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Nursing informatics in nursing education: a challenge to nurse teachers.

The use of computers in education has become commonplace. In this study with 162 nurse teachers, we found that although most nursing colleges in Finland have the necessary hardware for teaching informatics, teachers are not familiar with the software that is available for nursing education purposes. Teachers also lack confidence in their own abilities to cope with computer-assisted education. The information systems used in practical nursing are often inaccessible to nurse teachers. The teachers themselves say they would regularly need further training in their own computer skills.

Attitude of Health Personnel↗

Developing interactive computer-based simulations: an object-oriented development methodology enhances computer-assisted instruction.

The purpose of this research was to investigate the application of object-oriented technology and AI techniques to enhance development of computer-based training simulations. Towards that end, a comprehensive computer-assisted instructional unit was developed to teach the skills and concepts of window-based applications, the OS/2 desktop, and the use of a patient care information system. By taking advantage of sophisticated computer graphics for the visual representation of objects and the behavioral modeling capabilities of the object-oriented language, domain knowledge modeling and human-computer interactions were implemented without complex natural language processing techniques. The results of this research indicate that nurses and physicians are able to learn the basic skills and concepts of computer systems and how to query for patient information. The new methodology described for building these computer-assisted instructional simulations significantly eased the training and teaching of large numbers of nurses and physicians and simplified their transition to a complex, computer-based hospital information system environment.

Computer Graphics↗

Cut training costs with computer-based tutorials.

New clinical information systems use client-server software applications that require knowledge of personal computers, Microsoft Windows, and mouse control. Here, the authors describe a low-cost training method to supplement classroom teaching.

Computer User Training↗

New direction in PACS education and training.

The picture archiving and communication system (PACS) is an image information system that has become widely installed. For its successful implementation, training has been found indispensable. A review of PACS training thus far shows major emphasis was placed on the use of display workstations. As an integrated system, the PACS is much broader than the display workstations, having many components that need connectivity and customization. With the many potentials of further development, a more comprehensive education program on PACS is called for and a PACS simulator as a standalone training and research tool is deemed necessary.

Computer Simulation↗

Discrimination training of phonemic contrasts enhances phonological processing in mainstream school children.

Auditory perceptual learning has been proposed as effective for remediating impaired language and for enhancing normal language development. We examined the effect of phonemic contrast discrimination training on the discrimination of whole words and on phonological awareness in 8- to 10-year-old mainstream school children. Eleven phonemic contrast continua were synthesised using linear interpolation coding from real speaker endpoints. Thirty children were pre-tested on the Word Discrimination Test (WDT) and the Phonological Assessment Battery (PhAB). Eighteen then trained for 12 x 30min sessions over 4 weeks using an adaptive three interval two alternative phonemic matching task. The remaining children participated in regular classroom activities. In Post-testing, trained children significantly increased their age-equivalent scores on both the WDT and PhAB by about 2 years. For the PhAB, no improvement was found in the controls. Enhanced performance in the trained children was maintained in a delayed test 5-6 weeks following training. Enhancements on the trained discriminations were weak and variable. The results indicate a dramatic improvement in phonological awareness following phonemic discrimination training without matching perceptual learning.

Child↗

More than just a pamphlet: development of an innovative computer-based education program for cancer patients.

Patients with cancer continue to lack practical information regarding their illness and report low levels of awareness and use of patient services. The challenge to educators is to find cost-effective and timely ways to deliver a complex mix of interesting and high-quality information and expertise to this large and diverse audience, while still tailoring the content to individual needs and situations. In the present article, we describe the Princess Margaret Hospital (PMH) computer-based patient education program. The program is aimed toward empowering those dealing with cancer and provides comprehensive medical information and support via an interactive Intranet web site containing information about cancer (the Oncology Interactive Education Series), library resources, Internet links, information about PMH services, and a hospital calendar of events. Preliminary evaluation results have provided valuable direction for on-going program development and suggest that the program is easy to use, informative, and enjoyable for patients, families, volunteers, and health professionals.

Computer Communication Networks↗

A comparison of technologies for database-driven websites for medical education.

Static web pages may be easy to setup using text processors or user-friendly web editing software. However, some basic knowledge of the implementation (HTML) is usually needed for final editing and maintenance. As a result many static web pages are left without appropriate updating. With a database driven, dynamic approach web contents may change through user interaction, the pages are usually easier to maintain, and design elements are separated from contents. Database driven solutions (or content management systems) for larger organizations may be purchased at many different levels of complexity. For smaller systems, such as separate courses or projects, they may, however, be developed locally. The present study compares four alternative technologies for database driven web pages. Each technology offers advantages and disadvantages and many issues need to be considered when selecting platform. The present study demonstrates that database driven web pages may be effectively deployed using free Open Source software. Details may be found at www.intermed.dk/datadriven.

Computer User Training↗

MEDTUTOR: a microcomputer-based training program for MEDLINE.

MEDTUTOR is an interactive, microcomputer-based training package designed to teach medical and health professionals, as well as librarians and information specialists, how to use MEDLINE effectively. The objective of MEDTUTOR is to provide a comprehensive package for teaching the various commands and search techniques required for utilizing the MEDLINE database through the MEDLARS system. MEDTUTOR's menu-driven design allows novice users to learn about the content and use of MEDLINE, such as author searching, text word searching, MeSH indexing, etc., at their own pace and with considerable program feedback. In addition, MEDTUTOR provides the skilled searcher with a way to reinforce or recall previously-learned search techniques without incurring online charges. MEDTUTOR may be used in place of formal training, as a precursor to or as a refresher following formal training, or for review of a particular concept. It provides inexpensive and easily accessible instruction for searching MEDLINE.

Computer User Training↗

Optimizing computer-based system use in health professions' education programs.

The use of computer-based systems to support training in health profession education programs has been discussed and analyzed for more than 10 years. The literature is rich with examples of how using these systems can benefit programs by more effectively distributing human resources, by making the delivery of instruction more individual and more flexible, by expanding the professional and technical competence of trainees, and by improving the monitoring of trainee performance. Obstacles to and conventional recommendations for the broadened use of computer-based systems are discussed, and an additional set of system design characteristics are described that health care educators can use in their preview and specifications for procurement of more effective computer-based systems in their training settings.

Attitude to Computers↗

Developing a web page: bringing clinics online.

Introducing clinical staff education, along with new policies and procedures, to over 50 different clinical sites can be a challenge. As any staff educator will confess, getting people to attend an educational inservice session can be difficult. Clinical staff request training, but no one has time to attend training sessions. Putting the training along with the policies and other information into "neat" concise packages via the computer and over the company's intranet was the way to go. However, how do you bring the clinics online when some of the clinical staff may still be reluctant to turn on their computers for anything other than to gather laboratory results? Developing an easy, fun, and accessible Web page was the answer. This article outlines the development of the first training Web page at the University of Wisconsin Medical Foundation, Madison, WI.

Attitude of Health Personnel↗

Utilising multimedia for training merchant mariners as paramedics.

MERMAID is a telemedicine project with global reach and a 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model is not limited to medical diagnostics but it encompasses all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications are considered while the full range of network choices is explored in terms of the cost/performance tradeoffs inherent to them and the developmental stage each of these options occupies in its life cycle. MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialty care best suited to each particular case. Finally, the development of programme modules for training and education of the seafarers in the use of the MERMAID medical communications system is given top priority as such modules constitute the firmest basis for the promotion of proper practice of telemedicine at sea.

Commerce↗

PADS (Patient Archiving and Documentation System): a computerized patient record with educational aspects.

Rapid acquisition and analysis of information in an Intensive Care Unit (ICU) setting is essential, even more so the documentation of the decision making process which has vital consequences for the lives of ICU patients. We describe an Ethernet based local area network (LAN) with clinical workstations (Macintosh fx, ci). Our Patient Archiving and Documentation System (PADS) represents a computerized patient record presently used in a university hospitals' ICU. Taking full advantage of the Macintosh based graphical user interface (GUI) our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent and complete automatic encoding of diagnoses following the International Classification of Disease (ICD; WHO, [1]). For educational purposes the user can also view disease entities or complications related to the diagnoses she/he encoded. The system has links to other educational programs such as cardiac auscultation. A MEDLINE literature search through a CD-ROM based system can be performed without exiting the system; also, CD-ROM based medical textbooks can be accessed as well. Commercially available Macintosh programs can be integrated in the system without existing the main program thus enabling users to customize their working environment. Additional options include automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological and health care related problems. Furthermore, we are in the process of integrating sound and digital video in our system. This system represents one in a line of modular departmental models which will eventually be integrated to form a decentralized Hospital Information System (HIS).

Computer User Training↗

Age-related effects of blocked and random practice schedules on learning a new technology.

Computer technology is pervasive in today's society. Issues of training must be investigated to ensure that older individuals are capable of interacting with such technology. In the present research a simulated automatic teller machine (ATM) served as a prototypical technology for which issues of training and transfer could be investigated. The focus of the study was on the potential benefits of a random practice schedule (wherein trial types are intermixed) relative to a blocked practice schedule (wherein trial types are grouped together). Both younger and older adults benefited from random practice for the acquisition of the ability to perform transactions on an ATM. Moreover, random practice was beneficial for both age groups in the transfer of learning to novel tasks on a novel ATM. These data have general implications for theories of training and specific implications for the development of training protocols for older adults and new technologies.

Adolescent↗

A computer-based tutorial for H.I.S. orientation: laboratory results retrieval.

Computer-based training developed with high-level software packages offers a cost-efficient means of orienting large numbers of personnel to a hospital information system. Equally important, a decentralized, self-administered, self-paced tutorial allows professional personnel to get training where and when they want it, with as little or as much reinforcement as they desire. We will demonstrate the tutorial we developed to train 2500 clinical and unit support personnel to use the first clinical module of our Patient Care Information System. Although the Laboratory Results Inquiry function was simple to use, many of our staff had had little or no exposure to computers, and none knew how to use the system we would be implementing. About 300 of our 2500 personnel elected to come to mentored group classes, where the same computer-based tutorial was used, but a trained "superuser" was available to answer questions and offer guidance.

Boston↗

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↗

Authoring software for courses delivered on the Web, part 3: Designer's Edge/net synergy.

Designer's Edge is an excellent tool for any course developer who is new to the concepts of instructional design or who wants to formalize the process of designing online courses. Integrated storyboarding and publishing options for the Web make this application even more valuable, if the user is either satisfied with limited control over text formatting or is HTML knowledgeable. The steep price of Designer's Edge makes this tool most useful to larger universities and institutions that want to standardize and guide their online course development.

Authorship↗