Digital libraries in a clinical setting: Friend or foe?

Clinical requirements for quick accessibility to reputable, up-to-date information have increased the importance of web accessible digital libraries for this user community. To understand the social and organisational impacts of ward-accessible digital libraries (DLs) for clinicians, we conducted a study of clinicians. perceptions of electronic information resources within a large London based hospital. The results highlight that although these resources appear to be a relatively innocuous means of information provision (i.e. no sensitive data) social and organisational issues can impede effective technology deployment. Clinical social structures, which produce information. and technology. hoarding behaviours can result from poor training, support and DL usability

The unseen and unacceptable face of digital libraries

The social and organisational aspects of digital libraries (DLs) are often overlooked, but this paper reviews how they can affect users' awareness and acceptance of DLs. An analysis of research conducted within two contrasting domains (clinical and academic) is presented which highlights issues of user interactions, work practices and organisational social structures. The combined study comprises an analysis of 98 in-depth interviews and focus groups with lecturers, librarians and hospital clinicians. The importance of current and past roles of the library, and how users interacted with it, are revealed. Web-based DLs, while alleviating most library resource and interaction problems, require a change in librarians' and DL designers' roles and interaction patterns if they are to be implemented acceptably and effectively. Without this role change, users will at best be unaware of these digital resources and at worst feel threatened by them. The findings of this paper highlight the importance of DL design and implementation of the social context and supporting user communication (i.e., collaboration and consultation) in information searching and usage activities. © Springer-Verlag 2004

Acceptability of medical digital libraries

Evidenced-based medicine has increased the importance of quick accessibility to reputable, upto-date information. Web-accessible digital libraries (DLs) on the wards can address the demand for such information. The use and acceptability of these resources has, however, been lower than expected due to a poor understanding of the context of use. To appreciate the social and organizational impacts of ward-accessible DLs for clinicians, results of a study within a large London-based hospital are presented. In-depth interviews and focus groups with 73 clinicians (from pre-registration nurses to surgeons) were conducted, and the data analysed using the grounded theory method. It was found that clinical social structures interact with inadequate training provision (for senior clinicians), technical support and DL usability to produce a knowledge gap between junior and senior staff, resulting in information – and technology – hoarding behaviours. Findings also detail the perceived effectiveness of traditional and digital libraries and the impact of clinician status on information control and access. One important conclusion is that increased DL usability and adequate support and training for senior clinicians would increase perceptions of DLs as support for, rather than replacement of, their clinical expertise. © 2002, The Continuum Publishing Group Ltd. All rights reserved

Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

<b>Background</b> Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.<p></p> <b>Methods and findings</b> The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.<p></p> <b>Conclusions</b> Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

The learning technologies of the future: technologies that learn?

Higher Education Institutions (HEIs) operate in a borderless and complex environment, abundant in potentially useful information. The Creating Academic Learning Futures (CALF) research project, carried out in partnership by the University of Leicester and University College Falmouth in the UK, involves the development of approaches and tools for structuring and filtering information, in order to facilitate institutional decision-making in participative and creative ways. One of the aims of the CALF project is to involve students in creating and exploring a variety of plausible ‘alternative futures’ for learning and teaching technologies in higher education. This paper discusses some of the issues that are emerging in the course of the research process and presents ideas for the future, grounded in and emergent from ‘student voices’ from the CALF research project. Students expected the technologies of the near future to enable them to become co-creators in their own education processes. The future scenarios imagined the rise of learning technologies which instead of becoming outdated with use, become more valuable as more user-generated content is invested, technologies which are truly learning in that they learn about their users and constantly morph/adapt to their users’ needs. Finally, increasing virtualisation was a recurrent theme across most student-generated scenarios. The paper concludes with a discussion of some of the strengths and limitations of using technologies for involving students in creative activities for generating future scenarios for higher education. The technologies used by the project enabled collaborative creative thinking across a broader spectrum of possibilities about the relationship between the present and the future of higher education

Who do you think you are? Intimate pasts made public

This is the official published version of the Article - Copyright @ 2011 University of Hawaii Pres

Invisible publics: higher education and digital exclusion

Teaching in public involves reducing barriers to access and nowhere is this more appropriate than with the subject of electronic resources and the delivery of virtual learning opportunities. The future of the university, in a time of resurgence of neo-liberal values, the primacy of market forces and an increasing emphasis on private rather than public provision, has become the subject of much debate. Insufficient attention, however, is being paid to the possibility of exclusion, which is the inevitable result of increasing digital pedagogies and practices. This chapter focuses on the role of the university in ensuring equitable access to digital technology. Over the last decade, the possibilities of virtual learning have included pportunities for widening participation, increasing student numbers and opening up world trades in professional and academic expertise, thereby sustaining the globalization of education. This chapter addresses the limitations to these opportunities, in particular the failure to prioritize issues of digital inclusion and the divisive consequences of digital discrimination. The chapter is in two parts: the first examines the adoption of virtual learning within higher education, in particular, the ability of the technology to both enable and deny access. The second looks at the wider implications of this duality when set against the background of an increasingly digital society, and how inclusive practices are failing to have inclusive results