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Computer learning strategies and outcomes: a field test in health services administration.

Decisions in the changing, competitive and highly complex health care market must be arrived at faster. The argument for the extensive use of computers by modern health care executives and the inclusion of computer training in the health administration curriculum rests on the fact that the survival and growth of health care institutions is vitally tied to the capacity of their managers to absorb increasingly complex data and turn it rapidly into usable information. Although educators cannot solve all health care industry implementation problems either as consultants or as analysis in implementation studies, they must provide clear direction in the analytical training of future managers concerning computer utilization and management information systems generally. Without the basic foundation in knowledge, attitude, and behavior reinforcement, the risk of improper and insufficient computer utilization in the industry is large. This article examines the curricular structure, learning theory, and preliminary student learning and behavior outcomes of a course developed in 1985 for health administration students at Sangamon State University.

Computer User Training↗

Implementing an integrated clinical information system.

The authors examine the vital role nursing professionals have played in the successful implementation of a sophisticated computer system at a regional medical center in the midwest. From preselection analysis through training and implementation, nurses have assumed primary responsibility for managing the multifaceted adaptation and installation of a comprehensive array of patient care functions. This experience can serve as an invaluable example of the relationship between information management, patient management, cost management, and quality enhancement in the hospital setting.

Computer Systems↗

[Hygienic principles of the optimal arrangement of working place for students during the training in computer use].

Experimental studies aimed at hygienic substantiation of requirements for optimal organization of a workplace for schoolchildren using computers have been carried out. Hygienic requirements for basic parameters and design of a desk and a chair intended for those working with computers are presented. Practical recommendations on the equipment of computer rooms in secondary schools are given.

Adolescent↗

An evaluation of four end-user systems for searching MEDLINE.

This study compared features and determined which of four end-user systems (PaperChase, GRATEFUL MED, Med-Base, or Compact Cambridge: MEDLINE) would best serve the Medical Sciences and Optometry Libraries of Indiana University in providing biomedical information to faculty and graduate students through MEDLINE. Cost, ease of use, retrieval, training needs, equipment requirements, and adequacy of documentation were examined. The study consisted of a comparison of the features of each system based on available documentation; a controlled search performed by the investigators on each system and on regular NLM MEDLINE; and a user study based on observations, questionnaires, and interviews with eleven library patrons who performed the same search of their choice on each of the four systems.

Computer User Training↗

Teaching medical informatics a la carte: a curriculum for the professional palate.

Health professionals as well as students vary greatly in their appetite for medical informatics and evidence-based medicine. The information professional is challenged by the need for instructional programs that support the use of medical informatics to a diverse audience. For teaching programs to be successfully received, the information professional must be able to offer an adaptable curriculum that can be arranged to meet the differing needs of a wide range of health professionals. The Educational Services Department at New York University Medical Center has designed and implemented a multidisciplinary curriculum that serves as a model for health and information professionals to meet a variety of goals and objectives. This paper describes how the curriculum evolved. It is presented as a menu of offerings that may be coordinated and adapted to meet the varying skills and needs of clinicians, basic scientists, residency training programs, medical student clerkships, and nursing and allied health programs. Informatics programs that may include workshops in basic computer skills, identification of information resources, the structure of information, developing search strategies in support of evidence-based medicine, identifying qualitative journal literature, and critical appraisal of the literature, are easily adapted to any audience and schedule.

Academic Medical Centers↗

All you need to know about a PACS RFP, you learned in kindergarten.

Key to purchasing any picture archiving and communications system (PACS) is the generation of a request for proposal (RFP), which defines the system's requirements. An RFP is not difficult to create and, in fact, one can follow simple rules such as outlined in Robert Fulghum's book, All I Really Need to Know, I Learned in Kindergarten. "Take time to look" is the first rule--don't jump into new adventures. Instead, start with a mission statement and clear objectives. Define the stakeholders and assemble the team. "Share everything" is the second rule to follow. This includes information, objectives and definitions of the problem. You'll want to define your specifications. What are the component requirements? How will you integrate information systems at your facility? What about performance--how is it defined and what is expected? Warm cookies and cold milk--or common sense--is another rule, particularly around issues that may seem obvious such as training and service. Who is going to do it, and what is required? "Watch out for traffic and hold hands." This rule, as applied to PACS and an RFP, means stick together. Create a partnership with your vendors. Talk to as many vendors and other users as possible. Last, "be aware of wonder." Fulghum's Rule, as applied here, means performance will speak for itself, particularly when there is significant improvement in the service you provide to your users.

Competitive Bidding↗

Teaching EBM teachers: a team approach.

A collaborative Evidence-Based Medicine (EBM) course, co-taught by medical and library faculty, targets the needs of health care and information professionals involved in teaching and practicing EBM by introducing concepts, methods and tools of the EBM process. The one-week course engages working teams of health care and information professionals in case-based activities to encourage participation in the learning process and the "Train the Trainer" approach of the course. The interdisciplinary partnership, both of teachers and learners, has led to a successful and effective educational program that accentuates the strengths and contributions of each group. Further research will determine whether this collaborative experience leads to ongoing partnerships between these professional groups in the clinical setting.

Computer User Training↗

Train case managers in information technology.

At Hinsdale (IL) Hospital, health information specialists and case managers have created an innovative training and orientation program to get new case managers up to speed on the latest tools and techniques in information management. Established to help clinical case managers better comes to terms with complicated financial data, the program has grown into a comprehensive training system that acquaints new hires and old hands alike with the hospital's databases and teaches them appropriate methods of data mining, collection and usage. The program consists of a one-and-a-half hour initial orientation, a two-hour follow-up, and then less formal weekly and monthly meetings held on an ongoing basis.

Case Management↗

Planning for information technology key skills in nurse education.

New recruits to courses in nursing, midwifery and health visiting come from a wide range of educational backgrounds and it is reasonable to expect that this diversity will also be reflected in the range of their experience and competence with information technology (IT). Accommodating such variety can make the planning of appropriate training to enhance and develop their IT skills difficult. In order to explore the likely extent of diversity in IT experience and skills in today's recruits, the project reported here examined the competence, attitudes and previous IT training of two consecutive cohorts of new entrants to a higher diploma programme. The surveys add weight to the view that nurse educators do face a considerable diversity in new students' competence and experience with IT. Further analysis has also shown that subgroups of the cohorts, characterized by their age, gender, education or previous IT training, differed significantly in a 'knowledge of computers' score but not in their attitudes to IT. Arising from the results, the paper argues that, in seeking to develop a consistent level of IT literacy, core IT competence should be identified and all courses should have the clear objective of raising students' confidence in using computers.

Adult↗

Educational workshop improved information-seeking skills, knowledge, attitudes and the search outcome of hospital clinicians: a randomised controlled trial.

A double-blind randomised controlled trial was conducted on a group of Hong Kong hospital clinicians. The objective was to test if a three-hour educational workshop (with supervised hands-on practice) is more effective (than no training) to improve clinical question formulation, information-seeking skills, knowledge, attitudes, and search outcomes. The design was a post-test-only control group; recruitment by stratified randomization (by profession), blocked at 800. End-user training was more effective than no training in improving clinical question formulation, in raising awareness, knowledge, confidence and use of databases, but had made no impact on preference for secondary databases. It changed the attitude of clinicians to become more positive towards the use of electronic information services (EIS). Participants had higher search performance and outcomes (satisfaction with information obtained (NNT = 3), EIS satisfaction (NNT = 3) and success in problem solving (NNT = 4)). The workshop improved knowledge and skills in evidence-based searching, but this effect gradually eroded with time. Search logs confirmed that follow-up is required if effects are to be sustained. Longer effects on search behaviours appear to be positive. A randomised controlled trial is valuable in identifying cause-and-effect relations and to quantify the magnitude of the effects for management decision-making.

Adult↗

For better data, better utilized.

In Nigeria a training programme was devised whereby staff from health centres could appreciate the value of reliable data as a means of raising the standard of services. A process of learning by doing enabled the participants to turn routine data into tools for management and the improvement of service quality.

Community Health Centers↗

LIFENET/INTERNET and the health science librarian.

The Medical Library Center of New York, a cooperative library agency for the health sciences, developed a program to offer an electronic communications system (LIFENET) with access to the Internet for its members. Information on documentation and training as well as statistics on the subsequent use of the system and of the Internet are discussed in the article. Specific examples of how health science librarians are using the system include bibliographic verification, reference, research on integrated library systems, production of duplicate journal lists, and professional activities such as electronic mail and discussion groups (listservs).

Computer Communication Networks↗

AIDA and medical courseware.

For more than a decade the Department of Medical Informatics has offered one-week training courses on the subject of computer applications in medicine and health care. Since 1983 two courses are given at a rate of one course every two weeks. One course is on programming and problem solving and consists of three modules of increasing complexity in techniques and methods in programming and structured system development. This course focusses on only some aspects of medical informatics: the development of a medical information system, and the problems occurring in the process of automation. These aspects, however, are dealt with in detail. To this end the students are trained in using the programming system MUMPS and the fourth-generation software package AIDA. The second, introductory course is an intensive training on several distinct areas of man-machine interactions. It contains lessons in the fields of communication and recording; storage and retrieval and databases; computation and automation; recognition and diagnosis; and therapy and control. This paper describes the use of AIDA in developing and maintaining lessons for the latter course, and the assistance of AIDA for teaching purposes in the former course.

Computer User Training↗

Video-conferencing: under-used by rural general practitioners.

The objective was to investigate the use of and value General Practitioners place on video-conferencing as a tool in providing rural health care. The participants were 8 rural general practitioners in rural Victoria towns. I found that six out of the eight GPs did not value video-conferencing as a tool to assist with patient care, and the other two GPs were interested in the technology only for certain aspects of support with patient consultations and continuing education. In conclude that there needs to be a review of whether video-conferencing equipment should continue to be implemented in the same way that it has been so far in Victoria, and of the cost-effectiveness of providing video-conferencing facilities in rural health services. In particular, there needs to be a review of whether more training and support for rural general practitioners is needed to increase the uptake of video-conferencing. Alternatively, analysis can be undertaken of the intrinsic value of using video-conferencing as an interactive tool for obtaining specialist support for patient care or undertaking continuing education via video-conferencing, and the program discontinued if it is found to be unwarranted.

Attitude of Health Personnel↗

Acquisition and application of new technology skills: the influence of age.

This paper reviews the literature relating to the effects of ageing on the acquisition and application of new technology skills. Experiential, physiological, and cognitive factors are identified that place older adults at a disadvantage, relative to younger adults, when using new technologies. Consistent with this position, experimental evidence indicates an advantage for younger adults in speed of task performance, coupled with a tendency toward greater accuracy. The possibility that these differences can be overcome by means of training intervention is considered. However, it seems that age differences in performance persist, regardless of a training regime. Although some older adults are capable of high levels of performance, these tend to be individuals of high cognitive ability, relative to their peers. When age group means are considered, the only way that older adults are able to equal the performance of younger adults on new technology tasks is through additional practice.

Aged↗

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↗

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↗

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↗