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PubMed1995

Continuing education in health informatics in the UK: the need for learning materials.

The case for education in health informatics for all practitioners as well as information specialists has been well recognized [1]. Changes are occurring in the undergraduate medical curriculum in the UK. This can be seen by the general moves towards computer-based teaching in higher education and the recommendations for the new medical undergraduate curriculum by the General Medical Council (GMC). A survey of undergraduate students has shown that there is an increasing level of computer literacy [2]. We need, therefore, to concentrate on postgraduate education. In the UK, postgraduate and continuing education is organized under the auspices of Regional Postgraduate Deans, Regional Advisors in General Practice, and the educational initiatives of the Professional Royal Colleges. Educational guidelines for information management for undergraduates have been described [3] and these guidelines apply to practitioners as well. The main problems in postgraduate education are the scale of the task, the staff, facilities, and teaching materials available. Basic computer literacy will enable practitioners to make use of computers in their own environment and access the "information superhighway" via the Internet. When this becomes a reality, there will be a need for suitable teaching materials to be made available. The accessibility of these materials raises questions about credit for authorship and the production of flexible packages that can be used by different individuals with their own needs in mind. We have a number of educational materials, at different stages of development, that are described here in the hope that we may collaborate in the exchange of teaching materials.

Computer User Training↗
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↗
PubMed1998

[The concept of practical teaching of medical informatics at the Medical School of Palacký University in Olomouc].

The method and conditions of medical information technology teaching represent a direct reflection of both significant progress of information technology and change in public approach to computer techniques. Over the years, the content of the course has been changed to a large extent. It is a result of the existing wide scale of available program products, modernization of local computer network and information technology classrooms and especially common attempt to availability of Internet. The computer-literacy of students is increasing as well as the number and quality of specialized teaching programs and demands of theoretical subjects of study. However the level of computer-literacy of individual students is getting to be widely different. In answer to this situation our institute reacts by some measures, described here. The aim of this paper is to raise a discussion about them and about this issue and to learn more about the approaches and practise in other institutes. In our opinion, a general integration of the main features of the medical information technology teaching courses at Medical Faculties would be the most effective result.

Czech Republic↗
PubMed2006

From the front line, report from a near paperless hospital: mixed reception among health care professionals.

OBJECTIVE: Many Norwegian hospitals that are equipped with an electronic medical record (EMR) system now have proceeded to withdraw the paper-based medical record from clinical workflow. In two previous survey-based studies on the effect of removing the paper-based medical record on the work of physicians, nurses and medical secretaries, we concluded that to scan and eliminate the paper based record was feasible, but that the medical secretaries were the group that reported to benefit the most from the change. To further explore the effects of removing the paper based record, especially in regard to medical personnel, we now have conducted a follow up study of a hospital that has scanned and eliminated its paper-based record. DESIGN: A survey of 27 physicians, 60 nurses and 30 medical secretaries was conducted. The results were compared with those from a previous study conducted three years earlier at the same department. MEASUREMENTS: The questionnaire (see online Appendix) covered the frequency of use of the EMR system for specific tasks by physicians, nurses and medical secretaries, the ease of performing these tasks compared to previous routines, user satisfaction and computer literacy. RESULTS: Both physicians and nurses displayed increased use of the EMR compared to the previous study, while medical secretaries reported generally unchanged but high use. CONCLUSION: The increase in use was not accompanied by a similar change in factors such as computer literacy or technical changes, suggesting that these typical success factors are necessary but not sufficient.

Attitude of Health Personnel↗
PubMed2003

Measuring use patterns of online journals and databases.

PURPOSE: This research sought to determine use of online biomedical journals and databases and to assess current user characteristics associated with the use of online resources in an academic health sciences center. SETTING: The Library of the Health Sciences-Peoria is a regional site of the University of Illinois at Chicago (UIC) Library with 350 print journals, more than 4,000 online journals, and multiple online databases. METHODOLOGY: A survey was designed to assess online journal use, print journal use, database use, computer literacy levels, and other library user characteristics. A survey was sent through campus mail to all (471) UIC Peoria faculty, residents, and students. RESULTS: Forty-one percent (188) of the surveys were returned. Ninety-eight percent of the students, faculty, and residents reported having convenient access to a computer connected to the Internet. While 53% of the users indicated they searched MEDLINE at least once a week, other databases showed much lower usage. Overall, 71% of respondents indicated a preference for online over print journals when possible. CONCLUSIONS: Users prefer online resources to print, and many choose to access these online resources remotely. Convenience and full-text availability appear to play roles in selecting online resources. The findings of this study suggest that databases without links to full text and online journal collections without links from bibliographic databases will have lower use. These findings have implications for collection development, promotion of library resources, and end-user training.

Computer Literacy↗
PubMed1996

Students' perceptions of a multimedia computer-aided instruction resource in histology.

OBJECTIVE: To develop an interactive multimedia-based computer-aided instruction (CAI) programme, to determine its educational worth and efficacy in a multicultural academic environment and to evaluate its usage by students with differing levels of computer literacy. DESIGN: A prospective descriptive study evaluating pre- and post-module testing, student usage tracking and a questionnaire survey. SETTING: University of Natal Medical School. PARTICIPANTS: Thirty-four volunteers from the class of 125 second-year M.B. Ch.B. students who participated in the CAI study; 13 of these were not computer-literate. INTERVENTION: The study group used the CAI module for 2 weeks as part of the course. MAIN OUTCOME MEASURES: Post-test scoring and evaluation of questionnaire responses. RESULTS: Results of pre- and post-tests show that CAI users' scores were slightly lower on pre-testing (22.1% v. 23.2%), while their post-test scores were higher (65.6% v. 60.7%). Lack of computer literacy did not restrict or hinder students in their use of the programme. Responses to a questionnaire completed by all CAI users indicate consensus that the programme helped the students to learn (94%), that it provided important basic knowledge (88%) and that it was a helpful learning experience (88%). All but 1 student wished to have more programmes like this available in histology. CONCLUSIONS: The CAI programme reduced the time spent by students in the histology microscopy laboratory and did not negatively affect their marks in post-course evaluation. The concept of multimedia-based CAI in medical education was positively received by the students who participated.

Computer-Assisted Instruction↗
PubMed2004

Evaluation of a handheld clinical decision support tool for evidence-based learning and practice in medical undergraduates.

INTRODUCTION: Handheld computers (PDAs) uploaded with clinical decision support software (CDSS) have the potential to facilitate the adoption of evidence-based medicine (EBM) at the point-of-care among undergraduate medical students. Further evaluation of the usefulness and acceptability of these tools is required. METHODS: All 169 Year 4 undergraduate medical students at the University of Hong Kong completed a post-randomised controlled trial survey. Primary outcome measures were CDSS/PDA usefulness, satisfaction, functionality and utilisation. Focus groups were also conducted to derive complementary qualitative data on the students' attitudes towards using such new technology. RESULTS: Overall, the students found the CDSS/PDA useful (mean score = 3.90 out of 6, 95% confidence interval (CI) = 3.78, 4.03). They were less satisfied with the functional features of the CDSS (mean score = 3.45, 95% CI = 3.32, 3.59) and the PDA (mean score = 3.51 95% CI = 3.40, 3.62). Utilisation was low, with the average frequency of use less than once per week. Although students reported a need for information in patient care at least once daily, they infrequently used the CDSS in a clinical setting (20.4 +/- 10.4% of the time), with an average information retrieval success rate of 37.6 +/- 22.1% requiring 63.7 +/- 86.1 seconds. Multivariable regression shows that higher perceived CDSS/PDA usefulness was associated with more supportive faculty attitudes, greater knowledge of EBM, better computer literacy skills and increased use in a clinical setting. Greater satisfaction with the CDSS/PDA was associated with increased use in a clinical setting and higher successful search rates. Qualitative results were consistent with these quantitative findings and yielded additional information on students' underlying feelings that may explain the observations. CONCLUSIONS: While PDAs uploaded with the CDSS are able to provide students with better access to high quality information, improvements in faculty attitudes, students' knowledge of EBM and computer literacy skills, and having the CDSS specially designed for undergraduate use are essential to increasing student adoption of such point-of-care tools.

Attitude of Health Personnel↗
PubMed1999

A comparative study of the attitudes of users and non-users towards computerized care planning.

The aim of this study was to compare the attitudes of nurses who had little or no experience of computerized care planning (non-users) with those who had at least two years' experience (users). The study also assessed levels of computer literacy among both cohorts and the training methods that were considered most appropriate to meet their needs. The approach was quantitative, using a questionnaire to collect data from 15 non-users and 14 users. The overall results suggest that both non-users and users had favourable attitudes towards the use of computerized care plans. However, non-users with previous computer experience had more favourable attitudes towards the introduction of computerized care planning than those with no previous experience. The preferred teaching method identified by both groups was training by technical staff in the clinical area.

Adult↗
PubMedDate not supplied

Nursing students respond to a computer assignment.

Computer-generated information is becoming increasingly important in nursing. Nursing schools are faced with the need to ensure that students have basic informatics skills and rudimentary computer literacy. This article describes the introduction of an assignment using electronic communication skills within a teaching-learning course in a baccalaureate program. The assignment was designed to introduce the students to several tasks that would be useful to them in their studies as well as in their care of clients. Students learned to send electronic mail, post to a class list, use search engines, access libraries, and critique web pages. They developed increased confidence and skill, advancing from informed user to proficient user status as identified by Ronald & Skiba. The students' appraisal of the assignment in terms of value to their nursing education and their nursing careers indicated that they recognized the value of these skills for their professional nursing lives. Activities were monitored for content and technical glitches. Lessons learned are highlighted, and "Inbox overload" is identified. The authors found that nursing curricula can be designed to meet the challenge of fostering computer literacy. The assignment could be easily adapted for continuing education or other professional education endeavors.

Attitude to Computers↗
PubMed1982

The new literacy.

Only with a knowledge of computers can we participate effectively in all facets of modern life. Computer literacy will enable us to keep control over our own professional activities, to contribute effectively to debate, to use the new information systems and to develop our own projects. Anaesthetists can develop this literacy by consistent reading, by doing courses, and by using computers. This paper deals with what we can learn about computer language, and methods of developing a computer project.

Anesthesiology↗
PubMed2006

Multimedia-driven teaching significantly improves students' performance when compared with a print medium.

BACKGROUND: In this study, we compared the educational value of a multimedia module about aortic valve replacement as a preparation for the operating room with a print medium of identical content. METHODS: One hundred twenty-six students were randomly assigned in a prospective study to either use the multimedia course (n = 69) or a print version (n = 57). A 20-item multiple-choice test was performed before and after learning with the respective medium. Both groups participated in an operation during which they were evaluated with 28 standardized tasks and questions. Individual motivation, computer literacy, and didactic quality of both media were assessed with psychometric tests. RESULTS: There were no significant differences in the multiple-choice pretest (multimedia, 30.6% +/- 12.4% versus print, 27.9% +/- 11.4%) and posttest responses (multimedia, 76.7% +/- 13.3% versus print, 76.9% +/- 11.1). Mean percentage of correct answers during the operation was 82.9% +/- 10% in the online group and 64.7% +/- 12% in the print group (p < 0.0001). The multimedia group needed significantly (p < 0.001) less study time (105 +/- 24 minutes) when compared with the text group (122 +/- 30 minutes). There were no statistically significant differences in motivation, computer literacy, and didactic quality of either medium. CONCLUSIONS: Regarding factual knowledge, there is no difference between multimedia-driven learning and a print medium. During heart operations, when understanding of complex temporal and spatial events is essential, students' performance is significantly improved by multimedia-enhanced teaching. The latter further proved to be more efficient in terms of study time.

Adult↗
PubMed2004

A survey of the information management and technology training needs of doctors in an acute NHS trust in the United Kingdom.

BACKGROUND: Doctors need information skills to deliver health care in the 21st century. There is concern that those who trained before the 'information age' will be inadequately equipped for their work. OBJECTIVES: To assess doctors' use of computers for clinical tasks, and their knowledge and skills in health information management and technology. DESIGN: Questionnaire survey. SETTING: An acute NHS trust in the UK. PARTICIPANTS: 96 (83%) of all doctors in the trust responded. MAIN OUTCOME MEASURES: Proportion of respondents reporting the following: use of computer-based systems for clinical tasks, knowledge in eight health informatics topics, skills in using specific hardware and software applications. Also comparison of reported skills between senior and junior staff; proportion of doctors identifying specific training needs. RESULTS: All but one (1%) of the responding doctors used a computer regularly. Over three quarters of respondents reported they were semi-skilled or fully skilled in basic office applications, though the juniors scored significantly more highly than the seniors for some applications. However, 44% of doctors reported no skills in database software, identifying this as a training need. Around half of the doctors were unaware of health informatics topics, including electronic patient records, the Caldicott report and data protection law. In each case the senior doctors were significantly more aware than the juniors of the topic in question. CONCLUSION: Both junior and senior doctors have basic computer literacy, but nearly half of this population identify the use of database software as a training need. In addition, there are several health informatics topics of which a large proportion of doctors, particularly the juniors, have little knowledge, but which have not been identified as training needs. Some recommendations are made for provision of in-house health informatics education for doctors.

Attitude to Computers↗
PubMed2003

Adolescents searching for health information on the Internet: an observational study.

BACKGROUND: Adolescents' access to health information on the Internet is partly a function of their ability to search for and find answers to their health-related questions. Adolescents may have unique health and computer literacy needs. Although many surveys, interviews, and focus groups have been utilized to understand the information-seeking and information-retrieval behavior of adolescents looking for health information online, we were unable to locate observations of individual adolescents that have been conducted in this context. OBJECTIVE: This study was designed to understand how adolescents search for health information using the Internet and what implications this may have on access to health information. METHODS: A convenience sample of 12 students (age 12-17 years) from 1 middle school and 2 high schools in southeast Michigan were provided with 6 health-related questions and asked to look for answers using the Internet. Researchers recorded 68 specific searches using software that captured screen images as well as synchronized audio recordings. Recordings were reviewed later and specific search techniques and strategies were coded. A qualitative review of the verbal communication was also performed. RESULTS: Out of 68 observed searches, 47 (69%) were successful in that the adolescent found a correct and useful answer to the health question. The majority of sites that students attempted to access were retrieved directly from search engine results (77%) or a search engine's recommended links (10%); only a small percentage were directly accessed (5%) or linked from another site (7%). The majority (83%) of followed links from search engine results came from the first 9 results. Incorrect spelling (30 of 132 search terms), number of pages visited within a site (ranging from 1-15), and overall search strategy (eg, using a search engine versus directly accessing a site), were each important determinants of success. Qualitative analysis revealed that participants used a trial-and-error approach to formulate search strings, scanned pages randomly instead of systematically, and did not consider the source of the content when searching for health information. CONCLUSIONS: This study provides a useful snapshot of current adolescent searching patterns. The results have implications for constructing realistic simulations of adolescent search behavior, improving distribution and usefulness of Web sites with health information relevant to adolescents, and enhancing educators' knowledge of what specific pitfalls students are likely to encounter.

Adolescent↗
PubMed2001

Web-based tailored nutrition education: results of a randomized controlled trial.

There is ample evidence that printed, computer-tailored nutrition education is a more effective tool for motivating people to change to healthier diets than general nutrition education. New technology is now providing more advanced ways of delivering tailored messages, e.g. via the World Wide Web (WWW). Before disseminating a tailored intervention via the web, it is important to investigate the potential of web-based tailored nutrition education. The present study investigated the immediate impact of web-based computer-tailored nutrition education on personal awareness and intentions related to intake of fat, fruit and vegetables. A randomized controlled trial, with a pre-test-post-test control group design was conducted. Significant differences in awareness and intention to change were found between the intervention and control group at post-test. The tailored intervention was appreciated better, was rated as more personally relevant, and had more subjective impact on opinion and intentions to change than the general nutrition information. Computer literacy had no effect on these ratings. The results indicate that interactive, web-based computer-tailored nutrition education can lead to changes in determinants of behavior. Future research should be aimed at longer-term (behavioral) effects and the practicability of distributing tailored interventions via the WWW.

Adult↗
PubMed2001

Doctors' use of electronic medical records systems in hospitals: cross sectional survey.

OBJECTIVES: To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. DESIGN: Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. SETTING: 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. PARTICIPANTS: 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. MAIN OUTCOME MEASURES: Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. RESULTS: Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. CONCLUSIONS: Doctors used electronic medical records systems for far fewer tasks than the systems supported.

Cross-Sectional Studies↗
PubMed2004

VA QUERI informatics paper: information technology for clinical guideline implementation: perceptions of multidisciplinary stakeholders.

OBJECTIVE: This multisite study compared the perceptions of three stakeholder groups regarding information technologies as barriers to and facilitators of clinical practice guidelines (CPGs). DESIGN: The study settings were 18 U.S. Veterans Affairs Medical Centers. A purposive sample of 322 individuals participated in 50 focus groups segmented by profession and included administrators, physicians, and nurses. Focus group participants were selected based on their knowledge of practice guidelines and involvement in facility-wide guideline implementation. MEASUREMENTS: Descriptive content analysis of 1,500 pages of focus group transcripts. RESULTS: Eighteen themes clustered into four domains. Stakeholders were similar in discussing themes in the computer function domain most frequently but divergent in other domains, with workplace factors more often discussed by administrators, system design issues discussed most by nurses, and personal concerns discussed by physicians and nurses. Physicians and nurses most often discussed barriers, whereas administrators focused most often on facilitation. Facilitators included guideline maintenance and charting formats. Barriers included resources, attitudes, time and workload, computer glitches, computer complaints, data retrieval, and order entry. Themes with dual designations included documentation, patient records, decision support, performance evaluation, CPG implementation, computer literacy, essential data, and computer accessibility. CONCLUSION: Stakeholders share many concerns regarding the relationships between information technologies and clinical guideline use. However, administrators, physicians, and nurses hold different opinions about specific facilitators and barriers. Health professionals' disparate perceptions could undermine guideline initiatives. Implementation plans should specifically incorporate actions to address these barriers and enhance the facilitative aspects of information technologies in clinical practice guideline use.

Adult↗
PubMedDate not supplied

Computer graphics and developmental theory: a powerful partnership.

Educating student nurses to successfully use computer technology involves conscientious planning from nursing faculty responsible for curriculum integration. Many computer elements may be considered such as computer literacy, word processing, and computer assisted instruction. Database programs, spreadsheet applications, and statistical packages are also often incorporated into curriculum integration efforts. Computer graphics and desk-top publishing can also be used as an effective teaching strategy. The following describes an attempt to combine a creative teaching approach for developmental theory within a course on human development while expanding on students' computer skills in the field of computer graphics.

Computer Graphics↗