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Women's use of the Internet: what nurses need to know.

Women increasingly access the Internet for health information and social support in managing health-related changes. Some women's use of the Internet has empowered them and created changes in nurse-patient relationships. Nurses and patients must have a mutually respectful open dialogue to develop individualized appropriate plans of care, and nurses should recognize that women who do not have Internet access may have different learning needs.

Attitude to Computers↗

The effect of abbreviations on MEDLINE searching.

OBJECTIVE: To determine the effect of the use of abbreviations and acronyms on citation retrieval in MEDLINE searches. METHODS: Twenty common medical abbreviations that retrieved a minimum of 400 citations each in MEDLINE text word searches were studied. Each abbreviation was entered in a MEDLINE subject search to determine whether it mapped to an appropriate medical subject heading (MeSH) term. The MeSH category and the number of citations retrieved were recorded. The abbreviation and its definition were each entered in separate text word searches, and the number of citations retrieved was recorded. Sets were combined to determine the number of identical and unique citations retrieved in the searches. RESULTS: MEDLINE recognized all 20 abbreviations and mapped them to appropriate MeSH headings. MeSH term assignment, however, may be case- and space-sensitive. MeSH term searches retrieved more citations than text word searches for 18 of 20 abbreviations. Comparison of the document sets yielded by each search method revealed a subset of citations common to each. Although all sets retrieved showed overlap, no two were identical. In addition, each citation set contained a proportion of unique documents. CONCLUSION: Retrieval of all unique citations required three searches; subject with abbreviation, text word with abbreviation, and text word with definition. These results have important implications for MEDLINE users.

Abbreviations as Topic↗

Exploring telehealth opportunities in domestic violence shelters.

PURPOSE: To determine the degree of interest in using a computer for the purpose of accessing services from a nurse practitioner (NP) at domestic violence shelters (DVSs); and to identify issues of privacy and confidentiality that might arise from participation by victims of intimate partner violence (IPV) in a Telehealth intervention. DATA SOURCES: Focus groups with 19 women residing in two DVSs. Interviews were recorded, transcribed and themes were identified that answered the questions posed in the interviews. CONCLUSIONS: Most of the women understood the term NP and were favorably inclined to seek services from one. Over half of the women were not familiar with computer use, but were willing to learn in order to receive health care services, both for episodic needs and for maintenance of chronic conditions. After learning of the method proposed to allow them to access an NP through the internet while still protecting their privacy and confidentiality, the women felt comfortable with this approach to meeting their health care needs. IMPLICATIONS FOR PRACTICE: Results from this study can be used to support the development and testing of Telehealth interventions for these victims of IPV.

Adolescent↗

An assessment of practice support and continuing medical education needs of rural Pennsylvania family physicians.

Family physicians provide the greatest proportion of care in rural communities. Yet, the number of physicians choosing family practice and rural practice has continued to decline. Undesirable aspects of rural practice, such as professional isolation and a lack of or inadequate resources, are assumed to be associated with this decline. This article reports on the practice support and continuing medical education needs of rural family physicians. A mail survey was conducted in 1993 on a purposive sample of family physicians in 39 of 67 rural-designated or urban Pennsylvania counties with low population densities. The physicians identified needs that included patient education materials and programs, community health promotion, federal regulation updates, technical assistance with computers and business management, database software and a videotape lending library, a drug hotline, and mini-fellowships on clinical skill development. A majority of respondents were willing to participate in clinical educational experiences for students and residents. Some physicians indicated a lack of interest in access to information through telecommunications, e.g., video conference referrals and consultations. Overall, findings revealed that family physicians need and are receptive to a variety of practice support and continuing education programs. A practice support program coupled with policy coordination among public and private organizations is likely to lessen complaints by rural primary care physicians.

Clinical Competence↗

QA automation: what must be considered.

As healthcare quality assurance programs grow, so too does the need to gather and provide vast amounts of information. To meet this challenge, QA programs have turned to the use of computer systems. As this article makes clear, QA automation involves more than simply the purchase of computer hardware and software. Much time, planning, research, preparation, testing, and education are required to create an effectively automated QA program. The author provides a realistic review of the major stages and elements of the QA automation process, beginning with the search for appropriate software and concluding with the diversification possibilities of a fully integrated program.

Computer User Training↗

Computer-based physician order entry: the state of the art.

Direct computer-based physician order entry has been the subject of debate for over 20 years. Many sites have implemented systems successfully. Others have failed outright or flirted with disaster, incurring substantial delays, cost overruns, and threatened work actions. The rationale for physician order entry includes process improvement, support of cost-conscious decision making, clinical decision support, and optimization of physicians' time. Barriers to physician order entry result from the changes required in practice patterns, roles within the care team, teaching patterns, and institutional policies. Key ingredients for successful implementation include: the system must be fast and easy to use, the user interface must behave consistently in all situations, the institution must have broad and committed involvement and direction by clinicians prior to implementation, the top leadership of the organization must be committed to the project, and a group of problem solvers and users must meet regularly to work out procedural issues. This article reviews the peer-reviewed scientific literature to present the current state of the art of computer-based physician order entry.

Computer User Training↗

Variables that may enhance medical students' perceived preparedness for computer-based testing.

OBJECTIVE: To identify variables that may enhance medical student's preparedness for computer-based administration of the United States Medical Licensing Examination (USMLE). DESIGN: A cross-sectional survey of 301 medical students who completed a self-administered questionnaire. MEASUREMENTS: The questionnaire was designed to obtain information about students' computer resources, personal experience with computers, computer expertise, opinions about computers, experience with computer-based testing, perceived preparedness for the computer-based USMLE, and demographic variables. Variables related to students' perceived preparedness for the computer-based USMLE were identified by ordinal logistic regression. RESULTS: A significant regression model yielded four significant predictors: perceived preparedness for USMLE content (P: < 0.0001), opinions about computers (P: < 0.0012), gender (P: < 0.0001), and a gender by computer-based testing experience interaction (P: < 0. 0004). Computer resources, personal experience with computers, computer expertise, age, race, and year of medical school were not significant predictors. CONCLUSION: Students' perceived preparedness for computer-based administration of high-stakes examinations may be facilitated by preparing them for examination content, by enhancing their opinions about computers, and by increasing their computer-based testing experiences.

Attitude to Computers↗

Health professionals' views of informatics education: findings from the AMIA 1999 spring conference.

Health care leaders emphasize the need to include information technology and informatics concepts in formal education programs, yet integration of informatics into health educational programs has progressed slowly. The AMIA 1999 Spring Congress was held to address informatics educational issues across health professions, including the educational needs in the various health professions, goals for health informatics education, and implementation strategies to achieve these goals. This paper presents the results from AMIA work groups focused on informatics education for non-informatics health professionals. In the categories of informatics needs, goals, and strategies, conference attendees suggested elements in these areas: educational responsibilities for faculty and students, organizational responsibilities, core computer skills and informatics knowledge, how to learn informatics skills, and resources required to implement educational strategies.

Computer User Training↗

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↗

From Yoda to Sackett: the future of psychiatry medical student education.

OBJECTIVE: The authors discuss approaches to curricular goals, methods, and assessments in the education of medical students in psychiatry. METHODS: Using current educational principles and opinions on curricular reform in medical student education, an outline for a core curriculum and an individualized approach to medical student education were developed. RESULTS: A curricular outline addressing both content and organization was developed for all students as well as those specifically entering clinical psychiatry, neuroscience research, and primary care. CONCLUSIONS: In addition to a standard core curriculum there should be a tailored approach for certain subsets of students. The core curriculum should be an "ideal minimum" that recognizes the importance of evidence based medicine and is strategically planned and learner focused.

Clinical Clerkship↗

APA Summit on Medical Student Education Task Force on Informatics and Technology: learning about computers and applying computer technology to education and practice.

OBJECTIVE: This article provides a brief overview of important issues for educators regarding medical education and technology. METHODS: The literature describes key concepts, prototypical technology tools, and model programs. A work group of psychiatric educators was convened three times by phone conference to discuss the literature. Findings were presented to and input was received from the 2005 Summit on Medical Student Education by APA and the American Directors of Medical Student Education in Psychiatry. RESULTS: Knowledge of, skills in, and attitudes toward medical informatics are important to life-long learning and modern medical practice. A needs assessment is a starting place, since student, faculty, institution, and societal factors bear consideration. Technology needs to "fit" into a curriculum in order to facilitate learning and teaching. CONCLUSION: Learning about computers and applying computer technology to education and clinical care are key steps in computer literacy for physicians.

Computer User Training↗

Internet resources available to otolaryngologists.

During recent years, the Internet has evolved into the largest computer network in the world, allowing access to vast amounts of information and services. Medical information is increasingly available to both patients and professionals, and ever more biomedical resources are becoming available on-line to assist in research, clinical medicine, and education. The Internet has always provided useful resources to otolaryngologists, implemented at various academic departments and national organizations or by specialists or specific medical web sites offering technical, scientific, and biomedical information. The purpose of this article is to provide as complete a list as possible of the World Wide Web sites accessible through the Internet that are of interest to otolaryngologists. It summarizes different types of resources available, including educational material, audiology sites, outcomes research, discussion lists, research laboratories, publications, medical libraries, news and medical conferences, organizations, academic departments, otolaryngological and medical resources, medical and surgical equipment and suppliers, and miscellaneous other sites of interest to otolaryngologists. This review is intended to present the wealth of the accessible information on the Internet and to promote the use of the network to otolaryngologists who do not have extensive experience in computers or telecommunications.

Computer User Training↗

Policy issues for learning disability computer integration.

With the current expansion and development of educational computing in public and private schools across the country, policy issues for computer integration can be extremely important for educators. In the present article, research on a 3-year computer integration program at a private school for students with learning disabilities is used to illustrate integration issues. Problems and limitations in the computer program, ranging from lack of direction, support, and leadership from the administration to the lack of funds for maintenance or development, are identified and discussed. Policies and implications for the future of educational computing for students with learning disabilities as well as for private schools are examined.

Adolescent↗

Psychology of computer use: XVI. Effect of computer-pointing devices on children's processing rate.

Computer-pointing devices for input into microcomputers have become a commonplace component in direct manipulation interfaces. Use of these peripheral devices by children should result in processing rates comparable to those obtained when children are pointing with their fingers or other means. Recent research suggests that children's processing rates are substantially lower when they are manipulating computer devices. One possibility is that a child's motor system is subjected to a greater load because the child's hands are not visible while the action of pointing with a computer is being carried out. The effect of two conditions (viewing hands, not viewing hands) on 6-, 8-, and 10-yr.-old children's processing rates was investigated. Results showed that there was no difference between the two conditions although low processing rates similar to those previously obtained were recorded.

Attention↗