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Understanding communication in counterterrorism crisis management.
This report describes the purpose and results of the two-year, Sandia-sponsored Laboratory Directed Research and Development (LDRD) project entitled Understanding Communication in Counterterrorism Crisis Management The purpose of this project was to facilitate the capture of key communications among team members in simulated training exercises, and to learn how to improve communication in that domain. The first section of this document details the scenario development aspects of the simulation. The second section covers the new communication technologies that were developed and incorporated into the Weapons of Mass Destruction Decision Analysis Center (WMD-DAC) suite of decision support tools. The third section provides an overview of the features of the simulation and highlights its communication aspects. The fourth section describes the Team Communication Study processes and methodologies. The fifth section discusses future directions and areas in which to apply the new technologies and study results obtained as a result of this LDRD
Designing Tailored Web-Based Instruction to Improve Practicing Physicians' Preventive Practices
BACKGROUND: The World Wide Web has led to the rapid growth of medical information and continuing medical educational offerings. Ease of access and availability at any time are advantages of the World Wide Web. Existing physician-education sites have often been designed and developed without systematic application of evidence and cognitive-educational theories; little rigorous evaluation has been conducted to determine which design factors are most effective in facilitating improvements in physician performance and patient-health outcomes that might occur as a result of physician participation in Web-based education. Theory and evidence-based Web design principles include the use of: needs assessment, multimodal strategies, interactivity, clinical cases, tailoring, credible evidence-based content, audit and feedback, and patient-education materials. Ease of use and design to support the lowest common technology denominator are also important. OBJECTIVE: Using these principles, design and develop a Web site including multimodal strategies for improving chlamydial-screening rates among primary care physicians. METHODS: We used office-practice data in needs assessment and as an audit/feedback tool. In the intervention introduced in 4 phases over 11 months, we provided a series of interactive, tailored, case vignettes with feedback on peer answers. We included a quality-improvement toolbox including clinical practice guidelines and printable patient education materials. RESULTS: In the formative evaluation of the first 2 chlamydia modules, data regarding the recruitment, enrollment, participation, and reminders have been examined. Preliminary evaluation data from a randomized, controlled trial has tested the effectiveness of this intervention in improving chlamydia screening rates with a significant increase in intervention physicians' chlamydia knowledge, attitude, and skills compared to those of a control group. CONCLUSIONS: The application of theory in the development and evaluation of a Web-based continuing medical education intervention offers valuable insight into World Wide Web technology's influence on physician performance and the quality of medical care