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PubMed2001

Information technology sophistication in health care: an instrument validation study among Canadian hospitals.

Several empirical studies have shown that the use of computer-based information systems could have positive impacts on organizational performance. Many agree to say that health care organizations are no exceptions. But if one wishes to identify the effects of information technology (IT) on the delivery of care, one must be able to characterize IT for operationalization purposes. The primary objective of this research project is to develop and validate a measurement instrument of IT sophistication in the hospital milieu. Such instrument should provide hospital managers with a diagnostic tool capable of indicating the profile of their respective institutions in regard to IT adoption and comparing this profile to those of other similar medical centers. Both qualitative and quantitative data were collected in order to assess the psychometric properties of the measurement instrument. Overall, findings suggest a high-moderate level of functional sophistication, a somewhat low level of technological sophistication, and an even lower level of integration sophistication in all of the sampled medical centers. Hence, future investments shall therefore be directed towards the integration of clinical and administrative applications and the acquisition of more advanced technological devices, more specifically those, which allow direct capture of clinical data at the bedside.

Computer Literacy↗
PubMed1998

Determinants of microcomputer technology use: implications for education and training of health staff.

In hospitals and other Healthcare settings, increasingly, hands-on computer use is becoming an important behaviour for effective job performance. The literature has identified differences that relate to computer use between occupational categories in health services. The objectives of this study were to identify factors that determine computer acceptance among occupational groups in Community Health and to predict the factors that relate to computer use. A survey was administered to all Community Health staff in one health service area. Health administrators were found to have a significantly higher training in computers, a higher frequency of use and a higher level of skill for both applications (word processing (WP) and database (DB)) than nurses. The results of a regression analysis shows that about 55% of the variation in the use of WP is explained by computer skills, perceived usefulness (PU) and designation. In the case of DB use, PU was the only significant predictor explaining 53% of the variation. Both level of education and prior training were not significant predictors. The implication for health informatics education (and service training) of these findings is that, in the workplace, health professionals would use computers when they perceive it to be useful for performance in their jobs.

Administrative Personnel↗
PubMed1998

Computer-assisted creation of psychiatric advance directives.

Results are reported from a project that involved design, production, and feasibility testing of the use of a multimedia computer program to: 1) educate MH consumers about psychiatric advance directives (ADs), and 2) assist them in creating ADs. The feasibility results, based on a random sample of 60 adults meeting criteria for having a serious and persistent mental illness, were positive. Sixty-five percent of the sample were able to complete their ADs. Educational level, presence of a learning disability, and minority-group membership, but not diagnosis, were related to completion rates. The results dispel several popular myths about psychiatric ADs.

Adult↗
PubMed1993

Age differences in the performance of computer-based work.

This study investigated the extent to which age had an impact on the performance of computer-based work. Three simulated real-world computer-interactive tasks that varied in complexity and pacing requirements were evaluated. Ss included 65 women, ranging in age from 25 years to 70 years. The methodology encompassed physiological, subjective, and objective performance measures. The data indicated that previous computer experience and age had a significant impact on the performance of the 3 tasks. Increased age was associated with longer response times and a greater number of errors for all 3 tasks. Age also influenced perceptions of fatigue and task difficulty. The findings are discussed in terms of the implications for training and job design.

Adult↗
PubMed2001

Learning by imagining.

Five experiments were conducted to investigate the relative effectiveness of 2 alternative instructional strategies. Students who were engaged in studying worked examples that emphasized understanding and remembering procedures and concepts were compared with students who were engaged in imagining worked examples that emphasized imagining procedures and concepts. It was hypothesized that students who held prerequisite schemas would find imagining to have a beneficial effect on learning, compared with studying the material, whereas students who were less knowledgeable would find imagining to have a negative effect on learning, compared with studying. Experimental results were in accord with our hypotheses. It was concluded that, under specific circumstances, encouraging students to imagine procedures and concepts can substantially facilitate learning.

Adolescent↗
PubMed1994

Effects of conceptions of ability on anxiety, self-efficacy, and learning in training.

A field experiment of 76 employees studied the effects of induced conceptions of ability as either an acquirable skill or fixed entity on computer anxiety, computer efficacy beliefs, and the acquisition of declarative knowledge, drawing from social cognitive theory. The setting was an introductory microcomputer training course. The findings indicate that trainees in the acquirable skill condition experienced a significant decrease in computer anxiety between the pre- and posttraining assessments; however, trainees in the entity condition did not experience a significant change in computer anxiety. Also, trainees in the acquirable skill condition experienced a significant increase in computer efficacy beliefs, and trainees in the entity condition experienced a significant decrease in computer efficacy between the pre- and posttraining assessments. Contrary to expectations, the effects of the training intervention on the acquisition of declarative knowledge were not mediated by computer anxiety and computer efficacy beliefs. The significant results are consistent with deductions made from social cognitive theory.

Adult↗
PubMed1997

Relationship between conscientiousness and learning in employee training: mediating influences of self-deception and self-efficacy.

A field study of 97 employees tested a model of the mediating influences of self-deception and task-specific self-efficacy in the relationship between conscientiousness and learning. The setting was an introductory Windows 3.1 software training course. Findings indicated that, as hypothesized, self-deception and self-efficacy mediated the relationship between conscientiousness and learning. Specifically, conscientiousness was positively related to self-deception, which was negatively related to learning, and conscientiousness was positively related to self-efficacy, which was positively related to learning. In addition, 4 alternative models were estimated. The results of the tests of the 4 alternative models were not supported by the data, further substantiating the validity of the hypothesized model.

Adult↗
PubMed2004

Improving computer skill training: behavior modeling, symbolic mental rehearsal, and the role of knowledge structures.

Effective computer skill training is vital to organizational productivity. Two experiments (N = 288) demonstrated that the behavior modeling approach to computer skill training could be substantially improved by incorporating symbolic mental rehearsal (SMR). SMR is a specific form of mental rehearsal that establishes a cognitive link between visual images and symbolic memory codes. As theorized, the significant effects of SMR on declarative knowledge and task performance were shown to be fully mediated by changes in trainees' knowledge structures. The mediational role of knowledge structures is expected to generalize to other training interventions and cognitive skill domains. Our findings have the immediate implications that practitioners should use SMR for improving the effectiveness of computer skill training.

Adolescent↗
PubMed2005

Information about a layperson's knowledge supports experts in giving effective and efficient online advice to laypersons.

To give effective and efficient advice to laypersons, experts should adapt their explanations to the layperson's knowledge. However, experts often fail to consider the limited domain knowledge of laypersons. To support adaptation in asynchronous helpdesk communication, researchers provided computer experts with information about a layperson's knowledge. A dialogue experiment (N = 80 dyads of experts and laypersons) was conducted that varied the displayed information. Rather than sensitizing the experts to generally improve the intelligibility of their explanations, the individuating information about the layperson enabled them to make specific partner adjustments that increased the effectiveness and efficiency of the communication. The results are suggestive of ways in which the provision of instructional explanations could be enhanced in Internet-based communication.

Adult↗
PubMed1999

Meeting the information needs of clinicians for the practice of evidence-based healthcare.

This article reports on clinicians' use of library resources and the competencies they require to access information necessary for the practice of evidence-based healthcare. It is based on the results of a study commissioned by North Thames Region to identify the training needs of clinicians for the adoption and practice of evidence-based healthcare. Participants in this qualitative research study included librarians, clinicians (doctors, nurses and PAMs) and managers from four Acute and Community Trusts in and around London. The research indicates that the majority of clinicians recognize the need to keep up-to-date with changes in their specialty and many visit their libraries on a frequent basis, however, few appear to be searching for information with which to inform their immediate clinical decisions. Our sample acknowledged their low usage of journals such as Bandolier, the Health Effectiveness Bulletin and Journal of Evidence-Based Medicine. Similarly, low use of electronic databases, such as Cochrane and Cinahl, were reported. Examination of skill and self-efficacy levels in accessing and using information databases revealed wide variations across professions, specialities and Trusts. Qualitative research methods were employed to elicit the key competencies required to access clinically relevant research evidence, and a framework for integrating these competencies is presented.

Administrative Personnel↗
PubMed2000

Linking general practices to the medical schools: qualitative issues.

The University Linked Practices (ULP) programme links general practices involved in undergraduate medical education with computer services provided through the school of medicine and dentistry. In-depth interviews were conducted with 26 staff involved in teaching undergraduate medical students in 15 general practices across east London and Essex. The interview schedule focused on the use of the computer, IT experience and training needs and the use of the computer network as a resource in undergraduate teaching. It is important to work with curriculum planners to ensure that computers are fully integrated into new courses.

Computer Literacy↗
PubMed2001

Nursing informatics: yesterday, today and tomorrow.

Today, at the beginning of the 21st century, nursing informatics has become a part of our professional activities. Informatics has advanced the field of nursing by bridging the gap from nursing as an art to nursing as a science. This article discusses the major milestones that have influenced the growth of computer technology and the specific efforts that have influenced yesterday's creation of the nursing informatics movement. It also provides an overview of nursing informatics in today's health care industry, while highlighting the administrative, management, research and educational applications and initiatives. In addition, it provides an overview of Saba's Home Health Care Classification, a nursing language system that has influenced the field. Finally, it provides a prediction of how computer technology will impact the nursing profession in the 21st century.

Computer Literacy↗
PubMed2001

[Opinions of staff in the trial phase of standardized documentation of complementary psychiatric services].

A computerised standardised documentation system for non-hospital based psychiatric and psychosocial care is being developed in Saxony. A range of non-hospital based services was involved in the development process. Staff members were interviewed concerning their experience in using the documentation system. Results showed a critical appraisal by staff members, emphasising particularly (a) the investment of time required, and (b) the perceived usefulness of the documentation which was considered to be limited. Besides staff members feared that data protection issues might be disregarded and that data would be used to cut expenditure. Findings are compared with other studies assessing staff attitudes towards data collection in mental health services. It is concluded that the study adds to the existing evidence of staff scepticism towards computerised standardised documentation systems.

Adult↗
PubMedDate not supplied

[Telemedicine in pediatric oncology].

UNLABELLED: The telemedicine project of the Competence Net Pediatric Oncology of the German/Austrian Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) has as an initial step of its work-programme sent out a questionnaire to the 54 largest pediatric hematology/oncology units in Germany. Institutions were asked for their experience, motivation, existing infrastructure, and anticipated benefits and obstacles regarding the implementation of telemedicine in patient care and research. Of the 54 largest German Pediatric Oncology institutions asked, 46 completed the questionnaire (85 %). RESULTS: 1. The need for further detailed information on implementation and for help in technical realization of telemedicine applications was expressed by all participants. 2. The majority expected practical advantages from telemedicine communication and anticipated that telemedicine will increase quality in treating children with cancer. 3. Expert consultation (study chairman, reference radiologists) is stated as to be most important. 4. Thirty-three of 46 physicians (72 %) believe that telemedicine will reduce costs in medical care within the next years. 5. It is anticipated that the introduction of telemedicine is time consuming. 6. The lack of available medical informatics competence and manpower was regarded as the most important obstacle. 7. Data security and standardization, transfer speed and transmission quality are considered most important. 8. Most of the institutions (91 %) use computers in the management of patients. Fourty-four (96 %) are connected to the Internet. 9. Thirty-seven of 46 institutions were prepared to invest in the implementation of telemedicine. This analysis demonstrates that the use of telemedicine is expected to become standard in pediatric oncology, while the existing infrastructure and status of information regarding this subject at present are insufficient. The most pressing practical need for telemedicine applications is seen in the field of electronic expert consultation. Hence, the Telemedicine-Project of the GPOH Competence Net will focus on this aspect first.

Attitude of Health Personnel↗
PubMed1993

[Clinical documentation in obstetrics and collection of relevant data with reference to the structural reform law. Results of a survey of 72 clinics].

This study was conducted on the spread and usage of computer-aided software programme (GDS) in 72 obstetric departments. Standardised questionnaires were sent to universities and hospitals to ask for information on registered perinatal data. The record with the hand-written delivery book cannot record all data needed for quality protection as the PC is able to list. 89% of the obstetricians evaluate their clinical data regularly by statistical survey and classification. By analysing the general trend they can critically assess their actual obstetrical management. The PC is established in 83%, functions without technical problems in 92% and is optimal in the sequence of operation in 57% of all departments questioned. Overtime hours for the staff could be reduced in 11%, if a computer was used, and in 13% the nurses could take more care of mother and child because of less official red tape. Independent of the size of the department and the data processing knowledge of the staff, the software programme runs efficiently. The comprehensive basis data documentation with all perinatal and neonatal data is used to its full extent in 100% of the cases and documents the clinical effectivity. With regard to the standardised hospital quality control process by the modified requirements in the public health legislation, the directors of the hospital departments are able to assess the quality control and show economic independence.

Attitude of Health Personnel↗