The Case Report: a newsletter from the Case Management Society of America: the presidents' messages.
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Case Management↗
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Results for “Computer Literacy”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Effects of diversity in cognitive restructuring skills on human-computer performance.
The objective of this study was to determine if more efficient performance in hierarchical computer environments could be obtained from field-dependent (low technical aptitude) individuals by manipulating information structuring requirements. A three-dimensional (task complexity, quality of integration, and level of differentiation) conceptual model was proposed to explain differences in memory organization which were suggested to lead to computer performance differences. The model was tested with 36 subjects, 18 identified as field-dependent and 18 as field-independent. The subjects performed the information search task under three task conditions, two structured by the experimenter and one by the subjects. The results indicated that the effects of differences in the organization of task information on computer performance time can be controlled for by providing subjects with a period of time dedicated to the acquisition of a system's structure.
Adolescent↗
Accessible Web design.
As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent undertaking the exercises. This activity has been tested, and hours have been allocated to individual tasks (see clocks), but these are intended only as a guide. The answers to the questions, along with any notes and reflections you make or other publications you find, should be kept in your CPD portfolio.
Computer Literacy↗
Student access and use of IT during general practice attachments.
As universities change the delivery of their medical undergraduate courses, many have started to develop the community as a learning resource. In Manchester, part of the rationale behind problem-based learning is that students become familiar with the tools for finding information. Within the medical school and its main teaching hospitals, students have access to varied information resources using IT. These are often less available from off-campus sites and particularly within general practice. Even where available, students may not use them. Initial evaluation suggests that IT facilities are particularly useful for students who have longer placements. However, students prioritize their use of time in the community and furnishing general practices with a computer and other IT equipment does not, in itself, promote use by the students unless there is a perceived need. Training and support within the practice needs to be undertaken to enhance the learning environment for the undergraduates.
Computer Literacy↗
Computer skills among trainee doctors.
Computer skills are an essential part of every field, including medicine. However, training in computers is limited mainly to clerical and paramedical staff. We conducted this questionnaire survey to assess the extent of training and the opinion of trainee doctors in obstetrics and gynaecology in Wales. The results showed that the computer skills among these doctors was low and the majority of them agreed that there was a need for training in computer skills to assist them in their career progress. In view of the findings of this survey, we feel that incorporation of computer skills courses in the training curriculum must be of benefit.
Computer Literacy↗
Predictors of women's Internet access and Internet health seeking.
A random, population-based sample of 431 women aged 18-74 in King County, Washington, USA, completed a survey module on Internet use and access. Level of mental health, level of general health perceptions, older age, and higher income predicted women's health-related Internet use. Participants without access reported various barriers to obtaining access; perceived lack of usefulness of the Internet as an information source and unfamiliarity with using this technology appear equally important reasons as financial cost for not adopting the Internet. Internet use motivators are complex; these findings have relevance to the design of Internet-based interventions.
Adolescent↗
Making distance education accessible for students who are deaf and hard-of-hearing.
Distance education is based on providing learning "anytime, anywhere." The design of many distance education courses, however, may actually erect barriers to the full participation of some students with disabilities, particularly those with hearing impairments. Without careful consideration, distance education could become learning anytime, anywhere, but not for anybody. It is not only unethical, but also illegal to ignore the special needs of these learners. The specific impact of such legislation on distance education for those students with hearing impairments will be addressed. Students with disabilities are often faced with a double digital divide that must be bridged. Universal design uses an excellent proactive approach to closing this digital divide caused by inaccessible courses. Each medium of transmission in distance education poses unique access barriers. Even within the same medium, what is best for one student or class may not be the most ideal accommodation in another situation. Individualized accommodation methods will be examined, and specific technologies and software will be discussed.
Communication Devices for People with Disabilities↗
Design and acceptability of patient-oriented computerized diabetes care reminders for use at the point of care.
Despite the widespread availability of guidelines for caring for patients with diabetes and decades of research on computerized reminder systems, large gaps in quality remain in diabetes care remain and computerized reminder systems are rarely used for patients with diabetes. We set out to develop and test the feasibility of a system that would overcome many of the barriers preventing the widespread use of point-of-care computerized reminders to improve diabetes care. Five primary care physicians and 32 patients with type 2 diabetes pilot tested the system. We set out to design and measure the preliminary acceptability of patient-oriented point of care computerized diabetes care reminders. The main findings of our study were that (1) the reports were well accepted by both patients and providers and (2) survey and audiotape data suggest that they may be helpful at improving the quality of outpatient care for patients with diabetes.
Ambulatory Care↗
Adolescents' perceptions toward the internet: a 4-T framework.
This study could be viewed as one of the initial attempts to probe adolescents' general perceptions toward the Internet. Through interviewing 40 adolescents in Taiwan, this study found the following 4-T categories for interpreting their perceptions toward the Internet, which included Technology, Tool, Toy, and Travel. Most adolescents perceived the Internet as a tool, implying that these adolescents, in general, held pragmatic views about the Internet. This paper further proposes a framework to elaborate the 4-T categories. The framework consists of the following two axes: one axis probably shows the ontology of the Internet, ranging from a "product" to a "process," whereas the other axis indicates the perceived feature of the Internet, varying from "functional" to "technical." It is finally suggested to carefully investigate the effects of people's Internet perceptions on their behaviors, as well as psychological and cognitive activities in Internet-related environments.
Adolescent↗
Internet access and use among homeless and indigent drug users in Long Beach, California.
There has been a growing interest in using the Internet to access a variety of populations for prevention education and health care. It is not clear that this is viable for homeless and other marginalized populations. The purpose of this study was to describe Internet access and use among a sample of homeless and indigent drug users. A brief questionnaire was developed to assess computer ownership, use, email, and Internet access and use. Participants were recruited through a community-based human immunodeficiency virus (HIV) prevention program. 265 participants completed the questionnaire. While 55% had ever used a computer in their lifetime, only 25% had ever owned a computer, 24% had ever had their own email account, 33% had access to a working computer in the last 30 days, 10% had sent or received email in the last 30 days, and 19% had surfed or accessed information on the Internet in the last 30 days. Logistic regression predicting lifetime use of a computer showed predictive factors of having completed high school (Odds Ratio [OR] = 4.5; 95% Confidence Interval [CI] = 2.41, 8.38) and number of days used amphetamines in the last 30 days, per 5 days of use (OR = 1.64; 95% CI = 1.18, 2.27). Inversely related were age, per 5 years of age (OR = 0.78; 95% CI = 0.65, 0.93) and number of days used marijuana in the last 30 days, per 5 days of use (OR = 0.97; 95% CI = 0.76, 0.99). Very low access and usage suggest that Internet-based public health education models be reexamined for this population. The association with amphetamine use may indicate a facilitating effect of amphetamine by heightening awareness and increasing wakefulness.
Access to Information↗
Skill sets for the home telehealth practitioner: a recipe for success.
Successful implementation of home telehealth programs require unique skills and personality traits of professionals driving the program. Understanding these traits and skills, and how they predict performance will help staff recognize superior applicants when recruiting individuals for such positions. An extensive literature review ties research published on human factors, what they are, the role they play in performance, and how this may translate into a successful telehealth program. We compared case examples of some successful home telehealth programs. Furthermore, a summary of problems approached and resolved by the home telehealth professionals illustrated decision making and action steps taken that correlated to research published on human factors. Further research is needed to validate the tools used by other fields of study to select and identify successful individuals.
Computer Literacy↗
Management of bibliographic information by Dutch researchers in general practice.
BACKGROUND: As a result of changes in information technology and the rapid growth of publications methods of searching the literature have changed. Systematic searching of the growing literature has become very important. It is not known whether researchers in general practice search systematically, and whether they have incorporated computerized sources in their research practice. OBJECTIVES AND METHODS: We aimed to assess the methods of literature research used by GPs. We interviewed eight GP researchers, two information specialists and a psychologist working in primary health care organizations. RESULTS: The GP researchers began their search in their private book collections, or asked colleagues for information. Later in the search process, they used computerized information sources. Medline on CD-ROM and the computer-based indexes of two Dutch journals were most widely used. The GPs found it difficult to locate the appropriate terms to describe their research questions. Knowledge of the methodology of literature research, and skills required to use the information sources efficiently were lacking. There was a need for instruction and training in the use of information sources. GPs need a telephone help desk where their questions can be answered adequately. CONCLUSIONS: GP researchers search the literature unsystematically. Although computerized databases were being used, knowledge and skills related to the use of these information sources must be improved.
Attitude to Computers↗
Age differences in attitudes toward computers.
It is commonly believed that older adults hold more negative attitudes toward computer technology than younger people. This study examined age differences in attitudes toward computers as a function of experience with computers and computer task characteristics. A sample of 384 community-dwelling adults ranging in age from 20 to 75 years performed one of three real-world computer tasks (data entry, database inquiry, accounts balancing) for a 3-day period. A multidimensional computer attitude scale was used to assess attitudes toward computers pretask and posttask. Although there were no age differences in overall attitudes, there were age effects for the dimensions of comfort, efficacy, dehumanization, and control. In general, older people perceived less comfort, efficacy, and control over computers than did the other participants. The results also indicated that experience with computers resulted in more positive attitudes for all participants across most attitude dimensions. These effects were moderated by task and gender. Overall, the findings indicated that computer attitudes are modifiable for people of all age groups. However, the nature of computer experience has an impact on attitude change.
Adult↗
Readiness of U.S. nurses for evidence-based practice.
Evidence-based practice is a systematic approach to problem solving for health care providers, including RNs, characterized by the use of the best evidence currently available for clinical decision making, in order to provide the most consistent and best possible care to patients. Are RNs in the United States prepared to engage in this process? This study examines nurses' perceptions of their access to tools with which to obtain evidence and whether they have the skills to do so. Using a stratified random sample of 3,000 RNs across the United States, 1,097 nurses (37%) responded to the 93-item questionnaire. Seven hundred sixty respondents (77% of those who were employed at the time of the survey) worked in clinical settings and are the focus of this article. Although these nurses acknowledge that they frequently need information for practice, they feel much more confident asking colleagues or peers and searching the Internet and World Wide Web than they do using bibliographic databases such as PubMed or CINAHL to find specific information. They don't understand or value research and have received little or no training in the use of tools that would help them find evidence on which to base their practice. Implications for nursing and nursing education are discussed.
Adult↗
Applied informatics for quality assessment and improvement.
In our hospital, transition planning for order entry and clinical documentation has presented an opportunity for process changes and the ability to capture quality initiatives into data warehouses, where they can be utilized for building evidence-based practice. For example, the order entry and clinical documentation system allows for data retrieval of performance measures set by organizations including the Joint Commission on Accreditation of Healthcare Organizations, Centers for Medicare & Medicaid Services, and National Quality Forum. These data will reside in one system where they can be mined and extracted for reporting. Details of this magnitude are crucial when developing a CPR that will serve as the primary data source of clinical information. As we continue to seek IT solutions to improve patient safety and provide quality care, the use of informatics as a foundation in quality programs will provide the structure and database needed to support evidence-based practice at the point-of-care and reduce potential for error.
Academic Medical Centers↗
Preserving quality as the site of medical education shifts.
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Ambulatory Care Facilities↗
Medical students' use of information resources: is the digital age dawning?
PURPOSE: One of the many challenges clinicians face is applying growing medical knowledge to specific patients; however, there is an information gap between information needs and delivery. Digital information resources could potentially bridge this gap. Because most medical students are exposed to personal computers throughout their education, this study postulated that students may be more comfortable using computer-based information resources within clinical interactions. METHOD: In 2001, the authors monitored second-year medical students' use of a unique digital textbook, UpToDate, as they transitioned from preclinical to clinical years at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. In 2002, at the end of their third year, students were surveyed about their preferred clinical information resources. RESULTS: Medical students rapidly adopted UpToDate as a clinical resource during their clinical clerkship as evidenced by a rapid growth in the electronic textbook's use. One hundred sixteen of a possible 154 students (75%) responded to the survey. More than 85% of respondents identified electronic sources as their primary resource (UpToDate 53%, MDConsult 33%; p <.001 when compared to paper resources). They also reported using the information resources on a daily basis and requiring less than 15 minutes to answer most of their clinical questions. CONCLUSIONS: This study clearly demonstrates that medical students embrace and use electronic information resources much more than has been reported among practicing clinicians. The current generation of students may be the leaders in a medical culture shift from paper to electronic resources.
Attitude of Health Personnel↗
Medical knowledge overload: a disturbing trend for physicians.
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Artificial Intelligence↗