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PubMed2000

Preventing "information overdose": developing information-literate practitioners.

The practice of medicine has been transformed by the convergence of a number of trends and developments. These include changes in the regulatory environment, scientific advances, the emergence of pressures for evidence-based medicine, advances in pharmaceutical knowledge and manufacture, and a shift in the nature of the patient/provider relationship. Many of these circumstances have been brought about or amplified by a variety of technological innovations. Collectively, these changes necessitate continuing--perhaps even continuous--learning and adaptation on the part of both new and established practitioners. At the heart of this need is the explosion of information and of information technologies, which shows little sign of abating. However, it is not simply the volume of information nor even its form that poses a challenge. It is also that outdated, incorrect, or unproven information is as accessible as correct, defensible, and reliable information. Therefore, doctors must be equipped not only with the ability to locate information but to evaluate its relevance and credibility. In short, they must be "information literate." Since both information and the technologies that give access to it are constantly expanding, a practitioner can never claim to be "information literate" in any absolute or final sense. It is a constantly evolving attribute and, alongside biomedical, clinical, pharmaceutical, legislative, and other domains, needs to form part of the provision of continuing education. Five propositions are advanced concerning this particular aspect of continuing medical education, and the article concludes by arguing that, in the same way that educating patients is the best defense against accidental overdose in the pharmaceutical sense, the best way to prevent "information overdose" is the education of practitioners.

Certification↗
PubMed1993

Factors affecting students' use of MEDLINE.

MEDLINE search transcripts by a class of third-year medical students were analyzed. The 184 students were divided into three groups according to their search experience in terms of the number of sessions logged at the time of a search assignment. A strong relation was found between the level of search experience and the frequency of use in the subsequent 5 months. Over 80% of the students were able to retrieve a few useful items for an emergency clinical situation. More experienced searchers were able to retrieve more relevant items than less experienced searchers. However, no relation was found between search effectiveness and clinical knowledge as indicated by two scores derived from the University of Michigan's Comprehensive Clinical Assessment examination and Part II of NBME. Similarly, clinical knowledge also did not appear to relate to MEDLINE search experience. More exposure to MEDLINE during medical school could play an important role in developing effective literature searching skills for lifelong learning, which is essential for today's health professionals.

Clinical Competence↗
PubMed1991

Experience using the CQI model in health care management.

This article describes practical applications of the Continuous Quality Improvement (CQI) concept applied to management of the Information Services Departments of a health care institution. The article is valuable for two reasons: (1) it is valuable as a successful application of CQI in an award-winning information services division of an award-winning health care institution, and (2) since the work of the information services function is so complex, has major interdependencies with many other functions throughout the entire organization, and is driven by fast-paced change, successful use in that function can be a model for other major functions of the hospital.

Computer User Training↗
PubMed1999

Reengineering the picture archiving and communication system (PACS) process for digital imaging networks PACS.

Prior to June 1997, military picture archiving and communications systems (PACS) were planned, procured, and installed with key decisions on the system, equipment, and even funding sources made through a research and development office called Medical Diagnostic Imaging Systems (MDIS). Beginning in June 1997, the Joint Imaging Technology Project Office (JITPO) initiated a collaborative and consultative process for planning and implementing PACS into military treatment facilities through a new Department of Defense (DoD) contract vehicle called digital imaging networks (DIN)-PACS. The JITPO reengineered this process incorporating multiple organizations and politics. The reengineered PACS process administered through the JITPO transformed the decision process and accountability from a single office to a consultative method that increased end-user knowledge, responsibility, and ownership in PACS. The JITPO continues to provide information and services that assist multiple groups and users in rendering PACS planning and implementation decisions. Local site project managers are involved from the outset and this end-user collaboration has made the sometimes difficult transition to PACS an easier and more acceptable process for all involved. Corporately, this process saved DoD sites millions by having PACS plans developed within the government and proposed to vendors second, and then having vendors respond specifically to those plans. The integrity and efficiency of the process have reduced the opportunity for implementing nonstandard systems while sharing resources and reducing wasted government dollars. This presentation will describe the chronology of changes, encountered obstacles, and lessons learned within the reengineering of the PACS process for DIN-PACS.

Administrative Personnel↗
PubMed2002

Relevant EEG features for the classification of spontaneous motor-related tasks.

There is a growing interest in the use of physiological signals for communication and operation of devices for the severely motor disabled as well as for healthy people. A few groups around the world have developed brain-computer interfaces (BCIs) that rely upon the recognition of motor-related tasks (i.e., imagination of movements) from on-line EEG signals. In this paper we seek to find and analyze the set of relevant EEG features that best differentiate spontaneous motor-related mental tasks from each other. This study empirically demonstrates the benefits of heuristic feature selection methods for EEG-based classification of mental tasks. In particular, it is shown that the classifier performance improves for all the considered subjects with only a small proportion of features. Thus, the use of just those relevant features increases the efficiency of the brain interfaces and, most importantly, enables a greater level of adaptation of the personal BCI to the individual user.

Brain Mapping↗
PubMed1996

Human interaction with technology: the accidental user.

Information technology is part of a growing number of applications in work and everyday life. It seems inevitable that the average person soon will have to interact with information technology in many ways, even when there is no desire to do so. Examples include finding a book in a library, personal financial transactions, the health sector, traffic and transportation, process control, etc. People who in this way are forced to interact with information technology shall be called accidental users. The accidental users poses a particular challenge to the design of technological artefacts because the disciplines of dealing with human-machine interaction are predicated on the assumption that users are motivated and have a minimum level of knowledge and skills. In particular, models of 'human error' and human reliability implicitly assume that users are benign and only fail as anticipated by designers. In this paper we investigate the extent to which current models of human erroneous actions and cognitive reliability can be used to account for interactions between accidental users and technology.

Attitude to Computers↗
PubMed1991

The role of a clinically based computer department of instruction in a school of medicine.

The evolution of activities and educational directions of a department of instruction in medical computer technology in a school of medicine are reviewed. During the 18 years covered, the society at large has undergone marked change in availability and use of computation in every aspect of medical care. It is argued that a department of instruction should be clinical and develop revenue sources based on patient care, perform technical services for the institution with a decentralized structure, and perform both health services and scientific research. Distinction should be drawn between utilization of computing in medical specialties, library function, and instruction in computer science. The last is the proper arena for the academic content of instruction and is best labelled as the philosophical basis of medical knowledge, in particular, its epistemology. Contemporary pressures for teaching introductory computer skills are probably temporary.

Computer User Training↗
PubMed1996

Practical success of an electronic patient record system in community care--a manifestation of the vision and discussion of the issues.

This paper analyses the purpose, background, scope, and success to date of designing and implementing a comprehensive electronic patient record system for community care in the UK, in the context of the increasing policy focus upon community care. The project is situated in Plymouth in the UK, a major provider of community care. The paper indicates intended benefits of the system for patients, professionals, and health care organisations. The rationale behind the record content is explained, as is the record structure. Intended uses of the records form a further baseline for study, and the paper assesses the key success factors to achieving the goal of reliability, quality, and effective use of resources.

Community Health Services↗
PubMed1992

Acquisition and transfer of declarative and procedural knowledge by memory-impaired patients: a computer data-entry task.

Previous research demonstrated that a single amnesic patient could acquire complex knowledge and processes required for the performance of a computer data-entry task. The present study extends the earlier work to a larger group of brain-damaged patients with memory disorders of varying severity and of various etiologies and with other accompanying cognitive deficits. All patients were able to learn both the data-entry procedures and the factual information associated with the task. Declarative knowledge was acquired by patients at a much slower rate than normal whereas procedural learning proceeded at approximately the same rate in patients and control subjects. Patients also showed evidence of transfer of declarative knowledge to the procedural task, as well as transfer of the data-entry procedures across changes in materials.

Amnesia↗
PubMed1990

Micro-computers: availability to and use by trainees in public health medicine.

A survey of the availability to and use of micro-computers by public health medicine trainees was undertaken in February, 1989. Most departments have access to computers and trainees possess computing skills, but almost one in 15 trainees had no access to a micro-computer, and one trainee in eleven had no computing experience while a further one in eight had not progressed beyond word-processing. Departments of Public Health Medicine should review their computing resources and ensure that they are adequate for the challenges of the 1990s.

Computer User Training↗