Acquiring Previous Knowledge

September 2, 2016

Hello everyone! This week I will be discussing resources. It can be difficult to find what sources are credible on the internet, but it is doable. Charles encountered a new condition that he doesn't really remember, only from nursing school. He researched information on how to treat, administer, and assess the patient safely by using resources from the internet that included clinical databases and school textbooks. There are a few questions that will be answered below.

• What should Charles do when he encounters direct contradictions in information from two sources?
• If this happens Charles should continue to do more research and find resources that are peer-reviewed and have been studied/applied using evidence. Comparing sources can help him to determine similarities and differences in his findings. He can go to library websites and read through journals and articles to find the answers he is looking for. In doing this, it can also lead to more knowledge on the topics he is researching.

• Which resources are the most trusted, and how do you determine this?
• The sites that are most trusted are those sponsored by the U.S. government, not-for-profit health or medical organizations, and university medical centers. To determine this one can look at the 'About Us' section. There is also a red and blue "HONcode" seal at the bottom of the page (excluding government sponsored health sites) that determines the credibility of the website.

• Which sources are the most accurate, and how do you determine this?
• As mentioned above the most trusted sites are also the most accurate. Other examples of these sources include peer-reviewed journals and reputable news sources. An important aspect to look at is if the citations reference other work that is well-cited. Also looking at the author and recognizing that they are an expert in their field can also help to determine the accuracy of the source. 

• What criteria should Charles use to identify credible resources to enhance his clinical practice?
• There are five criteria that can be looked at:
• Accuracy
• This determines how reliable a source is and free from error. Who is hosting the site?
• Authority
• Examine information about the author. Are there references? Can you contact the author? 
• Objectivity
• Are there advertisements? Is there bias to the content being supplied?
• Currency
• When was the last time the page was updated? Are there broken links on the site? 
• Coverage
• Compare the website to other sources to determine the accuracy of the information being presented.

For more information:

http://unfccc.int/essential_background/library/items/1420.php

http://www.presentation.edu/wp-content/uploads/2013/07/Source-Evaluation-Cheat-Sheet.pdf
http://www.huffingtonpost.com/jim-t-miller/online-medical-information_b_3667454.html

Tuesday, August 16, 2016

After doing my Movenote presentation and providing a survey for others to complete, it was time to evaluate my results. My overall presentation was marked good by my respondents. One respondent suggested that I have more bullet points. In my years of school I have been told to not use too many bullet points because it can look clustered, but I think in the next presentation I can add a few more. Another suggestion was to ensure that the pictures did not overlap the text on the slide. I tried to fix that, but for some reason it wouldn't adjust. I could maybe try fixing the original PowerPoint to better accommodate the screen. Another respondent said the slides were not advancing correctly and the sound was going in and out. I did not have that problem when I recorded and posted. The next time I should try accessing the link on two different computers to ensure there are no technical issues. Overall, I received good feedback. There are definitely some changes that I need to make on the next presentation, but it was very beneficial to see how it looked to others and what I can improve on. Thank you for the responses!

Consumer Education and Information Technologies

Friday, August 11, 2016

Hello all. This week I have been given the task in helping my neighbor figure out what sources are credible online. He went to the doctor and was diagnosed with GERD. He has so many questions on this disease and went to these 3 websites:

• www.wikipedia.org
• www.webmd.com
• www.cdc.gov

The internet is filled with so much information on all different subjects so it can be hard to pick out which websites are valid and reliable. First, we can look at Wikipedia. This website is good if you are trying to familiarize yourself with a certain topic. The downside to Wikipedia is that anyone can post information on the website and the expertise of these posters are not taken into consideration. Next, is WebMD. This website is credible and can be used to gather information on health topics. The content displayed on the website is given by those individuals who hold advanced degrees in journalism, informatics, nursing, and medicine. There is credential verification by a third party that can justify the validity and reliability of this resource to the public. Third, is the CDC website, which is the most credible. CDC is the leading national public health institute of the United States. This website provides data, statistics, and is updated quite often with the newest health information related to the public. 

When talking with my neighbor I discussed with him what to look for when trying to find information on websites that are reliable. I told him to look for common domain names which is something I've done all through school to ensure that where I'm getting my information from is trusted. Some of these domains include:

• .edu
• .gov
• .org

Here are some hints to evaluate web resources

1. Credentials
2. Association to organization/institution
3. Publications in peer-reviewed publications
4. Bias of author
5. Information that is current
6. Works cited
7. Fully covered with WWW sources or should print sources provide balance
8. The kind of website is the information presented on

Some websites that I would refer my neighbor to are MedlinePlus, FDA.gov, rxlist, PubMed, and BioMed Central.

Harvard University. (2016). What's wrong with Wikipedia?. Retrieved from http://usingsources.fas.harvard.edu/icb/icb.do?keyword=k70847&pageid=icb.page346376 

Montecino, V. (1998). Criteria to evaluate the credibility of WWW resources. Retrieved from http://mason.gmu.edu/~montecin/web-eval-sites.htm

WebMD. (2014). What we do for our users. Retrieved from http://www.webmd.com/about-webmd-policies/about-what-we-do-for-our-users 

August 5, 2016

SURVEYS

Hello everyone. This week I will be discussing surveys and I will show you the presentation that I put together on Movenote. I will post a link so that you can evaluate my presentation by completing a survey.

Surveys are an integral part of evaluating new technology and to receive feedback on ways to improve. Surveys allow for answers to specific and important questions to be discussed. There are four main reasons why businesses and researchers conduct surveys. They are listed below!

1. Uncover the answers: You can learn about the respondents and what is important to them. Depending on the type of survey, one can attain meaningful information (opinions, comments, feedback) that is useful. An example is that a respondent may be more honest if the survey is online or on paper rather than face-to-face.

2. Evoke discussion: In order to gain a better perspective it is important to spark up a discussion about what it is that you are trying to improve on. Communication with the respondent is key in obtaining feedback.

3. Base decisions on objective behavior: Collecting unbiased surveys can help to make decisions that are based on those topics of importance. Analyzing the results can help to save time and resources.

4. Compare results: Surveys are snapshots of the attitudes and behaviors of the targeted survey population. One survey can be used as a baseline benchmark when compared to other surveys that will be conducted in the future. 

With all that being said this information can be applied to the implementation of new technology. After a new system or device comes out it is beneficial that feedback be reviewed. Hearing the concerns of what works and what doesn't can help to facilitate changes to better meet the needs of the healthcare staff. 

This week I created a presentation on simulation technology. Below you will find the link to view the recorded presentation along with a survey for you to complete. I would appreciate your honest feedback to better future presentations. Thank you all for watching!

Movenote Link

http://www.movenote.com/v/nI9SIqWkgXBdq

Survey Link

https://www.surveymonkey.com/r/RL8NGDF

Educational Technologies

Thursday, July 28, 2016

Simulation Technology

Hey everyone! Welcome back! This week I will be talking about educational technology that is used, more specifically, simulation technology. The use of simulation amplifies real experiences with guided experiences. A simulator can be a device that mimics a patient or part of a human body that creates interaction with the learner. Simulation allows for one to practice necessary skills without worrying about patient safety and expands professional growth. 

My job this week is to find a healthcare website that uses simulation. In my search I decided to choose one that I was familiar with called Shadow Health. When using Shadow Health it allows for students to  communicate and examine their virtual patients. It also allows for the student to document the findings while synthesizing the data and information they have found through each patient scenario. You are able to ask questions (interview-style) and use instruments to gather subjective and objective data. Single system assessment, focused exams, and concept labs are also used as learning tools for the student to engage in. After every assignment students participate in debriefing and receive feedback on those components of clinical reasoning. 

Shadow Health Clinical Reasoning Framework

These components are assessed as the student interacts with the virtual patient. Automatic scores are generated to assess their clinical reasoning ability.

For more information on Health Shadow:

https://shadowhealth.com/index.html

Educational technology has pros and cons and the simulation technique is no exception. I will identify some of these points below.

Easy access to learning opportunities	The cost of simulation education
Freedom to make mistakes and to learn from them	Real-life patient care is irreplaceable
Customization of learning experience	Requirement of computer access
Detailed feedback and evaluation	Little or no interaction with a trainer

For more information on simulation:

Galloway, S. (2009). Simulation techniques to bridge the gap between novice and competent healthcare professionals. The Online Journal of Issues in Nursing, 14(2). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Simulation-Techniques.html 

SSIH. (2016). About simulation. Retrieved from http://www.ssih.org/About-Simulation

TrainingToday. (2016). The most effective training techniques. Retrieved from http://trainingtoday.blr.com/employee-training-resources/How-to-Choose-the-Most-Effective-Training-Techniques

Teaching Strategies and Methodologies

New Technology = New Teaching

So we're back at it. This week I am part of the team that will be training staff on the opening of their unit. The staff will be taught the Electronic Health Record (EHR) and the use of mobile apps in the clinical setting. This is going to be a fun one. The use of technology will advance the effectiveness, accessibility, and efficiency of care. I'm ready for the ride!!

Now that I know who my group of learners are, I thought to myself, "how am I going to teach them?" 

I decided to use a face-to-face delivery method for the teaching of the electronic health record (EHR) and a tutorial for the mobile apps teaching in the clinical setting. I'm going to discuss why each method is appropriate for each teaching and why it's not for the other. Stay tuned and be prepared to learn!

               VS            

Let's start with the face-to-face method. This approach is appropriate for EHR teaching because it allows the staff to be in a classroom setting listening and watching me discuss the new system. This environment allows me to guide conversation and opens up the room for discussion. In order to keep them engaged I can incorporate a PowerPoint presentation that involves videos and music. I can include a game at the end to see how they picked up on the information and give them a chance to interact with other classmates. The use of this method for the mobile app teaching wouldn't be the best in my opinion. I don't think that the staff needs to be confined in a classroom to learn about mobile apps because most of them have smartphones so they can teach themselves in their own time.

The use of a tutorial for the mobile apps is good way to guide the staff through a series of objectives or tasks. This approach allows the learn to go at their own pace, which can be helpful for those that may not be as tech savvy. Just like the face-to-face method, I can use animation to intrigue the learners in wanting to be a part of the latest technology in healthcare. This approach allows for active learning and helps one to become familiar with how the apps are going to be utilized. A table of contents in this tutorial will allow for the staff to jump through different sections if a question or concern were to arise. A tutorial can be used with a face-to-face method, but I don't think that a tutorial would be as beneficial when teaching about such a huge part of what the staff will be working with. An EHR system needs more in depth information and one should be able to ask questions while being in front of someone.

There are so many ways that one can teach others. I think it is so important that the right strategy is used to ensure the learner is grasping the information. Let me know what you think and what other ways I can present my information by commenting below. All the advice is welcome. See you on the next blog!

Change Theory

Ronald Lippitt's Change Theory

As we all know there are changes occurring in the healthcare field, especially technological advances. A new teaching opportunity rose for me and that is teaching a group of physicians a new computerized physician order entry (CPOE) system. As a Nurse Informaticist I need to assess the group that I'm teaching and in this case I will be working with an older group who have little computer experience. They have never documented or entered orders using a computer. This can be challenging, but I'm ready for it. I decided to discuss Ronald Lippitt's Change Theory which will be applied in training these physicians. This theory has seven phases which are mentioned below.

Diagnose the problem

(Developing a need for change)

Assess motivation and capacity for change

(Establishing the change relationship)

Assess change agent's motivation and resources

(Diagnosing the client system's problem)

Select progressive change objective

(Examining alternative routes, establishing goals and intentions of actions)

Choose appropriate role of the change agent

(Transforming intentions into actual change efforts)

 Maintain change

(Stabilization)

Termination

(Achieving a terminal relationship)

In teaching this group of physicians I can apply these phases to ensure that they are feeling comfortable with what is expected from them. It is essential to develop a plan which is the implementation of the new CPOE. I would create a timescale to prepare them of when the system will go live. After development I would assess the concerns of the physicians by opening the floor up to them and allow for questions. This would give me a sense of any resistance one may be experiencing. It would be wise for me show why the change is being made to increase motivation and eagerness. As a group we would go over the goals of the new system by discussing the benefits and clarifying their roles and responsibilities. I would inform them that ongoing training can be offered for those who require additional help and also providing super users to be of assistance when they go live. Once the physician feels comfortable they will have access to resources should they come across a question/problem that needs addressed. 

More information available:

http://home.nwciowa.edu/publicdownload/Nursing%20Department%5CNUR310%5CSelecting%20the%20Best%20Theory%20to%20Implement%20Planned%20Change.pdf

Writing Learning Objectives

All about Objectives

As a new Nursing Informaticist I was given the opportunity to teach staff nurses on how to use a new (EHR) that was going to be implemented in their hospital. I had so many emotions running through my head. I was excited but super nervous at the same time. Then I started thinking about it and decided to tackle this project head on. Since I've been in school for what seems like forever I knew I had to start off with the basics....OBJECTIVES!! This allows for the staff to be aware of what they are expected to learn in my course. Knowing this, I had to be sure my objectives were clear and get them excited and eager to participate in my course. In this blog I will be using Bloom's Taxonomy when providing my examples.

Bloom's Taxonomy

Step 1: Knowledge 

Objective: At the end of this course, the staff nurse will be able to define an EHR and give three examples of its benefits.

Step 2: Understanding 

Objective: At the end of this course, the staff nurse will be able to compare/contrast between paper and electronic based charting. 

Step 3: Application

Objective: At the end of this course, the staff nurse will be able to apply the techniques used by demonstrating how to access different part of the EHR.

More information on Bloom's Taxonomy can be found on the link below:
http://teaching.uncc.edu/learning-resources/articles-books/best-practice/goals-objectives/writing-objectives