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PubMed2003

Do ergonomics improvements increase computer workers' productivity?: an intervention study in a call centre.

This paper examines whether improving physical ergonomics working conditions affects worker productivity in a call centre with computer-intensive work. A field study was conducted at a catalogue retail service organization to explore the impact of ergonomics improvements on worker production. There were three levels of ergonomics interventions, each adding incrementally to the previous one. The first level was ergonomics training for all computer users accompanied by workstation ergonomics analysis leading to specific customized adjustments to better fit each worker (Group C). The second level added specific workstation accessories to improve the worker fit if the ergonomics analysis indicated a need for them (Group B). The third level met Group B requirements plus an improved chair (Group A). Productivity data was gathered from 72 volunteer participants who received ergonomics improvements to their workstations and 370 control subjects working in the same departments. Daily company records of production outputs for each worker were taken before ergonomics intervention (baseline) and 12 months after ergonomics intervention. Productivity improvement from baseline to 12 months post-intervention was examined across all ergonomics conditions combined, and also compared to the control group. The findings showed that worker performance increased for 50% of the ergonomics improvement participants and decreased for 50%. Overall, there was a 4.87% output increase for the ergonomics improvement group as compared to a 3.46% output decrease for the control group. The level of productivity increase varied by the type of the ergonomics improvements with Group C showing the best improvement (9.43%). Even though the average production improved, caution must be used in interpreting the findings since the ergonomics interventions were not successful for one-half of the participants.

Computers↗
PubMed1997

A distributed virtual environment prototype for emergency medical procedures training.

Because of the increasing complexity of emergency medical care, medical staffs require increasingly sophisticated training systems. Virtual environments offer a low cost means to achieve a widely usable yet sophisticated training capability. We describe the Virtual Emergency Room (VER) project, a simulation system designed to enable emergency department personnel within level I and II emergency rooms to practice emergency medical procedures and protocols. Because emergency rooms are manned by a wide variety of medical professionals, we are developing a simulation facility that uses a distributed virtual environment architecture to enable real-time, multi-participant simulations. The potential advantages of this system include the ability to evaluate and refine treatment skills, and the ability to provide scenario-specific training for mobile military field hospital teams. These advantages will ultimately improve the readiness of emergency department staffs for a wide variety of trauma situations. This paper describes the VER and the major components of its distributed virtual environment. The current capabilities of our system are described followed by a discussion of recommended follow-on work.

Computer Simulation↗
PubMed2002

Surgical procedure logging with use of a hand-held computer.

OBJECTIVE: To evaluate the feasibility of incorporating hand-held computing technology in a surgical residency program, by means of hand-held devices for surgical procedure logging linked through the Internet to a central database. SETTING: Division of General Surgery, University of Toronto. DESIGN: A survey of general surgery residents. METHODS: The 69 residents in the general surgery training program received hand-held computers with preinstalled medical programs and a program designed for surgical procedure logging. Procedural data were uploaded via the Internet to a central database. Survey data were collected regarding previous computer use as well as previous procedure logging methods. MAIN OUTCOME MEASURE: Utilization of the procedure logging system. RESULTS: After a 5-month pilot period, 38% of surgical residents were using the procedure-logging program successfully and on a regular basis. Program use was higher among more junior trainees. Analysis of the database provided valuable information on individual trainees, hospital programs and supervising surgeons, data that would assist in program development. CONCLUSIONS: Hand-held devices can be implemented in a large division of general surgery to provide a reference database and a procedure-logging platform. However, user acceptance is not uniform and continued training and support are necessary to increase acceptance. The procedure database provides important information for optimizing trainees' educational experience.

Attitude to Computers↗
PubMed2005

Knowledge and use of electronic information resources by medical sciences faculty at The University of the West Indies.

OBJECTIVE: The objective was to determine faculty's knowledge of electronic resources, access to a computer, use of electronic resources (both number and frequency) available at the Medical Sciences Library (MSL), and the areas of training needed and to identify areas for further research. METHODS: A survey was administered to faculty in medicine, pharmacy, dentistry, and veterinary sciences at The University of the West Indies. The questions covered computer literacy, computer access and location, knowledge and use of electronic resources, and training needs. RESULTS: The response rate was 70%, of whom 97% were computer users. Seventy-three percent used computers daily, and 82% felt that their computer literacy level was average or beyond. Overall, it was found that faculty had high awareness of the electronic resources made available by the MSL but low use of MSL-specific resources supporting the suggested problem of underutilization. Many respondents felt that e-resources were important, and, though many felt that they were competent users, 83% were self-taught and many still expressed a need for training. Over 60% felt that a workshop with a hands-on component was the preferred format for training. It was recommended that there be greater promotion of the library's e-resources.

Attitude to Computers↗
PubMed2000

Parallel man-machine training in development of EEG-based cursor control.

A new parallel man-machine training approach to brain-computer interface (BCI) succeeded through a unique application of machine learning methods. The BCI system could train users to control an animated cursor on the computer screen by voluntary electroencephalogram (EEG) modulation. Our BCI system requires only two to four electrodes, and has a relatively short training time for both the user and the machine. Moving the cursor in one dimension, our subjects were able to hit 100% of randomly selected targets, while in two dimensions, accuracies of approximately 63% and 76% was achieved with our two subjects.

Biofeedback, Psychology↗
PubMed2005

Simulating the continuous curvilinear capsulorhexis procedure during cataract surgery on the EYESI system.

This paper describes a technique for simulating the capsulorhexis procedure during cataract surgery on the EYESI system. The continuous curvilinear capsulorhexis technique can be a difficult procedure for beginning ophthalmology surgeons. In the initial phase of tearing the tissue, the tear vector is tangential to the circumference of the tear circle. However, without the proper re-grasping of the flap of torn tissue close to the tear point, the tear vector angle quickly runs downhill possibly causing severe damage to the tissue. Novice surgeons tend to try to complete the capsulorhexis without the time consuming re-grasping of the tissue flap. Other factors such as anterior bowing of the lens diaphragm, patient age, and shallow anterior chambers add to the problematic nature of the procedure. The tissue area is modeled as a curvilinear mesh of nodes and springs. Deformation is accomplished via a physically based particle model utilizing a heuristic algorithm to constrain the deformation calculations to the locality of the tear area to speed up computations. The training software alerts the user of any potential tear problems before they occur thus instructing the novice surgeon. The EYESI hardware system (from VRMagic GmbH) provides the user with stereoscopic images thus providing 3D viewing. Our capsulorhexis simulator software models a number of tear problems and anomalies to provide a useful training environment without the dangers of using live patients.

Capsulorhexis↗
PubMed2002

Using virtual reality technology for aircraft visual inspection training: presence and comparison studies.

The aircraft maintenance industry is a complex system consisting of several interrelated human and machine components. Recognizing this, the Federal Aviation Administration (FAA) has pursued human factors related research. In the maintenance arena the research has focused on the aircraft inspection process and the aircraft inspector. Training has been identified as the primary intervention strategy to improve the quality and reliability of aircraft inspection. If training is to be successful, it is critical that we provide aircraft inspectors with appropriate training tools and environment. In response to this need, the paper outlines the development of a virtual reality (VR) system for aircraft inspection training. VR has generated much excitement but little formal proof that it is useful. However, since VR interfaces are difficult and expensive to build, the computer graphics community needs to be able to predict which applications will benefit from VR. To address this important issue, this research measured the degree of immersion and presence felt by subjects in a virtual environment simulator. Specifically, it conducted two controlled studies using the VR system developed for visual inspection task of an aft-cargo bay at the VR Lab of Clemson University. Beyond assembling the visual inspection virtual environment, a significant goal of this project was to explore subjective presence as it affects task performance. The results of this study indicated that the system scored high on the issues related to the degree of presence felt by the subjects. As a next logical step, this study, then, compared VR to an existing PC-based aircraft inspection simulator. The results showed that the VR system was better and preferred over the PC-based training tool.

Adult↗
PubMed1995

Arizona Health Information Network: the collaborative administration and management of a statewide computing resource for health information.

The need to access current, relevant health care information transcends the boundaries of the library. Many computer-based tools are now available that provide access to this information where and when it is needed. However, the provision of these tools often requires a substantial commitment of resources in the form of staff expertise, computer hardware and software, and user training. The need to access current information is critical for health care providers and students at all points of care regardless of the institution size or location. Unfortunately, the resources necessary to provide access to information may not be equally available at all sites. The Arizona Health Information Network (AZHIN) joins together librarians and information systems specialists from eleven institutions throughout the state in an effort to share computing resources and expertise in order to improve the quality of health care delivery, education and research. This cooperative effort allows each institution to contribute both financially and in the form of staff expertise, based upon its size and available resources. Although the benefits of this type of cooperation seem obvious, in a competitive environment it is necessary for each member to retain independence. To balance cooperation and independence, a framework has been established to enable individual AZHIN member institutions to administer local access to the shared resources.

Academic Medical Centers↗
PubMed2004

Allied health professionals' use of online evidence: a survey of 790 staff working in the Australian public hospital system.

OBJECTIVE: To measure the impact of a state health department policy to provide allied health professional staff with access to a point-of-care, 24h, online evidence system in terms of awareness, use and clinical impact of the system on clinical practice; to identify perceived barriers to use, and differences in measures between seven professional groups (physiotherapists, occupational therapists, speech pathologists, dieticians, clinical psychologists, pharmacists and social workers). METHOD: A convenience sample of 790 allied health professionals from 65 randomly selected hospitals in New South Wales, Australia. A self-administered questionnaire was distributed. Rates of use, frequency and types of resources accessed were calculated. Comparisons between professional groups were undertaken using Chi-square analyses and t-tests. RESULTS: The results showed that 82% of allied health professionals had heard of the online evidence system, and of those 76% had used it. Pharmacists had the highest rates of use and social workers the lowest. Of users, 90% agreed that use of the system had the potential to improve patient care and 45% reported direct experience of this. Computer skills and easy access were significantly associated with use and frequency of use. Among non-users, lack of specific training in the use of the online evidence system and lack of time were the most frequently reported reasons for not using the system. However, among users there was no relationship between this training and the frequency or effectiveness of use, i.e. the ability to find the information required. CONCLUSIONS: Allied health professionals will use an online evidence system when it is provided, however there are marked differences in use by professional groups. General training aimed at improving computer skills appears more important in encouraging use of an online evidence system, than specific system-based training. Perceptions of organisational and professional support for allied health professionals to use online evidence as a legitimate part of their work play an important role in influencing system use.

Allied Health Personnel↗
PubMed1997

Improving access to knowledge-based health sciences information: early results from a statewide collaborative effort.

Access to biomedical literature has been shown to reduce the patient's length of stay and thus reduce the cost of the hospital visit. Unfortunately, access to the most current information, at the time and place of need, requires a substantial commitment of resources in the form of staff expertise, computer hardware and software, and user training. The cost of these resources may be prohibitively high for all but the largest institutions. The Arizona Health Information Network (AZHIN) brings together librarians, information systems specialists, and health care professionals from hospitals throughout the state in an effort to share resources and expertise. By reducing the cost of access, AZHIN has increased the availability of health-related information across the state. Progress in AZHIN's first two years is described.

Arizona↗
PubMed1993

Computer-assisted instruction in emergency ophthalmological care.

The use of computer-assisted instruction in medical education has increased steadily in the last decade with the availability of personal computers. Many computer-assisted instruction programs train the user to handle various forms of disease or injury. Our intent was to provide medical students with more experience in managing ophthalmological emergencies, and we therefore designed a computerized teaching system for emergency ophthalmological care. The system makes it possible for inexperienced students to develop these skills, without jeopardizing the patient's health during training. Colour illustrations help teach the student to judge clinical signs. First, two classes of altogether 35 students used the teaching system. The students were shown to have gained significantly better knowledge of conditions which had been presented to them by the computerized teaching, than of conditions which had not been presented in this way. After having used the system, two other classes were asked about their attitudes towards this teaching modality. A majority regarded it as a valuable or very valuable addition to traditional methods of teaching. This type of instruction system may improve the quality of ophthalmic teaching without increasing teaching staff requirements.

Attitude of Health Personnel↗
PubMed1982

Computer assisted planning of parenteral hyperalimentation therapy.

A computer program has been written to assist the physician in the planning of nutritional support. The program is divided into individual segments dealing with nutritional assessment, caloric requirements, hyperalimentation planning, and evaluation of nutritional therapy. Tables of anthropometric data have been fitted to exponential and polynomial equations in order to minimize data storage requirements and eliminate the need for interpolation schemes. Operation of the program does not require any form of reference material and prior computer training is not a prerequisite for program users. The program may be run on either a large desktop computer or a hand-held programmable pocket calculator with continuous memory and optional printer.

Anthropometry↗
PubMed2001

CASE tools and UML: state of the ART.

With increasing need for automated tools to assist complex systems development, software design methods are becoming popular. This article analyzes the state of art in computer-aided software engineering (CASE) tools and unified modeling language (UML), focusing on their evolution, merits, and industry usage. It identifies managerial issues for the tools' adoption and recommends an action plan to select and implement them. While CASE and UML offer inherent advantages like cheaper, shorter, and efficient development cycles, they suffer from poor user satisfaction. The critical success factors for their implementation include, among others, management and staff commitment, proper corporate infrastructure, and user training.

Computer-Aided Design↗
PubMed2006

[Deployment of a computerized physician order entry: description of the process and challenges].

The introduction of a system of computerized physician order entry (CPOE) decreases medication error rates by formalizing the drafting of the orders and providing alarms which announce potential side effects, drug interactions and overly high doses. The quality of the CPOE does not insure its success. Its deployment must be preceded by an assessment and update of the available computer resources, by training of the users and setting up a help-desk attainable 24 hours a day. The project must be lead by senior medical and nursing staff. A joint effort is the key to ensure the success of CPOE and facilitate its acceptability. CPOE provides opportunities for improving: patient safety, training of professionals, quality and efficiency of care. CPOE systems are an ideal basis to set up clinical protocols and clinical pathways.

Medical Order Entry Systems↗
PubMed2003

Training brain retraction in a virtual reality environment.

A computer based virtual reality system is presented allowing the user to train skills related to brain retraction. The system is designed and the core training system implemented and tested. The initial test shows promising results.

Brain↗
PubMed2006

Physician characteristics, attitudes, and use of computerized order entry.

BACKGROUND: Computerized physician order entry (CPOE) is a widely advocated patient safety intervention, yet little is known about its adoption by attending physicians or community hospitals. METHODS: We calculated the order entry rates of attending physicians at 2 hospitals by measuring the number of orders entered directly and dividing this by the sum of orders entered directly and those written by hand. These findings were paired with the results of a survey that assessed attitudes concerning the impact of CPOE on personal efficiency, quality of care, and patient safety. RESULTS: Three hundred and fifty-six (71%) of the 502 surveys were returned by physicians, whose median order entry rate was 66%. Forty-two percent of respondents placed at least 80% of their orders electronically (high use), 26% placed 21%-79% of their orders electronically (intermediate use), and 32% placed 20% or less of their orders electronically (low use). Sex, years since medical school graduation, years in practice at the study institution, and use of computers in the outpatient arena were not meaningfully different among the 3 groups. However, use of the system to place orders varied by specialty, and those with intermediate or high use of the system were more likely than low users to have used CPOE during training and to be regular users of computers for personal activities. These physicians were more likely to believe that CPOE enabled orders to be placed efficiently, that directly entered orders were carried out more rapidly, and that such orders were associated with fewer errors. CONCLUSIONS: The adoption of CPOE by attending physicians at community hospitals varies widely. In addition to purchasing systems that support physician work flow, hospitals intent on successfully implementing CPOE should emphasize the benefits in safety and quality of this new technology.

Attitude of Health Personnel↗