Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2011
Single and multi-user virtual patient design in the virtual world.
This research addresses the need for the flexible creation of immersive clinical training simulations for multiple interacting participants and virtual patients by using scalable open source virtual world technologies. Initial development of single-user surgical virtual patients has been followed by that of multi-user multiple casualties in a field environment and an acute hospital emergency department. The authors aim to validate and extend their reproducible framework for eventual application of virtual worlds to whole hospital major incident response simulation and to multi-agency, pan-geographic mass casualty exercises.
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Stud Health Technol Inform · Jan 2011
Medication related computerized decision support system (CDSS): make it a clinicians' partner!
Medication related Computerized Decision Support System (CDSS) are known to have a positive impact on Adverse Drug Events (ADE) prevention but they face acceptance problems due to over alerting and usability issues. We present here a Human factors approach to the design of these Clinical Decision Support (CDS) functions and to their integration into different Electronic Health Record (EHR) / Computerized Physicians Order Entry (CPOE) systems, so that the resulting CDSS corresponds to the users needs and fits clinical workflows and cognitive processes. We used ethnographic observations completed with semi-structured interviews to analyse existing work situations and work processes. ⋯ This makes the system able to catch the context of the monitoring of the drugs through their corresponding lab tests and lab results (e.g. kalemia for potassium) and also part of the context of the clinical status of the patient (actual lab values, but also diseases and other pathologies that are identified as potential causes of the ADE e.g. renal insufficiency and potassium). We show that making the system able to catch the monitoring and clinical contexts opens interesting opportunities for the design of the CDS information content and display mode. Implementing this model would allow the CDSS to take into account the actions already engaged by the healthcare team and to adapt the information delivered to the monitoring and clinical context, thus making the CDSS a partner to the clinicians, nurses and pharmacists.
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Stud Health Technol Inform · Jan 2011
Serious adverse event reporting in a medical device information system.
The paper describes the design of a module that manages Serious Adverse Events (SAEs) reporting within a Clinical investigation on Medical devices. This module is integrated in a Medical Device Information System (MEDIS) that collects data and documents exchanged between applicants and the National Competent Authority during the clinical investigation lifecycle. To improve information sharing among different stakeholders and systems MEDIS design and developed were based on the HL7 v.3 standards. The paper provides a conceptual model on SAEs based on HL7 RIM that underlines Medical Device characteristics.
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Stud Health Technol Inform · Jan 2011
Combined intubation training (simulated and human) for 4th year medical students: the Center for Advanced Technology and Telemedicine airway training program.
The video laryngoscope is a useful tool in intubation training as it allows both the trainer and the student to share the same view of the airway during the intubation process. In this study, the Center for Advanced Technology and Telemedicine's airway training program employed videolaryngoscopy (VL) in teaching both simulated (manikin) and human intubation. ⋯ With human intubation training, there was statistically significant improvement in airway views using VL and a 97.5% intubation success rate. The enhanced view of the videolaryngoscope in airway intubation facilitates the learning process in performing both simulated and human intubation, making it a powerful tool in intubation training.
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Stud Health Technol Inform · Jan 2011
Anesthesia residents' preference for learning interscalene brachial plexus block (ISBPB): traditional Winnie's technique vs. ultrasound-guided technique.
There is a recent shift from traditional nerve stimulation (NS) to ultrasound-guided (UG) techniques in regional anesthesia (RA). This shift prompted educators to readdress the best way to teach these two modalities. Development of a more structured curriculum requires an understanding of student preferences and perceptions. ⋯ The residents completed a questionnaire regarding their impression of each technique and the learning experience. UG technique was perceived to be safer and to have more educational value than NS. However, residents felt both techniques should be mandatory in the teaching curriculum.