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Karvouniari A, Karabetsos D, Kleisiaris CF, Karavasileiadou S, Baghdadi N, Kyrarini VA, Kasagianni E, Tsalkitzi A, Malliarou M, Melas C. Translation and Validation of Digital Competence Indicators in Greek for Health Professionals: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1370. [PMID: 39057513 PMCID: PMC11276525 DOI: 10.3390/healthcare12141370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/05/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals. METHODS in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients. RESULTS the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018. CONCLUSIONS The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals.
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Affiliation(s)
- Alexandra Karvouniari
- Department of Nursing, School of Health Science, Hellenic Mediterranean University, 71410 Heraklion Crete, Greece;
| | - Dimitrios Karabetsos
- Department of Neurosurgery, University Hospital of Heraklion, 71500 Heraklion Crete, Greece;
| | - Christos F. Kleisiaris
- Department of Nursing, University of Thessaly, Gaiopolis, 41500 Larissa, Greece; (C.F.K.); (M.M.)
| | - Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Nadiah Baghdadi
- Nursing Management and Education Department, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | | | | | | | - Maria Malliarou
- Department of Nursing, University of Thessaly, Gaiopolis, 41500 Larissa, Greece; (C.F.K.); (M.M.)
| | - Christos Melas
- Department of Nursing, School of Health Science, Hellenic Mediterranean University, 71410 Heraklion Crete, Greece;
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Mainz A, Nitsche J, Weirauch V, Meister S. Measuring the Digital Competence of Health Professionals: Scoping Review. JMIR MEDICAL EDUCATION 2024; 10:e55737. [PMID: 38551628 PMCID: PMC11015375 DOI: 10.2196/55737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured. OBJECTIVE This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments. METHODS Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality. CONCLUSIONS The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity.
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Affiliation(s)
- Anne Mainz
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Julia Nitsche
- Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Vera Weirauch
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Department Healthcare, Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
| | - Sven Meister
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Department Healthcare, Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
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Alowais M, Rudd G, Besa V, Nazar H, Shah T, Tolley C. Digital literacy in undergraduate pharmacy education: a scoping review. J Am Med Inform Assoc 2024; 31:732-745. [PMID: 38055635 PMCID: PMC10873839 DOI: 10.1093/jamia/ocad223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES Conduct a scoping review to identify the approaches used to integrate digital literacy into undergraduate pharmacy programs across different countries, focusing on methods for education, training, and assessment. MATERIALS AND METHODS Following the Joanna Briggs Institute methodology, we searched 5 electronic databases in June 2022: MEDLINE (Ovid), PubMed, Embase, Scopus, and CINAHL. Three independent reviewers screened all articles; data extraction was conducted by 2 reviewers. Any discrepancies were arbitrated by 2 additional reviewers. RESULTS Out of 624 articles, 57 were included in this review. Educational and training approaches for digital literacy in undergraduate pharmacy programs encompassed a theoretical understanding of health informatics, familiarization with diverse digital technologies, and applied informatics in 2 domains: patient-centric care through digital technologies, and the utilization of digital technologies in interprofessional collaboration. Blended pedagogical strategies were commonly employed. Assessment approaches included patient plan development requiring digital information retrieval, critical appraisal of digital tools, live evaluations of telehealth skills, and quizzes and exams on health informatics concepts. External engagement with system developers, suppliers, and other institutes supported successful digital literacy education. DISCUSSION AND CONCLUSION This scoping review identifies various learning objectives, teaching, and assessment strategies to incorporate digital literacy in undergraduate pharmacy curricula. Recommendations include acknowledging the evolving digital health landscape, ensuring constructive alignment between learning objectives, teaching approach and assessments, co-development of digital literacy courses with stakeholders, and using standardized guidelines for reporting educational interventions. This study provides practical suggestions for enhancing digital literacy education in undergraduate pharmacy programs.
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Affiliation(s)
- Mashael Alowais
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, 51911, Saudi Arabia
| | - Georgina Rudd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
| | - Victoria Besa
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
| | - Hamde Nazar
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
| | - Tejal Shah
- School of Computing, Newcastle University, Newcastle upon Tyne, NE4 5TG, United Kingdom
| | - Clare Tolley
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom
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Zainal H, Xiaohui X, Thumboo J, Kok Yong F. Digital competencies for Singapore's national medical school curriculum: a qualitative study. MEDICAL EDUCATION ONLINE 2023; 28:2211820. [PMID: 37186901 DOI: 10.1080/10872981.2023.2211820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Studies have shown that national-level initiatives to equip medical students with relevant digital competencies carry many benefits. Yet, few countries have outlined such competencies for clinical practice in the core medical school curriculum. This paper identifies current training gaps at the national level in digital competencies needed by students in the formal curricula of all three medical schools in Singapore from the perspectives of clinical educators and institutional leaders. It bears implications for countries that intend to implement standardized learning objectives for training in these digital competencies. Findings were drawn from in-depth interviews with 19 clinical educators and leaders of local medical schools. Participants were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis. Thirteen of the participants were clinical educators while 6 were deans or vice deans of education from one of the three medical schools in Singapore. While the schools have introduced some relevant courses, they are not standardized nationally. Moreover, the school's niche areas have not been leveraged upon for training in digital competencies. Participants across all schools acknowledged that more formal training is needed in digital health, data management, and applying the principles of digital technologies. Participants also noted that the healthcare needs of the population, patient safety, and safe procedures in the utilisation of digital healthcare technologies should be prioritized when determining the competencies needed by students. Additionally, participants highlighted the need for stronger collaboration among medical schools, and for a stronger link between current curriculum and clinical practice. The findings highlighted the need for better collaboration among medical schools in the sharing of educational resources and expertise. Furthermore, stronger collaborations with professional bodies and the healthcare system should be established to ensure that the goals and outcomes of medical education and the healthcare system are aligned.
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Affiliation(s)
- Humairah Zainal
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Xin Xiaohui
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Fong Kok Yong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Fitton R. Engaging the public in digital health. BMJ 2023; 382:2155. [PMID: 37748798 DOI: 10.1136/bmj.p2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
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McMillan B, Davidge G, Nadeem F, Dowding D, Wilson K, Davies A. Navigating the electronic health record in university education: helping health care professionals of the future prepare for 21st century practice. BMJ Health Care Inform 2023; 30:bmjhci-2022-100722. [PMID: 36914229 PMCID: PMC10016237 DOI: 10.1136/bmjhci-2022-100722] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Gail Davidge
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Fatima Nadeem
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Kurt Wilson
- Manchester Medical School, The University of Manchester, Manchester, UK
| | - Angela Davies
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
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Zainal H, Tan JK, Xiaohui X, Thumboo J, Yong FK. Clinical informatics training in medical school education curricula: a scoping review. J Am Med Inform Assoc 2023; 30:604-616. [PMID: 36545751 PMCID: PMC9933074 DOI: 10.1093/jamia/ocac245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This scoping review evaluates the existing literature on clinical informatics (CI) training in medical schools. It aims to determine the essential components of a CI curriculum in medical schools, identify methods to evaluate the effectiveness of a CI-focused education, and understand its delivery modes. MATERIALS AND METHODS This review was informed by the methodological guidance of the Joanna Briggs Institute. Three electronic databases including PubMed, Scopus, and Web of Science were searched for articles discussing CI between January 2010 and December 2021. RESULTS Fifty-nine out of 3055 articles were included in our final analysis. Components of CI education include its utilization in clinical practice, ethical implications, key CI-related concepts, and digital health. Evaluation of educational effectiveness entails external evaluation by organizations external to the teaching institute, and internal evaluation from within the teaching institute. Finally, modes of delivery include various pedagogical strategies and teaching CI using a multidisciplinary approach. DISCUSSION Given the broad discussion on the required competencies, we propose 4 recommendations in CI delivery. These include situating CI curriculum within specific contexts, developing evidence-based guidelines for a robust CI education, developing validated assessment techniques to evaluate curriculum effectiveness, and equipping educators with relevant CI training. CONCLUSION The literature reveals that CI training in the core curricula will complement if not enhance clinical skills, reiterating the need to equip students with relevant CI competencies. Furthermore, future research needs to comprehensively address current gaps in CI training in different contexts, evaluation methodologies, and delivery modes to facilitate structured training.
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Affiliation(s)
- Humairah Zainal
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Joshua Kuan Tan
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Xin Xiaohui
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Fong Kok Yong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Puranik C, Slavik A, Pickett K, Dani A, Generalovich Z, Neveaux L, de Peralta T. Development of integrated electronic medical and dental record competencies and impact of training modalities. J Dent Educ 2023; 87:660-668. [PMID: 36718532 DOI: 10.1002/jdd.13175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/23/2022] [Accepted: 12/17/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The American Recovery and Reinvestment Act provided incentives for the adoption of electronic health records. The integrated electronic medical and dental records (iEMDRs) can minimize healthcare charting errors. The use of iEMDR by healthcare students requires training and competence. There are no defined student competencies to assess the effective and responsible use of iEMDR in dentistry. The goal of this study was to propose a student competency model and study the impact of training modalities on iEMDR competency. METHODS This retrospective observational cohort study evaluated de-identified assessment scores (AS) and performance scores (PS) in predoctoral dental student (PDS) and advanced standing predoctoral (ASP) student cohorts that received remote or in-person iEMDR training. The AS and PS evaluated the knowledge and application of iEMDR, respectively. A voluntary survey evaluated students' self-perceived preparedness for iEMDR use. Linear regressions were used to determine the association between training modality and scores. Mantel-Haenszel ordinal chi-square tested differences between groups and agreement by training type. Statistical significance was set at 0.05. RESULTS The sample size (N = 214) provided 95% power to detect differences between study groups. The knowledge of iEMDR (AS) was not impacted due to the training type (p = 0.90) in either student cohorts, whereas the application of knowledge (PS) was higher in ASP student cohort after remote training (p < 0.001) as compared to PDS student cohort. Higher proportion of students perceived preparedness after remote learning in comparison to in-person training (p < 0.001). DISCUSSION The iEMDR competency model was useful to test the effective and responsible use of iEMDR, and remote training improved students' self-perceived preparedness.
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Affiliation(s)
- Chaitanya Puranik
- Department of Pediatric Dentistry, Children's Hospital Colorado and School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amanda Slavik
- Doctor of Dental Surgery Candidate, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kaci Pickett
- Center for Research Outcomes in Children's Surgery (ROCS), Children's Hospital Colorado, Aurora, Colorado, USA
| | - Aditee Dani
- Graduate Student in Analytics Program, University of Harrisburg, Harrisburg, Pennsylvania, USA
| | - Zora Generalovich
- Clinical Application Services, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lindsay Neveaux
- Department of Pediatric Dentistry, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Tracy de Peralta
- Senior Associate Dean of Academic Affairs and Inovation, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Seemann R, Mielke A, Glauert D, Gehlen T, Poncette A, Mosch L, Back D. Implementation of a digital health module for undergraduate medical students: A comparative study on knowledge and attitudes. Technol Health Care 2023; 31:157-164. [PMID: 35754241 PMCID: PMC9912741 DOI: 10.3233/thc-220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Digital competencies are more and more required in everyday work, and training future healthcare professionals in digital health is highly important. OBJECTIVE Aim of this study was to assess medical students' gain of knowledge by participation in a teaching module "Digital Health", and to evaluate their attitudes towards digital health and its role in medical education. METHODS Students of the module were asked to complete a questionnaire and a multiple-choice-test before and after completing the classes. Students of the same educational level in different modules served as reference group. RESULTS 34 students took part (n= 17 "Digital Health group"; n= 17 "reference group"). There was no significant difference in pre-existing knowledge between the groups. After having completed the module, participants reached significantly higher scores, compared to their preexisting knowledge (p< 0.05) and the reference group (p< 0.05). Most students found that digital medicine is not sufficiently represented in undergraduate medical education, but will influence everyday work of physicians in the next five years. CONCLUSIONS Students showed a high awareness for the impact of digital health on physicians' work. The results suggest that the format can sufficiently transfer knowledge about digital health. Teaching of digital knowledge and competencies should be firmly implemented into medical education to form digitally competent future doctors.
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Affiliation(s)
- R.J. Seemann
- Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - A.M. Mielke
- Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - D.L. Glauert
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - T. Gehlen
- Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - A.S. Poncette
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - L.K. Mosch
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - D.A. Back
- Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin, Berlin, Germany,Dieter Scheffner Center for Medical Education and Educational Research, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Corresponding author: David Alexander Back, Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin Scharnhorststrasse 13, 10115 Berlin, Germany. E-mail:
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Electronic Health Records That Support Health Professional Reflective Practice: a Missed Opportunity in Digital Health. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2023; 6:375-384. [PMID: 36744083 PMCID: PMC9892400 DOI: 10.1007/s41666-022-00123-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023]
Abstract
A foundational component of digital health involves collecting and leveraging electronic health data to improve health and wellbeing. One of the central technologies for collecting these data are electronic health records (EHRs). In this commentary, the authors explore intersection between digital health and data-driven reflective practice that is described, including an overview of the role of EHRs underpinning technology innovation in healthcare. Subsequently, they argue that EHRs are a rich but under-utilised source of information on the performance of health professionals and healthcare teams that could be harnessed to support reflective practice and behaviour change. EHRs currently act as systems of data collection, not systems of data engagement and reflection by end users such as health professionals and healthcare organisations. Further consideration should be given to supporting reflective practice by health professionals in the design of EHRs and other clinical information systems.
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Lokmic-Tomkins Z, Gray K, Cheshire L, Parolini A, Sharp M, Tarrant B, Hill N, Rose D, Webster M, Virtue D, Brignell A, Waring R, Broussard F, Tsirgialos A, Meng Cham K. Integrating interprofessional electronic medical record teaching in preregistration healthcare degrees: A case study. Int J Med Inform 2023; 169:104910. [PMID: 36343511 DOI: 10.1016/j.ijmedinf.2022.104910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments. OBJECTIVE To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings. METHODS A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university. RESULTS In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated. DISCUSSION The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project. CONCLUSION The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management.
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Affiliation(s)
- Zerina Lokmic-Tomkins
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia.
| | - Kathleen Gray
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Lisa Cheshire
- School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Arno Parolini
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Megan Sharp
- School of Social and Political Sciences, Faculty of Arts and Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Bronwyn Tarrant
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Nicole Hill
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - David Rose
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Marilyn Webster
- Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Debra Virtue
- Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Amanda Brignell
- Department of Audiology and Speech Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Rebecca Waring
- Department of Audiology and Speech Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Fiona Broussard
- Learning Environments, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Alex Tsirgialos
- Learning Environments, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
| | - Kwang Meng Cham
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia
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Burns N, Okorie M. The education and training of medical students in electronic prescribing. Pharmacol Res Perspect 2022; 10:e01011. [PMID: 36183173 PMCID: PMC9526800 DOI: 10.1002/prp2.1011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/15/2022] Open
Abstract
Education and training in prescribing for medical student often relies on the use of paper drug charts. With the pending elimination of paper prescribing in UK hospitals we look to address how educators can introduce eprescribing into medical undergraduate teaching of prescribing skills.
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Affiliation(s)
- Naomi Burns
- Brighton and Sussex Medical SchoolEast SussexUK
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Macpherson I, Arregui M, Marchini L, Giner-Tarrida L. Analysis of moral reasoning in dentistry students through case-based learning (CBL). J Dent Educ 2021; 86:416-424. [PMID: 34796479 DOI: 10.1002/jdd.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/11/2021] [Accepted: 10/31/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE The aim of this study was to develop a tool to analyze the ethical dimensions during dental students' decision making, by using case-based learning (CBL). METHODS Five clinical scenarios involving ethical aspects addressing different moral dilemmas were selected. The cases were then administered to students during a course on ethics, and the students responded using a narrative technique. To analyze the responses, a criterion inspired by Kohlberg's theory of moral development was used. Subsequently, the data were analyzed statistically, and possible associations between the answers and other variables, such as the student's gender and theoretical knowledge of ethics, were evaluated. RESULTS A total of 260 students participated (182 women and 78 men), and 1300 narratives were analyzed. The reliability of the construct, as tested by the Cronbach's alpha and the homogeneity index, was acceptable (0.7). The validity of the construct was also assessed, suggesting a component analysis. The descriptive analysis suggests a certain tendency to solve moral problems by referring to established norms and laws. Furthermore, the correlation anaylysis suggests the interrelation between dimensions linked to patient integrity and respect for the truth, even though this conclusion is not reflected in the component analysis, which only detects a generic component of moral sensitivity. No significant differences by gender were found in the narratives, nor a strong correlation of the responses with theoretical knowledge on ethics. CONCLUSION CBL through the narrative method on ethical dilemmas is an effective tool for assessing dental students' moral competencies and their possible interactions with other variables.
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Affiliation(s)
- Ignacio Macpherson
- Department of Humanities, Faculty of Humanities, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Spain
| | - María Arregui
- Department of Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Spain
| | - Leonardo Marchini
- Department of Preventive and Community Dentistry, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa, USA
| | - Luís Giner-Tarrida
- Department of Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Spain
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Videau M, Charpiat B, Vermorel C, Bosson JL, Conort O, Bedouch P. Characteristics of pharmacist's interventions triggered by prescribing errors related to computerised physician order entry in French hospitals: a cross-sectional observational study. BMJ Open 2021; 11:e045778. [PMID: 34635512 PMCID: PMC8506887 DOI: 10.1136/bmjopen-2020-045778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Computerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals. DESIGN This was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018. SETTING PISREs from 319 French computerised healthcare facilities were analysed. PARTICIPANTS Among the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists. RESULTS Among the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p<0.001). The PISRE ratio for senior pharmacists was 9.2% and that for pharmacy residents 5.4% (p<0.001). Concerning prescriptions made by graduate prescribers and those made by residents, the PISRE ratio was 8.4% and 7.8%, respectively (p<0.001). CONCLUSION Computer-related prescribing errors are common. The PI acceptance rate by prescribers was higher than that observed for PIs that were not CPOE related. This suggests that physicians consider the potential clinical consequences of SREs for patients to be more frequently serious than interventions unrelated to CPOE. CPOE medication review requires continual pharmacist diligence to catch these errors. The significantly lower PISRE ratio for certified software should prompt patient safety agencies to undertake studies to identify the safest software and discard software that is potentially dangerous.
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Affiliation(s)
- Manon Videau
- Pharmacy, Grenoble Alpes University Hospital, Grenoble, France
- CNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France
| | - Bruno Charpiat
- CNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France
- Pharmacy, Hopital de la Croix-Rousse, Hospices civils de Lyon, Lyon, France
| | - Céline Vermorel
- CNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France
| | - Jean-Luc Bosson
- CNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France
| | - Ornella Conort
- Pharmacy, Hopital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pierrick Bedouch
- Pharmacy, Grenoble Alpes University Hospital, Grenoble, France
- CNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France
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Cook K, Elder KG, Richter SK, Ronald K. Electronic Health Records in Pharmacy Skills-based Curricula. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8453. [PMID: 34301536 PMCID: PMC8499655 DOI: 10.5688/ajpe8453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
Electronic health records (EHRs) are integral to contemporary pharmacy practice. The use of EHRs and associated skill development in curricula across pharmacy education is variable. Skills-based courses in the Doctor of Pharmacy curriculum are ideal areas to develop these competencies' and integrate EHR use and skills with the Pharmacists' Patient Care Process. Consideration should be given by each school and college of pharmacy for having an EHR curriculum embedded within skills-based courses to prepare students for advanced pharmacy practice experiences as well as professional practice after graduation. A consensus on what skills or competencies should be consistently included in pharmacy curricula should be developed across pharmacy education to increase consistency in the delivery of EHR skills education and assessment. Emphasis on EHR skills and incorporation of them into national pharmacy education standards would help further guide development and assessment, as well as ensure new pharmacists are on the cutting edge of patient care and technology.
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Affiliation(s)
- Kristen Cook
- University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska
| | - Kimberly G Elder
- Sullivan University, College of Pharmacy and Health Sciences, Louisville, Kentucky
| | - Sara K Richter
- University of Health Sciences and Pharmacy, St. Louis, Missouri
| | - Katie Ronald
- Southern Illinois University, Edwardsville School of Pharmacy, Edwardsville, Illinois
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Watson CL. Time for change? A qualitative exploration of the educational preparation and subsequent continuing professional development needs of nurse and midwife prescribers. Nurse Educ Pract 2021; 54:103100. [PMID: 34089974 DOI: 10.1016/j.nepr.2021.103100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
AIM/OBJECTIVE The aim of this study was to explore nurse and midwife prescribers' perception of their educational preparation for the role and identify continuing professional development (CPD) requirements to generate practitioner-based knowledge with the potential to inform education and research, policy and practice. BACKGROUND Educational preparation for the nurse and midwife prescribing role has remained relatively unchanged since its introduction and follows a model whereby practitioners engage in theoretical learning and learning situated within the clinical environment, facilitated by a dedicated medical mentor. No significant examination of this preparation has been undertaken in Ireland since 2009. DESIGN This was a qualitative study, guided by elements associated with hermeneutic phenomenology. METHODS Following research ethics approval and informed consent, 16 participants from 2 maternity hospitals participated in one-to-one audio recorded semi-structured interviews. RESULTS Participants experience of the education programme varied with some acknowledging the importance of a broad pharmacological module whereas others believed it to be irrelevant given their prescribing scope was in many instances quiet narrow. The experience of being mentored by a medical doctor ranged from a positive learning experience to one which did not contribute to learning. Barriers to engaging with CPD were identified along with advancements in the practice arena which identify additional CPD requirements. CONCLUSIONS This study has generated practitioner-based knowledge which provides direction for future developments in the educational preparation of nurse and midwife prescribers, particularly around pharmacology and mentorship and outlines specific CPD requirements for practitioners.
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Affiliation(s)
- Chanel L Watson
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; Department of Adult and Community Education, Maynooth University, Maynooth, Ireland.
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Li S, Gong H, Pan J, Wu X. Relationship Between Undergraduate Nursing Students' Self-directed Learning and Training Demands for Nursing Information Systems: A Cross-sectional Study. Comput Inform Nurs 2021; 39:908-915. [PMID: 34010172 DOI: 10.1097/cin.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Self-directed learning refers to an approach to acquiring knowledge and skills in which learners take responsibility for themselves. Currently, it is a feasible way to familiarize with nursing information systems, which are essential components of hospital information systems and widely used in clinical nursing. This study assessed undergraduate nursing students' self-directed learning of nursing information systems and explored influencing factors, using a cross-sectional design and a convenience sample. Participants voluntarily completed a general information questionnaire, a training demands questionnaire for nursing information systems, and the Self-rating Scale for Self-directed Learning, which measured the level of self-directed learning. A total of 353 valid surveys were analyzed, among which 51.8% agreed with the necessity of mastering nursing information systems. Nursing students present a moderate level of self-directed learning, with an advantage in interpersonal skills and a deficiency in learning activities. Students' training demands, confidence in using nursing information systems in clinical practice, attitude toward nursing as a career, and academic performance were identified as predictors of self-directed learning for nursing information systems. Future cross-national research, studies about other factors, and ways to improve formal education are needed.
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Affiliation(s)
- Shijia Li
- Author Affiliations: Peking University School of Nursing (Ms Li, Ms Pan, and Dr Wu); and China-Japan Friendship Hospital, Beijing, China (Ms Gong)
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Beltran-Aroca CM, Ruiz-Montero R, Labella F, Girela-López E. The role of undergraduate medical students training in respect for patient confidentiality. BMC MEDICAL EDUCATION 2021; 21:273. [PMID: 33980240 PMCID: PMC8117324 DOI: 10.1186/s12909-021-02689-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Encouraging professional integrity is vital for providing a standard of excellence in quality medical care and education and in promoting a culture of respect and responsibility. The primary objective of this work consisted of studying the relationship of medical students to the right to patient privacy in Spain, specifically by analysing the conditions for accessing patient clinical histories (CHs). METHODS A cross-sectional study was conducted based on a questionnaire sent by e-mail to final-year students at 41 Spanish universities. It had 14 multiple choice and closed questions framed in 3 large blocks. The first question addressed basic general knowledge issues on the right to privacy and the obligation for confidentiality. The two remaining blocks were made up of questions directed towards evaluating the frequency with which certain requirements and action steps related to students attending patients were performed and regarding the guarantees associated with accessing and handling patient CHs both on paper and in the Electronic Medical Record. RESULTS A total of 245 valid replies were considered. A total of 67.8 % of participants were women, with an average age of 24.05 ± 3.49 years. Up to 90.6 % were aware that confidentiality affected the data in CHs, although 43.3 % possessed non-anonymized photocopies of patient clinical reports outside the healthcare context, and only 49.8 % of the students were always adequately identified. A total of 59.2 % accessed patient CHs on some occasions by using passwords belonging to healthcare professionals, 77.2 % of them did not have the patients' express consent, and 71.9 % accessed a CH that was not anonymised. CONCLUSIONS The role of healthcare institutions and universities is considered to be fundamental in implementing educational measures regarding the risks and ethical and legal problems arising from the use of CHs among professionals and students. A thorough study of medical ethics is needed through the analysis of clinical cases and direct exposure to situations in which the patient's confidentiality is questioned.
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Affiliation(s)
- Cristina M Beltran-Aroca
- Sección de Medicina Legal y Forense, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
| | - Rafael Ruiz-Montero
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
| | - Fernando Labella
- Sección de Oftalmología, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
| | - Eloy Girela-López
- Sección de Medicina Legal y Forense, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
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Aulenkamp J, Mikuteit M, Löffler T, Schmidt J. Overview of digital health teaching courses in medical education in Germany in 2020. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc80. [PMID: 34056069 PMCID: PMC8136344 DOI: 10.3205/zma001476] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 11/20/2020] [Accepted: 01/09/2021] [Indexed: 05/13/2023]
Abstract
Objective: The digitalization of the healthcare system poses new challenges for physicians. Thus, the relevance of learning digital competencies (DiCo), such as dealing with data sets, apply telemedicine or using apps, is already growing in medical education. DiCo should be clearly separated from digitized teaching formats, which have been increasingly used since the COVID 19 pandemic. This article outlines the faculties in Germany where DiCo are already integrated into medical education. Methods: Courses with DiCo as teaching content were collected by a literature research on Pubmed and Google as well as by contacting all dean's offices and other persons responsible for teaching at German medical faculties. The courses were summarized in a table. Results: In a first survey, 16 universities were identified that offer courses on DiCo. In the elective area at the universities, 17 courses and in the compulsory area eight courses could be identified. The scope and content of the courses diverged between compulsory curricula, integrated courses of different lengths, and elective courses that are one-time or longitudinally integrated. The topics taught are heterogeneous and include fundamentals of medical informatics such as data management on the one hand and a collection of e.g. ethics, law, apps, artificial intelligence, telemedicine and robotics on the other hand. Conclusion: Currently, only some German medical faculties offer courses on DiCo. These courses vary in scope and design. They are frequently part of the elective curriculum and only reach some of the students. The possibility of embedding DiCo in the already existing cross-sectional area appears limited. In view of the ongoing digitalization of healthcare, it is necessary to make future courses on DiCo accessible to all medical students. In order to drive this expansion forward, the implementation of the new learning objectives catalogue, in which DiCo are integrated, a network formation, a teaching qualification as well as the involvement of students is recommended.
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Affiliation(s)
- Jana Aulenkamp
- Universitätsklinikum Essen, Klinik für Anästhesiologie und Intensivmedizin, Essen, Germany
- *To whom correspondence should be addressed: Jana Aulenkamp, Universitätsklinikum Essen, Klinik für Anästhesiologie und Intensivmedizin, Hufelandstr. 55, D-45147 Essen, Germany, E-mail:
| | | | - Tobais Löffler
- Eberhard-Karls Universität Tübingen, Tübingen, Germany
- Bundesvertretung der Medizinstudierenden in Deutschland, Berlin, Germany
| | - Jeremy Schmidt
- Bundesvertretung der Medizinstudierenden in Deutschland, Berlin, Germany
- Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
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Foadi N, Koop C, Mikuteit M, Paulmann V, Steffens S, Behrends M. Defining Learning Outcomes as a Prerequisite of Implementing a Longitudinal and Transdisciplinary Curriculum with Regard to Digital Competencies at Hannover Medical School. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211028347. [PMID: 34368455 PMCID: PMC8299879 DOI: 10.1177/23821205211028347] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/09/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Worldwide educational programs face the challenge how to define and integrate digital competencies in medical education. This article describes the implementation of learning outcomes with respect to digital competencies in the compulsory curriculum at Hannover Medical School (MHH). METHODS An interdisciplinary MHH project group was constituted consisting of physicians and experts in medical informatics and in curriculum development. Over the course of 7 work sessions the group compared different international and national frameworks dealing with digital competencies for physicians. By a consensus driven approach the working group drew up a collection of learning outcomes which were regarded relevant to be incorporated in the curriculum at MHH. RESULTS The analysis of different frameworks indicated that data literacy is a central domain within all viewed preexisting catalogs. During the course of the project group analysis, 57 learning outcomes with respect to digital competencies were identified as necessary to be integrated in the compulsory curriculum. They were divided in 5 main categories: "handling of medical data," "the digital infrastructure of the health system," "scope of application: usage in patient care and in the field of preventive medicine," "medico-legal and ethical basics," and "transformation processes in medicine due to digitalization." CONCLUSIONS The MHH project group concluded that medical students should be taught digital competencies that enable an understanding of underlying functional principles of digital systems rather than their correct utilization. The presented project indicates that a close interdisciplinary collaboration of physicians and medical informaticians can be a promising approach to incorporate digital competencies in the undergraduate medical curriculum.
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Affiliation(s)
- Nilufar Foadi
- Dean’s Office, Hannover Medical School, Hannover, Germany
| | - Christian Koop
- Dean’s Office, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Dean’s Office, Hannover Medical School, Hannover, Germany
| | | | | | - Marianne Behrends
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
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Seemann RJ, Herbstreit S, Weber M, Erne F, Ansorg J, Back DA. [Potential of digitalization in undergraduate and postgraduate medical education and training in orthopedics and trauma surgery]. Unfallchirurg 2020; 123:836-842. [PMID: 33037457 DOI: 10.1007/s00113-020-00897-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In its digital agenda the German Federal Government pursues the ambitious objective to facilitate digital competence and perform research into digital learning and teaching processes. Considerable investments are to be concentrated into the future viability of education, academic research and digitalization. As far as academic teaching and further education are concerned, not only in the field of orthopedics and trauma surgery, three aspects can be identified: digital organization, digital competence and digital tools. DIGITAL APPLICATIONS New formats, such as the elective subject digital health of the Charité in Berlin, enable digital competences to be mediated in a multimodal and interdisciplinary way. With the help of a newly developed app the University of Essen provides teachers and students with mobile and flexible access to information on lectures in terms of content and organization. Especially because of transparency, high legal compliance and predictability, the digital logbook for the resident training program promises a real innovation for trainees in the further training reformation. Augmented and virtual reality play a crucial role in the imparting of practical skills and interconnect high-tech with classical craftsmanship. Digital training course formats have significantly gained in importance and are meanwhile well-established tools for efficient advanced medical training. OUTLOOK If orthopedic and trauma surgeons take an active role in the process of digitalization of teaching, they can take part in decisions, adequately prepare the colleagues of tomorrow, optimize patient care, encourage innovations and altogether improve the discipline even more.
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Affiliation(s)
- Ricarda J Seemann
- Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Stephanie Herbstreit
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Essen, Essen, Deutschland
| | - Markus Weber
- Klinik und Poliklinik für Orthopädie, Universität Regensburg, Asklepios Kliniken Bad Abbach, Bad Abbach, Deutschland
| | - Felix Erne
- Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen, Eberhard Karls Universität, Tübingen, Deutschland
| | - Jörg Ansorg
- Berufsverband für Orthopädie und Unfallchirurgie, Berlin, Deutschland
| | | | | | - David A Back
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
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Alshahrani F, Marriott JF, Cox AR. A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system. Int J Clin Pharm 2020; 43:884-892. [PMID: 33165835 PMCID: PMC8352824 DOI: 10.1007/s11096-020-01192-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/29/2020] [Indexed: 11/16/2022]
Abstract
Background Computerised Physician Order Entry (CPOE) is considered to enhance the safety of prescribing. However, it can have unintended consequences and new forms of prescribing error have been reported. Objective The aim of this study was to explore the causes and contributing factors associated with prescribing errors reported by multidisciplinary prescribers working within a CPOE system. Main Outcome Measure Multidisciplinary prescribers experience of prescribing errors in an CPOE system. Method This qualitative study was conducted in a hospital with a well-established CPOE system. Semi-structured qualitative interviews were conducted with prescribers from the professions of pharmacy, nursing, and medicine. Interviews analysed using a mixed inductive and deductive approach to develop a framework for the causes of error. Results Twenty-three prescribers were interviewed. Six main themes influencing prescribing were found: the system, the prescriber, the patient, the team, the task of prescribing and the work environment. Prominent issues related to CPOE included, incorrect drug name picking, default auto-population of dosages, alert fatigue and remote prescribing. These interacted within a complex prescribing environment. No substantial differences in the experience of CPOE were found between the professions. Conclusion Medical and non-medical prescribers have similar experiences of prescribing errors when using CPOE, aligned with existing published literature about medical prescribing. Causes of electronic prescribing errors are multifactorial in nature and prescribers describe how factors interact to create the conditions errors. While interventions should focus on direct CPOE issues, such as training and design, socio-technical, and environmental aspects of practice remain important.
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Affiliation(s)
- Fahad Alshahrani
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Security Forces Hospital, Riyadh, Saudi Arabia
| | - John F Marriott
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Anthony R Cox
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
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Poncette AS, Glauert DL, Mosch L, Braune K, Balzer F, Back DA. Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study. J Med Internet Res 2020; 22:e22161. [PMID: 33118935 PMCID: PMC7661229 DOI: 10.2196/22161] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 01/07/2023] Open
Abstract
Background Owing to an increase in digital technologies in health care, recently leveraged by the COVID-19 pandemic, physicians are required to use these technologies appropriately and to be familiar with their implications on patient care, the health system, and society. Therefore, medical students should be confronted with digital health during their medical education. However, corresponding teaching formats and concepts are still largely lacking in the medical curricula. Objective This study aims to introduce digital health as a curricular module at a German medical school and to identify undergraduate medical competencies in digital health and their suitable teaching methods. Methods We developed a 3-week curricular module on digital health for third-year medical students at a large German medical school, taking place for the first time in January 2020. Semistructured interviews with 5 digital health experts were recorded, transcribed, and analyzed using an abductive approach. We obtained feedback from the participating students and lecturers of the module through a 17-item survey questionnaire. Results The module received overall positive feedback from both students and lecturers who expressed the need for further digital health education and stated that the field is very important for clinical care and is underrepresented in the current medical curriculum. We extracted a detailed overview of digital health competencies, skills, and knowledge to teach the students from the expert interviews. They also contained suggestions for teaching methods and statements supporting the urgency of the implementation of digital health education in the mandatory curriculum. Conclusions An elective class seems to be a suitable format for the timely introduction of digital health education. However, a longitudinal implementation in the mandatory curriculum should be the goal. Beyond training future physicians in digital skills and teaching them digital health’s ethical, legal, and social implications, the experience-based development of a critical digital health mindset with openness to innovation and the ability to assess ever-changing health technologies through a broad transdisciplinary approach to translate research into clinical routine seem more important. Therefore, the teaching of digital health should be as practice-based as possible and involve the educational cooperation of different institutions and academic disciplines.
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Affiliation(s)
- Akira-Sebastian Poncette
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | - Daniel Leon Glauert
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lina Mosch
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Balzer
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | - David Alexander Back
- Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Bundeswehr Hospital Berlin, Berlin, Germany,Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Abdallah O, Ageeb RA, Elkhalifa WHI, Zolezzi M, El-Awaisi A, Diab MI, Awaisu A. Evaluating prescribing competencies covered in a Canadian-accredited undergraduate pharmacy program in Qatar: a curriculum mapping process. BMC MEDICAL EDUCATION 2020; 20:253. [PMID: 32762671 PMCID: PMC7409697 DOI: 10.1186/s12909-020-02109-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/09/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the existing Bachelor of Science in Pharmacy [BSc (Pharm)] curriculum at Qatar University College of Pharmacy (QU CPH), for addressing international prescribing competencies. METHODS The Australian National Prescribing Service (NPS MedicineWise) Competencies Required to Prescribe Medicines framework (the Prescribing Competencies Framework) was used in the BSc (Pharm) curriculum mapping process. The NPS MedicineWise Prescribing Competencies Framework outlines seven competency areas that are essential for pharmacist prescribing. The first mapping activity assessed the learning outcomes (LOs) of 62 courses within the BSc (Pharm) curriculum for covering and addressing the NPS MedicineWise competencies. The second mapping activity involved matching the LOs identified to address the NPS MedicineWise prescribing competencies, to the 2017 Association of Faculties of Pharmacy of Canada (AFPC) educational outcomes, on which the QU CPH BSc (Pharm) program is based. The AFPC educational outcomes address seven key program-level learning outcomes. RESULTS The QU CPH BSc (Pharm) curriculum addresses most of the prescribing competencies listed in the NPS MedicineWise Prescribing Competencies Framework. However, gaps were identified in the curricular content and in the LOs that were related, but not restricted, to the following: electronic prescribing, physical examinations/preparing patients for investigations, and policies/procedures and quality assurace related to prescribing. Other gaps identified include legislative and workplace requirements for obtaining consent to access confidential patient's health information. CONCLUSION The curriculum mapping exercise provided evidence that, for the most part, the existing BSc (Pharm) curriculum at QU CPH prepares pharmacy graduates for prescribing. However, there are areas that need better alignment between the taught curriculum and training on prescribing in practice. The results of this study are important to consider if pharmacist prescribing is to be implemented in Qatar.
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Affiliation(s)
- Oraib Abdallah
- Mental Health Services, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Rwedah Anwar Ageeb
- College of Pharmacy, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Monica Zolezzi
- College of Pharmacy, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Alla El-Awaisi
- College of Pharmacy, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, PO Box 2713, Doha, Qatar
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Vlashyn OO, Adeoye-Olatunde OA, Illingworth Plake KS, Woodyard JL, Weber ZA, Russ-Jara AL. Pharmacy students' perspectives on the initial implementation of a teaching electronic medical record: results from a mixed-methods assessment. BMC MEDICAL EDUCATION 2020; 20:187. [PMID: 32517745 PMCID: PMC7285515 DOI: 10.1186/s12909-020-02091-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Electronic medical records (EMRs) have been used for nearly three decades. Pharmacists use EMRs on a daily basis, but EMRs have only recently been incorporated into pharmacy education. Some pharmacy programs have implemented teaching electronic medical records (tEMRs), but best practices for incorporating tEMRs into pharmacy education remain unknown. The objectives of this study were to 1) assess pharmacy students' views and experiences with a tEMR; and 2) identify current learning activities and future priorities for tEMR use in pharmacy education. METHODS We used a mixed-methods approach, including three, two-hour student focus groups and a 42-item web-based survey to examine student perspectives of the tEMR. All first, second, and third year professional pharmacy students were eligible to participate in the survey and a focus group. Web-based survey items were measured on a 7-point Likert scale, and quantitative analyses included descriptive statistics. Two researchers independently coded transcripts using both deductive and inductive approaches to identify emergent themes. These analysts met and resolved any coding discrepancies via consensus. RESULTS Focus groups were conducted with 22 total students, with 6-8 students represented from each year of pharmacy training. The survey was completed by 156 students: 47 first year, 55 second year, and 54 third year. Overall, 48.7% of survey respondents altogether agreed or strongly agreed that using the tEMR enhanced their learning in pharmacy classes and laboratories. Qualitative data were organized into four major themes regarding tEMR adoption: current priorities for use within the pharmacy curriculum; tEMR benefits; tEMR barriers; and future priorities for tEMR use to prepare students for pharmacy practice. CONCLUSIONS This study reveals pharmacy students' perspectives and attitudes towards using a tEMR, the types of classroom activities that incorporate the tEMR, and students' future suggestions to enhance the design or application of the tEMR for their learning. Our research findings may aid other pharmacy programs and promote more effective use of tEMRs in pharmacy education. In the long-term, this study may strengthen pharmacy education on EMRs and thus increase the efficacy and safety of pharmacists' EMR use for patients' medication management.
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Affiliation(s)
- Olga O. Vlashyn
- Purdue University College of Pharmacy, 575 W. Stadium Ave, West Lafayette, IN 47907 USA
- The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210 USA
| | | | | | - Jamie L. Woodyard
- Purdue University College of Pharmacy, 575 W. Stadium Ave, West Lafayette, IN 47907 USA
| | - Zachary A. Weber
- Purdue University College of Pharmacy, 575 W. Stadium Ave, West Lafayette, IN 47907 USA
| | - Alissa L. Russ-Jara
- Purdue University College of Pharmacy, 575 W. Stadium Ave, West Lafayette, IN 47907 USA
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