A Health Informatics and eHealth Curriculum for Clinical Health Profession Degrees HIC 2015, Brisbane, 4 August 2015 Kathleen GRAY a , Dawn CHOO a , Kerryn BUTLER-HENDERSON b , Sue WHETTON c , Anthony MAEDER d a Health and Biomedical Informatics Centre, The University of Melbourne b Centre for Rural Health, University of Tasmania c Tasmanian School of Business and Economics, University of Tasmania d School of Computing, Engineering and Mathematics, University of Western Sydney
“Clinical” = dentistry, dietetics, medicine, midwifery, nursing, occupational therapy, optometry, paramedics, pharmacy, physiotherapy, psychology, radiography, social work and complementary therapies, and so on ~2000 clinical health profession degrees offered in Australia’s ~40 universities from Bachelor degree to coursework Doctorate How many of these degrees teach health informatics or ehealth? How well? Image credit: adctoday .com
Very few can give a clear account. Those who do may teach with reference to recognised curriculum guidelines – or not. Examples… Australian Health Informatics Education Council, Health Informatics – Scope, Careers and Competencies, 2011. http://www.ahiec.org.au/Documents.htm J. Mantas, E. Ammenwerth, G. Demiris, A. Hasman, R. Haux, W. Hersh, et al., Recommendations of the International Medical Informatics Association (IMIA) on education in biomedical and health informatics – 1st revision. Methods of Information in Medicine 49 (2010), 105-120. Based on findings from our 2010-2013 study of entry-level degrees, including 100 interviews with university teachers in all States: K. Gray, A. Dattakumar, A. Maeder, K. Butler-Henderson, & H. Chenery, Advancing Ehealth Education for the Clinical Health Professions Final Report, Australia. Department of Education and Training, 2014. http://olt.gov.au/project-coordinated-interprofessional-curriculum-renewal-ehealth-capability-clinical-health-professi Image credit: timeshigherducation.co.uk
Yes, we’re teach health informatics and ehealth: • “The curriculum containing individual subjects on evidence based practice in addition to discipline specific EBP [evidence-based practice] content dispersed throughout the curriculum”. Physiotherapist, SP13 • “Students have access to remotely located guest lecturers who present using teleconferencing”. Nurse, SP15 • “Several lectures include content relating to electronic patient records, how they are accessed and how they relate to the hospital environment and private practice”. Physiotherapist, SP32 • “Evidence -based practice, Communication, Clinical decision support systems, Professional Experiences in actual health care agencies”. Nurse, SP61 • “The fact that the subject notes must be down loaded by students provides a basis for this type of learning environment. However, there is no designated aspect of the course in which this sort of information is presented”. Myotherapist, SP69 • “Guest speaker from the State Government […] Data Collection Unit”. Midwife, SP80 • “Some components of public health essays may touch upon ehealth as a component of a question or as part of an answer”. Medical Practitioner, SP89
No, we’re not teaching this stuff • “Some staff are more e -savvy and use technologies such as Skype & Adobe Connect but there is no requirement. …Our assessment strategies do not address anything related to ehealth”. Psychologist, SP4 • “This is not specifically taught as a topic within the current degree program but electronic record keeping is used throughout most clinics and students are expected to conform to current practices of reporting”. Audiologist, SP22 • “Only limited specific discussion of evidence based practice however would not include this as part of ehealth or informatics”. Nurse, SP81 • “The teaching methods to date do not use telehealth or other methods”. Dietitian, SP90 • “Our students use electronic records in our clinic however they are not assessed on them”. Chiropractor, SP102
Why should we? Why don’t we? Image credit: amia.org
Why should they? Safety and quality of care Efficiency and efficacy Health sector restructuring Why don’t they? Few people, thinly spread, with the expertise to teach Not required for degree (re)accreditation Unclear signals from employers Image credit: amia.org
This project How could we address scarcity of : quality-assured curriculum? teaching expertise? $$$ to do anything about it? • Let’s apply for an OLT extension grant! • Let’s design a curriculum aligned with CHIA competencies ! • Let’s target postgraduate level, for students and staff ! • Let’s make it available online ! Image credit: www.brentholm.com
Three-step curriculum development Step 1. Peer review Brief: Six CHIA competency areas including 52 sub-topics, chunked into 10 roughly • Suit multi-professional and equal blocks of study interprofessional learning Each of the four academics drafted • Be relevant for health professional curriculum related to competencies practice in local, national and with best fit to their expertise international settings Task: define key concepts, construct • Rely on resource based learning, overviews, design learning activities, using a variety of free full-text online select or create supporting resource resources materials • Represent intellectual effort and time Project officer to keep us on track, honest commitment equivalent to 12.5 and real credit points at AQF level 8/9
Block 10 of 10 Developer TEAM MEMBER NAME Competency area CHIA Competency 6 - Human and social context mapped from CHIA Sub-topics 6.1 Technology and social aspects mapped from CHIA 6.2 The relevance of ethical and legal issues for health informatics 6.3 Policies, principles and guidelines for health informatics management 6.4 Usability and human factors Learning outcomes Discuss the areas of design, evaluation and social sciences taking into account mapped from CHIA technological limitations Apply good practice to ethical, legislative political and regulatory obligations related to health information management (e.g. protecting the privacy of consumers) Apply good practice to the collection, use, disclosure, access, protection and destruction of health information Apply good practice to human centred design, usability, human factors and ergonomic sciences Overview 150 word transcript, alternative short introduction recording Learning resources For each sub-topic provide at least one well-chosen document with full citation Learning activities For each sub-topic provide clear instructions on one learning activity, reflecting learning outcomes, linked to learning resources, and able to be written up for assessment
Three-step curriculum development Step 2. External review Measures Twenty-five experts selected from health profession degree and subject coordinators, Responses on a 5-point Likert scale to three members of the CHIA Examination Group, and questions about each sub-topic: other interested members of national ehealth • How relevant are the learning activity and and health informatics organisations resources to the clinical professions? • How well do the learning activity and resources align with the CHIA competency? Email invitation with link to online survey for • How interesting are the learning activity and anonymous review, open December 2014 and resources for a clinical health degree student? January 2015. Respondents were also asked: Options : review curriculum for all 52 sub-topics • make open-ended comments about curriculum in all 6 areas of competency; or review in each sub-topic curriculum just in your area of interest; or • rate their expertise in each sub-topic as low, medium or high. read all curriculum and review none • say whether associated with the CHIA Examination Group; and /or a degree or subject coordinator in a clinical health degree; and / or experienced in developing curriculum for ehealth and health informatics
12 reviews received, all competency areas reviewed. Useful comments, including: • ”Purely from a clinical perspective, much of this is (as previously mentioned) actually not generally visible and could prove both challenging and indeed, awkward for a purely clinically focussed individual to comprehend.” (Q6) • “... free -text analysis of data is [fraught] with data integrity issues; and in fact should not even be proposed to students, in that the major drive for decision support is the absolute requirement for strongly codified information values, such that there is a high(er ) confidence in the decisions provided by the system ... “(Q9) • “There is literature on the 'clinical method' that might help, and early writings by McWhinney, that I think are very relevant here. Need to counter the mechanical view of clinical decision making that pervades HI.” (Q37)
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