scholarly journals Mobile Clinical Decision Tools Among Emergency Department Clinicians: Web-Based Survey and Analytic Data for Evaluation of The Ottawa Rules App

10.2196/15503 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e15503 ◽  
Author(s):  
Amanda My Linh Quan ◽  
Ian Stiell ◽  
Jeffrey J Perry ◽  
Michelle Paradis ◽  
Erica Brown ◽  
...  
Keyword(s):  
Medical Students ◽  
New Technologies ◽  
User Behavior ◽  
Clinical Decision ◽  
Perceived Usefulness ◽  
Snowball Sampling ◽  
Web Based ◽  
User Acceptability ◽  
Ottawa Rules ◽  
Study Participants

Background The Canadian CT Head Rule (CCHR), the Canadian Transient Ischemic Attack (TIA) Score, and the Subarachnoid Hemorrhage (SAH) Rule have all previously demonstrated the potential to significantly standardize care and improve the management of patients in emergency departments (EDs). On the basis of user feedback, we believe that the addition of these rules to the Ottawa Rules App has the potential to increase the app’s usability and user acceptability. Objective This study aimed to evaluate the perceived usefulness, acceptability, and uptake of the enhanced Ottawa Rules App (which now includes CCHR, TIA, and SAH Rules) among ED clinicians (medical students, residents, nurses, and physicians). Methods The enhanced Ottawa Rules App was publicly released for free on iOS and Android operating systems in November 2018. This study was conducted across 2 tertiary EDs in Ottawa, Canada. Posters, direct enrollment, snowball sampling, and emails were used for study recruitment. A 24-question Web-based survey was administered to participants via email, and this was used to determine user acceptability of the app and Technology Readiness Index (TRI) scores. In-app user analytics were collected to track user behavior, such as the number of app sessions, length of app sessions, frequency of rule use, and the date app was first opened. Results A total of 77 ED clinicians completed the study, including 34 nurses, 12 residents, 14 physicians, and 17 medical students completing ED rotations. The median TRI score for this group was 3.38, indicating a higher than average propensity to embrace and adopt new technologies to accomplish goals in their work or daily lives. The majority of respondents agreed or strongly agreed that the app helped participants accurately carry out the clinical rules (56/77, 73%) and that they would recommend this app to their colleagues (64/77, 83%). Feedback from study participants suggested further expansion of the app—more clinical decision rules (CDRs) and different versions of the app tailored to the clinician role. Analysis and comparison of Google Analytics data and in-app data revealed similar usage behavior among study-enrolled users and all app users globally. Conclusions This study provides evidence that using the Ottawa Rules App (version 3.0.2) to improve and guide patient care would be feasible and widely accepted. The ability to verify self-reported user data (via a Web-based survey) against server analytics data is a notable strength of this study. Participants’ continued app use and request for the addition of more CDRs warrant the further development of this app and call for additional studies to evaluate its feasibility and usability in different settings as well as assessment of clinical impact.

scholarly journals Mobile Clinical Decision Tools Among Emergency Department Clinicians: Web-Based Survey and Analytic Data for Evaluation of The Ottawa Rules App (Preprint)

2019 ◽  
Author(s):  
Amanda My Linh Quan ◽  
Ian Stiell ◽  
Jeffrey J Perry ◽  
Michelle Paradis ◽  
Erica Brown ◽  
...  
Keyword(s):  
Medical Students ◽  
New Technologies ◽  
User Behavior ◽  
Clinical Decision ◽  
Perceived Usefulness ◽  
Snowball Sampling ◽  
Web Based ◽  
User Acceptability ◽  
Ottawa Rules ◽  
Study Participants

BACKGROUND The Canadian CT Head Rule (CCHR), the Canadian Transient Ischemic Attack (TIA) Score, and the Subarachnoid Hemorrhage (SAH) Rule have all previously demonstrated the potential to significantly standardize care and improve the management of patients in emergency departments (EDs). On the basis of user feedback, we believe that the addition of these rules to the <i>Ottawa Rules App</i> has the potential to increase the app’s usability and user acceptability. OBJECTIVE This study aimed to evaluate the perceived usefulness, acceptability, and uptake of the enhanced <i>Ottawa Rules App</i> (which now includes CCHR, TIA, and SAH Rules) among ED clinicians (medical students, residents, nurses, and physicians). METHODS The enhanced <i>Ottawa Rules App</i> was publicly released for free on iOS and Android operating systems in November 2018. This study was conducted across 2 tertiary EDs in Ottawa, Canada. Posters, direct enrollment, snowball sampling, and emails were used for study recruitment. A 24-question Web-based survey was administered to participants via email, and this was used to determine user acceptability of the app and Technology Readiness Index (TRI) scores. In-app user analytics were collected to track user behavior, such as the number of app sessions, length of app sessions, frequency of rule use, and the date app was first opened. RESULTS A total of 77 ED clinicians completed the study, including 34 nurses, 12 residents, 14 physicians, and 17 medical students completing ED rotations. The median TRI score for this group was 3.38, indicating a higher than average propensity to embrace and adopt new technologies to accomplish goals in their work or daily lives. The majority of respondents agreed or strongly agreed that the app helped participants accurately carry out the clinical rules (56/77, 73%) and that they would recommend this app to their colleagues (64/77, 83%). Feedback from study participants suggested further expansion of the app—more clinical decision rules (CDRs) and different versions of the app tailored to the clinician role. Analysis and comparison of Google Analytics data and in-app data revealed similar usage behavior among study-enrolled users and all app users globally. CONCLUSIONS This study provides evidence that using the <i>Ottawa Rules App</i> (version 3.0.2) to improve and guide patient care would be feasible and widely accepted. The ability to verify self-reported user data (via a Web-based survey) against server analytics data is a notable strength of this study. Participants’ continued app use and request for the addition of more CDRs warrant the further development of this app and call for additional studies to evaluate its feasibility and usability in different settings as well as assessment of clinical impact.

scholarly journals Determinants of COVID-19 vaccine acceptance in Saudi Arabia: a web-based national survey

2020 ◽  
Author(s):  
Bijaya Kumar Padhi ◽  
Mohammed Al-Mohaithef
Keyword(s):  
Saudi Arabia ◽  
Perceived Risk ◽  
Vaccination Program ◽  
Vaccine Hesitancy ◽  
Global Public Health ◽  
Snowball Sampling ◽  
Vaccine Acceptance ◽  
Web Based ◽  
The Future ◽  
Study Participants

AbstractBackgroundVaccine hesitancy is a potential threat to global public health. Since, there is an unprecedented global effort to develop a vaccine against the COVID-19 pandemic, much less is known about its acceptance in the community. Understanding key determinants that influence the preferences and demands of a future vaccine by the community may help to develop strategies for improving the global vaccination program. This study aimed to assess the prevalence of the acceptance of COVID-19 vaccine, and their determinants among people in Saudi Arabia.MethodsA web-based, cross-sectional study was conducted using snowball sampling strategy under a highly restricted environment. A bilingual, self-administered anonymous questionnaire was designed and sent to 1000 study participants through social media platforms and email. Study participants were recruited across the country, including the four major cities (Riyadh, Dammam, Jeddah, and Abha) in Saudi Arabia. Associations between COVID-19 vaccine acceptance and sociodemographic profile of the respondents were explored using the chi-squared test. Key determinants that predict vaccine acceptance among respondents were modelled using logistic regression analysis.ResultsOf the 1000 survey invitees, 992 responded to the survey (response rate, 99.2%). The majority (65.8%) of the study participants were female, 29.53% were in the age group (36–45 years), and 17.9% were non-Saudi. Of the 992 respondents, 642 (64.72%) showed interest to accept the COVID-19 vaccine if it is available. Willingness to accept the future COVID-19 vaccine is relatively high among older age groups (79.2% among 45+ year old), being married (69.3%), participants with education level postgraduate degree or higher (68.8%), non-Saudi (69.1%), employed in government sector (68.9%). In multivariate model, respondents who were above 45 years (aOR: 2.15; 95% CI: 1.08-3.21), and married (aOR: 1.79; 95% CI: 1.28-2.50) were significantly associated with vaccine acceptance (p <.05). Besides, people having trust in the health system were most likely to accept the vaccine (aOR: 3.05; 95% CI: 1.13-4.92), and those having a higher perceived risk of acquiring infection were 2.13 times (95% CI: 1.35-3.85) higher odds of accepting the vaccine.ConclusionAddressing sociodemographic determinants relating to the COVID-19 vaccination may help to increase uptake of the global vaccination program to tackle future pandemics. Targeted health education interventions are needed to increase the uptake of the future COVID-19 vaccine.

scholarly journals Challenges involved in establishing a web-based clinical decision support tool in community health centers

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 100488
Author(s):  
Rachel Gold ◽  
Mary Middendorf ◽  
John Heintzman ◽  
Joan Nelson ◽  
Patrick O'Connor ◽  
...  
Keyword(s):  
Decision Support ◽  
Community Health ◽  
Clinical Decision Support ◽  
Community Health Centers ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Health Centers ◽  
Web Based ◽  
Support Tool ◽  
Clinical Decision Support Tool

scholarly journals Clinician acceptance of complex clinical decision support systems for treatment allocation of patients with chronic low back pain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie Jansen-Kosterink ◽  
Lex van Velsen ◽  
Miriam Cabrita
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Perceived Usefulness ◽  
Intention To Use ◽  
Low Back ◽  
Research Model ◽  
Online Questionnaire ◽  
Treatment Allocation

Abstract Background The uptake of complex clinical decision support systems (CDSS) in daily practice remains low, despite the proven potential to reduce medical errors and to improve the quality of care. To improve successful implementation of a complex CDSS this study aims to identify the factors that hinder, or alleviate the acceptance of, clinicians toward the use of a complex CDSS for treatment allocation of patients with chronic low back pain. Methods We tested a research model in which the intention to use a CDSS by clinicians is influenced by the perceived usefulness; this usefulness, in turn is influenced by the perceived service benefits and perceived service risks. An online survey was created to test our research model and the data was analysed using Partial Least Squares Structural Equation Modelling. The study population consisted of clinicians. The online questionnaire started with demographic questions and continued with a video animation of the complex CDSS followed by the set of measurement items. The online questionnaire ended with two open questions enquiring the reasons to use and not use, a complex CDSS. Results Ninety-eight participants (46% general practitioners, 25% primary care physical therapists, and 29% clinicians at a rehabilitation centre) fully completed the questionnaire. Fifty-two percent of the respondents were male. The average age was 48 years (SD ± 12.2). The causal model suggests that perceived usefulness is the main factor contributing to the intention to use a complex CDSS. Perceived service benefits and risks are both significant antecedents of perceived usefulness and perceived service risks are affected by the perceived threat to autonomy and trusting beliefs, particularly benevolence and competence. Conclusions To improve the acceptance of complex CDSSs it is important to address the risks, but the main focus during the implementation phase should be on the expected improvements in patient outcomes and the overall gain for clinicians. Our results will help the development of complex CDSSs that fit more into the daily clinical practice of clinicians.

scholarly journals A day in the life: a qualitative study of clinical decision-making and uptake of neurorehabilitation technology

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Courtney Celian ◽  
Veronica Swanson ◽  
Maahi Shah ◽  
Caitlin Newman ◽  
Bridget Fowler-King ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
New Technologies ◽  
Clinical Decision ◽  
Relative Advantage ◽  
Personal Attributes ◽  
Design Work ◽  
Cognitive Limitations ◽  
Knowledge And Beliefs ◽  
Cord Injury

Abstract Background Neurorehabilitation engineering faces numerous challenges to translating new technologies, but it is unclear which of these challenges are most limiting. Our aim is to improve understanding of rehabilitation therapists’ real-time decision-making processes on the use of rehabilitation technology (RT) in clinical treatment. Methods We used a phenomenological qualitative approach, in which three OTs and two PTs employed at a major, technology-encouraging rehabilitation hospital wrote vignettes from a written prompt describing their RT use decisions during treatment sessions with nine patients (4 with stroke, 2 traumatic brain injury, 1 spinal cord injury, 1 with multiple sclerosis). We then coded the vignettes using deductive qualitative analysis from 17 constructs derived from the RT literature and the Consolidated Framework for Implementation Research (CFIR). Data were synthesized using summative content analysis. Results Of the constructs recorded, the five most prominent are from CFIR determinants of: (i) relative advantage, (ii) personal attributes of the patients, (iii) clinician knowledge and beliefs of the device/intervention, (iv) complexity of the devices including time and setup, and (v) organizational readiness to implement. Therapists characterized candidate RT as having a relative disadvantage compared to conventional treatment due to lack of relevance to functional training. RT design also often failed to consider the multi-faceted personal attributes of the patients, including diagnoses, goals, and physical and cognitive limitations. Clinicians’ comfort with RT was increased by their previous training but was decreased by the perceived complexity of RT. Finally, therapists have limited time to gather, setup, and use RT. Conclusions Despite decades of design work aimed at creating clinically useful RT, many lack compatibility with clinical translation needs in inpatient neurologic rehabilitation. New RT continue to impede the immediacy, versatility, and functionality of hands-on therapy mediated treatment with simple everyday objects.

scholarly journals Burnout syndrome in Spanish medical students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javier Gil-Calderón ◽  
Jéssica Alonso-Molero ◽  
Trinidad Dierssen-Sotos ◽  
Inés Gómez-Acebo ◽  
Javier Llorca
Keyword(s):  
Medical Students ◽  
Family Support ◽  
Maslach Burnout Inventory ◽  
Influential Factors ◽  
Burnout Syndrome ◽  
Small Samples ◽  
Academic Efficacy ◽  
Web Based ◽  
Huge Impact ◽  
Vocational Studies

Abstract Background Burnout syndrome is a frequent syndrome related to people that feel a deterioration in their daily activities due to highly demandant psychological requirements in their workplaces. Within last decades, this syndrome has been studied across medical professionals, concluding that stress levels that physicians suffer is high enough to make them develop burnout syndrome. In the case of medical students, there are some recent studies, although with small samples. For this reason, given that this phenomenon may produce a huge impact in medical students’ development, the aim of this study is to analyze the influential factors that may contribute to its occurrence. Methods The necessary information was gathered through a web-based questionnaire, divided in two parts. The first part of the survey included questions related to personal aspects of the students. Burnout related questions (second part) were divided in three subscales to evaluate exhaustion, cynicism, and academic efficacy levels. Results Family support for studying medicine is associated with lower burnout levels in all three scales of the Maslach Burnout Inventory. The number of years spent in the degree show the opposite trend: the more years in the degree, the higher score in all burnout scales. Conclusions Burnout syndrome is a problem among medical students in Spain that increases with the number of years studying medicine. It should be also noticed that family support and vocational studies are independent factors related to lower levels of burnout.

scholarly journals Webinar : An Initial Experience with Web-based Real Time Interactive Clinical Seminars for Japanese Medical Students

2010 ◽  
Vol 11 (2) ◽  
pp. 87-90 ◽  
Author(s):  
Gerald H. Stein ◽  
Ayako Shibata ◽  
Miho Kojima Bautista ◽  
Yasuharu Tokuda
Keyword(s):  
Medical Students ◽  
Real Time ◽  
Initial Experience ◽  
Web Based
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