Medical Library provide documentation and offer formal and informal training on the use of the system to search MEDLINE. To assess the educational needs of the end users, 643 searches were analyzed. Although a high proportion (84%) of the searches were judged to be successful, the use of medical subject headings (MeSH) to obtain optimal results was low; only 20% of all successful subject searches employed MeSH. Also, the advanced features of the system were underutilized. While it is promising to learn that many end users are obtaining positive results, methods which will encourage end users improve their retrievals need to be developed.

Computer User Training↗
PubMed1998

Using biomedical databases in everyday clinical practice: the Front-Line Evidence-Based Medicine project in North Thames.

The aims of this project were to assess the feasibility of using biomedical databases in everyday clinical settings, and the infrastructure needed to support such practice. Fourteen firms or units whose lead clinician was enthusiastic for the principles of evidence-based medicine were provided with 24-h access to databases in their clinics or offices. All members of the firms were trained in the principles of evidence-based practice and in the use of databases for finding evidence. The firms were volunteers from a variety of specialties in both hospital and community Trusts in North Thames Region. Assessment of changes in practice was carried out by questionnaire and interview. Also, any changes needed to improve the use of primary research data in everyday clinical settings was investigated. Seven firms found that the project had made their journal clubs and their clinical discussion meetings more structured and focused, with research evidence for and against interventions discussed. The use of evidence in a case-related form was limited by the time available. The other seven firms were: dissatisfied with their training, dissatisfied with their computer facilities or lacked time. The changes necessary to improve the utilization of research data included: closer collaboration with librarians, continuing training and fast delivery of documents. The limitations of this study are that initial data were not recorded and the assessments made were subjective. Using biomedical databases in everyday clinical practice could be feasible provided that there is a coordinated implementation strategy, which requires a significant commitment of time and resources from all parties involved (clinicians, other health care professionals, librarians and managers).

Computer User Training↗
PubMed2000

Enhancing technology skills of maternal and child health professionals.

OBJECTIVE: Information technology skills are essential for effective and efficient practice in maternal and child health (MCH). METHODS: Prior to the beginning of a web-based analytic skills training course, enrolled MCH professionals confidence in using e-mail and other Internet skills and beliefs about their usefulness were assessed. RESULTS: The assessment showed that participants believed strongly in the value of the specific technology skills but confidence in the ability to use these skills was low. CONCLUSION: An online technology skills training module was developed based on skills needed for the course to ensure that course participants learned and practiced the technology skills necessary to successfully complete the online analytic skills course. We describe the development, implementation, and results of the online technology skills module.

Administrative Personnel↗
PubMed1994

Information use, information perceptions and information flows in primary care medical practice.

A research project funded by the Welsh Office and undertaken by the Department of Information and Library Studies, University of Wales, Aberystwyth examined the information systems in place in a sample of general medical practices in Wales. Shortcomings were identified in patient records, the supply of medical information for patients, staff training and staff communications. Practices lacked coherent information management strategies to relate information to practice goals and to define responsibility and protocols for information tasks. Unless rectified, these deficiencies will inhibit the viability of primary care data as a basis for medical research, audit and for identifying the health needs of communities.

Attitude of Health Personnel↗
PubMed1988

Achieving order entry by physicians in a computerized medical record.

When Community Memorial Hospital selected a computerized Medical Information System (MIS), it was recognized that physician use and acceptance was paramount to success. To achieve this, active participation from the medical-dental staff via an advisory committee, system education and emphasis on physician benefits was sought. Advance preparation included selection of light pen technology, field trips by selected physicians to other hospitals with the same system, and strategic placement and availability of terminals. During implementation, training was scheduled at the convenience of the physician. This training continues to be offered immediately to new physicians as they join the staff. System upgrades and added functions prompt scheduling of demonstrations for interested physicians. Many developmental ideas come from physicians using MIS indicating their interest in maintaining the system. New approaches that will make order entry easier for physicians so that everyone can benefit from their cooperation and participation are continually being looked for.

Computer User Training↗
PubMed2000

A two-year experience teaching computer literacy to first-year medical students using skill-based cohorts.

Because it is widely accepted that providing information online will play a major role in both the teaching and practice of medicine in the near future, a short formal course of instruction in computer skills was proposed for the incoming class of students entering medical school at the State University of New York at Stony Brook. The syllabus was developed on the basis of a set of expected outcomes, which was accepted by the dean of medicine and the curriculum committee for classes beginning in the fall of 1997. Prior to their arrival, students were asked to complete a self-assessment survey designed to elucidate their initial skill base; the returned surveys showed students to have computer skills ranging from complete novice to that of a systems engineer. The classes were taught during the first three weeks of the semester to groups of students separated on the basis of their knowledge of and comfort with computers. Areas covered included computer basics, e-mail management, MEDLINE, and Internet search tools. Each student received seven hours of hands-on training followed by a test. The syllabus and emphasis of the classes were tailored to the initial skill base but the final test was given at the same level to all students. Student participation, test scores, and course evaluations indicated that this noncredit program was successful in achieving an acceptable level of comfort in using a computer for almost all of the student body.

Computer Communication Networks↗
PubMed1990

Teaching reprint file management: a hands-on approach.

The development of user-friendly search systems has enabled physicians to perform their own MEDLINE searches These physicians are recognizing a need to learn how to organize their growing reprint collections. Librarians at the University of Michigan, Alfred Taubman Medical Library have developed a unique course that presents a variety of techniques to meet the needs of a wide audience. For some users, such as students or house officers who have limited funds or lack support devices, a variety of manual methods are presented. Advantages and disadvantages of using manual versus computerized systems are discussed. Following the illustration of the manual methods, users are introduced to a simple computerized method using a utility type database management package, PC-FILE. Hands-on training under the direction of librarians allows students to develop and use a practice database while having experts available to answer questions. Users are encouraged to take a copy of PC-FILE (shareware) with them to experiment with before committing themselves to a more expensive database management software package. Before the class ends, those interested in a more sophisticated package with specialized report formats and downloading/uploading capabilities are given a brief demonstration of PRO-CITE. Evaluations have shown that there is interest in all three methods.

Computer User Training↗
PubMedDate not supplied

Building a virtual network in a community health research training program.

OBJECTIVE: To describe the experiences, lessons, and implications of building a virtual network as part of a two-year community health research training program in a Canadian province. DESIGN: An action research field study in which 25 health professionals from 17 health regions participated in a seven-week training course on health policy, management, economics, research methods, data analysis, and computer technology. The participants then returned to their regions to apply the knowledge in different community health research projects. Ongoing faculty consultations and support were provided as needed. Each participant was given a notebook computer with the necessary software, Internet access, and technical support for two years, to access information resources, engage in group problem solving, share ideas and knowledge, and collaborate on projects. MEASUREMENTS: Data collected over two years consisted of program documents, records of interviews with participants and staff, meeting notes, computer usage statistics, automated online surveys, computer conference postings, program Web site, and course feedback. The analysis consisted of detailed review and comparison of the data from different sources. NUD*IST was then used to validate earlier study findings. RESULTS: The ten key lessons are that role clarity, technology vision, implementation staging, protected time, just-in-time training, ongoing facilitation, work integration, participatory design, relationship building, and the demonstration of results are essential ingredients for building a successful network. CONCLUSION: This study provides a descriptive model of the processes involved in developing, in the community health setting, virtual networks that can be used as the basis for future research and as a practical guide for managers.

Canada↗
PubMed1986

End-user searching in medicine.

Investigation of end-user searching at the New York Hospital-Cornell University Medical Center (NYH-CUMC) revealed that 8% of the physicians surveyed were end users, 63% were interested in learning to search, and 29% were not interested. When training sessions were offered at the Burke Rehabilitation Center, an affiliated institution, 50% of the medical staff attended at least one class, but only 7% of the total staff became frequent searchers. Analysis of the precision and recall ratios of searches conducted by five end users at HYH-CUMC indicated that the best results were obtained by end users who had been taught to search by experienced librarian-searchers. The quality of end user searches did not appear to be affected by the "friendliness" of the systems used, the frequency of searching habits, or the length of time that an end user had been searching.

Attitude↗
PubMed1989

Analysis of non-urban end users' MEDLINE training.

The University of Oklahoma Health Sciences Center (OUHSC) Library mailed a MEDLINE End User Practice Survey Form to 310 health professionals who had attended MEDLINE seminars supported by a two-year NLM grant. The survey sought to determine how many respondents had obtained NLM codes, reasons for not obtaining a code, searching time done since the seminar, differences in the use of information since taking the seminar, factors helpful in successful searching, and factors contributing to frustrations. The most prevalent reasons for not obtaining a code were lack of a microcomputer and modem, infrequent use of MEDLINE, cost, lack of time, complications, and ability to obtain free searches.

Computer User Training↗
PubMedDate not supplied

Flawless information system implementation.

When it was decided to replace the homegrown materiel management information system at Barnes Hospital, a 1,200-bed hospital in St. Louis, Missouri, with a more comprehensive one, the aim was to have a swift, error-free selection, testing and implementation process. It met these goals by dedicating the following resources to the process: 1) a dedicated, full-time user responsible for requirements definition, testing, training and user support, 2) a dedicated IS support team for selection, testing and implementation of the software package, 3) availability of additional personnel in Materiel Management for general assistance, 4) a team approach, both at the project team level, and hospital wide, 5) a total commitment to quality at every phase, 6) a thorough approach to testing, both at the system level, and at the unit, or program level and 7) the vendor commitment of extra time, money and energy to help us make the system work to the best of its ability.

Competitive Bidding↗
PubMed1997

Do nurses have the information resources and skills for research utilization?

While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.

Computer User Training↗
PubMedDate not supplied

Installing PACS--lessons learned.

In 1997, Carson-Tahoe Hospital in Carson City, Nev., looked into the possibility of installing its own PACS system. Increased productivity was the main business goal the hospital hoped a PACS system would meet. Only two of three chosen vendors seriously considered the request to bid because of the small number of films produced by the hospital. After installation, the hospital identified the referring physicians who used the most film and then directed its marketing efforts to them. Lessons learned include the tremendous need for training of staff, referring physicians and radiologists. Expect everyone to be slow the first week the new system is running. Map out all processes to prepare for contingencies. Make plans for archiving and be flexible in assigning tasks--next week things may change. Consider bringing in an outside consultant to measure people's expectations and fears. After nearly a year, neither the technologists nor physicians express any regrets about the installation of PACS at Carson-Tahoe.

Capital Expenditures↗
PubMed1992

Introducing computer literacy skills for physicians.

Computers are integral to medical practice, education, and research. While medical students learn computer skills during their training, many practicing physicians do not have the same computer experience. To familiarize this group with the exciting developments in medical informatics, the Himmelfarb Health Sciences Library and Department of Computer Medicine at the George Washington University Medical Center organized a workshop "Introducing Your Office Computer!" for attending physicians. The workshop featured a short lecture/video presentation on computer applications in medicine followed by a "computer fair" of five computer applications. Eleven physicians attended the workshop. Feedback was very positive; many called later to request more detailed instructions on using the programs demonstrated. It was a valuable experience for the staff, and new bridges were built between departments and clients.

Computer User Training↗
PubMed1995

Surfing the Internet.

More physicians are surfing the Internet than ever before, thanks to the recent launch of MSMSNET, the Michigan State Medical Society's new online service for physician members. If words like World Wide Web, E-mail, and Hypertext links send you into a state of confusion, then read on. This month's cover story discusses MSMS's launch into the information superhighway and training programs MSMS has in store for physician members. Also included is an examination of the Internet--past, present and future--by the president of Voyager Information Networks, Inc., a Michigan corporation specializing in Internet services for Michigan trade groups and other organizations, including MSMS. This cover story marks the beginning of a series of articles on the Internet which will appear in future issues of Michigan Medicine. Hop on board and enjoy the ride!

Computer Communication Networks↗
PubMed1995

Computing education of medical students through a study of hospital and clinical activities: seven years' experience.

With the widespread use of information technology (IT) in health care, the need to teach computing to doctors and medical students has become increasingly apparent. This paper describes a course for medical students immediately before their clinical training; it lasts one semester and was first introduced in 1987 at St. George's Hospital Medical School, London. It is generally accepted that the present curriculum leaves little opportunity for the introduction of new subjects. This paper therefore describes the content of an elective in computing and the reactions of medical students to it. It is intended that this paper will help other educationalists who may obtain insights and consequently be able to negotiate medical informatics changes into their medical school environments.

Computer Literacy↗
PubMed2001

Access to the evidence base from general practice: a survey of general practice staff in Northern and Yorkshire Region.

AIM: To identify and describe current methods of making health related research evidence accessible to general practice staff in the Northern and Yorkshire Region. METHOD: A postal survey questionnaire of general practice staff in the Northern and Yorkshire Region. RESULTS: At least one completed questionnaire was obtained from 70% of the general practices surveyed, and the individual response rate to the survey was 45%. Just under 60% of all respondents reported having no access to the NHS internet and just under 50% also reported having no access to the internet. All respondents in this survey reported greater access to paper based information than to electronic databases. However, this research provides evidence of differential access to information resources between different professions in general practice with GPs clearly having easier access than other professions to both paper based resources and electronic databases. 70% of all respondents said that they would need to be trained to use either a computer, the internet, or to search databases if the opportunity for easy access to any of these information services was available. CONCLUSIONS: At the time of this survey, general practices seemed to be struggling to set up the infrastructure and develop the skills that are necessary to make best use of available research evidence. In addition, there is a need for further investigation into the reasons why different professions working in the same practice setting have differential access to information resources available in primary care.

Computer User Training↗
PubMedDate not supplied

The informatics nurse specialist as change agent. Application of innovation-diffusion theory.

The informatics nurse specialist (INS) is often the primary change agent in facilitating the implementation of clinical information systems (CIS) in healthcare settings. The INS has a unique understanding of the nursing issues that can affect the change process, and thus is in a key position to facilitate positive implementation outcomes. Innovation-diffusion theory is particularly useful in its application to the change agent role of the INS. With this theoretical knowledge, the INS can design CIS training interventions according to the psychological phenomena of Rogers' Innovation-Decision Process. An understanding of the decision-making process and the distribution of different rates of innovation adoption within a given population enable the INS to anticipate and address influential factors that affect the implementation process. Thus, Innovation-Diffusion Theory may be used as a powerful cognitive tool for the INS in facilitating the diffusion process and nurses' adoption of the technology in practice.

Attitude of Health Personnel↗