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202. Techniques to aid the implementation of novel clinical information systems: A systematic review

Author

iHealth Project Team, Kelay, Tanika, Kesavan, Sujatha, Collins, Ruth E., Kyaw-Tun, Jimmy, Cox, Benita, Bello, Fernando, Kneebone, Roger L., Sevdalis, Nick, Kitney, R.I., Dickinson, R.J., Guo, Yike, iHealth Project Team, Kelay, Tanika, Kesavan, Sujatha, Collins, Ruth E., Kyaw-Tun, Jimmy, Cox, Benita, Bello, Fernando, Kneebone, Roger L., Sevdalis, Nick, Kitney, R.I., Dickinson, R.J., and Guo, Yike

Abstract

Background: This systematic review identifies and evaluates techniques that aid the implementation of novel clinical information systems (CIS) within healthcare. Methods: We searched electronic databases (MEDLINE, EMBASE, PsycINFO and HMIC Health Management Information Consortium). Desktop reviews for all potentially eligible studies were also conducted via reference lists and forward citation searches. 14,198 abstracts were identified through the initial electronic search. 63 articles were retained following title and abstract reviews, and submitted for full text evaluation. Of these, 18 papers met eligibility criteria. Results: The 5 techniques that emerged from the review and that can assist CIS implementation were: system piloting, eliciting acceptance, use of simulation, training and education, and provision of incentives. These techniques were evaluated with a range of study endpoints (including system utilisation, clinical effectiveness, user satisfaction, attitudes towards system training, and attitudes towards implementation). Consideration of the clinical context in which the CIS was implemented was a consistent theme in the evidence-base. Conclusions: Although some evidence is available for the effectiveness of the 5 implementation techniques found in this review, the variable endpoints and the non-comparable study designs mean that the evidencebase needs further developing. We discuss the potential role of simulation and clinical leadership, particularly in relation to surgeons, in CIS implementation and we propose practical advice for CIS implementation and evaluation within hospital settings. © 2013 Surgical Associates Ltd.

Published
2013

203. Technology-enabled assessment of health professions education: consensus statement and recommendations from the Ottawa 2010 Conference

Author

Amin, Zubair, Boulet, John R, Cook, David A, Ellaway, Rachel, Fahal, Ahmad, Kneebone, Roger, Maley, Moira, Ostergaard, Doris, Ponnamperuma, Gominda, Wearn, Andy, Ziv, Amitai, Amin, Zubair, Boulet, John R, Cook, David A, Ellaway, Rachel, Fahal, Ahmad, Kneebone, Roger, Maley, Moira, Ostergaard, Doris, Ponnamperuma, Gominda, Wearn, Andy, and Ziv, Amitai

Abstract

The uptake of information and communication technologies (ICTs) in health professions education can have far-reaching consequences on assessment. The medical education community still needs to develop a deeper understanding of how technology can underpin and extend assessment practices. This article was developed by the 2010 Ottawa Conference Consensus Group on technology-enabled assessment to guide practitioners and researchers working in this area. This article highlights the changing nature of ICTs in assessment, the importance of aligning technology-enabled assessment with local context and needs, the need for better evidence to support use of technologies in health profession education assessment, and a number of challenges, particularly validity threats, that need to be addressed while incorporating technology in assessment. Our recommendations are intended for all practitioners across health professional education. Recommendations include adhering to principles of good assessment, the need for developing coherent institutional policy, using technologies to broaden the competencies to be assessed, linking patient-outcome data to assessment of practitioner performance, and capitalizing on technologies for the management of the entire life-cycle of assessment.

Published
2011

205. New professional roles in surgery

Author

Kneebone, Roger and Darzi, Ara

Subjects
Surgery -- Management, Medical personnel -- Training, Medical personnel -- Practice, Company business management
Published
2005

209. Distributed Simulation

Author

Tang, Jessica Janice, primary, Tun, Jimmy Kyaw, additional, L Kneebone, Roger, additional, and Bello, Fernando, additional

Published
2013
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211. Holding the Scalpel

Author

Bezemer, Jeff, primary, Cope, Alexandra, additional, Kress, Gunther, additional, and Kneebone, Roger, additional

Published
2013
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212. Surgical decision making in a teaching hospital: a linguistic analysis.

Author

Bezemer, Jeff, Murtagh, Ged, Cope, Alexandra, and Kneebone, Roger

Subjects
CHOLECYSTECTOMY, MEDICAL decision making, LAPAROSCOPIC surgery, TEACHING hospitals, LINGUISTIC analysis, AUDIOVISUAL materials
Abstract

Background The aim of the study was to gain insight in the involvement of non-operating surgeons in intraoperative surgical decision making at a teaching hospital. The decision to proceed to clip and cut the cystic duct during laparoscopic cholecystectomy was investigated through direct observation of team work. Method Eleven laparoscopic cholecystectomies performed by consultant surgeons and specialty trainees at a London teaching hospital were audio and video recorded. Talk among the surgical team was transcribed and subjected to linguistic analysis, in conjunction with observational analysis of the video material, sequentially marking the unfolding operation. Results Two components of decision making were identified, participation and rationalization. Participation refers to the degree to which agreement was sought within the surgical team prior to clipping the cystic duct. Rationalization refers to the degree to which the evidential grounds for clipping and cutting were verbalized. Conclusion The decision to clip and cut the cystic duct was jointly made by members of the surgical team, rather than a solitary surgeon in the majority of cases, involving verbal explication of clinical reasoning and verbal agreement. The extent of joint decision making appears to have been mitigated by two factors: trainee's level of training and duration of the case. [ABSTRACT FROM AUTHOR]

Published
2016
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213. Fantasies of medical reality: An observational study of simulation-based medical education.

Author

Pelletier, Caroline and Kneebone, Roger

Subjects
*MEDICAL education, *SIMULATION methods in education, *VIRTUAL reality, *LOYALTY, *TECHNOLOGY
Abstract

Medicine is increasingly taught in immersive simulated environments to supplement the apprenticeship model of work-based learning. Clinical research on this educational practice focuses on its realism, defined as a property of simulation technology. We treat realism as a function of subjective but collectively organized perception and imbued with fantasy, which we define by drawing on Lacanian studies of virtual reality and workplace organization. Data from an observational study of four simulation centres in London teaching hospitals is drawn on to present an account of what was taught and learned about medicine, including medical failure, when medical practice was simulated. [ABSTRACT FROM AUTHOR]

Published
2016
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214. Playful Simulations Rather Than Serious Games.

Author

Pelletier, Caroline and Kneebone, Roger

Abstract

Medical simulation has historically been studied in terms of the delivery of learning outcomes or the social construction of knowledge. Consequently, simulation-based medical education has been researched primarily in terms of the transfer of skills or the reproduction of professional communities of practice. We make a case for studying simulation-based medical education as a cultural practice, situating it within a history of gaming and simulation, and which, by virtue of distinctive aesthetics, does not simply teach skills or reproduce professional practices but rather transforms how medicine can be made sense of. Three concepts from the field of game studies—play, narrative, and simulation—are deployed to interpret an ethnographic study of hospital-based simulation centers and describe underreported phenomena, including the cooperative work involved in maintaining a fictional world, the narrative conventions by which medical intervention are portrayed, and the political consequences of simulating the division of labor. [ABSTRACT FROM AUTHOR]

Published
2016
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222. “Blowing up the Barriers” in Surgical Training

Author

Kassab, Eva, primary, Tun, Jimmy Kyaw, additional, Arora, Sonal, additional, King, Dominic, additional, Ahmed, Kamran, additional, Miskovic, Danilo, additional, Cope, Alexandra, additional, Vadhwana, Bhamini, additional, Bello, Fernando, additional, Sevdalis, Nick, additional, and Kneebone, Roger, additional

Published
2011
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223. Key challenges in simulated patient programs: An international comparative case study

Author

Nestel, Debra, primary, Tabak, Diana, additional, Tierney, Tanya, additional, Layat-Burn, Carine, additional, Robb, Anja, additional, Clark, Susan, additional, Morrison, Tracy, additional, Jones, Norma, additional, Ellis, Rachel, additional, Smith, Cathy, additional, McNaughton, Nancy, additional, Knickle, Kerry, additional, Higham, Jenny, additional, and Kneebone, Roger, additional

Published
2011
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233. Mental Practice Enhances Surgical Technical Skills

Author

Arora, Sonal, primary, Aggarwal, Rajesh, additional, Sirimanna, Pramudith, additional, Moran, Aidan, additional, Grantcharov, Teodor, additional, Kneebone, Roger, additional, Sevdalis, Nick, additional, and Darzi, Ara, additional

Published
2011
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