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With information technology affecting every area of the health service, increasing numbers of staff are looking for training to help them keep up. John Hepworth offers some guidelines for choosing the right course.
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One hundred sixty-one MEDLINE searches conducted by third-year medical students were analyzed and evaluated to determine which search moves were used, whether those individual moves were effective, and whether there was a relationship between specific search behaviors and the effectiveness of the search strategy as a whole. The typical search included fourteen search statements, used seven terms or "limit" commands, and resulted in the display of eleven citations. The most common moves were selection of a database, entering single-word terms and free-text term phrases, and combining sets of terms. Syntactic errors were also common. Overall, librarians judged the searches to be adequate, and students were quite satisfied with their own searches. However, librarians also identified many missed opportunities in the search strategies, including underutilization of the controlled vocabulary, subheadings, and synonyms for search concepts. No strong relationships were found between specific search behaviors and search effectiveness (as measured by the librarians' or students' evaluations). Implications of these findings for system design and user education are discussed.
The University of Illinois at Chicago (UIC) provides the campus community, including the main campus and three regional sites, with a local MEDLINE option through a GRATEFUL MED fixed-fee licensing agreement with the National Library of Medicine. Searching is available via the Internet. A password server and customized GRATEFUL MED clients were built in order to adapt this off-the-shelf product to match the look and feel of other UIC campus-wide Internet resources. Installation, documentation, and training issues affecting the success of the project are discussed.
The objectives of this study were to undertake a systematic review to determine the effectiveness of information skills training, to identify effective methods of training and to determine whether information skills training affects patient care. A systematic review, using an iterative approach to searching, was employed. Studies selected for inclusion in the review were critically appraised using a tool used in previous reviews. A tabular approach was used to provide a summary of each paper allowing synthesis of results. One thousand, three hundred and fifty-seven potentially relevant papers were located. On the basis of titles and abstracts, 41 potentially relevant studies were identified for potential inclusion. Further reading and application of the inclusion criteria left 24 studies for critical appraisal and inclusion in the review. Study designs included randomised controlled trials, cohort designs and qualitative studies. The majority of studies took place in US medical schools. Wide variations were found in course content and training methods. Eight studies used objective methods to test skills, two compared training methods and two examined the effects on patient care. There was limited evidence to show that training improves skills, insufficient evidence to determine the most effective methods of training and limited evidence to show that training improves patient care. Further research is needed in a number of areas.
The chief consumers of patient information--physicians--are often the last to actually use systems that are designed to provide that information quickly. The reasons for this are deeply entrenched, but if physicians are properly incentivized and adequately trained, they can leap this hurdle. Competitive advantage to hospitals is an immediate benefit, as well.
Using a "Who, What, Where, When, and How" approach, the author addresses multiple issues that must be considered during computer education planning and development. The nursing department usually has the largest number of people requiring computer education and their training must be coordinated with other departments, so a well-thought-out training plan is required. This article presents practical hints and helpful strategies for developing such a plan.
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The internet has become an everyday communication tool for countless people throughout the world. It has a variety of potential uses in education, practice and research, but only in the last decade have nurse researchers begun to take advantage of the multiple uses the internet has to offer. The author reviews the uses of the internet to conduct research and addresses challenges and issues that currently influence web-based research.
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We describe the FORUM project which is a computer-assisted learning tool written with hypertext and hypermedia software emphasizing student interaction. This project is designed to allow the user to teach himself uterine Magnetic Resonance Imaging, which is a rapidly expanding technique with a wealth of specific findings. The program is currently available for Apple personal computers and is intended for beginners or confirmed radiologists and gynaecologists.
OBJECTIVE: To determine if a preceptor and timely, individualized feedback improves the performance of physicians in searching MEDLINE using GRATEFUL MED in clinical settings. DESIGN: Randomized controlled trial. SETTING: A 300 bed primary to tertiary care teaching hospital. Computers were installed in wards and clinics of 6 major clinical services, and the emergency room, intensive care and neonatal intensive care units. SUBJECTS: All physicians and physicians-in-training from the departments of Medicine, Family Medicine, Surgery, Psychiatry, Pediatrics, and Obstetrics and Gynecology were included if they made patient care decisions for at least 8 weeks during the study period. INTERVENTION: All participants were given a 1-hour training class and 1 hour of individualized searching with 1 of the 2 study librarians. After training, participants were randomized to a control group who received no further intervention or to an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback by a study librarian on their first 10 searches, indicating search quality and providing suggestions for improvement. Feedback was mailed the first week day after the search was done. MAIN MEASURES: Baseline characteristics by study group, department and level of training, study participation rates, and searching rates. MAIN RESULTS: 308 of 392 eligible physicians joined the study. Participation was almost 80% with some variation by department and level of training. Excellent balance in the baseline characteristics was achieved for the 2 groups, as well as for the number who did first searches. Intervention group participants searched MEDLINE more often than did controls (3.5 searches per month vs 2.5 per month for controls, P = 0.046). The recall and precision for first searches for both groups was significantly less than that of librarians. The analysis of study data will be completed by September 1991. CONCLUSIONS: Clinicians are willing to do self-service searching of MEDLINE in clinical settings but their precision and recall are less than a trained librarian at baseline. Search skills enhancements are needed and the effect of feedback and preceptors is being tested. SOURCE OF FUNDING: U.S. National Library of Medicine and Ontario Ministry of Health.
OBJECTIVES: a) To present a review of ongoing health telematic applications in Cyprus. b) To promote the use of these health telematic applications in the Cyprus region. c) To help in the spin off of other health telematic applications thus enabling the offering of a better health service to the citizens. METHODS AND RESULTS: The health telematics applications include a medical system for emergency telemedicine (AMBULANCE and EMERGENCY-112 projects), a system for the evaluation of the risk of stroke by telemedicine (EROS), a diagnostic telepathology network in gynaecological cancer (TELEGYN), a collaborative virtual medical team for home healthcare of cancer patients (DITIS), and a health telematics training network (HEALTHNET). The paper refers to the set-up and characteristics of these applications and tries to relate them with the health policies that should be applied in Cyprus. CONCLUSIONS: It is anticipated that this paper will promote the importance of health telematics applications for Cyprus and increase the awareness on the possibilities that these applications offer for health policies in all levels of health related human resources.
OBJECTIVE: We examined the effectiveness of a one-on-one training strategy for advanced proficiency in computer information systems (CIS) by clinicians in a large Health Maintenance Organization (HMO). Specifically, this study assessed the level of self-reported improvement in CIS efficiency following one-on-one training, and assessed the perceived value of one-on-one training compared to other teaching methods. DESIGN: We performed a cross-sectional study using a paper-based survey of 129 clinicians practicing in the HMO. MEASUREMENTS: We used a multi-item satisfaction index to measure clinician satisfaction with the one-on-one training. We measured whether clinicians thought they were more efficient using the system after training. RESULTS: The one-on-one method was significantly preferred over other teaching methods. Compared to other CIS components, use of the electronic medical record (EMR) improved most following one-on-one training. Sixty-one percent of the clinicians reported major improvements (i.e., >3 on a 5-point Likert scale; five being the highest score) in using the EMR. CONCLUSION: Perceived effectiveness of one-on-one training and overall satisfaction were ranked high by clinicians. The findings support the assumption that clinicians value one-on-one training and value this training method above other methods.
Patient response is a critical aspect of successful POC technology implementation. This article presents the results of a pilot POC patient satisfaction study conducted at four home health agencies. Variables impacting patient receptiveness and recommendations for patient education are discussed to help agencies develop individual POC training and education plans.
This paper briefly describes major changes in the, management and organization of the English National Health Service from 1985. The information consequences of those changes and the central programme necessary both to realize and to achieve them, are summarized. The requirements for training flowing from these developments are analysed, as are some of the obstacles to be overcome in meeting them. The national programme of training in information management, currently in its third year, is set out, and its particular aims described.
OBJECTIVE: The purpose of this study was to investigate whether occupational therapy intervention that focused on teaching children to use word processing, either alone or with word prediction, was effective in improving the written communication skills of children with learning disabilities and handwriting problems. METHOD: A single-subject alternating treatments design was replicated across three children in grades 4 and 5. During the baseline phase the children wrote stories by hand; during the intervention phase, the children wrote stories, alternating among handwriting, word processing, and word processing with word prediction. Dependent variables focused on percentages of legible words, percentages of correctly spelled words, total amount written, and rate of writing. Data were analyzed by visual inspection. RESULTS: Results were variable. Two children had clear improvements in legibility when using either word processing alone or with word prediction. These same children demonstrated clear improvements in spelling when using word prediction. Though rate of writing was best for two children when using handwriting, relative to total amount produced, one method was not clearly preferable to another. CONCLUSION: Occupational therapy intervention involving word processing with word prediction improves the legibility and spelling of written assignments completed by some children with learning disabilities and handwriting difficulties. It is important to evaluate each child individually and provide training and ongoing support for technology use.