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Do you Mini-Med School? Leveraging library resources to improve Internet consumer health information literacy.

Popular for engaging public interest in medical science while promoting health awareness, Mini-Med School (MMS) programs also afford important if largely unrealized opportunities to improve the health information literacy of attendees. With a growing population using the Internet to make health decisions, needed venues for improving Internet Consumer Health Information (CHI) literacy may be found in the MMS platform. Surveyed directors of MMS programs understand the need to include CHI, and successful programs at SUNY Stony Brook and elsewhere demonstrate the potential for collaboration with affiliated health sciences libraries to integrate CHI instruction into MMS curricula.

Academic Medical Centers↗

Overcoming remoteness in CME videoteleconferencing: "I want my MD TV".

Videoteleconferencing in continuing medical education (CME) is here to stay. In the growing health care climate, with increased mergers of institutions and facilities, education's reliance on this medium promises to grow. This project summary describes one large metropolitan institution's effort to improve the commitment to, use in, and effectiveness of videoteleconferencing in its multisite delivery of CME programs. The institution is a nationally renowned interdisciplinary teaching and research hospital health center, with more than 1000 beds. The medical staff numbers more than 1100. The CME program, accredited by the Medical Society of the State of New York, sponsors more than 44 activities a year, awarding over 13,000 certified category 1 CME credits and serving a combined total of over 806 participating MDs and DOs. A study team comprised of the Medical Board Education Committee's Chair-director of CME, an adult education consultant-professor of adult education, and a visual literacy consultant undertook a year-long qualitative research project to explore issues, unearth dilemmas in practice, and generate recommendations for future policy and practice related to videoteleconferencing. The primary objective was to derive strategies for enhancing the educational effectiveness and community building potential of videoteleconferencing at the hospital-health center.

Computer Literacy↗

A multidimensional evaluation of a nursing information-literacy program.

The goal of an information-literacy program is to develop student skills in locating, evaluating, and applying information for use in critical thinking and problem solving. This paper describes a multidimensional evaluation process for determining nursing students' growth in cognitive and affective domains. Results indicate improvement in student skills as a result of a nursing information-literacy program. Multidimensional evaluation produces a well-rounded picture of student progress based on formal measurement as well as informal feedback. Developing new educational programs can be a time-consuming challenge. It is important, when expending so much effort, to ensure that the goals of the new program are achieved and benefits to students demonstrated. A multidimensional approach to evaluation can help to accomplish those ends. In 1988, The University of Northern Colorado School of Nursing began working with a librarian to integrate an information-literacy component, entitled Pathways to Information Literacy, into the curriculum. This article describes the program and discusses how a multidimensional evaluation process was used to assess program effectiveness. The evaluation process not only helped to measure the effectiveness of the program but also allowed the instructors to use several different approaches to evaluation.

Adolescent↗

Computer speech-based training of literacy skills in neurologically impaired children: a controlled evaluation.

Twenty-two reading-disabled children were randomly assigned to one of four training conditions to evaluate the effectiveness of a computer speech-based system for training literacy skills. The sample included 17 children with significant neurological impairment of various etiologies (including spina bifida and hydrocephalus, seizure disorder, brain tumors, cerebral palsy, and head injury) and five developmental dyslexics. The training employed a "talking" computer system that provides synthesized speech feedback during the course of learning. The training conditions included three word recognition and spelling-training programs and a math-training control program. Three different literacy-training procedures were compared, with the size of the trained print-to-sound unit varying as letter-sound (LSD: train-->t/r/ai/n); onset-rhyme (OR: train-->tr/ain) and whole word units (WW: train-->train). All literacy-training groups made significant gains in word recognition and spelling, with the LSD- and OR-trained subjects making the greatest word recognition gains on the words that could be trained with segmented speech feedback (i.e., words with regular spelling-to-sound patterns). All literacy-training groups demonstrated significant transfer on uninstructed rhymes of instructed regular words, with the greatest degree of transfer achieved by the LSD-trained subjects. These findings suggest that the neurologically impaired children were able to profit from instructional procedures that segment the printed word into units corresponding to onsets, rhymes, and phonemes and that this segmentation training may facilitate transfer-of-training for them.

Analysis of Variance↗

Teaching of medical informatics in UME-21 medical schools: best practices and useful resources.

OBJECTIVES: Information-based decision making is important to modern medical practice. This report identifies learning objectives, teaching innovations, and student outcomes for teaching medical informatics (MI) in medical schools that participated in the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project. METHODS: Project reports by the UME-21 schools were analyzed, and curricular content was classified in terms of the five categories for MI literacy adapted from the Medical School Objectives Project. Student self-assessments of adequacy of exposure to MI were reviewed. RESULTS: Teaching methods included demonstrations, lectures, small-group tutorials, hands-on labs, and task-based assignments. The curriculum was taught during the first 3 years of medical school with medical librarians participating. Content examples in the five categories of medical literacy were: "Role of the Lifelong Learner" (accessing, evaluating, and using information and databases), "Role of Clinician" (obtaining patient information, using decision support), "Role of Educator/Learner/Communicator" (accessing information for patient education, student-teacher communication, studying Web-based cases, making presentations, accessing on-line course information), "Role of Researcher/Evaluator" (documenting patient encounters), and "Role of Manager" (using drug formularies and clinical guidelines). Seniors exposed to the UME-21 curriculum reported higher levels of exposure to MI than did untrained seniors 2 years earlier; however, seniors at non-UME-21 schools reported equally high levels. CONCLUSIONS: UME-21 schools developed creative materials for teaching students to use computers for learning, communication, and searching for information. Outcome measures suggest that MI has become an important curriculum topic in most medical schools.

Computer Literacy↗

Adolescents and the internet: health and sexuality information.

PURPOSE OF REVIEW: Adolescents are known to be frequent users of the Internet, but less is known about the frequency and nature of their searches for information about health and sexuality. In theory, the Internet offers adolescents unprecedented access to such information in a convenient and confidential way. In turn, this information may help them to seek medical care or advice. This article reviews new research relating to adolescents' uses of the Internet for health and sexuality information, including contextual adult population studies. RECENT FINDINGS: Adolescents are using the Internet in order to find health information on a range of subjects. Search engines are the primary strategy for such searches. The quality of the online experience is often limited by health/online literacy skills. The only reference to adolescents' quests for online information about sexuality was that they frequently sought this information from a Web site created primarily to provide information about sexually transmitted diseases. SUMMARY: Empirical research with adolescents on this subject is scarce. More research is needed regarding issues such as the impact of software filters on ability to access health information and the medium's potential to help and harm adolescents.

Adolescent↗

Nursing informatics knowledge and competencies: a national survey of nursing education programs in the United States.

An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as "novice" and "advanced beginners" in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice.

Clinical Competence↗

Library outreach: addressing Utah's "Digital Divide".

A "Digital Divide" in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine-- Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program.

Area Health Education Centers↗

Information literacy skills of occupational therapy graduates: a survey of learning outcomes.

OBJECTIVES: The purpose of this study is to assess whether recent graduates of the Ohio State University's Occupational Therapy division are applying information-seeking skills they learned as undergraduates, and to seek their advice on ways to improve information-literacy instruction for current and future occupational therapy students. METHOD: A survey was sent to a sample of graduates from 1995-2000. The results were entered into an SPSS database, and descriptive and inferential results were calculated to determine the information-seeking patterns of these recent graduates. RESULTS: A majority of the occupational therapy graduates who responded to the survey prefer to use information resources that are readily available to them, such as advice from their colleagues or supervisors (79%) and the Internet (69%), rather than the evidence available in the journal literature. Twenty-six percent (26%) of the graduates have searched MEDLINE or CINAHL at least once since they graduated. Formal library instruction sessions were considered useful by 42% of the graduates, and 22% of the graduates found informal contacts with librarians to be useful. CONCLUSIONS: Librarians and occupational therapy faculty must intensify their efforts to convey the importance of applying research information to patient care and inform students of ways to access this information after they graduate. In addition to teaching searching skills for MEDLINE and CINAHL, they must provide instruction on how to assess the quality of information they find on the Internet. Other findings suggest that occupational therapy practitioners need access to information systems in the clinical setting that synthesize the research in a way that is readily applicable to patient-care issues.

Computer Literacy↗

Physician Internet medical information seeking and on-line continuing education use patterns.

INTRODUCTION: Although physician Internet use patterns have been studied, little attention has been paid to how current physician learning and change theories relate to physician Internet information seeking and on-line learning behaviors. The purpose of this study was to examine physician medical information-seeking behaviors and their relevance to continuing education (CE) providers who design and develop on-line CE activities. METHODS: A survey concerning Internet use and learning was administered by facsimile transmission to a random sample of 2,200 U.S. office-based physicians of all specialties. RESULTS: Nearly all physicians have access to the Internet, know how to use it, and access it for medical information; the Internet's professional importance to physicians currently is in the area of professional development and information seeking to provide better care rather than for patient-physician communication. A particular patient problem was the most common reason for seeking information. The credibility of the source, quick and 24-hour access to information, and ease of searching were most important to physicians. Barriers to use included too much information to scan and too little specific information to respond to a defined question. DISCUSSION: The importance of the Internet to physician professional development is growing rapidly. Access to on-line continuing medical education must be immediate, relevant, credible, and easy to use. A sense of high utility demands content that is focused and well indexed. The roles of the CE provider must be reshaped to include helping physicians seek and construct the kind of knowledge they need to improve patient care.

Attitude of Health Personnel↗

Information-seeking behaviors and reflective practice.

INTRODUCTION: As they care for patients, physicians raise questions, but they pursue only a portion of them. Without the best information and evidence, care and patient safety may be compromised. Understanding when and why problems prompt physicians to look for information and integrate results into their knowledge base is critical and shapes one part of reflection about care. This study explores the role of the Internet in gathering medical information as one step in that reflective practice, the barriers to its use, and changes in utilization over time. METHODS: A questionnaire with 18 items adapted from previous studies was sent by facsimile to a randomly selected sample of U.S. physicians in all specialties and active in practice. RESULTS: Specific patient problems and latest research in a specific topic most often prompt physicians to search on the Internet. Younger physicians and female physicians were most likely to seek information on a specific patient problem. Only 9% of all respondents (n = 2,500) searched for information during a patient encounter. When unsure about diagnostic and management issues for a complex case, 41.3% chose to consult with a colleague or read from a text (22.8%). Searching most often occurred at home after work (38.2%) or during breaks in the day (35.7%). Most (68.7%) found the information they were looking for more than 51% of the time. Searching was facilitated by knowing preferred sites and access in the clinical setting. The greatest barriers to answering clinical questions included a lack of specific information and too much information to scan. DISCUSSION: Although physicians are increasingly successful and confident in their Internet searching to answer questions raised in patient care, few choose to seek medical information during a patient encounter. Internet information access may facilitate overall reflection on practice; physicians do not yet use this access in a just-in-time manner for immediately solving difficult patient problems but instead continue to rely on consultation with colleagues. Professional association Web sites and point-of-care databases are helpful. From physicians' use of the Internet, professionals in continuing medical education must learn which search engines and sites are trusted and preferred.

Attitude of Health Personnel↗

Providing internet lessons to oncology patients and family members: a shared project.

The paper describes the steps in a pilot study taken to develop and evaluate an Internet intervention for cancer patients and family members. The intervention was a shared project of two hospital departments; a volunteer oncology support service, Hope & Cope, and the Health Services Library. Forty subjects were surveyed on their computer use and interest, and of these, half used the Internet to access health and medical information. Of the 40 subjects, 28 participated in an innovative, one-to-one teaching session with a medical librarian where they learned to access Internet sites to find information specific to their needs and subsequently be more confident in their perceived ability to evaluate the information received. Follow up interviews found that the sessions were well received and at two months follow-up the participants attributed their positive well being in large part to the intervention. Internet use by oncology patients and family members in conjunction with skilled help has the potential to contribute in a timely fashion to the well being of those with cancer.

Adolescent↗

The effects of electronic mail on communication in two health sciences institutions.

A study was done during 1991-1992 to determine the perceived impact of electronic mail (E-mail) relative to other forms of communication in health sciences institutions. E-mail subscribers at two major health sciences institutions were sent 2919 surveys, and 823 (28%) completed survey instruments were returned. A significant positive impact of E-mail was found relative to other forms of communication (e.g., paper, phone) with regard to E-mail messaging, response rates, influence, value, formality, perceptions, errors in communication, cost-effectiveness, communication style, and other factors. Areas where no differences were found between communication mechanisms were also revealing. Technical problems, maintenance, and confidentiality of E-mail messaging were not found to be significant problems. Trends, value, and impact of E-mail use in health sciences institutions are also discussed.

Academic Medical Centers↗

The relationship of age, level of formal education, and duration of employment toward attitudes concerning the use of computers in the workplace.

The introduction of computer technology in the Canadian health care environment necessitates an adaptation by hospital employees in order to perform their jobs. One thousand twenty-two hospital staff were surveyed immediately following their initial orientation to computers. The survey identified attitudes toward change, and the use of computers in the workplace. Demographic data and job classifications of all respondents were tabulated. Hypotheses were tested regarding the relationships between age, formal education, and duration of employment, and attitudes toward computers and change. Results indicated a generally positive response toward the use of computers in the workplace and to change in general. However, statistically significant results were obtained indicating that age, level of education, and length of employment affect the degree of positive response to both computers and change. The results suggest that demographic variables such as age, level of education, and employment duration must be taken into consideration when planning for the implementation of computer systems in the health care setting.

Adult↗

[Physicians, internet and new knowledge. Utilization and efficiency of new continuing education media in the hospital].

BACKGROUND AND OBJECTIVES: The application of new information technologies will have a lasting impact on the physicians' working environment. Not only will classic learning methods change, but also ways of communication and strategies to find relevant information. This survey is designed to demonstrate current methods of and demand for continuing medical education and communication. METHODS: 110 participating physicians (26% female, 74% male) in nine different regional hospitals were asked regarding "continuing medical education", "communication" and "use of computerized technology". RESULTS: Most physicians regard their colleagues, scientific journals, textbooks and scientific meetings as most useful. The internet, scientific staff at research institutions and pharmaceutical representatives were valued as less useful. Physicians regarded scientific basis, speed and user-friendliness as the most important features of potential data and knowledge sources. Case specificity, German language and interactivity were viewed as less important. Most physicians expressed a growing need for education regarding use of e-mail as a communication tool and internet research techniques. CONCLUSION: Continuing medical education is in strong demand. The successful introduction of modern information technologies into physicians' daily work may and should be enhanced by specifically tailored training courses.

Adult↗

Internet user profile in the field of parasitology.

This study determined a profile of current Internet users in parasitology, their use patterns on the Internet for parasitologic purposes, and the Web sites they would recommend. In a European survey, 689 parasitologically engaged scientists were asked to fill out a questionnaire about Internet access, current problems, current and future use, and which Web sites they would recommend as well as about the use of e-mail. In all, 153 (22.2%) of the interviewees returned the questionnaire. Only one participant had no access to the Internet. Time expenditure was considered the main problem involved in use of the Internet. The Internet was mainly used for e-mail (96.1%); for literature research (93.5%); for reading of electronic journals (51.6%); and for gathering of information, e.g., about institutes and colleagues (58.2%) and about congresses (49.7%). In the future, 71.9% of the respondents would like to read electronic journals more often and 49.7% would like to use the web more intensively for acquisition of information about congresses, universities, and institutions. Requests for the future included an easier application of the browser software (33%) and a shorter response time (47.7%). The survey demonstrates that the Internet has assumed a definite place in the lives of researchers in the field of parasitology. Survey responses indicate a need for electronic journals. In our opinion, universities and parasitology societies should be urged to publish journals electronically on the Web. To diminish current problems involved in the finding of relevant information on the Internet, we strongly recommend careful reading of the instructions regarding the search engines used. Web pages with clear structures, small file sizes, precise HTML (hypertext markup language) key-word editing, and page titles would facilitate more accurate discovery of specific sites. In addition, there seems to be a need for regular publication of reviewed parasitology-link collections.

Computer Literacy↗

Defining the role of a PACS technologist.

As hospitals convert from conventional image processing to picture archiving and communication systems (PACS) technology, new job opportunities arose for PACS analysts, PACS system administrators, PACS operators, and PACS trainers. To support a PACS, these positions require education in computer information systems and work experience in information technology. At Texas Children's Hospital, new roles for radiologic technologists (RT) in supporting the operation of PACS were not recognized until after implementation of the filmless system. A new position entitled PACS technologis was created, but roles and responsibilities largely were undefined. The inadequate job description contributed to problems with appropriate utilization of the PACS technologist. The primary role of the technologist was nebulous, and the priority of tasks was undefined. There was an excessive volume of information and technology to be mastered. The role represented a new paradigm, so no template for the job description was available that encompassed the array of functions to be performed. The result was a "morph" of the RT and PACS analyst job descriptions that was contrived and unworkable. The role of the PACS technologist is vital to the operation of the radiology department that uses PACS. There is a well-established need for cross training of RTs in PACS. PACS technology is not taught in RT training programs. There are recurrent communications problems between RT and Information Technology (IT) personnel. The PACS technologist can participate in a number of activities that improve the overall level of proficiency in the imaging operation, such as specialized PACS training for RTs, collection and analysis of quality control data, and planning for installations of PACS acquisition modalities. RTs have acquired knowledge of medical terminology and human anatomy, imaging modalities, and workflow. These qualifications constitute a common basis for communication with other RTs, physicians, and other health care providers. In addition the appropriate candidate for PACS technologist should have computer software and hardware knowledge, interpersonal skills, oral and written communications skills, and analytical skills to troubleshoot issues. This report will describe the evolution of a more accurate job description for the PACS technologist, the relationship between the PACS technologist and the RT supervisor, and specific tasks are appropriate for the PACS technologist to perform.

Allied Health Personnel↗