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PubMed1985

User involvement in the development and use of computer based systems for the health and rehabilitation sciences: reducing protocol test errors.

In this study an attempt was made to clarify conflicting results in the learner control literature. The learner control concept was redefined in order to include both choice and self investment variables. The combined effects of choice and self investment variables were considered in this study to be motivational variables which affect the learner's attitudes and performance on a computer assisted instructional task. The results of this investigation indicated overall differences in performance among treatment groups. An interaction effect between choice and self investment was found for the performance measure. The expected interaction and perceived control measures were not found. Various analyses of the postexperimental test protocol scoring errors were conducted in order to investigate the effectiveness of the computer assisted instruction (CAI) task. Completion of the CAI task seemed to decrease the number of scoring errors made on subsequent test protocols as compared to those who did not use the CAI task. Implications for the health and rehabilitation sciences are discussed.

Attitude↗
PubMed2006

Involving users in the design of a system for sharing lessons from adverse incidents in anaesthesia.

In this qualitative study using observation and interviews, 10 anaesthetists from five Departments of Anaesthesia in the North-West region of England were enlisted to participate in the design of an online system to allow the sharing of critical incidents. Respondents perceived that existing schemes had differing and sometimes conflicting aims. Reporting was used for reasons other than simply logging incidents in the interests of promoting patient safety. No existing scheme allowed the lessons learned from incidents to be shared between members of the professional group from which they arose. Using participants' suggestions, we designed a simple, secure, anonymous system favouring free-text description, intended to enable the on-line sharing and discussion of selected incidents. Seven incidents were posted during the 6-month pilot period. The practitioners in our study valued the opportunity to share and discuss educational incidents 'horizontally' within their community of practice. We suggest that large-scale reporting systems either incorporate such a function or allow other systems that permit such sharing to co-exist.

Anesthesia↗
PubMed2003

Involving users in the implementation of an imaging order entry system.

Physician order entry is a powerful function of a computerized hospital information system. Although designed to be clinician-driven, the imaging section of the order entry system may not be designed optimally to engage the clinician with imaging procedures logically organized for the clinician's typical work patterns. There also may be resistance among overburdened clinicians in having to take the time to learn a new computer system and to assume "clerk's duties" of entering imaging orders. A potential means to address clinician opposition is to cooperatively engage each clinical service in the design of an imaging order entry system with customized menus for each service. This article reports a step-by-step process for the implementation of an imaging order entry system with specialized menus for an orthopedic service. This implementation process includes (1) identification of key personnel, (2) familiarization with the system, (3) discussion and dialogue between key personnel, (4) addressing specific problems, (5) education and orientation of the target group, (6) initial implementation, (7) feedback and improvement, (8) demonstration project (time study) to foster acceptance, and (9) ongoing enhancement.

Attitude to Computers↗
PubMed2003

Design and introduction of an electronic patient record: how to involve users?

OBJECTIVES: Two forms of participatory design (PD) - management-dominated and end-users focused - are described in the design and introduction of an electronic patient record (EPR) for a mental health care centre. METHODS: Qualitative research methods were used to achieve a 'fine-grained' insight into the EPR development process and its impacts. These methods included interviews, document study and observation of project group meetings. RESULTS: Management-dominated PD is highly structured, led by managers and centred around rationalisation of work. End-user focused PD is more bottom-up oriented. Central in this approach are users' working patterns and user needs. In the case described, both forms actually lead to a poorly functioning EPR. It is explained why these results could be expected. CONCLUSION: Our findings suggest not to reject PD, but to find a more appropriate balance between the two forms of PD.

Community Mental Health Centers↗