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PubMedDate not supplied

Attitudes of Australian nurses toward the implementation of a clinical information system.

A computerized clinical information system (CIS) used for the majority of patient charting and medical records was installed in six of 15 beds in the intensive care unit (ICU) of a large Australian hospital in November 1993. Staff acceptance was identified as integral to the success of the system. A survey was issued to all nursing staff of the ICU to identify factors that affected attitude toward computers in the critical care environment. Factors resulting in negative attitudes then could be targeted through training and support for users. The factors considered that potentially could influence attitudes were age, nursing experience, intensive care nursing experience, and education. The study showed that nursing experience had a statistically significant effect on motivation to use computers. A strong relation was evident between the concepts of beliefs, attitudes, and motivation. A less apparent association was present between knowledge and the other concepts. Orientation and in-service education programs should provide appropriate and applied information to optimize the motivation, beliefs, and computer literacy of nurses using CIS frameworks.

Adult↗
PubMed1996

Improving the surgical screening process.

Computer and medical technologies have merged in health care practice and have clearly enhanced overall patient care. Nurses must possess computer literacy skills if they are to control their practice effectively in this high-tech environment. This article presents an overview of how one large midwestern hospital has enhanced patient care through the merging of computer technology with anesthesia and surgical pre-screening and preparation.

Hospital Information Systems↗
PubMed2005

Effect of an informatics for evidence-based practice curriculum on nursing informatics competencies.

Effective and appropriate use of information and communication technologies is an essential competency for all health care professionals. The purpose of this paper is to describe the effect of an evolving informatics for evidence-based practice (IEBP) curriculum on nursing informatics competencies in three student cohorts in the combined BS/MS program for non-nurses at the Columbia University School of Nursing. A repeated-measures, non-equivalent comparison group design was used to determine differences in self-rated informatics competencies pre- and post-IEBP and between cohorts at the end of the BS year of the combined BS/MS program. The types of Computer Skill competencies on which the students rated themselves as competent (> or =3) on admission were generic in nature and reflective of basic computer literacy. Informatics competencies increased significantly from admission to BS graduation in all areas for the class of 2002 and in all, but three areas, for the class of 2003. None of the three cohorts achieved competence in Computer Skills: Education despite curricular revisions. There were no significant differences between classes at the end of the BS year. Innovative educational approaches, such as the one described in this paper demonstrate promise as a method to achieve informatics competence. It is essential to integrate routine measurement of informatics competency into the curriculum so that approaches can be refined as needed to ensure informatics competent graduates.

Clinical Competence↗
PubMed2002

Cognitive engineering of film library transition from film medium to digital environment in a Texas teaching hospital.

Digital imaging technology promises efficient, economical, and fast service for patient care, but the challenges are great in the transition from film to a filmless (digital) environment. This change has a significant impact on the film library's personnel (film librarians) who play a leading roles in storage, classification, and retrieval of images. The objectives of this project were to study film library errors and the usability of a physical computerized system that could not be changed, while developing an intervention to reduce errors and test the usability of the intervention. Cognitive and human factors analysis were used to evaluate human-computer interaction. A workflow analysis was performed to understand the film and digital imaging processes. User and task analyses were applied to account for all behaviors involved in interaction with the system. A heuristic evaluation was used to probe the usability issues in the picture archiving and communication systems (PACS) modules. Simplified paper-based instructions were designed to familiarize the film librarians with the digital system. A usability survey evaluated the effectiveness of the instruction. The user and task analyses indicated that different users faced challenges based on their computer literacy, education, roles, and frequency of use of diagnostic imaging. The workflow analysis showed that the approaches to using the digital library differ among the various departments. The heuristic evaluation of the PACS modules showed the human-computer interface to have usability issues that prevented easy operation. Simplified instructions were designed for operation of the modules. Usability surveys conducted before and after revision of the instructions showed that performance improved. Cognitive and human factor analysis can help film librarians and other users adapt to the filmless system. Use of cognitive science tools will aid in successful transition of the film library from a film environment to a digital environment.

Cognitive Science↗
PubMed2000

The impact of information technology on histopathology.

Pathology is one of the most computer intensive areas of medicine and as a result diagnostic pathologists in histopathology have often been at the cutting edge of computer literacy. The majority of laboratories use laboratory information systems to issue and store pathology reports. Many of these systems provide the diagnostician with the ability to retrieve reports and cases using coding systems such as SNOMED, but more advanced computer facilities that might assist the pathologist in the diagnosis or interpretation of a case are often lacking. In recent years advances in computer technology have begun to have a much wider impact on the practice of medicine and newer technologies are beginning to find their way into the reporting room. In this review, I cover some of the recent and emerging advances in IT that have the potential to revolutionize the practice of diagnostic histopathology in the next 5 years. The major area of telepathology has been a subject of several recent reviews and will not be covered here.

Databases, Factual↗
PubMed1985

Computers in family medicine. Automating outpatient medical practice.

The American Academy of Family Practice has been on a 4-year quest for a universal family practice office computer that it can recommend to its membership. Much as individual physicians struggle for computer "literacy," all medical organizations likewise face their own steep learning curve in the attempt to discern their memberships' needs and to provide guidance in meeting them.

Ambulatory Care↗
PubMed1995

Results from the use of a 3-year computer competency curriculum in a family practice residency.

BACKGROUND: Computer competency is becoming essential to practicing family physicians. However, no published computer curricula exist for family practice residents. METHODS: A computer competency curriculum was designed, implemented, and evaluated. Computer software was divided into four categories: patient care, education, practice management, and hospital resources. Competency was measured and recorded by faculty. The residents evaluated the adequacy and relevance of the curriculum to their current and future needs using a questionnaire. RESULTS: Competency testing revealed that residents uniformly achieved competency but at different rates. Residents rated the quality and quantity of instruction in patient care programs highest and in practice management lowest. The usefulness of patient care programs was perceived as high during residency but was expected to be less useful after residency. In contrast, the usefulness of practice management programs was rated as low during residency but expected to be high after graduation. Education and hospital programs were intermediate. Self-assessment indicated that computer use increased during residency; 90% of residents characterized themselves as frequent users. CONCLUSIONS: Despite logistical problems, teaching computer literacy is a responsibility of physician educators. A curriculum must be continually evaluated to ensure that it remains current and relevant to the needs of the residents.

Computer User Training↗
PubMed2005

Improving scientists' interaction with complex computational-visualization environments based on a distributed grid infrastructure.

The grid has the potential to transform collaborative scientific investigations through the use of closely coupled computational and visualization resources, which may be geographically distributed, in order to harness greater power than is available at a single site. Scientific applications to benefit from the grid include visualization, computational science, environmental modelling and medical imaging. Unfortunately, the diversity, scale and location of the required resources can present a dilemma for the scientific worker because of the complexity of the underlying technology. As the scale of the scientific problem under investigation increases so does the nature of the scientist's interaction with the supporting infrastructure. The increased distribution of people and resources within a grid-based environment can make resource sharing and collaborative interaction a critical factor to their success. Unless the technological barriers affecting user accessibility are reduced, there is a danger that the only scientists to benefit will be those with reasonably high levels of computer literacy. This paper examines a number of important human factors of user interaction with the grid and expresses this in the context of the science undertaken by RealityGrid, a project funded by the UK e-Science programme. Critical user interaction issues will also be highlighted by comparing grid computational steering with supervisory control systems for local and remote access to the scientific environment. Finally, implications for future grid developers will be discussed with a particular emphasis on how to improve the scientists' access to what will be an increasingly important resource.

Computer Graphics↗
PubMed1999

Computer support for recording and interpreting family histories of breast and ovarian cancer in primary care (RAGs): qualitative evaluation with simulated patients.

OBJECTIVES: To explore general practitioners' attitudes towards and use of a computer program for assessing genetic risk of cancer in primary care. DESIGN: Qualitative analysis of semistructured interviews and video recordings of simulated consultations. PARTICIPANTS: Purposive sample of 15 general practitioners covering a range of computer literacy, interest in genetics, age, and sex. INTERVENTIONS: Each doctor used the program in two consultations in which an actor played a woman concerned about her family history of cancer. Consultations were videotaped and followed by interviews with the video as a prompt to questioning. MAIN OUTCOME MESURESs: Use of computer program in the Consultation. RESULTS: The program was viewed as an appropriate application of information technology because of the complexity of cancer genetics and a sense of "guideline chaos" in primary care. Doctors found the program easy to use, but it often affected their control of the consultation. They needed to balance their desire to share the computer screen with the patient, driven by their concerns about the effect of the computer on doctor-patient communication, against the risk of premature disclosure of bad news. CONCLUSIONS: This computer program could provide the necessary support to assist assessment of genetic risk of cancer in primary care. The potential impact of computer software on the consultation should not be underestimated. This study highlights the need for careful evaluation when developing medical information systems.

Adult↗
PubMed2005

Improving completeness, accuracy & timeliness of HIV voluntary counseling & testing client data in Malawi using touchscreen computers.

A real-time data collection system can mitigate problems of data completeness, accuracy and timeliness often experienced using paper-based data collection and subsequent data entry. The Client Management Information System developed for the Malawi AIDS Counseling and Resource Organization employs touchscreen computers to collect client information during voluntary counseling and testing sessions. A user-friendly interface allows counselors with low levels of computer literacy to electronically capture client data in real-time without compromising the quality of counseling.

Attitude to Computers↗
PubMed1999

RWMODEL II: computer simulation of the Rescorla-Wagner model of Pavlovian conditioning.

RWMODEL II simulates the Rescorla-Wagner model of Pavlovian conditioning. It is written in Delphi and runs under Windows 3.1 and Windows 95. The program was designed for novice and expert users and can be employed in teaching, as well as in research. It is user friendly and requires a minimal level of computer literacy but is sufficiently flexible to permit a wide range of simulations. It allows the display of empirical data, against which predictions from the model can be validated.

Animals↗
PubMed2004

Acceptability and feasibility of an interactive computer-tailored fat intake intervention in Belgium.

In order to reduce the risk of chronic diseases health authorities recommend restricting fat intake to 30% of the total energy uptake. However, fat intake in Belgium is much higher warranting interventions aimed at reducing fat intake. Tailored interventions have shown to be promising; however, studies on effectiveness of interactive computer-tailored systems are needed. We investigated the acceptability and feasibility of a recently developed interactive computer-tailored fat reduction intervention. Differences in the reported acceptability and feasibility according to demographic and stages of change were explored. Participants (n = 220) completed a computerized questionnaire, and received a personal fat intake advice, which was almost immediately displayed on screen. They also completed an evaluation questionnaire, during and after they ran the tailored program, with questions on the quality, user-friendliness and applicability of the program. Participants rated the program positively on all aspects. No significant differences in acceptability and feasibility scores were found according to sex, education levels and computer literacy. Although several significant differences were found between age groups and stages of change (oldest group, contemplators and preparators were more positive about the program), the importance of these differences is probably not great, since acceptability and feasibility scores for the different age groups and stages of change were always very high. These results suggest that the computer-tailored intervention is an acceptable and feasible tool for reducing fat intake in a general population in Belgium.

Adult↗
PubMedDate not supplied

Laboratory cross training needs assessment.

OBJECTIVE: To define the continuing education topics and methods in the area of chemistry and hematology, that if developed, would best support the cross-training needs of hospital based laboratories in the State of Georgia. DESIGN: A cross sectional study of hospital based laboratories in Georgia was completed using surveys sent to 181 hospital laboratory managers and administrators. Descriptive statistics were used to evaluate the survey results. SETTING: Department of Medical Technology, Medical College of Georgia, Augusta GA. PARTICIPANTS: Laboratory managers and administrators. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENTS: Four descriptive outcome measurements were requested from each participant: 1) demographic questions, 2) cross-training topics desired, 3) training material desired, and 4) computer literacy and equipment assessment. RESULTS: Sixty-six surveys were completed and returned in a usable form (36% return rate). Demographically, the respondent group is a representative sample of hospital based laboratories in the State of Georgia with 46% of the respondents from facilities of 100 hospital beds or less. Respondents desired that case study training topics be developed using paper and computer assisted instruction mediums. Additionally, respondents desired that Professional Acknowledgement for Continuing Education (P.A.C.E.) be associated with the training material. They were willing to pay for this administrative service. CONCLUSION: This cross sectional study assessed the cross-training needs of hospital based laboratories in Georgia. Findings will allow educators to focus and develop continuing education packages that best meet the needs of the laboratorian workforce.

Chemistry, Clinical↗
PubMed1990

Drug information skills for pharmacy students: curriculum integration.

For pharmacy students to provide optimal and complete pharmaceutical care, it is vital that they develop drug information skills. At the University of Southern California, the School of Pharmacy and the Norris Medical Library have established an interactive educational program. Library programs support an increasingly complex progression of information retrieval, evaluation, organization, application, and communication. Librarians are systematically involved in all four years of coursework for the doctor of pharmacy degree. Training and experience in computer literacy and online database searching are included in the library components. Description of the educational program covers its beginning a decade ago, current status, and future in an environment of rapidly advancing technology.

California↗
PubMedDate not supplied

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↗
PubMed1986

Computerizing clinical patient problems: an evolving tool for medical education.

A natural language, free enquiry patient simulation of high fidelity has been developed using low cost microcomputer technology. The simulation is flexible, portable, responsive to individual student needs, and does not require computer literacy. The design is based on the principles of problem-based self-directed learning. The simulation is useful in individual and group learning and evaluation of data management and clinical reasoning skills.

California↗
PubMed2000

[Physicians' assessment of computerized prescribing].

Prescription errors are a major source of preventable adverse drug events. Computerized prescribing (CP) which screens physicians' order for mistakes, drug-allergy, drug-disease, drug-laboratory and drug-drug interactions can prevent many of these errors and improve quality of care. However, computerized systems are often time-consuming, difficult to handle, and may create their own mistakes. Following the introduction of CP on an internal medicine ward, we administered a questionnaire to evaluate physicians' opinions about the new system. The survey assessed computer literacy, ease of using CP, effects on time management, opinion of users regarding error prevention, and usefulness of the information provided. Opinions were generally favorable; most users felt that CP makes their work more accurate, reduces errors, is easy to learn and to use, and provides important and useful information. Physicians were most critical of equipment failure and drugs and dosages not included in the CP program, a result of rapid development of the system. Errors resulting from the use of CP were considered minimal. Comparison of physicians, with and without previous experience with computer work, as well as local and foreign graduates, revealed minor differences. But once physicians learn to work with a well-organized CP system and computerized work stations, they appreciate the order, safety and knowledge they provide.

Clinical Pharmacy Information Systems↗
PubMed2002

WebCT: integrating computer-mediated communication and resource delivery into a new problem-based curriculum.

WebCT, front-end software for Internet-delivered material, became an integral part of a problem-based learning, student-centred curriculum introduced in January 2001 at the Nelson R. Mandela School of Medicine (South Africa). A template for six curriculum and two supplementary modules was developed. Organiser and Tool pages were added and files uploaded as each module progressed. This study provides feedback from students with regard to the value of WebCT in their curriculum, as well as discussing the value of WebCT for the delivery of digitized material (e.g., images, videos, PowerPoint presentations). In an anonymous survey following the completion of the first module, students, apparently irrespective of their level of computer literacy, responded positively to the communication facility between staff and students and amongst students, the resources and the URLs. Based on these preliminary responses, WebCT courses for all six modules were developed during 2001. With Faculty support, WebCT will probably be integrated into the rest of the MBChB programme. It will be particularly useful when students are off campus, undertaking electives and community service in the later years.

Computer-Assisted Instruction↗