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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

Computer-Assisted Vocabulary Acquisition: The CSLU Vocabulary Tutor in Oral-Deaf Education.

Deficits in vocabulary have a negative impact on literacy and interpersonal interaction for deaf children. As part of an evaluation, an outcomes assessment was conducted to determine the effectiveness of a computer-based vocabulary tutor in an elementary auditory/oral program. Participants were 19 children, 16 profoundly deaf and 3 hearing. The vocabulary tutor displays line drawings or photographs of the words to be learned while a computer-generated avatar of a "talking head" provides synthesized audiovisual speech driven from text. The computer system also generates printed words corresponding to the imaged items. Through audiovisual reception, children memorized up to 218 new words for everyday household items. After 4 weeks, their receptive vocabulary was tested, using the avatar to speak the name of each item. Most of the students retained more than half of the new words. The freely available vocabulary tutor, whose characteristics can be tailored to individual need, can provide a language-intensive, independent learning environment to supplement classroom teaching in content areas.

Journal Article↗
PubMed2003

Collecting behavioural data using the world wide web: considerations for researchers.

OBJECTIVE: To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. METHODS: This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. RESULTS: The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. CONCLUSIONS: Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.

Behavioral Research↗
PubMed2006

Case-based exercises fail to improve medical students' information management skills: a controlled trial.

BACKGROUND: Tomorrow's physicians must learn to access, retrieve, integrate and apply current information into ambulatory patient encounters, yet few medical schools teach 'real time' information management. METHODS: We compared two groups of clerkship students' information management skills using a standardized patient case. The intervention group participated in case-based discussions including exercises that required them to manage new information. The control group completed the same case discussions without information management exercises. RESULTS: After five weeks, there was no significant difference between the control and intervention groups' scores on the standardized patient case. However, third rotation students significantly outperformed first rotation students. CONCLUSION: Case-based exercises to teach information management failed to improve students' performance on a standardized patient case. Increased number of clinical rotations was associated with improved performance.

Adult↗
PubMed1992

A new EPI strategy to reach high risk urban children in Bangladesh: urban volunteers.

Many community based outreach programs in low income countries utilize illiterate women to provide health services. However, illiteracy may present special problems in immunization or other programs requiring extensive record-keeping and follow-up. In a trial involving twenty-nine volunteers from urban slum communities in Dhaka, Bangladesh, a community-based referral and record-keeping system for use by semi-literate and illiterate volunteers in immunization outreach activities was evaluated over a thirteen month period. The women were uniformly, regardless of literacy, able to use the system to effectively refer and follow-up clients. Although volunteer performance as measured by numbers of referrals was below initial targets, completion rates were high; 87% of children and 96% of women referred completed the full series of immunizations. By facilitating active community participation, the system provides a feasible approach to reducing the high drop-out rates currently associated with immunization programs.

Bangladesh↗
PubMed1999

Preparing for the future: the status of genetics education in diploma-level training courses for nurses in the UK.

This paper offers new information about genetics education provided by diploma level training programmes for nurses in the UK. Those responsible for the development and provision of curricula were asked to complete a questionnaire that attempted to assess the nature of genetics education and their attitudes towards it. The response rate was 84%. Whist genetics teaching is included on all but two training courses, variation in content, delivery and timetable allocation indicates disparity. Genetics is taught for 10 hours or less on most courses, utilizing a limited number of approaches. Most courses do not have compulsory assessment. The majority of respondents (81%) agreed that genetics will have a major impact on health care, and will become an increasingly important issue in education. A small majority (58%) agreed that genetics should have a higher profile in professional training yet many respondents (68%) felt that the teaching they were already offering was appropriate to meet patients' needs. In the absence of any clear national framework for delivery and assessment of genetics education, the author questions whether current training is sufficient to provide nurses with the basic genetic literacy needed to respond to developments in genetics as they impact on health care.

Clinical Competence↗
PubMed1998

Initial results of 'Language for Health': cardiovascular disease nutrition education for English-as-a-second-language students.

Low literacy skills may negatively affect health through misuse of medication, inability to follow medical directions or due to limitations placed on the consumer's ability to access health information. The association between low literacy among adults and cardiovascular disease has not been thoroughly investigated in some ethnic groups. The purpose of this comprehensive study is to describe the results of a nutritional-related cardiovascular health program for limited English proficient adults enrolled in English-as-a-second-language (ESL) classes. Subjects (n = 408), nearly 87% of whom were Latino, were exposed to either nutrition education (intervention group) or stress management (attention-placebo control group) classes designed specifically for ESL classes. Subjects completed physiological measures assessing blood pressure, total and high-density lipoprotein (HDL) cholesterol, waist and hip circumference, and body mass. Self-report surveys were administered to collect students' nutrition-related knowledge, attitudes and behaviors. Data were collected at baseline, 3 month post-test and 6 month follow-up. Analyses showed that differential group change was seen for fat avoidance, nutrition knowledge, HDL and total cholesterol:HDL ratio, but, for the two latter variables, the effect was not maintained at the 6 month follow-up. Both groups showed positive changes in blood pressure, total cholesterol and nutrition-related attitudes. Results showed moderate success of the intervention, but suggest contamination between experimental groups may have occurred.

Adult↗
PubMedDate not supplied

Disparities in diabetes management practice between racial and ethnic groups in the United States.

PURPOSE: The purpose of this study was to evaluate the association between race/ethnicity and self-management practices of people with diabetes. METHODS: Analyses were based on data from the 2001 Behavioral Risk Factor Surveillance System. Contingency tables and multiple logistic regression were used to assess the data. RESULTS: Frequency distributions of selected diabetes management variables significantly varied across levels of race/ethnicity. These differences persisted after adjusting for current age, age at diagnosis, gender, marital status, income, and education. Analyses revealed that Hispanics, compared with whites, were more likely to take oral agents to control their blood glucose, less likely to monitor their blood glucose daily, and less likely to check their feet for sores or irritation. There was no difference among the racial/ethnic groups use having participated in a diabetes education class. CONCLUSIONS: Health literacy and cultural factors, including the influence of family, beliefs about diabetes, and access and utilization of health care, may influence Hispanic diabetes management behaviors. Understanding these influences is essential to the development of programs, policies, and other strategies that are culturally appropriate and relevant.

Blood Glucose↗
PubMed2004

Electronic reporting to improve patient safety.

BACKGROUND: Limited data are available on the experiences of voluntary event reporting systems to improve patient safety. OBJECTIVE: Development and implementation of educational initiatives to facilitate the use of an electronic reporting system (ERS) in an academic medical center to measure the impact on knowledge of the ERS on reporting behavior and safety attitudes and to evaluate the accuracy of the information being reported. METHODS: A voluntary internal confidential electronic system for reporting safety events was implemented which involved patients and visitors. A multifaceted educational program was developed to promote safety awareness and use of the ERS system. The safety event detail reported for the calendar year 2002 was tracked and trended and central event analyses were performed for five high event clinical areas. A survey was administered to assess safety knowledge and attitudes of patient care personnel. RESULTS: 2843 safety events were entered into the ERS during 2002 with an increase during the course of the year (p = 0.055, linear trend) for all events. Nurses entered 73% of the events and physicians only 2%. 453 events (16%) were unsafe conditions or near misses and 623 (22%) were associated with patient harm. System factors were considered by the reporter as contributing to the event in only a few cases (5%). Central event analysis revealed that 39% of events had coding errors either in event classification, level of impact, or location; significant underreporting was also present. Although survey response rates were low (10.3%), responders showed a high degree of knowledge on general questions of patient safety and an increase in knowledge on use of the ERS (p = 0.0015, linear trend). CONCLUSIONS: Knowledge on the use of the reporting system and the frequency of reported events increased over the first year of the study. More work is needed to involve physicians in reporting, to improve the accuracy of submitted information, and to better prioritize, organize, and streamline event analysis.

Computer Literacy↗
PubMed1999

Risk analysis of poor health and growth failure of children in the central highlands of Guatemala.

Child morbidity and growth failure are multidimensional phenomena. An assessment was undertaken of the food and nonfood risk factors of poor health and growth failure in children of different age groups in the central highlands of Guatemala. The aim was to identify high risk factors in under-five and school-age children. Under-five children at high risk of being ill tended to come from households with: high needs of child care, a lack of access to a private well or piped water, and no sewage connection. Women's illiteracy constituted an additional risk factor for diarrheal disease in under-five children. Growth failure in under-five children was mainly due to chronic factors: 74% were stunted, 6% were wasted and 44% were weight deficient. These prevalence rates were lower among school-age children. Low per capita food availability, and particularly the absence in the household of self-produced staple foods, was the most significant risk factor of growth failure in under-five children, followed by high risk of being ill, and participation by women in farm production. The latter was particularly a risk factor of wasting. Nonfood risk factors were most important for growth failure in school-age children. These factors included: sanitation, housing conditions, women's literacy status, and adult women's body mass index. Participation in farm production by school-age children was associated with a higher risk of growth failure in younger siblings. It is concluded that multisectoral programs need to reduce the impact of various risk factors of poor health and growth failure in children, and be careful not to introduce new risk factors. Depending on which age group is targeted, such programs should either prioritize improvements in household food availability, or nonfood interventions that reduce women's illiteracy and improve sanitary and housing conditions.

Adolescent↗
PubMed1986

The role of dietitians in a work-site health promotion program.

Nutrition education has become an integral part of work-site health promotion programs. As more corporations, large and small, become involved in establishing their own programs, the need for qualified nutrition educators will increase. Registered dietitians should have a proactive role in this awareness process and should strive to develop specific skills in the areas of communications, management, and computer literacy. To succeed as nutrition educators at the work site, registered dietitians need to be able to wear many hats and to be organizers, planners, and innovative deliverers of nutrition information, as more and more U.S. corporations "reach out for health."

Dietary Services↗
PubMed1998

Bringing physician nutrition specialists into the mainstream: rationale for the Intersociety Professional Nutrition Education Consortium.

Given the prevalence of nutritionally related chronic diseases in American society, the training of physicians should include a focus on the relations of diet to disease. Yet, despite scientific data, public interest, US government reports, society studies, and congressional mandates, the teaching of nutrition in medical schools and residency programs remains inadequate. The authority whom patients most wish to consult for information on health-their physician-thus remains insufficiently informed about the role of diet in the prevention and treatment of disease. New efforts must be initiated to train nutrition-literate physicians. The principal obstacle to nutrition literacy among physicians is the paucity of physician nutrition specialists (PNSs) on medical school faculties who can effectively advocate for change in medical school and residency curricula and who can serve as role models for incorporating nutrition into patient care. To encourage nutrition societies to unite in addressing these issues, the Intersociety Professional Nutrition Education Consortium was founded in 1997. The Consortium aims to establish educational standards for fellowship training and a unified mechanism for posttraining certification of PNSs, and to develop a long-term plan to increase the pool of PNSs and surmount obstacles that currently impede the incorporation of nutrition education into the curricula of medical schools and primary-care residency programs.

Education, Medical↗
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↗
PubMed1997

[Computer-based training--a new method in surgical education and continuing education].

Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively checking the knowledge gained. The interactive use of multimedia components, such as text, graphics, animation, sound, digital slide shows, videos and quizzes, facilitates the learning process. The aim of this study was the development and evaluation of a CBT program for use by surgeons teaching students. Using SuperCard, a teaching module for distal radius fracture (DRF) was developed, containing detailed clinical information. Video clips and vivid animation combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90-min lecture, DRF was discussed. In all evaluated criteria (distinctness, detailed description, presentation of materials, structure, motivation to learn, time saved while learning and memory retention), CBT gained 15-20% better scores than the lecture. Although 87% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems helpful in student teaching. Most of them suggested the use of such programs as a exam preparation/self study method (90%) or as a supplement to a lecture (40%). Based on these evaluations, it is clear that CBT modules are an appropriate future teaching and learning system that will be well accepted. In conclusion, CBT programs should be integrated into medical education as a valuable supplement. With this aim, CBT systems should be developed and used at universities as an information system for the surgical residency program.

Achievement↗
PubMed2006

The presence of mathematics and computer anxiety in nursing students and their effects on medication dosage calculations.

AIM: To determine if the presence of mathematical and computer anxiety in nursing students affects learning of dosage calculations. METHOD: The quasi-experimental study compared learning outcomes at differing levels of mathematical and computer anxiety when integrative and computer based learning approaches were used. Participants involved a cohort of second year nursing students (n=97). RESULTS: Mathematical anxiety exists in 20% (n=19) of the student nurse population, and 14% (n=13) experienced mathematical testing anxiety. Those students more anxious about mathematics and the testing of mathematics benefited from integrative learning to develop conditional knowledge (F(4,66)=2.52 at p<.05). Computer anxiety was present in 12% (n=11) of participants, with those reporting medium and high levels of computer anxiety performing less well than those with low levels (F(1,81)=3.98 at p<.05). CONCLUSION: Instructional strategies need to account for the presence of mathematical and computer anxiety when planning an educational program to develop competency in dosage calculations.

Analysis of Variance↗
PubMedDate not supplied

Promoting health and home safety for children of parents with intellectual disability: a randomized controlled trial.

The objective of this study was to evaluate the efficacy of a home-based intervention targeted to parents with intellectual disability to promote child health and home safety in the preschool years. A total of 63 parents were recruited for the study with 45 parents (40 mothers and 5 fathers) from 40 families completing the project. The research design permitted comparison between the intervention and three alternative conditions with all parents receiving the intervention in an alternating sequence over the life of the project. The intervention consisted of 10 weekly lessons carried out in the parent's home focusing on child health and home safety. The program was adapted to suit the Australian context from the UCLA Parent--Child Health and Wellness Project (Tymchuk, Groen, & Dolyniuk, 2000). Outcome measures assessed parental health and safety behaviours. Standard measures included parental health, intelligence and literacy. The intervention improved parents' ability to recognize home dangers, to identify precautions to deal with these dangers and resulted in a significant increase in the number of safety precautions parents implemented in their homes with all gains being maintained at 3 months post-intervention. Parents' health behaviours including improved understanding of health and symptoms of illness, knowledge of and skills needed to manage life-threatening emergencies, knowledge about visiting the doctor, knowing when to call, what information to provide and what questions to ask, and how to use medicines safely significantly increased. Again, all gains were maintained 3 months post-intervention. The intervention was effective regardless of parental health, literacy skills, and IQ. This form of home-based intervention promotes a healthy and safe environment which is a prerequisite to continuing parental custody.

Adult↗
PubMed1986

An economic evaluation of "Health for All".

The World Health Organization's 'Global Strategy' is an ambitious vision, but to achieve its goals it must first be implemented. Implementation will require careful and detailed planning. This paper evaluates the possibilities of transforming the Global Strategy from a laudable policy initiative into an actual 'Plan for Health', from the point of view of a health economist. This economic evaluation assesses the probable costs of implementing various activities of the Strategy, and the likelihood that developing countries will be able to afford these costs, either on their own, or with the assistance of the developed countries. A final section considers the current global situation and presents trends over the last two decades. The numbers of countries that have already achieved the goals of the Strategy, that can be expected to achieve the goals of the Strategy by the year 2000, and that are unlikely to achieve these goals (on the basis of current trends) are shown. The WHO 'success indicator' based on numbers of countries is compared to a more epidemiological one based on deciles of the world's population. It is argued that, even several years after the initiation of the Global Strategy, insufficient information exists on the next logical step of transforming the Policy into a Plan. Unless adequate attention is paid to this vital step, implementation of the Strategy will inevitably be ad hoc and patchy. Further research on the costs of the activities proposed by the Global Strategy, and the probable effects on health of those activities, is desperately needed.

Data Collection↗