Active Learning Centre: utilization patterns of an interactive educational World Wide Web site.
(33/1298)
The advent of the World Wide Web (WWW) provides unique opportunities to transform medical education. Interactive computer assisted instruction has shown promising results but its growth has been impeded by logistical barriers. We designed an interactive WWW site--Active Learning Centre (ALC)--that offers a novel approach to these problems, combining remotely authored databases with computer-generated self-assessment tests. This study analyzes utilization and user assessment of the site. The site was found to be patronized mostly by students and health professionals from English-speaking countries. Users have been pleased with their experience and suggest further expansion of the ALC. Our data have also tentatively shown that their knowledge improved with repeated visits to the site. (+info)
Effectiveness of an information broker service.
(34/1298)
The many disparate databases existing within the same health care organization create confusion and frustration for the consumer trying to get integrated information. The purpose of this research was to create a regional service that would provide a customer oriented information broker service with a single point of contact and guaranteed performance. From 1/98-6/99 there were 34 requests made. 23 were completed on time, eight still in progress and three were late (86.46% on time, average late time 0.76 days). 13 clinical departments used the service. Data was integrated from twelve different data sources. The requests produced about 2 Gigabytes of integrated data (416,666 single spaced pages). The resources required were approximately 1.3 FTE ($65K in direct costs). The cost/page of integrated information was 19 cents. The benefit to cost ratio was at least 3 and most likely higher. Surveys of customers indicated high satisfaction with services and would both utilize the service again and recommend it to others. (+info)
User satisfaction and frustration with a handheld, pen-based guideline implementation system for asthma.
(35/1298)
OBJECTIVE: To evaluate clinicians' satisfaction and frustrations with the use of a handheld computer system that implements a guideline for management of childhood asthma exacerbations. SETTING: Nine primary-care pediatric practices. DESIGN: Survey component of a randomized, prospective before-after trial. INTERVENTION: Newton MessagePad outfitted with custom software (called "AsthMonitor") that assists in documentation of clinical findings and provides guideline-based recommendations. RESULTS: Overall, 3 users gave strongly positive global ratings while 6 users were neutral. The majority used the documentation functions concurrently with care. Except for recommendations to administer oxygen (which were unsupported by evidence), users found the recommendations appropriate and appreciated the reminders. Seven of 9 participants believed it took more time to document with AsthMonitor. CONCLUSIONS: Handheld computers are acceptable to some office-based practitioners to provide guideline-based advice within the context of the clinical encounter. (+info)
Medical student database development: a model for record management in a multi-departmental setting.
(36/1298)
Student records flow through medical school offices at a rapid rate. Much of this data is often tracked on paper, spread across multiple departments. The Medical Student Informatics Group at the University of Utah School of Medicine identified offices and organizations documenting student information. We assessed departmental needs, identified records, and researched database software available within the private sector and academic community. Although a host of database applications exist, few publications discuss database models for storage and retrieval of student records. We developed and deployed an Internet based application to meet current requirements, and allow for future expandability. During a test period, users were polled regarding utility, security, stability, ease of use, data accuracy, and potential project expansion. Feedback demonstrated widespread approval, and considerable interest in additional feature development. This experience suggests that many medical schools would benefit from centralized database management of student records. (+info)
Qualitative research and the profound grasp of the obvious.
(37/1298)
OBJECTIVE: To discuss the value of promoting coexistent and complementary relationships between qualitative and quantitative research methods as illustrated by presentations made by four respected health services researchers who described their experiences in multi-method projects. DATA SOURCES: Presentations and publications related to the four research projects, which described key substantive and methodological areas that had been addressed with qualitative techniques. PRINCIPAL FINDINGS: Sponsor interest in timely, insightful, and reality-anchored evidence has provided a strong base of support for the incorporation of qualitative methods into major contemporary policy research studies. In addition, many issues may be suitable for study only with qualitative methods because of their complexity, their emergent nature, or because of the need to revisit and reexamine previously untested assumptions. CONCLUSION: Experiences from the four projects, as well as from other recent health services studies with major qualitative components, support the assertion that the interests of sponsors in the policy realm and pressure from them suppress some of the traditional tensions and antagonisms between qualitative and quantitative methods. (+info)
Questionnaire survey of California consumers' use and rating of sources of health care information including the Internet.
(38/1298)
OBJECTIVE: To understand how Californians use and rate various health information sources, including the Internet. RESEARCH DESIGN: Computer-assisted telephone interviews through which surveys were conducted in English or Spanish. SUBJECTS: A household sample generated by random digit dialing. The sample included 1007 adults (18+), 407 (40%) of whom had access to the Internet. MAIN OUTCOME MEASURES: Past health information sources used, their usefulness and ease of use; future health information sources, which are trusted and distrusted; and concerns about integrating the Internet into future health information seeking and health care behaviors. RESULTS: Physicians and health care providers are more trusted for information than any other source, including the Internet. Among those with Internet access, a minority use it to obtain health information, and a minority is "very likely" to use e-mail to communicate with medical professionals or their own doctors and nurses, to refill prescriptions, or to make doctor appointments. Also, most of those with Internet access are "unlikely" to make their medical records available via the Internet, even if securely protected. CONCLUSIONS: The public, including frequent Internet users, has major concerns about the confidentiality of electronic medical records. Legislation may not assuage these fears and a long-term, open and collaborative process involving consumers and organizations from all the health care sectors may be needed for full public assurance. (+info)
Trained sensory panel and consumer evaluation of the effects of gamma irradiation on palatability of vacuum-packaged frozen ground beef patties.
(39/1298)
The objectives for this experiment were to determine the effects of gamma irradiation on 1) the palatability of vacuum-packaged frozen ground beef patties by trained sensory panel and 2) consumer evaluation of the taste of hamburgers made with those patties. Boxes (4.5 kg) of frozen (-28 degrees C) ground beef patties (113.4 g/patty, 19% fat) from a commercial supplier were irradiated at a commercial gamma irradiation facility at one of three levels (0, 3.0, or 4.5 kGy). All boxes were stored at 28 degrees C for 27 to 29 d after irradiation before evaluation by a trained descriptive attribute sensory panel and for 62 to 104 d after irradiation before consumer evaluation. The trained panel evaluated grilled patties for ground beef aroma intensity, off-aroma, and off-flavor on 4-point scales (4 = intense, none, and none; 1 = none, intense, and intense, respectively) and ground beef flavor intensity, tenderness, and juiciness on 8-point scales (8 = extremely intense, tender, or juicy; 1 = extremely bland, tough, or dry). Control patties had more intense (P<.05) ground beef aroma (3.1 vs 2.6), less off-aroma (3.3 vs 2.6), and more intense ground beef flavor (4.9 vs. 4.3) than irradiated patties. However, there were no differences (P>.05) in any sensory trait between frozen ground beef patties treated with 3.0 or 4.5 kGy of gamma irradiation. There were no differences (P>.05) among treatments for tenderness (6.3, 6.6, and 6.7) or juiciness ratings (5.7, 5.9, and 5.9), respectively, for 0, 3.0, and 4.5 kGy. The consumers evaluated taste of a hamburger that included their choice of condiments on a 10-point scale (10 = excellent; 1 = terrible). Hamburgers made with patties treated with 4.5 kGy were rated lower (P<.05) in taste than hamburgers made with either control patties or those treated with 3.0 kGy (6.5, 6.6, and 6.2, respectively, for 0, 3.0, and 4.5 kGy); however, all doses were rated at some level of "fair." These results imply that hamburgers made from ground beef patties irradiated under the conditions of this experiment would encounter little, if any, consumer acceptance problems at the 3.0 kGy dose and only slightly greater problems at the 4.5 kGy dose. (+info)
Which literature retrieval method is most effective for GPs?
(40/1298)
BACKGROUND: Evidence-based medicine requires new skills of physicians, including literature searching. OBJECTIVE: To determine which literature retrieving method is most effective for GPs: the printed Index Medicus; Medline through Grateful Med; or Medline on CD-ROM. METHODS: The design was a randomized comparative study. In a continuing medical education course, three groups of health care professionals (87 GPs and 16 other health care professionals) used one of the literature retrieval methods to retrieve citations on four search topics related to general practice. For the analysis in pairs, we used the search results of the 75 participants who completed all four assignments. As outcome measures, we used precision, recall and an overall search quality score; we also had a post-course questionnaire on personal characteristics, experience with computers, handling medical literature and satisfaction with course instruction and search results. RESULTS: The recall and overall search quality scores in the Index Medicus groups (n = 32) were higher (P = <0.001) than those in the CD-ROM groups (n = 31). In addition, the search quality scores in the Grateful Med groups (n = 12) were higher (P < 0.003) than those in the CD-ROM groups. There were no differences in precision. CONCLUSION: In the period 1994-1997, the printed Index Medicus was the most effective literature retrieval method for GPs. For inexperienced GPs, there is a need for training in electronic literature retrieval methods. (+info)