Needs must when the devil drives – Migration of an entire university to digital teaching

This study describes how the pandemic and its need for digitization catalyzed broadly implemented further education at the University of Witten/Herdecke. The empirical data consist of 117 courses for the training of 320 university members. In addition, 424 students were surveyed on the perception of digital teaching. It became evident that even though technical knowledge was transferred successfully, the didactic implementation left room for improvement. The results of this study stress that a wide range of training opportunities support the use of technology enhanced learning as well as collaboration between faculty experts, IT professionals and educational developers

Participatory Design of a Medication Module in an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Approach with Nurses and Physicians

Background: Electronic medical records (EMRs) play a key role in improving documentation and quality of care in paediatric palliative care (PPC). Inadequate EMR design can cause incorrect prescription and administration of medications. Due to the fact of complex diseases and the resulting high level of medical complexity, patients in PPC are vulnerable to medication errors. Consequently, involving users in the development process is important. Therefore, the aim of this study was to evaluate the acceptance of a medication module from the perspective of potential users in PPC and to involve them in the development process. Methods: A qualitative observational study was conducted with 10 nurses and four physicians using a concurrent think-aloud protocol and semi-structured qualitative interviews. A qualitative content analysis was applied based on a unified theory of acceptance and use of technology. Results: Requirements from the user’s perspective could be identified as possible influences on acceptance and actual use. Requirements were grouped into the categories “performance expectancies” and “effort expectancies”. Conclusions: The results serve as a basis for further development. Attention should be given to the reduction of display fragmentation, as it decreases cognitive load. Further approaches to evaluation should be taken

Evaluation of an Electronic Medical Record Module for Nursing Documentation in Paediatric Palliative Care: Involvement of Nurses with a Think-Aloud Approach

Background: Paediatric palliative care (PPC) is a noncurative approach to the care of children and adolescents with life-limiting and life-threatening illnesses. Electronic medical records (EMRs) play an important role in documenting such complex processes. Despite their benefits, they can introduce unintended consequences if future users are not involved in their development. Aim: The aim of this study was to evaluate the acceptance of a novel module for nursing documentation by nurses working in the context of PPC. Methods: An observational study employing concurrent think-aloud and semi-structured qualitative interviews were conducted with 11 nurses working in PPC. Based on the main determinants of the unified theory of acceptance and use of technology (UTAUT), data were analysed using qualitative content analysis. Results: The main determinants of UTAUT were found to potentially influence acceptance of the novel module. Participants perceived the module to be self-explanatory and intuitive. Some adaptations, such as the reduction of fragmentation in the display, the optimization of confusing mouseover fields, and the use of familiar nursing terminology, are reasonable ways of increasing software adoption. Conclusions: After adaptation of the modules based on the results, further evaluation with the participation of future users is required

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements

Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen

Viele digitale Interventionen sind auf die Mitwirkung ihrer Nutzer*innen angewiesen, damit sie eine positive Wirkung erzielen können. In verschiedenen Bereichen ist zu beobachten, dass die Anwendung digitaler Interventionen durch Nutzer*innen oftmals nach einer kurzen Zeit reduziert oder in Gänze eingestellt wird. Dies wird als einer der wesentlichen Faktoren angesehen, der die Wirksamkeit digitaler Interventionen einschränken kann. In diesem Zusammenhang gewinnt das Konzept der Adhärenz (Einhalten therapeutischer Vorgaben) bei digitalen Interventionen zunehmend an Bedeutung. Definiert wird Adhärenz bei digitalen Interventionen etwa als 'the degree to which the user followed the program as it was designed' ('Ausmaß, in dem die Nutzer*innen die Software so verwenden, wie sie konzipiert wurde'). Dies wird auch oftmals mit 'intended use' oder 'use as it is designed' umschrieben ('bestimmungsgemäße Verwendung' bzw. 'Verwendung, wie es konzipiert wurde'). Jedoch finden sowohl die theoretisch-konzeptionelle als auch die praktische Auseinandersetzung hinsichtlich der Adhärenz bei digitalen Interventionen noch eine zu geringe Berücksichtigung in der Forschung. Ziel dieses narrativen Übersichtsartikels ist es, das Konzept der Adhärenz bei digitalen Interventionen näher zu beleuchten und von verwandten Konzepten abzugrenzen. Zudem wird diskutiert, mit welchen Methoden und Messgrößen die Adhärenz operationalisiert werden kann und welche Prädiktoren sie positiv beeinflussen. Weiterhin wird auf die Dosis-Wirkungs-Beziehung bei der Anwendung digitaler Interventionen eingegangen. Abgeschlossen wird mit einer ethischen Betrachtung der Thematik

Views on Using Social Robots in Professional Caregiving: Content Analysis of a Scenario Method Workshop

BackgroundInterest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. ObjectiveIn addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. MethodsIn February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. ResultsThe majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. ConclusionsThe literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future

Electronic Health Records in Specialized Pediatric Palliative Care: A Qualitative Needs Assessment among Professionals Experienced and Inexperienced in Electronic Documentation

Background: Currently, to the best of our knowledge, no findings exist concerning the needs of professionals in specialized pediatric palliative care (PPC) regarding electronic health records (EHRs). Several studies have highlighted benefits concerning the use of EHRs in pediatrics. However, usability is strongly affected by the degree of adaptivity to the context of application. The aim of this study is to examine the needs of professionals concerning an EHR in the specialized PPC inpatient and outpatient settings. Methods: A qualitative research design was chosen to address the complex aspects of user demands. Focus group interviews and semi-structured one-on-one interviews were conducted with PPC professionals. N = 23 participants from inpatient and N = 11 participants from outpatient settings of specialized PPC representing various professions took part in the study. Results: The findings could be grouped into four categories: (1) attitude towards the current methods of documentation, (2) attitude towards electronic documentation in general, (3) general requirements for an EHR, and (4) content requirements for an EHR. Conclusions: Professionals in specialized PPC expect and experience many benefits of using electronic documentation. Their requirements for an EHR for inpatient and outpatient settings of PPC are largely consistent with EHRs for pediatrics. However, individual specifications and adaptations are necessary for this particular setting

Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study

Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients

Participatory Design of a Medication Module in an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Approach with Nurses and Physicians

Background: Electronic medical records (EMRs) play a key role in improving documentation and quality of care in paediatric palliative care (PPC). Inadequate EMR design can cause incorrect prescription and administration of medications. Due to the fact of complex diseases and the resulting high level of medical complexity, patients in PPC are vulnerable to medication errors. Consequently, involving users in the development process is important. Therefore, the aim of this study was to evaluate the acceptance of a medication module from the perspective of potential users in PPC and to involve them in the development process. Methods: A qualitative observational study was conducted with 10 nurses and four physicians using a concurrent think-aloud protocol and semi-structured qualitative interviews. A qualitative content analysis was applied based on a unified theory of acceptance and use of technology. Results: Requirements from the user’s perspective could be identified as possible influences on acceptance and actual use. Requirements were grouped into the categories “performance expectancies” and “effort expectancies”. Conclusions: The results serve as a basis for further development. Attention should be given to the reduction of display fragmentation, as it decreases cognitive load. Further approaches to evaluation should be taken