Health informatics in UK Medical Education: an online survey of current practice

OBJECTIVE: Health informatics has growing importance in clinical practice with successive General Medical Council recommendations. However, prior data suggest that undergraduate medical education largely neglects this area. An up-to-date, UK-wide view of health informatics training in medical schools is required. DESIGN: An online survey was developed using current guidance and recommendations of UK professional bodies. PARTICIPANTS AND SETTING: Senior academic staff and health informatics educators at all 34 UK medical schools were invited to complete the survey. MAIN OUTCOME AND MEASURES: Quantitative and qualitative data regarding health informatics in the undergraduate medical curriculum. RESULTS: A total of 26/34 (76%) of UK medical schools responded and 23 provided full information. Aspects most frequently mentioned were literature searching and research governance. Seventeen per cent of respondents felt there was little or no HI training, although clinical record keeping was addressed by all medical schools. Pedagogies used to teach health informatics were self-directed learning (78%) to lecture based (70%), seminars (70%), informal teaching in clinical settings (57%) and problem-based learning (22%). Health informatics was usually integrated vertically and horizontally across the curriculum (76%). Assessment and updates of the health informatics curriculum are limited (57 and 41%, respectively). Thirty-two per cent of respondents reported a low level of confidence among students to use health informatics as doctors. In the most up-to-date survey of health informatics teaching in UK medical schools, there are three major findings. First, the proportion of health informatics in the medical undergraduate curriculum is low. Second, there was variation in content, pedagogy and timing across medical schools. Third, health informatics is rarely assessed and course content is not regularly updated. CONCLUSIONS: There is a role for national guidelines and further research in this area of the curriculum which is rapidly gaining in prominence

Integrating nursing informatics into undergraduate nursing education in Africa: a scoping review

Background: Information and communication technologies have become omnipresent in healthcare systems globally, and since nurses comprise the majority of the health sector workforce, they are expected to be adequately skilled to work in a technology-mediated environment. Integrating nursing informatics into undergraduate nursing education is a cornerstone to nursing education and practice in Africa. Aim: This scoping review aimed to evidence the integration of nursing informatics into undergraduate nursing education in Africa. Methods: A scoping review of the literature used electronic databases including CINAHL Plus databases; EmCare; MEDLINE Ovid; Scopus; ERIC ProQuest; Web of Science; Google; and Google Scholar to locate papers specific to the African context. From a total of 8723 articles, 19 were selected for critique and synthesis. Results: Selected studies indicated that nursing students used several information and communication technologies tools primarily for academic purposes, and rarely for clinical practice. In Africa, the challenges for teaching informatics in nursing education included: limited information and communication technologies skills among faculty and students; poor teaching strategies; and a lack of standardization of nursing informatics competencies. Successful integration of nursing informatics into undergraduate nursing education in African countries depends on restructuring nursing informatics content and teaching strategies, capacity building of the faculty and students in information and communication technologies, political commitment, and collaborative partnership. Conclusion: Nursing informatics is scarce in undergraduate nursing education in Africa due to the implementation and adoption challenges. Responding to these challenges requires a multi-sectoral approach in the revision of undergraduate nursing curricula. Implication for nursing education, practice, policy and research: This study highlights the importance of nursing informatics in undergraduate nursing education, with its challenges and success. Nursing education policies should support the development of well-standardized nursing informatics content and appropriate teaching strategies to deliver it. Further research is needed to establish which aspects of nursing informatics are integrated into undergraduate nursing education and nursing practice, implementation process, challenges and possible solutions. Collaborative partnerships are vital to developing nursing informatics policies to better prepare graduate nurses for the African healthcare workforce in the digital era

INFORMATICS AND FACULTY INTRAPROFESSIONAL ASSESSMENT AND GAP ANALYSIS OF CURRENT INTEGRATION OF INFORMATICS COMPETENCIES IN A BACCALAUREATE NURSING PROGRAM

Abstract Background: In its effort to improve patient safety and quality in the U.S. healthcare system, the Institute of Medicine (IOM) called for the integration of health information technology and informatics in the education of healthcare professionals, especially nurses (IOM, 2001, 2003, 2012; National League for Nursing, 2008). Despite this recommendation, the integration of clinical informatics in nursing education has been slow and inconsistent, leaving gaps in the knowledge and skills that future nurses need to use clinical informatics competencies effectively in a variety of healthcare settings. Purpose: This quality improvement project had three aims: (1) to assess the current state of informatics competency integration in the baccalaureate program; (2) to identify gaps in teaching informatics competencies in the curriculum; and (3) to present the gap analysis and clinical informatics coverage gap/needs assessment related to informatics competencies of the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing Practice, Quality and Safety Education for Nurses (QSEN), and Technology Informatics Guiding Education Reform (TIGER). Method: A nursing informatics competency checklist worksheet was created based on the competencies outlined by the AACN, QSEN, and TIGER. This worksheet was completed by faculty and an informatician to assess the current state of integration of informatics competencies in the curriculum. Gaps between the two assessments were analyzed. Results: The informatician survey showed coverage of 94% of the competencies, while the faculty member survey showed coverage of 82%. There were three major findings: (1) coverage of informatics competencies related to basic computer literacy, clinical information literacy, and health information literacy was adequate; (2) competencies associated with the history and evolution of nursing informatics were underdeveloped in the curriculum; and (3) there were inadequate opportunities to develop and have students apply informatics competencies explicitly in most of the courses. Conclusions: Based on evidence, the nursing informatics competency checklist can be used as a guide in assessing and evaluating current undergraduate curricula and determining how nursing informatics competencies are integrated in nursing programs. The gap analysis helped faculty highlight areas of strength and identified deficiencies in informatics competency development within the program. The project lays the foundation for further work on applied assignments in the baccalaureate program. Additionally, a next phase of a curricular quality improvement project can include developing and integrating a comparable set of informatics competencies in other prelicensure nursing undergraduate, such as the associate degree program, RN to BSN completion and graduate programs. Results suggest that further education is required in the field of teaching informatics through additional training workshops and continuing education opportunities for faculty

Clinical Information System (CIS) teaching is ESSENTIAL for Primary Care

Supported by the local SHA and PCTs and with live access to a clinical information system (CIS), Leeds University Academic Unit of Primary Care and the Yorkshire Centre for Health Informatics together developed teaching tools to meet this outcome and prepare undergraduate medical students for clinical placements and future practice. Tomorrow’s Doctors Outcome 19 (TD 19) states that doctors should make effective use of computers and information systems, understand confidentiality and data protection and apply the principle of health informatics to medical practice. The aim of the project is to ensure health care professionals are better able to use clinical information system (CIS) for patient care (4PC), and that CIS use is maximised in supporting teaching of undergraduates, postgraduates and in continuing professional development. The main objectives of CIS4PC include enabling students’ to explore the CIS and understanding how CISs support clinical care (e.g.: decision aids, prompts,); quality monitoring and patient safety (e.g.: read coding, audit, e-Prescribing); and communication (e.g.: Choose and Book, GP2GP record transfer). The live system (TPPs SystmOne) is used to deliver ‘hands on’ interactive teaching sessions covering topics on information governance, patient record keeping, the consultation, chronic disease management and soon prescribing and public health. The poster provided an overview of the project, what has been developed, delivered and student feedback on the benefits of received the teaching

Mission Impossible? Putting the Patient Back in Patient Care

The primary focus of this teaching case is the patient journey, as facilitated and influenced by an e-system or electronic health record (EHR) system. The goal of this case is to provide the learner with the knowledge and skills needed to effectively incorporate patient-centered e-health (PCEH) principles into existing and planned e-health systems such as EHRs. This case can be used to help students understand a hospital experience from the perspective of a patient and her family. It is loosely based on an experience one of the authors had with an actual patient. This case is intended for use with upper level undergraduate and graduate health informatics, information systems, and nursing students. Students assigned to this case should have a working knowledge of clinical terms and the general workings of a hospital. This teaching case is best suited to an advanced course in a health informatics curriculum. Possible applications of the case include, but are not limited to, describing the patient journey, modeling the process flow, diagramming the data flow, and applying the principles of patient-centered e-health

Health informatics education for clinicians and managers - What's holding up progress?

This paper reports outcomes of a national survey of health informatics (HI) education and training carried out in the UK. A questionnaire to elicit details of HI and IT skills teaching was derived from a national consensus document (Learning to Manage Health Information, LtMHI). Forms were sent to all pre-qualification medical and nursing schools and to a stratified sample of postgraduate and post-registration programmes. Three case studies were carried out in acute hospital trusts to gain insight into opportunities for continuing professional development in health informatics and IT. Our evidence suggests that in the UK, health informatics is not yet integrated into the clinical curriculum. Nearly all the pre-qualification courses made some provision for teaching IT skills. Nonetheless, many respondents felt that students did not receive sufficient training. There was considerable variation in the amount of HI teaching provided in the different educational sectors. The case studies suggested very little HI training was provided for clinical staff and take-up of provision was not monitored. A number of factors are holding up progress, the most important being a lack of staff with the knowledge and skills to provide academic leadership. The paper outlines some steps that need to be taken to ensure health informatics is embedded in all clinical curricula. © 2003 Elsevier Ireland Ltd. All rights reserved

Implementing Guided Inquiry Learning and Measuring Engagement Using an Electronic Health Record System in an Online Setting

In many courses, practical hands-on experience is critical for knowledge construction. In the traditional lab setting, this construction is easy to observe through student engagement. But in an online virtual lab, there are some challenges to track student engagement. Given the continuing trend of increased enrollment in online courses, learning sciences need to address these challenges soon. To measure student engagement and actualize a social constructivist approach to team-based learning in the virtual lab setting, we developed a novel monitoring tool in an open-source electronic health records system (EHR). The Process Oriented Guided Inquiry Learning (POGIL) approach is used to engage students in learning. In this paper, we present the practice of POGIL and how the monitoring tool measures student engagement in two online courses in the interdisciplinary field of Health Information Management. To the best of our knowledge, this is the first attempt at integrating POGIL to improve learning sciences in the EHR clinical practice. While clinicians spend over 52% of a patient visit time on computers (called desktop medicine), there is very little focus on learning sciences and pedagogy to train clinicians. Our findings provide an approach to implement learning sciences theory to eHealth use training

The Digital Transformation Journey of a Large Australian Hospital: A Teaching Case

With the vision of a seamless, state-wide approach to patient management, the Department of Health within the Queensland State Government of Australia embarked on a digital transformation journey. This involved the configuration and rollout of an integrated electronic medical record system (ieMR) with computerized provider order entry, ePrescribing, decision support, analytics, and research functionalities, together with new devices and work practices, to create a multi-hospital, whole-of-state digital health ecosystem. Drawing on multiple perspectives, including executives and front-line clinicians who are both optimistic and pessimistic towards the ieMR, this teaching case describes the digital transformation of the lead site, Princess Alexandra Hospital, and their experience in becoming Australia’s first large digital hospital. This case has been informed by a multi-year qualitative study involving the collection of primary (observations and interviews) and secondary data (publicly available project records) before and after the implementation. This case is relevant to undergraduate and postgraduate students in information systems, executive management, and clinical/health informatics

Surfing or still drowning? Student nurses’ Internet skills

A study into student nurses’ ability to use the Internet was published in Nurse Education Today in 2004. This paper repeats the research with a cohort of students starting their pre-registration programme in a UK university in 2007. In 2004 students were reported as having poor Internet skills, and as not being frequent users of the Internet. In this study students were found to have significantly better ability to carry out basic tasks and significantly higher levels of Internet use. Their ability to apply these skills to more complex information literacy tasks however had not increased, with more than half of all students saying they found far too much irrelevant information when searching for specific information on the Internet. The earlier study found that skills and age were not related, which appears to still be the case. The need for these skills is increasing as education, lifelong learning, and patient information are all increasingly drawing on the developing Internet. Nurse education however is not integrating the skill and knowledge base essential to support this into pre-registration programmes, and the evidence suggests that this will not happen without active management

Educating the educators: Incorporating bioinformatics into biological science education in Malaysia

Bioinformatics can be defined as a fusion of computational and biological sciences. The urgency to process and analyse the deluge of data created by proteomics and genomics studies has caused bioinformatics to gain prominence and importance. However, its multidisciplinary nature has created a unique demand for specialist trained in both biology and computing. In this review, we described the components that constitute the bioinformatics field and distinctive education criteria that are required to produce individuals with bioinformatics training. This paper will also provide an introduction and overview of bioinformatics in Malaysia. The existing bioinformatics scenario in Malaysia was surveyed to gauge its advancement and to plan for future bioinformatics education strategies. For comparison, we surveyed methods and strategies used in education by other countries so that lessons can be learnt to further improve the implementation of bioinformatics in Malaysia. It is believed that accurate and sufficient steerage from the academia and industry will enable Malaysia to produce quality bioinformaticians in the future