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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↗
PubMed2005

The use of Information and Communication Technology (ICT) in the rehabilitation of individuals with severe functional impairments in a municipal care service system.

This article explores the development of a scheme to use Information and Communication Technology (ICT) in the training of individuals with severe functional impairments. Computers were used as an integral part of a rehabilitation programme for training, and the authors found that the resource was a useful addition to other treatment methods. This article describes the development and subsequent setting up of computers for training and how the study progressed. The study used a somewhat unique bottom up approach that first trained care-giving staff in computer skills. The caregivers in turn worked with and trained some of those they served. This learning strategy drew upon the concept of learning, empowerment and the motivation of all involved in a system and process. The study found that by using ICT all involved felt a greater sense of empowerment and improvement in the quality of life. That caregivers were involved at all stages was valuable in that they felt an ownership of the process and that they also benefited from being involved because they also learned new skills.

Computer User Training↗
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↗
PubMed2004

Assessing computer skills in Tanzanian medical students: an elective experience.

BACKGROUND: One estimate suggests that by 2010 more than 30% of a physician's time will be spent using information technology tools. The aim of this study is to assess the information and communication technologies (ICT) skills of medical students in Tanzania. We also report a pilot intervention of peer mentoring training in ICT by medical students from the UK tutoring students in Tanzania. METHODS DESIGN: Cross sectional study and pilot intervention study. PARTICIPANTS: Fourth year medical students (n = 92) attending Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. MAIN OUTCOME MEASURES: Self-reported assessment of competence on ICT-related topics and ability to perform specific ICT tasks. Further information related to frequency of computer use (hours per week), years of computer use, reasons for use and access to computers. Skills at specific tasks were reassessed for 12 students following 4 to 6 hours of peer mentoring training. RESULTS: The highest levels of competence in generic ICT areas were for email, Internet and file management. For other skills such as word processing most respondents reported low levels of competence. The abilities to perform specific ICT skills were low - less than 60% of the participants were able to perform the core specific skills assessed. A period of approximately 5 hours of peer mentoring training produced an approximate doubling of competence scores for these skills. CONCLUSION: Our study has found a low level of ability to use ICT facilities among medical students in a leading university in sub-Saharan Africa. A pilot scheme utilising UK elective students to tutor basic skills showed potential. Attention is required to develop interventions that can improve ICT skills, as well as computer access, in order to bridge the digital divide.

Adult↗
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↗
PubMed1989

Extending the limits of complex learning in organic amnesia: computer training in a vocational domain.

This study explored the limits of learning that could be achieved by an amnesic patient in a complex real-world domain. Using a cuing procedure known as the method of vanishing cues, a severely amnesic encephalitic patient was taught over 250 discrete pieces of new information concerning the rules and procedures for performing a task involving data entry into a computer. Subsequently, she was able to use this acquired knowledge to perform the task accurately and efficiently in the workplace. These results suggest that amnesic patients' preserved learning abilities can be extended well beyond what has been reported previously.

Adult↗
PubMed1994

The evolution of undergraduate medical informatics programmes.

This article summarizes developments in the teaching of medical informatics to undergraduate health care professionals. Whilst clinical schools are adopting quite different approaches to informatics education and training, there seem to be a number of common factors shaping educational policies and the resultant programmes. Different professional schools face similar problems in relation to resources and staff development. At the same time, examination of different syllabuses suggests the existence of divergent models as to what medical informatics should encompass, as well as different views as to what elements of the domain should be included in preliminary or undergraduate courses. The relevance of these trends to health libraries is briefly considered.

Attitude to Computers↗
PubMedDate not supplied

Acceptance of PACS utilizing a PACS QI Program.

This article describes the quality improvement program that Mercy Hospital (Alegent Health System) initiated after it implemented a picture archiving and communication system (PACS) in November 2003. The radiology department encountered numerous PACS-related issues that directly affected the quality and workflow of patient care. In order to get a better understanding of the situation, the department developed a quality improvement plan for its PACS program. The first step was to dedicate a resource--in this case, a radiology information technology (RIT) support specialist--who would serve as a PACS subject matter expert while dealing with day-to-day PACS-related issues--specifically, errors. The error data were collected and categorized for consistency using statistical process control (SPC) tools. The information gathered was then traced back to the team members responsible for the errors and used as a training tool to further educate them. As a result of this program, the average error rate was reduced from 12% to 4% because the radiology team developed a better understanding of the errors by identifying the root causes and being accountable for eliminating errors within their control. In addition, the radiology staff learned to accept and trust the PACS, resulting in a positive culture change that benefited teamwork and staff morale as well as improve the workflow and the quality of patient care.

Attitude of Health Personnel↗
PubMed2000

Computer education. Don't forget the older GPs.

OBJECTIVE: To implement and evaluate a computer education and support program for GPs. METHODS: A 'hands-on' curriculum, based on small group learning in a clinical computing laboratory and supported via the Internet, was developed and implemented. Evaluation was threefold: observations during lessons; interviews; and participants completing a questionnaire before and six months after the course. A randomly selected group of GPs from the same region completed a modified version of the 'before' questionnaire at the same time as participating GPs were completing their six month questionnaire. Participants included 128 GPs in a computer education program in Victoria (Australia) plus 127 'control' GPs. Outcome measures were self reported computing skill, attitudes to and actual use of clinical applications. RESULTS: Six months after training, there was a significant increase in self reported computer skill (p < 0.01). Multivariate regression found that, after controlling for gender, practice characteristics, and previous training, the older (> 55 years) GPs reported greater change in their skills than their younger colleagues. The increased skill happened regardless of which or how many modules were completed, and included use of email, the Internet, computers for research and electronic prescribing. Awareness of relevant computer applications, confidence with computers and intention to use applications also increased. Participants found the dedicated clinical computing laboratory useful; however, there are significant issues with maintenance and keeping systems up-to-date. CONCLUSIONS: The computer education and support program was relevant to GP needs, deliverable and effective in improving skills and utilisation. Divisions and other GP organisations should be assisted to establish similar education and support programs and, perhaps, target older doctors.

Adult↗
PubMed1995

Education strategy for the implementation of computerized nursing documentation.

Educators at The Toronto Hospital took an innovative approach to providing education and support to nursing staff prior to, during, and after the implementation of computerized nursing documentation. The education strategy included a combination of formal classroom training, inservices on the unit, a self-learning package and an electronic scavenger hunt. Resources such as Clinical Teachers, Clinical Nurse Specialists and Information Systems Analysts and Educators who provided support during the implementation phase received additional education to prepare for their role on the nursing units. Nurses were provided intensive twenty-four hour support for a period of four weeks, and a documentation checklist helped monitor the progress of individual nurses during the implementation. This strategy was designed to maximize consistent support and to minimize cost.

Attitude to Computers↗
PubMed1990

Teachers and artificial intelligence. The Logo connection.

This article describes a three-phase program for training special education teachers to teach Logo and artificial intelligence. Logo is derived from the LISP computer language and is relatively simple to learn and use, and it is argued that these factors make it an ideal tool for classroom experimentation in basic artificial intelligence concepts. The program trains teachers to develop simple demonstrations of artificial intelligence using Logo. The material that the teachers learn to teach is suitable as an advanced level topic for intermediate- through secondary-level students enrolled in computer competency or similar courses. The material emphasizes problem-solving and thinking skills using a nonverbal expressive medium (Logo), thus it is deemed especially appropriate for hearing-impaired children. It is also sufficiently challenging for academically talented children, whether hearing or deaf. Although the notion of teachers as programmers is controversial, Logo is relatively easy to learn, has direct implications for education, and has been found to be an excellent tool for empowerment-for both teachers and children.

Artificial Intelligence↗
PubMed2003

Human factors barriers to the effective use of ten HIV clinical reminders.

OBJECTIVE: Substantial variations in adherence to guidelines for human immunodeficiency virus (HIV) care have been documented. To evaluate their effectiveness in improving quality of care, ten computerized clinical reminders (CRs) were implemented at two pilot and eight study sites. The aim of this study was to identify human factors barriers to the use of these CRs. DESIGN: Observational study was conducted of CRs in use at eight outpatient clinics for one day each and semistructured interviews were conducted with physicians, pharmacists, nurses, and case managers. MEASUREMENTS: Detailed handwritten field notes of interpretations and actions using the CRs and responses to interview questions were used for measurement. RESULTS: Barriers present at more than one site were (1) workload during patient visits (8 of 8 sites), (2) time to document when a CR was not clinically relevant (8 of 8 sites), (3) inapplicability of the CR due to context-specific reasons (9 of 26 patients), (4) limited training on how to use the CR software for rotating staff (5 of 8 sites) and permanent staff (3 of 8 sites), (5) perceived reduction of quality of provider-patient interaction (3 of 23 permanent staff), and (6) the decision to use paper forms to enable review of resident physician orders prior to order entry (2 of 8 sites). CONCLUSION: Six human factors barriers to the use of HIV CRs were identified. Reducing these barriers has the potential to increase use of the CRs and thereby improve the quality of HIV care.

Attitude of Health Personnel↗
PubMed2002

Seniors connect: a partnership for training between health care and public libraries.

Kaleida Health Libraries, in partnership with the Buffalo and Erie County Public Library, presented "Seniors Connect: A Health Information Project." The program was funded by the Community Foundation for Greater Buffalo and the Kaleida Health Foundation. The purpose of the project was to teach African-American and Hispanic senior citizens or their caregivers residing in the city of Buffalo how to search the Internet to find quality, accurate, understandable health information. Attendees were taught to distinguish quality information from inaccurate, misleading, and fraudulent material. A total of fourteen training sessions were offered. The Seniors Connect program was initiated with health fair at each branch library, conducted by Kaleida Health staff, to provide an opportunity for participants to learn about health care services available in their community; observe demonstrations of health information searches on the Internet; learn about new treatment modalities for diseases such as diabetes, high cholesterol, thyroid abnormalities, and hypertension; and interact with area health care providers and library staff. The sessions were highly rated by attendees and many participants expressed their gratitude for a program geared specifically toward seniors.

Black or African American↗
PubMed1999

The Wisdom Project: virtual education in primary care.

This article examines the development of the Wisdom Project, a pilot for the teaching of informatics to primary health care professionals, using an original educational model based on e-mail and Web pages. The article begins by placing the development of the Wisdom Project in the context of changes in medical education and training. The aims and objectives of Wisdom are outlined, and the methodologies for setting up and evaluating the project are described. The article then presents the results of the evaluation, including the identification of significant improvements in knowledge of CD ROMs (P = 0.01), e-mail (P = 0.03), Medline (P = 0.02), operating systems (P = 0.02), Web browsers (P = 0.003) and word processing (P = 0.03). Improvements in evidence-based practice (EBP) did not reach significance. Finally, a number of conclusions are presented, considering the lessons learnt for the future development of such projects.

Attitude to Computers↗
PubMed2006

A participatory program evaluation of a systems change program to improve access to information technology by people with disabilities.

PURPOSE: To pilot-test and evaluate an innovative program providing information technology (IT) access to people with disabilities transitioning out of nursing homes into the community using a participatory approach. METHODS: Pre- and post-training data was collected on the 61 program participants to reflect three broad areas related to the IT training experience: performance; self-efficacy; importance, satisfaction and control. Additionally, semi-structured interviews were conducted with seven participants and five members of the program staff to explore environmental barriers to IT access for this group and the efficacy of the program in addressing these barriers. Data analyses followed a mixed methods approach incorporating both qualitative and quantitative techniques. RESULTS: Participants showed substantive changes in different spheres of IT use after completion of training. Post-training changes were significant particularly in areas related to self-efficacy, importance and satisfaction pertaining to use of IT. Qualitative findings substantiated the quantitative results and also revealed the numerous barriers to IT access that persons with disabilities continue to face within their communities. CONCLUSION: Results indicate the feasibility, effectiveness and value of IT access to people with disabilities particularly those transitioning from institutional life to community living. Further action research aimed at increasing IT access for this group within local communities and neighborhoods is needed to address this issue at a broader societal level.

Access to Information↗
PubMed2002

The internet and locus of control in older adults.

OBJECTIVE: To investigate how training older adults to find medical information using the Internet affects their locus of control. METHODS: Quantitative methods were utilized. Specifically, the Multidimensional Health Locus of Control survey was distributed at the onset of each seminar and again at the conclusion. RESULTS: Paired t-tests revealed that the subjects did not change their locus of control regarding their health beliefs over the period of the seminar. However, there was statistical significance with regard to eight specific questions. CONCLUSION: Subjects scored high on their level of internal locus of control coming into the study. The majority of subjects had already learned to use the computer, owned a home computer, and had access to the Internet, but had not used the Internet to search for healthcare information. The challenge continues to be reaching those older adults who have not encountered the computer and the Internet.

Aged↗