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PubMed2005

Practical applications of usability theory to electronic data collection for clinical trials.

Pharmaceutical and device companies are more frequently considering and using electronic data collection (EDC) to collect patient-reported outcomes such as satisfaction and quality of life for clinical trials. The transition from paper-and-pencil data collection to EDC is not without risks. The unique context of clinical trials presents challenges that, if not addressed, can lead to expensive mistakes. The advantages inherent to EDC can easily be cancelled out without careful attention to the characteristics of the clinical setting. This paper provides an overview of EDC issues specific to clinical trials and health care settings. In particular, it evaluates usability issues associated with methods of EDC and suggests strategies to minimize potential problems. Lessons learned from usability testing in the unique setting of the clinical trial can be applied to other projects to decrease costs, enhance the quality of the data, and minimize time to analysis.

Clinical Trials as Topic↗
PubMed2002

Data acquisition in emergency medicine: electronic communication using free text.

OBJECTIVES: 1) To describe the content of medical data obtained from parents' use of free text during a computer interview; 2) To assess whether differences in parents' demographics or experience with computers differentiate their production of free text; and 3) To compare parents' entry of free text with the final physician-generated electronic medical record (EMR) regarding the chief complaint. METHODS: Data entered by parents during a prospective trial of electronic data entry were examined. Content analysis of parents' free text entries examined absolute word count and categorized entries by type of information. Demographic and technology-related variables were analyzed against the type of information and the absolute word count. Two reviewers independently judged agreement between parents' and physicians' data for the chief complaint. RESULTS: Of 100 parents enrolled, 30 entered data for the chief complaint using free text. Amount of free text entered ranged from 1 to 142 words with a median of 8 words. Parents' free text was categorized into 4 types of information: simple descriptive (n = 16), problem-focused (n = 7), descriptive plus a question agenda (n = 2), and descriptive with reference to past medical history (n = 5). Parental demographics and computer-related experience did not predict differential production of free text. Agreement between parents' and physicians' entries for the chief complaint was 80% (95% CI 66-94) [reviewer A] and 73% (95% CI 57-89) [reviewer B]. Seven of 30 parental entries (23%) provided data not contained in the EMR. CONCLUSIONS: When entering a chief complaint during an electronic interview, a majority of parents report descriptive data using short phrases. Good agreement between parents' and physicians' electronic report was demonstrated for the chief complaint.

Computer Literacy↗
PubMed2001

The emergency medicine department system: a study of the effects of computerization on the quality of medical records.

A template based computerized medical record system known as the Emergency Medicine Department System (EMDS) was installed in the emergency department of the National University Hospital, Singapore, replacing handwritten records. A study was carried out to show how the implementation of the EMDS improved the quality of medical records. A retrospective review of old manual records and the ones generated by the EMDS was done by means of a scoring system. The raw scores represent the amount of information captured. The calculated means of scores were then used to compare the records. It was found that EMDS improves the quantity of data capture over the old records in all sections compared. This was seen regardless of the experience of the user. The use of a non-structured generic template results in less data captured compared with a structured symptom-specific template. The design of questions has a great influence in that a double-choice question captures more data than single-choice questions. Building in 'locking' or enforcement mechanisms in the EMDS also helped achieve almost full capture of critical information, such as examination time.

Chest Pain↗
PubMed2002

Implications of document-level literacy skills for Web site design.

The proliferation of World Wide Web (Web) sites and the low cost of publishing information on the Web have placed a tremendous amount of information at the fingertips of millions of people. Although most of this information is at least intended to be accurate, there is much that is rumor, innuendo, urban legend, and outright falsehood. This raises problems especially for students (of all ages) trying to do research or learn about some topic. Finding accurate, credible information requires document-level literacy skills, such as integration, sourcing, corroboration, and search. This paper discusses these skills and offers a list of simple ways that designers of educational Web sites can help their visitors utilize these skills.

Computer Literacy↗
PubMed2004

Structure and content of chronic kidney disease information on the World Wide Web: barriers to public understanding of a pandemic.

Chronic kidney disease (CKD) is a pandemic and the need to inform those at risk has never been more important. The World Wide Web (WWW) is no w considered a key source of health information, but the quality and utility of this information has been challenged. In this article, we assess structural, content, and linguistic barriers to accessed CKD information and discuss the implications of limited Internet access to communicating health. Technical (number of hyperlinks), content (number of six core CKD and risk factor information domains included), and linguistic (readability and variation in readability) barriers were assessed for websites offered by 12 kidney disease associations. The Flesch Reading Ease Index method was used to estimate readability scores, and variation in the readability of information was assessed. Eleven websites met inclusion criteria. Six of 11 websites provided information in all 6 domains of CKD information. A mean of 4 hyperlinks (range 3-5) was clicked before CKD information was available and a mean of 6 hyperlinks (range 4-12) was clicked to access all available CKD information. Mean readability scores for all six domains of CKD information exceeded national average literacy skills and far exceeded the 5th grade level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. The WWW currently has little utility for informing populations at greatest risk for CKD. Barriers to accessing CKD information on the WWW are socioeconomic, technical, and linguistic. Having lower socioeconomic status, less access to computers and the WWW, multiple website hyperlinks, incomplete information, difficult readability, and significant variation in readability of CKD information on the WWW are social, structural, and content barriers to communicating CKD information. This may contribute to the growing epidemics of diminished public understanding about CKD, and disparities in CKD health status experienced by racial/ethnic minority populations globally.

Computer Literacy↗
PubMed1997

Evaluating the options for developing databases to support research-based medicine at the NHS Centre for Reviews and Dissemination.

The paper presents the results of a questionnaire survey and user interface review group experiments to determine the value and ease of use of the Database of Abstracts of Reviews of Effectiveness (DARE) and the NHS Economic Evaluations Database (NEED). The results are interpreted with other recent studies of the use of electronic databases, including the NHS Research Register User Requirements Specification. The study found that most frequent users of the DARE database tend to use the CD-ROM version. Librarians were found to have the greatest awareness of the databases, with relatively low levels of use by operational NHS Staff. Untrained users found the online databases difficult to access and had erroneous perceptions of the database content which were only realised when queries returned unexpected answers. Experienced users of online information systems tended to want more sophisticated search facilities than inexperienced users. Nearly all users in the review groups wanted to access the databases in conjunction with other information sources, such as the Cochrane Library, Medline and the ACP Journal Club, highlighting the need for cross organisational strategies for the dissemination of research-based information.

CD-ROM↗
PubMed1997

An interactive computer program for educating and counseling patients about genetic susceptibility to breast cancer.

Educating individuals who seek information about genetic testing for cancer susceptibility is a complex task. Because of the psychological and social risks to patients of being identified as susceptible to a genetic disorder, it is important that education take place before a patient undergoes gene testing. However, it is not known who will provide such education. Since primary care physicians have limited knowledge, time, and confidence with genetic counseling, they are not ideal educators. Genetic counselors are well trained to provide the service, but many patients lack access to them. Other specialists are scare. Interactive computers hold much promise as a supplemental or alternative modality for education. The authors describe their experience with developing an interactive CD-ROM on gene testing and breast cancer, and respond to anticipated criticisms of this technology.

Aged↗
PubMedDate not supplied

Overcoming interface problems in computerized monitoring of clinical outcomes.

Monitoring clinical outcome and its cost can improve the quality and efficiency of health care, and computers offer a cost-effective way to collect such data routinely. We report the development of a new computer system, including the initial requirements specified and experience with introducing a pilot system and then a commercially developed system in several sites. Problems met when designing, implementing, and operating the system are described, together with solutions to the problems. Costs and benefits of the system are assessed, and rules to follow in introducing computerized monitoring of clinical outcomes are suggested.

Anxiety Disorders↗
PubMed2003

Nurses resisting information technology.

Resistance in the workplace, by nurses, has not been extensively studied from a sociological perspective. In this paper, nurses' resistance to the implementation and use of computer systems is described and analysed, on the basis of semistructured interviews with 31 nurses in three UK NHS hospitals. While the resistance was not "successful", in that it did not prevent the implementation of the systems, it nonetheless persisted. Resistance took a wide variety of forms, including attempts to minimise or "put off" use of the systems, and extensive criticism of the systems, though outright refusal to use them was very rare. Resistance was as much about the ideas and ways of working that the systems embodied as it was about the actual technology being used. The patterns of resistance can best be summed up by the phrase "resistive compliance".

Attitude of Health Personnel↗
PubMed2003

A collaborative approach for improving information literacy skills of dental hygiene students.

BACKGROUND: Evidence-based practitioners need to develop proficiency in locating and evaluating necessary information from a variety of sources, a concept known as information literacy. One potential source of information is the World Wide Web; however, the wide range in the quality of information available through the Internet indicates a need for strong critical appraisal skills. OBJECTIVES: To facilitate development of these skills in dental hygiene students, dental hygiene faculty collaborated with a librarian to implement a project to improve information literacy skills and integrate the use of the Internet into dental hygiene course work. METHODS: Students were required to develop a scenario about an aspect of dental hygiene practice, such as client health concern, practice management, or selection of an appropriate dental hygiene therapy. Students were to search the Internet, locate and evaluate a website that could address their scenario, and post this information and additional comments to a text-based computer conferencing section of a class website. Web CT software, particularly the computer conferencing function, was used to support asynchronous online activities. Student evaluation of the assignment was conducted using a 5-point Likert scale. RESULTS: Mean ratings for structure variables ranged from 3.94 to 3.81. Slightly lower mean ratings for process variables, ranging from 3.74 to 3.21, suggest room for improvement to activities. Mean ratings for outcome variables, ranging from 4.42 to 3.29, suggest achievement of the desired learning outcomes. CONCLUSION: Evaluation results warrant the continued inclusion of asynchronous online activities in conjunction with face-to-face classroom instruction.

Computer Literacy↗
PubMed1998

Health Sciences Information Tools 2000: a cooperative health sciences library/public school information literacy program for medical assistant students.

Educating diverse groups in how to access, use, and evaluate information available through information technologies is emerging as an essential responsibility for health sciences librarians in today's complex health care system. One group requiring immediate attention is medical assistants. Projections indicate that medical assistant careers will be among the fastest growing occupations in the twenty-first century. The expanding use and importance of information in all health care settings requires that this workforce be well versed in information literacy skills. But, for public school vocational education staff charged with educating entry level workers to meet this specialized demand, the expense of hiring qualified professionals and acquiring the sophisticated technology necessary to teach such skills poses a dilemma. Health Sciences Information Tools 2000, a cooperative work-study information literacy program jointly formulated by the Wayne State University's Shiffman Medical Library and the Detroit Public Schools' Crockett Career and Technical Center, demonstrates that cooperation between the health sciences library and the public school is a mutually beneficial and constructive solution. This article describes the background, goals, curriculum, personnel, costs, and evaluation methods of Tools 2000. The Shiffman-Crockett information literacy program, adaptable to a variety of library settings, is an innovative means of preparing well-trained high school vocational education students for beginning level medical assistant positions as well as further education in the health care field.

Allied Health Personnel↗
PubMed2026

Assessing AI literacy and attitudes among medical students: implications for integration into healthcare practice.

PURPOSE: This study aims to assess AI literacy and attitudes among medical students and explore their implications for integrating AI into healthcare practice. DESIGN/METHODOLOGY/APPROACH: A quantitative research design was employed to comprehensively evaluate AI literacy and attitudes among 374 Lusaka Apex Medical University medical students. Data were collected from April 3, 2024, to April 30, 2024, using a closed-ended questionnaire. The questionnaire covered various aspects of AI literacy, perceived benefits of AI in healthcare, strategies for staying informed about AI, relevant AI applications for future practice, concerns related to AI algorithm training and AI-based chatbots in healthcare. FINDINGS: The study revealed varying levels of AI literacy among medical students with a basic understanding of AI principles. Perceptions regarding AI's role in healthcare varied, with recognition of key benefits such as improved diagnosis accuracy and enhanced treatment planning. Students relied predominantly on online resources to stay informed about AI. Concerns included bias reinforcement, data privacy and over-reliance on technology. ORIGINALITY/VALUE: This study contributes original insights into medical students' AI literacy and attitudes, highlighting the need for targeted educational interventions and ethical considerations in AI integration within medical education and practice.

Students, Medical↗
PubMedDate not supplied

Electronic health records documentation in nursing: nurses' perceptions, attitudes, and preferences.

A descriptive study of 100 nursing personnel at a large Magnet hospital in Southwest Florida was conducted to assess their needs, preferences, and perceptions associated with Electronic Health Record (EHR) documentation methods. Nurses' attitudes about the use of EHRs and their perceived effects on patient care were assessed. The five-item, Likert-type attitude scale explained 54% of the variance in attitude scores and demonstrated sound construct validity and internal consistency (r = 0.77). More than one third, 36%, perceived that EHRs had resulted in a decreased workload. The majority of nurses, 64%, preferred bedside documentation but reported that environmental and system barriers often prevent EHR charting at the bedside. Overall, 75% of nurses thought EHRs had improved the quality of documentation and 76% believed electronic charting would lead to improved safety and patient care. Nurses with expertise in computer use, 80%, had a more favorable attitude toward EHRs than those with less expertise. Results have been used to implement clinical system changes.

Adult↗
PubMed2003

Information literacy: instrument development to measure competencies and knowledge among nursing educators, nursing administrators, and nursing clinicians: a pilot study.

This poster describes a pilot study conducted to establish validity and reliability of an instrument that will be used in a nationwide needs assessment, implemented to identify gaps in Information Literacy skills, competencies, and knowledge among key nursing groups nationally. Data and information gathered using the tool will guide the profession in developing appropriate education and continuing education programs to close identified gaps and enhance nurses' readiness for Evidence-Based Practice (EBP).

Computer Literacy↗
PubMed2003

Nursing information technology knowledge, skills, and preparation of student nurses, nursing faculty, and clinicians: a U.S. survey.

Because health care delivery increasingly requires timely information for effective decision making, information technology must be integrated into nursing education curricula for all future nurse clinicians and educators. This article reports findings from an online survey of deans and directors of 266 baccalaureate and higher nursing programs in the United States. Approximately half of the programs reported requiring word processing and e-mail skill competency for students entering nursing undergraduate programs. Less than one third of the programs addressed the use of standardized languages or terminologies in nursing and telehealth applications of nursing. One third of the programs cited inclusion of evidence-based practice as part of graduate curricula. Program faculty, who were rated at the "novice" or "advanced beginner" level for teaching information technology content and using information technology tools, are teaching information literacy skills. The southeastern central and Pacific regions of the United States projected the greatest future need for information technology-prepared nurses. Implications for nurse educators and program directors are discussed.

Computer Literacy↗
PubMedDate not supplied

A survey study of pediatric nurses' use of information sources.

This survey study explored use of different information sources among a convenience sample of 113 bedside pediatric nurses. The study was guided by three interrelated concepts: types of information sources, levels of evidence, and computer skill. The Nursing Information Use Survey measured use of information sources, impact of information sources on nursing care, barriers to information, and expectations that a computerized clinical desktop or patient information management system would improve patient care. Significant correlations between use of interpersonal and non-computer-based information and non-computer- and computer-based information supported the conceptual model. Use of traditional, non-computer information sources such as textbooks and print-based journals was higher among baccalaureate, compared with diploma, prepared nurses. Nurses with greater computer and online searching skill used more computer-based information. Findings suggested that strategies to improve nurses' computer and information searching skills may promote use of higher-level evidence in planning nursing care.

Adult↗
PubMed2004

Internet usage by low-literacy adults seeking health information: an observational analysis.

BACKGROUND: Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. OBJECTIVE: The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. METHODS: Subjects (n=8) were enrolled in a reading assistance program at Bidwell Training Center in Pittsburgh, PA, and read at a 3rd to 8th grade level. Subjects conducted self-directed Internet searches for designated health topics while utilizing a think-aloud protocol. Subjects' keystrokes and comments were recorded using Camtasia Studio screen-capture software. The search terms used to find health information, the amount of time spent on each Web site, the number of Web sites accessed, the reading level of Web sites accessed, and the responses of subjects to questionnaires were assessed. RESULTS: Subjects collectively answered 8 out of 24 questions correctly. Seven out of 8 subjects selected "sponsored sites"-paid Web advertisements-over search engine-generated links when answering health questions. On average, subjects accessed health Web sites written at or above a 10th grade reading level. Standard methodologies used for measuring health literacy and for promoting subjects to verbalize responses to Web-site form and content had limited utility in this population. CONCLUSION: This study demonstrates that Web health information requires a reading level that prohibits optimal access by some low-literacy adults. These results highlight the low-literacy adult population as a potential audience for Web health information, and indicate some areas of difficulty that these individuals face when using the Internet and health Web sites to find information on specific health topics.

Adult↗