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PubMed2006

Computer literacy, skills and knowledge among dentists and dental care professionals (DCPs) within primary care in Scotland.

OBJECTIVE: To gain a better understanding of the level of literacy in information technology (IT) across the dental team working within primary care in Scotland, thus allowing appropriate planning of education and training for effective use of IT. DESIGN: A postal questionnaire survey of all dentists and dental care professionals (DCPs) within primary care in Scotland; online reply was also an option. SETTING: General dental practice and the salaried dental service, May 2004. SUBJECTS AND METHODS: 2679 dentists and 2861 DCPs were surveyed. RESULTS: Forty-three percent of respondents considered their IT skills to be 'moderate', with a further one-third reporting 'nil' or 'low' skill level. Only a quarter of respondents had accessed a learning programme by computer. The majority of IT competence was self-acquired. CONCLUSIONS: 'Upskilling' the dental team in IT may be required in order to take advantage of e-learning opportunities available now and in the future.

Adult↗
PubMed2002

A medical informatics curriculum for 21st century family practice residencies.

BACKGROUND AND OBJECTIVES: An informatics curriculum was developed by integrating evidence-based medicine, communication and behavioral sciences, patient education, and computer skills. Introduction of an electronic medical record (EMR) to our family practice center was a focal point of this training. Our objective was to measure whether the new curriculum improved our residents' informatics skills and computer knowledge. METHODS: Before and after institution of the curriculum, residents' self-rated skills and attitudes were measured with a questionnaire. They also took an objective test of informatics skills after the curriculum was implemented, and their scores were compared to scores from five other control residencies that did not use the curriculum. RESULTS: The curriculum, including use of the electronic record, was successfully implemented and tested. The curriculum improved residents' self-ratings of informatics knowledge and computer skills, but the objective test did not show a significant difference between programs. CONCLUSIONS: After implementation of a medical informatics curriculum, residents self-reported an improvement in computer and informatics skills. The objective measurement of knowledge did not demonstrate the benefit of our curriculum compared to other programs.

Computer Literacy↗
PubMed1993

The success of a clinical librarian program in an academic autopsy pathology service.

Residents in pathology must acquire a broad base of knowledge in all areas of medicine and the basic medical sciences. We report our experience with the first Clinical Medical Librarian (CL) program used to aid resident training in anatomic pathology. This program was developed by the Lister Hill Library of Health Sciences (LHL) of the University of Alabama at Birmingham (UAB) to test the value of a CL program in filling the clinical needs of medical students and residents by providing key recent references to the wide variety of diseases seen in a busy autopsy service. Use of a CL was accepted completely by both faculty and residents as a method of increasing their efficiency in evaluating the recent literature on diseases seen in the autopsy service. Our use of this program broadened the scope and extent of specific case-oriented medical literature read by both residents and faculty.

Autopsy↗
PubMed1994

Bibliographic instruction in the hospital library.

The nature of bibliographic instruction in this hospital library continues to evolve. As the library makes easy-to-master, menu-driven tools for online searching available to end users, the demand for this service and the accompanying training increases. The demand for formal sessions covering research techniques is also increasing. Upon request, the library offered an extended research orientation to the housestaff in Obstetrics and Gynecology in May of 1993. An introduction to the use of CD-ROM was included to highlight its usefulness for citation verification, author searches, and for periodic current awareness searches on a particular topic. The UMH Library staff strive to offer the most current and comprehensive facilities and services to their users. These include automated access to the library's book, journal, and audiovisual holdings using the Data Trek system; online bibliographic searching by library staff and end users using CD Plus MEDLINE on CD-ROM and Grateful MED software; participation in clinical rounds to provide research support for clinical care; and several types of bibliographic instruction. In addition to the informal teaching of library research techniques that the library staff offers on a daily basis, the Library at Union Memorial Hospital is pleased to be able to provide a formalized and evolving bibliographic instruction program.

Computer User Training↗
PubMed2002

Filmless in New Jersey: the New Jersey Medical School PACS Project.

Transitioning to a filmless department is no easy task, especially at a large academic medical center. At the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, a phased modality integration schedule was implemented to allow the technical and clinical staff to gradually absorb all of the changes to workflow. One-on-one training sessions were designed to prepare radiologists and referring clinicians to access and navigate the in-house picture archiving and communication system (PACS) workstations as well as to view images over the Internet via the PACS Web server. An interdepartmental steering committee was formed to plan deployment of the in-house workstations. A planning committee met on a weekly basis to outline placement of workstations within the Radiology Department, and to redesign the reading room. A user group was created to discuss specific user problems. Of particular interest was the challenge of outfitting a dozen conference rooms with projection systems capable of displaying radiologic images. We distinguished between regular and working conferences. At regular conferences only a few cases are reviewed over the course of an hour and only after the diagnosis has been made at a PACS workstation. In contrast, the surgical and medical intensive care units conduct daily working conferences. At those sessions the images of 20 to 30 patients are reviewed, many of them for the first time, and for each case a definitive diagnosis is expected. During the implementation process, a range of issues came up that limited access of certain studies to radiologists and referring clinicians alike. Even after the initial PACS installation, many studies went unread because of a lack of worklists. Other problems included image ordering for head computed tomography and magnetic resonance imaging. A few of our modalities were not DICOM compliant and needed image capture devices in order to be integrated with the PACS. To our dismay, this was also true of one of our modalities that was supposed to be DICOM compliant. These problems, and the solutions we discovered, are discussed in this paper.

Academic Medical Centers↗
PubMedDate not supplied

The effect of switch control site on computer skills of infants and toddlers.

OBJECTIVE: The purpose of this study was to determine whether switch control site (hand vs. head) affects the age at which children can successfully activate a computer to play a cause-and-effect game. METHOD: The sample consisted of 72 participants randomly divided into two groups (head switch and hand switch), with stratification for gender and age (9-11 months, 12-14 months, 15-17 months). All participants were typically developing. After a maximum of 5 min of training, each participant was given five opportunities to activate a Jelly Bean switch to play a computer game. Competency was defined as four to five successful switch activations. RESULTS: Most participants in the 9-month to 11-month age group could successfully use a hand switch to activate a computer, and for the 15-month to 17-month age group, 100% of the participants met with success. By contrast, in the head switch condition, approximately one third of the participants in each of the three age ranges were successful in activating the computer to play a cause-and-effect game. CONCLUSION: The findings from this study provide developmental guidelines for using switches (head vs. hand) to activate computers to play cause-and-effect games and suggest that the clinician may consider introducing basic computer and switch skills to children as young as 9 months of age. However, the clinician is cautioned that the head switch may be more difficult to master than the hand switch and that additional research involving children with motor impairments is needed.

Age Factors↗
PubMed2006

How women with breast cancer learn using interactive cancer communication systems.

To provide insights about how women with breast cancer learn from interactive cancer communication systems (ICCSs), this study examined how use of different types of services that employ conceptually distinct pedagogical methods relates to learning outcomes. The study sample included 231 recently diagnosed, lower income breast cancer patients. Participants were provided a free computer, Internet access and training in how to use an ICCS called the Comprehensive Health Enhancement Support System 'Living with Breast Cancer' program. Data comprised survey information collected at pre-test and 4 months after using the system and computer records of how women used the system (use data). The findings suggest that use of the information and interactive services independently contributed to perceived information competence, though the communication services, including both discussion group and ask an expert, did not. Consistent with expectations, use of discussion group and interactive services amplified the learning effects of using the information services. However, use of the ask an expert service did not amplify the learning effects of using the information services as predicted. Some constructivist pedagogical methods-specifically online support groups and intelligently designed, computer-driven interactive services-may supplement and extend the learning potential of information services delivered via a transmission-oriented pedagogical approach.

Breast Neoplasms↗
PubMedDate not supplied

The computer-literate nurse.

This study investigated the perceptions of nursing educators concerning the amount and kinds of computer training that should occur in the nursing degree program. Data were collected in two phases: a semi-structured interview of experts in the application of the computer to nursing and a random sample of nursing educators in 2-year and 4-year nursing degree programs. The panel of experts identified objectives within each of seven domains: programming and algorithms, skills in computer usage, major uses and applications, limitations of computers, personal and social aspects, and relevant values and attitudes. The responses of this panel were used to generate an universe of computer literacy objectives. The sample of nursing educators then identified a subset of objectives within the universe that they felt nursing students should master in order to be computer literate. The survey found that nursing educators desire graduates of nursing degree programs to understand how a computer works and to develop skills in using application programs. They do not expect nursing graduates to acquire programming skills, however, they do expect the graduates to acquire skills in using the computer as a tool in nursing. These skills include using a word processor for writing nursing care plans, using computer-aided instruction as a learning tool, using a hospital computer information system, using a computerized library database, and using software for statistical computations.

Computer Literacy↗
PubMed2000

[Possibilities and chances for using the internet by the elderly].

More and more older people interested in continuing education recognise the many possibilities for information, communication and co-operation which Internet offers to them. Institutes of continuing education and other institutions serving older people are required to provide training for this target group in order to make access to the world of the digital media easier, to support them in acquiring media competence and to design interesting virtual educational programmes and courses. In this article, the possibilities of showing people over 50 the way to the new communication technologies will be described in view of the experiences gained during the information campaign "Senior-Info-Mobil". It will also be demonstrated based on the examples of the European network "Learning in Later Life" and other projects such as "Learning through Research" that virtual working groups and networks of elders can become a driving force of a new "learning culture", involving also those who do not live near universities or who for health and other personal reasons cannot participate in educational programmes offered in the area.

Activities of Daily Living↗
PubMed2004

Electronic nursing documentation in primary health care.

The aim of this study was to describe and analyse nursing documentation based on an electronic patient record (EPR) system in primary health care (PHC) with emphasis on the nurses' opinions and what, according to the nursing process and the use of the keywords, the nurses documented. The study was performed in one county council in the south of Sweden and included 42 Primary Health Care Centres (PHCC). It consisted of a survey, an audit of nursing records with the Cat-ch-Ing instrument and calculation of frequencies of keywords used during a 1-year period. For the survey, district nurses received a postal questionnaire. The results from the survey indicated an overall positive tendency concerning the district nurses' opinions on documentation. Lack of in-service training in nursing documentation was noted and requested from the district nurses. All three parts of the study showed that the keywords nursing interventions and status were frequently used while nursing diagnosis and goal were infrequent. From the audit, it was noted that medical status and interventions appeared more often than nursing status. The study demonstrated limitations in the nursing documentation that inhibited the possibility of using it to evaluate the care given. In order to develop the nursing documentation, there is a need for support and education to strengthen the district nurses' professional identity. Involvement from the heads of the PHCC and the manufactures of the EPR system is necessary, in cooperation with the district nurses, to render the nursing documentation suitable for future use in the evaluation and development of care.

Adult↗
PubMed2006

Cardiovascular disease prevention for underserved patients using the Internet: bridging the digital divide.

For underserved populations, telemedicine can address the high prevalence and suboptimal control of cardiovascular disease (CVD) risk factors. However, Internet access issues may limit the successful application of telemedicine. We tested the hypothesis that computer skills, and not access per se, was the main obstacle to using the Internet for health care. After informed consent, 44 participants with little or no computer experience received 2 hours of training covering 14 basic computer use skills, Internet access, and our telemedicine system. The telemedicine system enables reporting blood pressure, weight, physical activity, cigarette use, provider feedback, personal medication information, and educational information about CVD risk factors. The patient population included 12 males and 32 females. Of this total were 23 African Americans. The average patient age was 60.4 +/- 3 years, and 64% had annual family incomes under 25,000 dollars. Eighty-two percent of the participants averaged 4 or higher (on a scale of 1 to 5) on basic computer skills. Only 11% had an average score below 3. Thirty-seven of 44 participants reported on their health status from a local Internet access site within 10 days. Participants' successful use of the telemedicine system was not correlated with age, gender, education level, or ownership of a computer. Computer skill score had a positive effect on system use. Underserved populations without computer experience or skills and at increased risk for CVD can be educated to use an Internet telemedicine system to communicate health status to their health care providers. Ownership of a computer was not a factor that predicted system use.

Aged↗
PubMed2001

Resident utilization of information technology.

OBJECTIVE: To determine if a simple educational intervention can increase resident physician literature search activity. DESIGN: Randomized controlled trial. SETTING: University hospital-based internal medicine training program. PATIENTS/PARTICIPANTS: Forty-eight medical residents rotating on the general internal medicine service. INTERVENTIONS: One-hour didactic session, the use of well-built clinical question cards, and practical sessions in clinical question building. MEASUREMENTS AND MAIN RESULTS: Objective data from the library information system that included the number of log-ons to medline, searching volume, abstracts viewed, full-text articles viewed, and time spent searching. Median search activity as measured per person per week (control vs intervention): number of log-ons to medline (2.1 vs 4.4, P <.001); total number of search sets (24.0 vs 74.2, P <.001); abstracts viewed (5.8 vs 17.7, P=.001); articles viewed (1.0 vs 2.6, P=.005); and hours spent searching (0.8 vs 2.4, P <.001). CONCLUSIONS: A simple educational intervention can markedly increase resident searching activity.

Adult↗
PubMed2004

Variation in implementation and use of computerized clinical reminders in an integrated healthcare system.

OBJECTIVES: To identify patterns of use of computerized clinical reminders (CCRs) across an integrated healthcare system and describe institutional factors associated with their implementation. STUDY DESIGN: Cross-sectional study. METHODS: At a national electronic health record (EHR) meeting, we surveyed 261 participants from 104 Veterans Health Administration (VHA) healthcare facilities regarding the number and types of CCRs available at each facility. Potential explanatory measures included perceived utility and ease of use of CCRs, training and personnel support for computer use, EHR functionalities, and performance data feedback to providers at each facility. RESULTS: The number of conditions with CCRs in use at a facility ranged from 1 to 15; most reported implementation of reminders for 10 of the 15 conditions surveyed. The most commonly implemented CCRs, used in more than 85% of facilities, were for conditions with VHA national performance measures (eg, tobacco cessation, immunizations, diabetes mellitus). The least commonly implemented CCRs were for post-deployment health evaluation and management, medically unexplained symptoms, and erectile dysfunction. Facilities that had implemented greater numbers of clinical reminders had providers who reported greater ease of use and utility of the reminders (P= .01). CONCLUSIONS: VHA facilities vary markedly in their implementation of CCRs. This effect may be partly explained by greater incorporation of clinical reminders for conditions with performance measures. Further study is needed to determine how to best implement clinical reminders and the institutional factors important in their use.

Attitude of Health Personnel↗
PubMedDate not supplied

Training faculty in Bangladesh to use a microcomputer for public health: followup report.

In 1984 the Western Consortium for the Health Professions, Inc., under contract to the United Nations Fund for Population Activities (UNFPA), began a project to assist Bangladesh's National Institute for Preventive and Social Medicine (NIPSOM) in establishing a microcomputing capability. The project's goal was to enable NIPSOM to become self-sufficient in the analysis by microcomputer of health, population, and family planning data; program evaluation; and policy activities. Lack of a local microcomputer infrastructure demanded that a local team of experts be developed to run the system described in a previous report. Five NIPSOM faculty members--three of whom had taken the workshop held when the system was first installed--were assigned to a computer committee, which was responsible for the computer's well-being. Six months after the microcomputer system was installed, a second 2-week workshop was given. The consortium's consultant facilitated the development of a basic microcomputer course, which was taught by four members of the computer committee to an additional eight NIPSOM faculty members. Emphasis was placed on developing local self-reliance and the need to overcome obstacles imposed by the lack of local hardware and software support systems. A strategy is proposed for the successful introduction of microcomputers in developing countries.

Bangladesh↗
PubMed1996

An adult education model for training third-year medical students in use of the Physician Data Query (PDQ) System.

BACKGROUND AND METHODS: An adult education model was developed to familiarize third-year medical students with the Physician Data Query (PDQ) system, a computerized, full-text database of state-of-the-art cancer information developed by the National Cancer Institute. The educational model was designed in collaboration with a medical librarian and was implemented within the context of a busy surgery clerkship using only modest resources that were readily available within the medical school. RESULTS: During three years, 275 medical students participated in the exercise and evaluated both the PDQ system and the educational model. Overall, 87% of the students considered the PDQ system to be a valuable source of information, and 84% anticipated using PDQ after completing their surgical rotations. Ninety-six percent of the students agreed that the objectives of the exercise were met. CONCLUSIONS: This article provides a description of the educational model and discusses the principles of adult education and andragogy on which it was developed. The importance of emphasizing the process of learning as well as the content is described relative to self-directed and life-long learning.

Adult↗
PubMed1993

A program to enhance clinical use of MEDLINE. A randomized controlled trial.

OBJECTIVE: To determine if a preceptor and individualized feedback improves the performance of physicians in searching MEDLINE in clinical settings. DESIGN: Randomized controlled trial with 2 to 10 months follow-up. SETTING: A 300-bed teaching hospital. PARTICIPANTS: All 392 physicians and physicians-in-training from 6 major clinical departments were invited to participate if they made patient-care decisions during the study period; 79.4% agreed. INTERVENTIONS: All participants were given 2 hours of basic training, then randomized to a control group (no further intervention) or an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback from a study librarian on each of their 1st 10 searches. MAIN OUTCOME MEASURES: The number and proportion of relevant and irrelevant references retrieved for 1st, 4th, and 8th searches of participants were compared with independent librarian searches on the same topics. RESULTS: Intervention group members did not search more often than controls (5.9 searches per month versus 4.7, respectively; P = 0.26) and there were no significant differences in the quality of searches. Rather, search performance for both groups improved, with the average number of relevant references retrieved per search increasing from 4.5 to 7.4 (P < 0.01). The librarian retrieved more relevant citations than participants for the 1st search (P = 0.001) but not for the 4th (P = 0.60) or 8th (P = 0.76) searches. CONCLUSIONS: A program of assigning preceptors and providing feedback on individual searches did not enhance the quantity or quality of searches. Soon after a basic introduction to searching, however, clinicians in both groups improved their search performance.

Clinical Medicine↗
PubMed2004

An evaluation of information-seeking behaviors of general pediatricians.

OBJECTIVE: Usage of computer resources at the point of care has a positive effect on physician decision making. Pediatricians' information-seeking behaviors are not well characterized. The goal of this study was to characterize quantitatively the information-seeking behaviors of general pediatricians and specifically compare their use of computers, including digital libraries, before and after an educational intervention. METHODS: General pediatric residents and faculty at a US Midwest children's hospital participated. A control (year 1) versus intervention group (year 2) research design was implemented. Eligible pediatrician pools overlapped, such that some participated first in the control group and later as part of the intervention. The intervention group received a 10-minute individual training session and handout on how to use a pediatric digital library to answer professional questions. A general medical digital library was also available. Pediatricians in both the control and the intervention groups were surveyed using the critical incident technique during 2 6-month time periods. Both groups were telephoned for 1- to 2-minute interviews and were asked, "What pediatric question(s) did you have that you needed additional information to answer?" The main outcome measures were the differences between the proportion of pediatricians who use computers and digital libraries and a comparison of the number of times that pediatricians use these resources before and after intervention. RESULTS: A total of 58 pediatricians were eligible, and 52 participated (89.6%). Participant demographics between control (N = 41; 89.1%) and intervention (N = 31; 70.4%) were not statistically different. Twenty pediatricians were in both groups. Pediatricians were slightly less likely to pursue answers after the intervention (94.7% vs 89.2%); the primary reason cited for both groups was a lack of time. The pediatricians were as successful in finding answers in each group (95.7% vs 92.7%), but the intervention group took significantly less time (8.3 minutes vs 19.6 minutes). After the intervention, pediatricians used computers and digital libraries more to answer their questions and spent less time using them. CONCLUSION: This study showed higher rates of physician questions pursued and answered and higher rates of computer use at baseline and after intervention compared with previous studies. Pediatricians who seek answers at the point of care therefore should begin to shift their information-seeking behaviors toward computer resources, as they are as effective but more time-efficient.

Computer User Training↗