Dispatches from the hi-blogs.info krew

IMIA Education WG – Tuesday afternoon papers October 28, 2008

After attempts to take an ‘official group photo’ lost several people on the walk through the hospital, we managed to get most people together; will provide links to various versions when I get them.

The afternoon session began with a further series of short paper presentations. The first paper, by  Kathryn Brillinger from Conestoga College in Canada, on ‘Intercultural Communication: A “Foundation” Competency in Health Informatics’. The skills are necessary due to the diversity of the student group in terms of gender, ethnic, generational, religious, geographic differences, and especially when they have work experience in Toronto, where 1 in 2 people are from another country. Intercultural communication (ICC) and competency in it are seen as important for health informatics students to work in teams and on projects; teaching team looked at over 150 definitions of culture, and came to a short definition of ‘shared meaning’. Her team have found that health informatics tends to be Western-centric in terms of what is covered in health record systems, and that many of their students are often not aware, when they come to the courses, of many wider ‘political’ and cultural differences between different parts of the world.

Jeannette Murphy presented on ‘Designing an Induction Programme for a Blended Learning Postgraduate Program in Health Informatics’. She reported that both online and face-to-face inductions were needed, due to lack of experience by both teachers and students in online learning; they wanted to prepare students for using the virtual learning environment, and to foster a supportive learning community. Study skills were seen as important due to many of the students having been away from education for some time.  Jeanette described the sequencing and rationale for having face to face induction before online induction; her team’s evaluation, from student feedback, is that face to face feedback is necessary.

Fernando Martin Sanchez, from Spain, on behalf of Victoria Lopez-Alonso, presented on ‘NBIOTIC, an Educational Resource on Convergent Technologies (NBIC) for BioMedical informaticians’. Around 2000, the team began to look at the potential impact of increasing amounts of genomic and bioinformatics data on all levels of health informatics. He says that a new wave/trend that will impact medicine is regenerative and nano medicine, for example development of drugs that bind to nanoparticles. However, as these nw developments are being explored, possible toxic and pathological effects are emerging and need to be explored (eg possibility of carbon nanotubes having similar deleterious effects to asbestos fibres). He described nanoinformatics as ‘ a new discipline to organise, standardise, share, compare, analyse, etc. the vast amounts of data being gathered at the nano scale’. This potentially adds a new level to the spectrum of health/informatics from the nano to population levels, and provides for converging technologies that complement each other at difference levels/scales. The Spanish team are developing a new educational resource to bring together information; part of this work is the EU-funded ACTION-Grid to provide EU-Latin American co-operation.

Paula Otero, from Hospital Italiano in Buenos Aires, presented on ‘Variables and reasons for student’s dropout in elearning courses at the Virtual Campus and distance education in medical informatics’. She says this is the first part of a larger project, and she will present the initial findings.
She summarised the pro’s and con’s of elearning, with the latter including poor local Internet access and lack of motivation. The Virtual Campus was created in 2004, and has 9,000 students registered; Moodle is used as the VLE and there are 80 courses. Drop-out rates in postgraduate courses (health informatics, healthcare management, epidemiology and medicine) in 2007 were explored; informatics courses had one of the lowest completion rates. Older students tended to have higher dropout rates, males had higher rates, as did non-Argentinian students. Further work is going to be undertaken to explore in more detail the reasons for dropping out of courses.

Joanne Valerius, from Oregon Health Sciences University (OHSU) in USA, presented on ‘Workforce Development and Education of Professionals in Health Information Management and Health Informatics’. OHSU developed a graduate level certificate, through an analysis of established biomedical informatics and health information management programmes and courses.

Sedick Isaacs, from Cape Peninsula University of Technology in Cape Town, South Africa, presented ‘Some thoughts on trans-national course selection in Medical Informatics’. He said that availability of courses often compels students to seek education in different parts of the world. As a result, culture and human knowledge can influence decisions made, as can differences in language, differences in mental models and traditional views. The student may become acculturated to the new culture in which they study; this may cause problems when they return to their own original culture. He suggested that acculturation may also happen through distance education. Sedick reported how one of his students explored the introduction of the same information systems in hospitals with different cultures, and differences were found in the degree of success in implementation. Professionalisation, a socialisation process, has an effect on acquisition of knowledge, and this has effect on ways in which the profession is practiced; Sedick says that while studies have been done in medicine, there seem to be no such studies for health informatics.

Sedick explored a spectrum of health informatics, from micro to macro levels; in Africa, the focus is more at the macro and sociological and population health levels, and less on the cellular level. Commodification of education/knowledge, the selling of courses, may result in imbalances of course provision and development of some professions in some African countries.

The final short presentation of the afternoon is from Ken Toyoda, from the Japan Association for Medical Informatics, talked about the ‘Certification programme of healthcare information technologist in Japan’. The Japanese association was founded about 25 years ago, as a result of the  medinfo conference held in Tokyo. A certification programme has been developed; starting in 2003, the annual certification examination focuses on healthcare professionals, and many other sectors of the health informatics community, and as a result over 7,000 healthcare information technologists have been certificated. The programme examines skills and knowledge in IT, healthcare and health information systems in Japan; textbooks have been published to accompany the certification. Issues covered include not only technical subjects, but also health information ethics, as well as communication and collaboration. In 2007, a ‘senior healthcare information technologist’ examination was developed, for those with five years experience in healthcare information systems.; this also includes an essay and interview, as well as paper-based test.

IMIA Education WG – afternoon papers October 27, 2008

The first presenter is Steve Bedrick, a PhD student in Portland, Oregon, talking about ‘Non native English speaking researchers and English language information systems’, which relates to areas he wil be investigating as part of his dissertation work. He notes that much of the informatics literature is published in English, but this is not the first language of many people around the world, including informaticians. This, he sees, is a barrier to information access; machine translation tools (Google, Babelfish, etc) may help reduce the height of the barrier to access, and may be better than nothing. He is looking to build some tools and see who they might be useful for; he wants to do preliminary research to help in the design of the tools, through in-person interviews (convenience sample) and electronic questionnaires, using a well-defined population. Clinicians (including students) will be researched, along with researchers, informaticians and others, for whom English is not their first language; the primary focus will be on Spanish speakers. He wants to look at whether they perceive a need to access English language information, what electronic information systems they use and what language-related difficulties or barriers they have faced, and what tools and techniques they have developed to surmount the barriers.

Jeanette Murphy then preented on ‘Fitting  IT training into the medical curriculum’, a project she has been involved in for the past six years. Jeanette has been collecting data on medical students’ IT skills since 1996, which have shown dramatic improvement since 2001; while most have basic comepetencies in IT, they are mostly self-taught. She covered information on facilitating students’ study of ECDL (European Computer Driving Licence) to gain basic skills.

Juliana Brixey, from University of Kansas School of Nursing, presented on ‘Creating a toolkit for synchronous and asynchronous computer-mediated communications applications for online health information systems’.  She gave an overview of Web 2.0 tools that facilitate different types of social interaction and communications. CMC tools can provide for collaboration, interactivity and other benefits. University of Kansas have an island within Second Life, which can only be accessed by students or by invitation to others. It is used for a variety of purposes, including data collection activities, for poster presentations individually and in groups. Blogs and social bookmarking via del.icio.us have been trialled.

Jeanette Murphy presented a paper co-authored by her colleagues, on ‘Health informatics postgraduate education at University College London’, and outlined the development of CHIME and its curriculum, and how it meets changing UK needs.

Guillermo Lopez-Campos, from Institute of Health ‘Carlos III’ (biotic.isciii.es) in Madrid, Spain, presented on ‘Training health professionals in bioinformatics’. His department has been working on biomedical informatics since 1998, and began by discussing the importance of personalised medicine mediated through genomics. as an underpinning motivation for teaching bioinformatics in the medical curriculum. A number of different learning modes have been trialled for teaching different subjects, including face to face and online courses.

Claire Dixon-Lee, from AHIMA in the USA, presented on ‘An international academic curriculum for the Health Records Administration (HRA)/Health Information Management (HIM) professional workforce’. They are currently looking at curriculum models to develop a scalable curriculum that might be adaptable to global needs and settings. AHIMA have developed online courseware, using a co-operative model to encourage sharing and development of new materials.

The final presentation of the afternoon was from Jana Zvarova, from Charles University in Prague in the Czech Republic, on ‘Higher education program in biomedical informatics’. She described the development of the EU-funded EuroMISE project for developing materials relating to medical informatics, statistics and epidemiology, and the IT-EDUCTRA project.

The day has covered a diverse range of issues from a number of countries and disciplines. I have not had much time to reflect on common issues from the day, but maybe tomorrow – it’s been a long day.

IMIA Education WG – academia and eHealth keynote October 27, 2008

The start of the afternoon session is a keynote from Kendall Ho, from University of British Columbia (UBC) Faculty of Medicine, titled ‘Involving academia in e-health capacity building – a Canadian perspective’. He framed questions around meeting health information needs today, and how to train today’s and tomorrow’s practitioners, how to keep up with innovations, and how we might turn today’s best practices into tomorrow’s routines. He opened with the Chinese idiom about ‘throwing bricks to get jade’.

He described the study undertaken in 2007-08 to look a EHR training in academia, and at the opportunities and challenges; they surveyed physicians, nurses and pharmacists, and found a clinical/education gap with uneven recognition and acceptance of practices, lack of formal training in health informatics; accommodating health informatics in the curriculum s very difficult for all health professionals, due to crowded curricula; capacity is lacking in terms of faculty champions in many areas, and there is a reseach gap. Traditional curriculum approaches have been unhelpful (trying to squeeze new subjects into a crowded area), and curriculum evolution can be challenging; should health informatics be elective or required, and is it a separate discipline or not?

He raised questions around whether institutions see health informatics as the ‘burning platforms’ that are ‘must have’ developments, and how to involve curriculum decision-makers. Research and evaluation, and the attraction of research fund to the field, are often seen as strong drivers/attractors for many institutional leaders. UBC has created a new eHealth Strategy Office that Dr Ho chairs, and sees anecessary interaction between research, evaluation, and translation into routine practice.

In terms of education, he described the need for pre-med health informatics introductions, medical student EHR, residents to MD training in health informatics skills, community training based in patient-driven needs for information, and the need to develop an ehealth masters degree. Similarly, he sees the need to develop research in parallel to all of these areas, and then translating these into developments such as evidence-based policy and global eHealth developments. He sees these areas interacting and re-inforcing each other.

Dr Ho talked about some specific examples, such as PDA clinial practice guidelines, that have been in development for several years (www.clinipearls.ca); this aims to deliver 80% of the information needed by clinicians within 3 screen clicks and 15 seconds. Technology enabled academic detailing (http://www.mytead.ca/), deriving out of evidence-based prescribing, eprescribing and reporting is also being developed and researched, due to funding from several sources, including Nokia Foundation and canadian provincial government. His final example is ICT for muticultural public engagement (www.iconproject.org) in a Chinese Online Health Network.

He closed by raising a ‘wish list’ including research into the sociology of e-presence and moving from educational experimentation to standardisation, and the development of resources of expertise to aid other institutions in development of health informatic curricula.