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The training demands imposed by HIS installations are often substantial. And since hospitals have limited training budgets, quality can suffer. One hospital found that computer-based training (CBT) helped it meet the challenge.
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Through casual observations, formal consultations, and educational sessions, the authors have identified various indexing features of the National Library of Medicine's Medical Subject Headings (MeSH) that pose challenges to end users while attempting to obtain relevant retrieval when searching MEDLINE. These problematic features include the use of Explodes, Tree structures, subheadings, Text Word vs. subject heading searching, and central concept searching. End-user search software is becoming more sophisticated with an increasing number of choices offered for search strategy formulation. Methods of instruction to orient the end user to these systems will also have to become more detailed. A review of the literature, that discusses end-user problems with using MEDLINE and MeSH, is included.
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Researchers at the University of Washington have created and studied a computer-assisted, client-centered, prevention and education program that they hope will encourage risk-reduction behaviors and HIV testing, all on a more affordable basis.
OBJECTIVES: To compare two clinical workstations in one hospital with respect to technical, organizational, cultural and human factors. One clinical workstation was a GUI to the HIS. The other was an electronic patient record for stroke. METHODS: Data were collected by means of in-depth interviews with end-users of both clinical workstations. The interviews were audio taped and transcribed for analysis. RESULTS: End users assessed both clinical workstations as user friendly. Coordination between health care workers was perceived to be enhanced. However, in both situations poor communication between management, implementers and users resulted in uncertainty and skepticism about future perspectives. Further-more, it appeared that inpatient and outpatient settings needed clinical workstations with different requirements for an optimal fit between work practices and information system. CONCLUSIONS: Regardless of the domain and content of a workstation, it can support coordination between disciplines. The communication concerning the information technology strategy deserves much attention. Finally, the requirements for inpatient and outpatient workstations differ.
Colleague and PaperChase are the two most widely used computer systems designed specifically for clinicians and scientists who wish to search the National Library of Medicine's MEDLINE data base of references to the biomedical literature. The present study compares the performance of these two systems. Two matched groups of second-year medical students each received 3 hr of instruction, one group in Colleague, the other in PaperChase. Each student then attempted 10 test searches. The next day the groups were reversed, and each student attempted 5 additional searches. During 3 1/2 hr allocated for searching, users of Colleague attempted 64 test searches and retrieved 326 target references; users of PaperChase attempted 78 searches and retrieved 496. Users of Colleague took a mean of 2.2 min and spent a mean of $1.20 to find each target reference; users of PaperChase took 1.6 min and spent $0.92. We conclude that after limited training, medical students find more references faster and at lower cost with PaperChase than with Colleague.
Implementation of an ICU data management system requires consideration of many factors, including site preparation for equipment, system backup, ICU & medical staff training and evaluation. This paper describes the strategy for implementing a patient data management system at Cedars-Sinai Medical Center and details our steps for planning, training, configuration and problem resolution.
The purpose of this study was to identify nurses' computer training needs. A 20-statement questionnaire was circulated to 30 nurses. From the 26 responses received, a profile was created of the target group (nurses working in a teaching hospital), with a view to determining their current and desired level of knowledge. A number of diverse training needs were revealed through the study. The most interesting aspects, from the nurses' point of view, were those related to clinical practice and education. Figure one illustrates the low level of current knowledge of computer science. Figure two, however, demonstrates the high level of interest on the part of respondents (desired level) in becoming more computer literate and their wish to use computers in a wide range of applications, including teaching, health care delivery, clinical decision making and in-service training. Figure three highlights the training needs identified under each statement. The establishment of an information system in a teaching hospital setting is not dealt with in this article. This will be the subject of a second article, to appear next month. A number of teaching variables are described here, including the instructor, the learner, the training process itself, content, media and budgetary constraints. The outline of a training program will be proposed in a third and final article.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Evidence suggests that MEDLINE is becoming an important clinical tool that can improve the care and health of patients. Efforts to improve the quality and impact of end-user searching are needed and ongoing. End users are completing many MEDLINE searches. They appreciate and value training along with feedback on their searching techniques. Practice, is however, the biggest single factor in improving the quality of searching. Key roles for the library in end-user searching include, providing the most effective MEDLINE access possible to the maximum number of users, and providing training that includes feedback and practice opportunities. System-wide advances in structured abstracts, indexing, system design, informatics research and the literature itself will make searching easier and more effective in the future. More important than the quality of search results per se is the impact that end-user searches have on patient care and patient outcomes. Growing evidence shows that both patient care and patient outcomes are improved by end-user searches.
With the growing use of computers and on-line hospital information systems, a need exists for health care managers trained in computing and computer applications. This article reviews the advances in health care computing and reports on the design and implementation of a new course in a specific computer application, known as expert systems, in a health administration curriculum. The specific course framework is described and several student projects are presented and discussed.
This study examines how the cognitive and perceptual loads introduced by a word prediction feature impact learning and performance. Two groups of able-bodied subjects transcribed text using two row-column scanning systems for 10 consecutive trials each. The two systems differed only in that one system had a word prediction feature. Subject groups differed in their order of system use. The results show that, under the conditions of this study, the word prediction system was not substantially more difficult to learn, but it did not yield a statistically significant improvement in text generation rate. This suggests that the cost of using this word prediction system balanced the benefit of the keystroke savings achieved by these subjects. The relationship between keystroke savings, cost in item selection rate, and improvement in text generation rate is explored in order to provide insight into this outcome.
It is a fact that elderly peoples' life is characterized by problems such as deteriorating health and physical condition, feelings of loneliness, isolation, and of being dependent on others, in many aspects of their everyday lives. The objective of the RISE project is to provide an efficient vehicle for Health Care Professionals for improving Health Care, quality of life and integration of the elderly and disabled people with society by implementing Information technology applications. In particular, RISE project aims in developing a distributed network of service providers across the European Union, which will provide integrated types of services to the elderly and disabled population. The purpose of this paper is to present the impact of this project concerning the Health Informatics sector. It will describe the issues regarding, the needs for education and training of the professionals that arise by the introduction of this concept, and, the possible ways that such a concept forms an efficient vehicle for Health Professionals in assisting these particular groups of users. The longer perspective seeks to redefine and reshape the Health Care services' larger purpose, i.e. to make those comport with elementary individual needs of the elderly and disabled by introducing new methods of efficient health service provision. To achieve this there is an increased need for the training of the professionals. The outcome of RISE will be a set of specialised software components, tools and training methodologies designed to assist the Health Professionals achieving the aforementioned tasks.
Electronic access to on-line information is now available for dentists. One such resource is MEDLINE, a database of more than 7,500,000 biomedical references indexed by the National Library of Medicine. MEDLINE searching can be performed on-line or locally using a CD-ROM drive. Dentists should evaluate equipment requirements, availability of training, extent of the bibliographic database, ease of using the searching software and adequacy of documentation before selecting a mode of MEDLINE access.