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PubMedDate not supplied

Women's health nursing in the context of the National Health Information Infrastructure.

Nurses must be prepared to participate in the evolving National Health Information Infrastructure and the changes that will consequently occur in health care practice and documentation. Informatics technologies will be used to develop electronic health records with integrated decision support features that will likely lead to enhanced health care quality and safety. This paper provides a summary of the National Health Information Infrastructure and highlights electronic health records and decision support systems within the context of evidence-based practice. Activities at the Columbia University School of Nursing designed to prepare nurses with the necessary informatics competencies to practice in a National Health Information Infrastructure-enabled health care system are described. Data are presented from electronic (personal digital assistant) encounter logs used in our Women's Health Nurse Practitioner program to support evidence-based advanced practice nursing care. Implications for nursing practice, education, and research in the evolving National Health Information Infrastructure are discussed.

Adolescent↗
PubMed2002

Assessment of emergency medicine residents' computer knowledge and computer skills: time for an upgrade?

OBJECTIVE: To describe emergency medicine residents' (EMRs') personal computer (PC) use and educational needs and to compare their perceived and actual PC skills. METHODS: This was a prospective, cross-sectional study. Subjects were all EMRs at seven midwestern Accreditation Council for Graduate Medical Education (ACGME) residency programs. The EMRs completed a questionnaire about their PC use and ability to perform 23 tasks derived from two national retail-training programs. The tasks covered word processing, slide making, and Internet use. The EMRs then took a three-part test performing the skills in the questionnaire. Two independent raters scored the tests. Frequencies with 95% confidence intervals (95% CIs) were calculated for categorical data. Positive and negative predictive values were used to report information comparing residents' performance with their self-assessment of skills. Cohen's kappa was used to test agreement between raters. RESULTS: One hundred twenty-four of 158 (79%) eligible EMRs participated. Since not all participants engaged in all parts of the study, the sample size varies between 121 and 124. One hundred one of 122 (83%; 95% CI = 75 to 89) owned a PC. The EMRs use home PCs a mean of 3.8 hours/week for physician duties and use residency PCs 1.9 hours/week (range 0-20). Ninety-six of 122 (79%; 95% CI = 70 to 86) EMRs reported no formal PC training during residency. Thirty-five percent (43/122; 95% CI = 27 to 44) passed the word-processing test and 50% (62/123; 95% CI = 41 to 60) passed the slide-making test. Reasons for failure were because of errors and not having a presentable product. Thirty-eight of 122 (31%; 95% CI = 23 to 40) failed the literature search, including 33 who said they could perform it. One hundred fifteen of 123 (94%; 95% CI = 88 to 98) EMRs were able to find an Internet address, including ten who stated they could not. Twenty-one percent of the residents who attempted any test (26/124; 95% CI = 14 to 29) passed all three tests. There was no association between year of training and success on the tests (p = 0.374). Thirty-seven of 115 (32%; 95% CI = 24 to 42) EMRs said they had insufficient PC training to meet their physician needs. CONCLUSIONS: Emergency medicine residents have much access to computer technology and possess some computer skills; however, many are unable to produce a usable product or conduct a literature search. Emergency medicine residents have not had sufficient computer training prior to residency. The computer skills of EMRs should be assessed through skills testing rather than self-assessment, and computer training during residency should be improved.

Computer Literacy↗
PubMed2006

German dental faculty attitudes towards computer-assisted simulation systems correlated with personal and professional profiles.

BACKGROUND: Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted simulation (CAS) systems still appear to be underutilised. OBJECTIVES: To investigate the practical usage of CAS/computer-assisted learning (CAL) systems, the familiarity and level of use of CAS systems, as well as the acceptance of approved learning content and English as the language of instruction in CAS/CAL systems. METHODS: A survey was conducted in the Departments of Conservative Dentistry and Prosthetic Dentistry of all 32 dental schools in Germany. Besides investigating the usefulness of, familiarity with and level of current usage of CAS systems, the questionnaire also contained questions regarding each respondent's gender, age, academic rank, experience in academia and computer skills, all of which correlated with the responses. RESULTS: The response rate was 90% (112 out of 125). The use of CAS/CAL systems was considered 'partly' to 'very' useful for evaluating the acquisition of knowledge (83.9%), qualitative issues (73.2%) and processes (72.3%) of dental preparation exercises and complex treatment strategies. However, only about half the respondents reported that they knew of, and even fewer used, the following systems in preclinical or clinical training: EDUnet (KaVo, Germany) (46.3%/0.9 %), PREPassistant (KaVo, Germany) (50%/0.9%), or the DentSim system (DenX, Israel) (52.8%/1.9%). The virtual simulation system VRDTS-CP (Novint, USA), used by none of the respondents, was known to only 16.5%. Responders agreed at least partly to accept approved learning content (74.9%) and English as the language of instruction (82.1%) as the standards for CAS systems. CONCLUSION: The survey indicates a distinct discrepancy between a generally positive attitude towards the usefulness of computer technology for dental education, the level of familiarity with current computer systems and their actual use. However, two prerequisites for ultimately decreasing the cost and increasing the usage of CAS systems--the acceptance of approved learning content and English as the language of instruction in CAS systems--seem to be generally accepted by respondents.

Adult↗
PubMedDate not supplied

A new Internet resource for chronic kidney disease patients.

This paper focuses on the development of a portal in the World Wide Web (WWW), which captures and locates quality information for patients with chronic kidney disease (CKD). It examines the problems patients face when accessing and understanding information gleaned from Web sites and describes an idea from a Research Board Member to facilitate patient access to quality information. The idea germinated into the development of a patient specific Web site, providing one stop access and links to appropriate CKD information, assessed by patients and health professionals. Collaboration between the EDTNA/ERCA Research Board and CEAPIR the European Federation of Kidney Patients has enhanced the project.

Computer Literacy↗
PubMedDate not supplied

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↗
PubMed2004

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↗
PubMed2004

Assessing computer skills in Tanzanian medical students: an elective experience.

BACKGROUND: One estimate suggests that by 2010 more than 30% of a physician's time will be spent using information technology tools. The aim of this study is to assess the information and communication technologies (ICT) skills of medical students in Tanzania. We also report a pilot intervention of peer mentoring training in ICT by medical students from the UK tutoring students in Tanzania. METHODS DESIGN: Cross sectional study and pilot intervention study. PARTICIPANTS: Fourth year medical students (n = 92) attending Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. MAIN OUTCOME MEASURES: Self-reported assessment of competence on ICT-related topics and ability to perform specific ICT tasks. Further information related to frequency of computer use (hours per week), years of computer use, reasons for use and access to computers. Skills at specific tasks were reassessed for 12 students following 4 to 6 hours of peer mentoring training. RESULTS: The highest levels of competence in generic ICT areas were for email, Internet and file management. For other skills such as word processing most respondents reported low levels of competence. The abilities to perform specific ICT skills were low - less than 60% of the participants were able to perform the core specific skills assessed. A period of approximately 5 hours of peer mentoring training produced an approximate doubling of competence scores for these skills. CONCLUSION: Our study has found a low level of ability to use ICT facilities among medical students in a leading university in sub-Saharan Africa. A pilot scheme utilising UK elective students to tutor basic skills showed potential. Attention is required to develop interventions that can improve ICT skills, as well as computer access, in order to bridge the digital divide.

Adult↗
PubMed2006

Duke Surgery Research Central: an open-source Web application for the improvement of compliance with research regulation.

BACKGROUND: Although regulatory compliance in academic research is enforced by law to ensure high quality and safety to participants, its implementation is frequently hindered by cost and logistical barriers. In order to decrease these barriers, we have developed a Web-based application, Duke Surgery Research Central (DSRC), to monitor and streamline the regulatory research process. RESULTS: The main objective of DSRC is to streamline regulatory research processes. The application was built using a combination of paper prototyping for system requirements and Java as the primary language for the application, in conjunction with the Model-View-Controller design model. The researcher interface was designed for simplicity so that it could be used by individuals with different computer literacy levels. Analogously, the administrator interface was designed with functionality as its primary goal. DSRC facilitates the exchange of regulatory documents between researchers and research administrators, allowing for tasks to be tracked and documents to be stored in a Web environment accessible from an Intranet. Usability was evaluated using formal usability tests and field observations. Formal usability results demonstrated that DSRC presented good speed, was easy to learn and use, had a functionality that was easily understandable, and a navigation that was intuitive. Additional features implemented upon request by initial users included: extensive variable categorization (in contrast with data capture using free text), searching capabilities to improve how research administrators could search an extensive number of researcher names, warning messages before critical tasks were performed (such as deleting a task), and confirmatory e-mails for critical tasks (such as completing a regulatory task). CONCLUSION: The current version of DSRC was shown to have excellent overall usability properties in handling research regulatory issues. It is hoped that its release as an open-source application will promote improved and streamlined regulatory processes for individual academic centers as well as larger research networks.

Academic Medical Centers↗
PubMed2005

Molecular and cellular biology animations: development and impact on student learning.

Educators often struggle when teaching cellular and molecular processes because typically they have only two-dimensional tools to teach something that plays out in four dimensions. Learning research has demonstrated that visualizing processes in three dimensions aids learning, and animations are effective visualization tools for novice learners and aid with long-term memory retention. The World Wide Web Instructional Committee at North Dakota State University has used these research results as an inspiration to develop a suite of high-quality animations of molecular and cellular processes. Currently, these animations represent transcription, translation, bacterial gene expression, messenger RNA (mRNA) processing, mRNA splicing, protein transport into an organelle, the electron transport chain, and the use of a biological gradient to drive adenosine triphosphate synthesis. These animations are integrated with an educational module that consists of First Look and Advanced Look components that feature captioned stills from the animation representing the key steps in the processes at varying levels of complexity. These animation-based educational modules are available via the World Wide Web at http://vcell.ndsu.edu/animations. An in-class research experiment demonstrated that student retention of content material was significantly better when students received a lecture coupled with the animations and then used the animation as an individual study activity.

Audiovisual Aids↗
PubMedDate not supplied

A national education strategy to develop nursing informatics competencies.

Advances in the sophistication of information and communication technologies offer nursing practitioners opportunities for better information management, more complete documentation of their work, and knowledge development to support evidence-based nursing practice. However, a nursing culture that recognizes and adopts the contributions of technology to practice is required to take advantage of these opportunities. The nature of this change suggests a shift in emphasis from specialists in Nursing Informatics (NI) to NI being integrated into all four domains of nursing practice. The magnitude of change required on individual, organizational and professional levels points to the need for Nursing Informatics education strategies on a national level. Recognizing the role and history of NI specialists, defining NI and the required NI competencies are necessary first steps in developing such a plan. Expanding and adapting the educational infrastructure required to support this initiative follows. A working committee at the national level with representatives from a number of stakeholder groups is currently working on a National Nursing Informatics Project to address these issues. This article summarizes key points of an initial discussion paper.

Canada↗
PubMed1988

Women, work and computers.

The introduction of computers into the working environment may raise fundamental issues about the organization of work, the working environment and other fundamental social and health issues. This paper delineates some of these social and health issues and describes governmental and private initiatives designed to understand them and to prevent potential adverse effects. In addition, results of an ongoing study of a research project, the RAM project, on computerization and the psychosocial environment of work are described. Based on these data, recommendations for future programs and actions designed to maximize worker health and well-being, with a particular emphasis on women's roles and needs, are made.

Computer Literacy↗
PubMedDate not supplied

Nontraditional roles for certified pharmacy technicians in a pharmaceutical company.

OBJECTIVE: To describe nontraditional roles for Certified Pharmacy Technicians (CPhTs) within pharmaceutical industry. SETTING: Drug information department within a large biotechnology/pharmaceutical organization. PRACTICE DESCRIPTION: The Medical Communications department within Genentech uses a skills-mix staffing model in which employees with varying educational and training backgrounds work as a team on meeting the informational needs of consumers and health professionals who contact the company. One position within the department is that of Medical Communications Associate, responsible primarily for managing product inquiries. PRACTICE INNOVATION: Medical Communications Associates have degrees in life sciences or an equivalent combination of education and experience, including a minimum of 2 years of related experience in the health care industry. Currently, four of the seven Medical Communications Associates in the department are CPhTs. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Ability to recruit CPhTs for Medical Communications Associate positions, and job satisfaction of those hired into these positions. RESULTS: Critical basic skills needed for the Medical Communications Associate position include strong computer literacy, ability to multitask, and ability to work in an environment with frequent interruptions. Strong oral and written communications skills, customer service skills, ability to deal with stressful situations, product-specific knowledge, ability to work on a daily basis with Medical Communications Pharmacists, and knowledge of medical terminology are also important. The skills set of CPhTs matches these requirements, as evidenced by the experiences of the four staff members who have worked in the department for a total of 17 person-years. CONCLUSION: This nontraditional role for CPhTs can be rewarding and beneficial to all, affording an unique opportunity within the pharmaceutical industry. The skill set and experience of CPhTs can be used in the nontraditional pharmacy practice setting of drug information.

Certification↗