Introduction: A jointly funded partnership between a large Midwestern University School of Nursing and a premier Health Care Information Technology (HCIT) supplier represents a pioneering event for education and for the health care information technology industry. It marks the first time that a live-production, clinical information system designed for care delivery is being used in a simulated way for teaching curriculum content to nursing students. The impetus for this partnership arises from the Institute of Medicine (IOM) reports published in late 1999 and early 2001 addressing the quality, error and waste in the U.S. health care system. The IOM's recommendations clearly validate the curriculum changes and plan to integrate IT into the preparation and core clinical competencies of all health professionals. The project called the Simulated E-hEalth Delivery System (SEEDS) was launched in fall 2001 with a pilot group of beginning undergraduate nursing students.
Objectives: Objectives guiding the evaluation of this pilot project are that SEEDS (1) enhances the development of critical thinking and problem solving; (2) integrates online patient assessment, problem identification, treatment, and evaluation; (3) demonstrates the impact that structured data and information have on patient care; (4) provides the information infrastructure for evidence-based clinical practice; and (5) promotes the dissemination and evaluation of knowledge and research.
Design: The evaluation plan incorporates both quantitative and qualitative strategies to examine best practice outcomes of technology based education for teaching applied clinical informatics.
Population, Sample, Setting: The population for this study is the undergraduate nursing students at a large Midwestern University. A cohort of 34 undergraduate nursing students selected from the first semester nursing curriculum served as the pilot for this project. This represents four of twelve clinical seminar groups. The remaining eight clinical groups (86 students) used traditional learning methods in their clinical seminars.
Concepts or Variables Studied: A new skill set and language to change the way data is structured, recorded and communicated is required to function competently in the electronic information age. Teaching nursing students to think in a data driven mode helps lay the foundation for evidence based practice and reduces the risk of treatment errors. The processing of data, information and knowledge to support the health care delivery system needs to be an essential component of the curriculum for all health professionals. The challenge to academic educational centers is how to best integrate these concepts and competencies to the extent they need to be integrated into the education and training of health professionals.
Methods: Thirty-four of 120 students in the foundations and health promotion clinical course (the pilot group) had hands-on training with the CIS using virtual patient, while the other two-thirds used the traditional methods for learning the nursing process, documentation, and disease-state management. All students who participated in the pilot project were asked to participate in the evaluation study. Data were collected in conjunction with the standard University course and faculty evaluation. Data regarding best practice outcomes were gathered using the online SEEDS survey instrument and focus groups. Data were collected at the completion of each of the three levels of the undergraduate curriculum.
Findings: Results of this study indicated that the integration of the CIS into the pedagogy of the curriculum enhances collaborative learning, provided rich rapid feedback, promotes cognitive and creative outcomes, and prepares graduates for "real world" experiences. It also requires changes in teaching and learning strategies. In general, both students and faculty appear satisfied with the integrated learning experience.
Conclusion:
With this push for technology-integrated curriculum, it is important to remember that the integrated advanced telecommunications technologies that are available today and projected for the future provide powerful teaching and learning tools. Teaching with the technologies will require educators to develop new skill sets and to re-engineer their pedagogical approach so that the technology itself is transparent to the learning process. Integrating CIS into curriculum is costly and can best be accomplished through academic-business partnerships.
Implications: The 2001 IOM report strongly recommends the need for information-rich environments for undergraduate and graduate health professional education. Also, it is clear from the IOM study that not just any IT investment will enable health care organizations to fix the problem. Only fully integrated architecture that spans the entire health care organization and throughout the community into the homes of consumers will meet this need. Nursing and other health professional programs need to respond to this demand for educating future health professionals.
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