Browsing by Author "Strayer, Scott M"
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- ItemAssessing medical residents' usage and perceived needs for personal digital assistants.(2004-03-23) Barrett, James R; Strayer, Scott M; Schubart, Jane RHealth care professionals need information delivery tools for accessing information at the point of patient care Personal digital assistants PDAs or hand held devices demonstrate great promise as point of care information devices An earlier study The Constellation Project experience and evaluation of personal digital assistants in the clinical environment in Proceedings of the 19th Annual Symposium on Computer Applications in Medical Care 1995 678 on the use of PDAs at the point of care found that hardware constraints such as memory capability limited their usefulness however they were used frequently for accessing medical references and drug information The Constellation Project experience and evaluation of personal digital assistants in the clinical environment in Proceedings of the 19th Annual Symposium on Computer Applications in Medical Care 1995 678 Since this study was completed in 1995 hand held computer technology has advanced rapidly and between 26 and 50 of physicians currently use PDAs Physician s use of hand helds increases from 15 in 1999 to 26 in 2001 Harris interactive poll results Harris Poll 8 24 2002 electronic citation ACP ASIM survey finds nearly half of U S members use hand held computers ACP ASIM press release American College of Physicians 9 3 2002 electronic citation This use appears higher among residents with one recent study finding that over two thirds of family practice residencies use hand held computers in their training programs J Am Med Inform Assoc 9 1 2002 80 In this study we systematically evaluate PDA usage by residents in our institution using quantitative and qualitative methods Our evaluation included a brief on line survey of 88 residents in seven residency programs including primary care and specialty practices The surveys were completed between 26 October 2001 and 30 April 2002 Follow up interviews with 15 of the surveyed residents were then conducted between 24 April 2002 and 13 May 2002 The original contributions of this study are the evaluation of residents in primary and specialty programs and evaluation of both medical application software and the conventional personal organizational software such as calendars and to do lists This evaluation was also conducted using significantly advanced hardware and software compared with previous studies The Constellation Project experience and evaluation of personal digital assistants in the clinical environment in Proceedings of the 19th Annual Symposium on Computer Applications in Medical Care 1995 678 Results of our survey and follow up interviews of residents showed most residents use PDAs daily regardless of practice or whether their program encourages PDAs Uses include commercial medical references and personal organization software such as calendars and address books Concerns and drawbacks mentioned by these residents included physical size of the PDA and the potential for catastrophic data loss Another issue raised by our results suggests that security and Health Information Portability and Accountability Act HIPAA compliance need to be addressed in part by resident education about securing patient data on PDAs Overall PDAs may become even more widely used if two issues can be addressed a providing secure clinical data for the current patients of a given resident and b allaying concerns of catastrophic data loss from their PDAs e g by educating residents about procedures to recover information from PDA backup files
- ItemA handheld computer smoking intervention tool and its effects on physician smoking cessation counseling.(2006-06-30) Strayer, Scott M; Rollins, Lisa K; Martindale, James ROBJECTIVE The objective of this study was to evaluate a handheld computer smoking cessation intervention tool designed to assist physicians in their smoking cessation counseling with patients METHODS This study used a pre post survey design with a 4 month trial period for the software Study participants included 22 faculty and resident physicians from the University of Virginia Paired samples t tests were used to assess mean differences in the 4 main subscales physician behavior attitudes comfort related to counseling patients about smoking cessation and knowledge RESULTS No statistically significant mean differences were found for physician behavior mean increase 0 44 P 55 or physician attitude mean increase 0 44 P 16 A statistically significant mean increase of 2 29 was observed for the physician comfort subscale t 3 87 df 16 P 001 Physicians indicated improved comfort in counseling patients about smoking cessation P 007 and improved comfort in using the Public Health Service Clinical Practice Guidelines P 012 CONCLUSION Physician comfort level in counseling patients about smoking cessation can be improved through handheld computer software When used in conjunction with other practice modifications this tool has the potential to improve physician smoking cessation intervention practices
- ItemImproving smoking cessation counseling using a point-of-care health intervention tool (IT): from the Virginia Practice Support and Research Network (VaPSRN).(2013-03-08) Strayer, Scott M; Heim, Steven W; Rollins, Lisa K; Bovbjerg, Marit L; Nadkarni, Mohan; Waters, David B; Hauck, Fern R; Schorling, John BPURPOSE Primary care practices are an ideal setting for reducing national smoking rates because 70 of smokers visit their physician annually yet smoking cessation counseling is inconsistently delivered to patients We designed and created a novel software program for handheld computers and hypothesized that it would improve clinicians ability to provide patient tailored smoking cessation counseling at the point of care METHODS A handheld computer software program was created based on smoking cessation guidelines and an adaptation of widely accepted behavioral change theories The tool was evaluated using a validated before after survey to measure physician smoking cessation counseling behaviors knowledge and comfort self efficacy RESULTS Participants included 17 physicians mean age 41 years 71 male 5 resident physicians from a practice based research network After 4 months of use in direct patient care physicians were more likely to advise patients to stop smoking P 049 and reported an increase in use of the 5 As P 03 Improved self efficacy in counseling patients regarding smoking cessation P 006 was seen as was increased comfort in providing follow up to patients P 04 CONCLUSIONS Use of a handheld computer software tool improved smoking cessation counseling among physicians and shows promise for translating evidence about smoking cessation counseling into practice and educational settings
- ItemInformation needs of residents during inpatient and outpatient rotations: identifying effective personal digital assistant applications.(2004-01-19) Barrett, James R; Strayer, Scott M; Schubart, Jane RLast year we reported 2002 AMIA Proceedings p 971 on how medical school residents report on their use of personal digital assistants PDA or hand held devices We first surveyed 88 residents in six residency programs representing both generalist and specialist practices Family Medicine Internal Medicine Neurology Pediatrics Radiology and Surgery Following our survey we contacted some of these same residents for follow up advantages and disadvantages of specific software applications and what information residents would like to have on their PDAs Our survey and interview results included several specific advantages and disadvantages of PDA usage by residents Advantages included 1 many residents readily adapted the personal organizers calendars address books to do lists to help keep track of their clinical tasks and keeping in touch with patients 2 commercial medical references such as ePocrates are used most by the surveyed residents to answer immediate medical questions Perceived drawbacks include 1 calculators and patient trackers that were not clearly able to be tailored to residents needs e g to limit and modify types of calculations to just those actually used 2 physical size both too small a display size and too bulky overall and 3 several residents mentioned a concern of becoming too dependent on one source of information a source that was viewed as being too easy to lose or break Three broad patterns emerged First residents in all seven of our surveyed practices use PDAs and most surveyed residents use them on a daily basis we conclude that PDAs are being widely used across the spectrum of generalist to specialty practices regardless of whether a residency program specifically encourages PDA usage Second security and HIPAA compliance issues need to be addressed in part by resident education about archiving PDA files Lastly PDAs may become even more widely used if clinical data specific to an individual resident can easily and securely be maintained on PDAs Design of Current Studies Our current study builds on the above perceived needs we will follow residents during portions of a clinical day Preliminary observations in three clinical areas Medical Intensive Care Unit MICU General Medicine Outpatient and Family Medicine Outpatient confirm the conclusions of our previous study PDAs are used for 1 medical references e g five minute clinical consult Infotriever 2 pharmaceutical information such as ePocrates and 3 professional organization calendar address book Our intention in this new study is to identify the overall flow of information and how PDAs might improve the information flow in clinical settings We choose to observe residents in both inpatient and outpatient clinics We anticipate that PDAs will have different uses in these two settings preliminary observations in one outpatient clinic Family Medicine suggests that PDAs are used during the doctor patient interaction specifically to suggest the importance of smoking cessation Preliminary observations in an inpatient clinical setting the MICU suggest that PDAs are primarily used outside of patient rooms e g to make medical calculations and to obtain diagnostic procedures We plan to observe residents during various parts of their days in order to develop a detailed understanding of what information sources e g consultations computer reports paper charts are available at different times and which sources are frequently used This information will help us develop a pocket sized paper based checksheet that the residents carry with them The checksheet will help us identify which information sources are used at various times and frequencies Interviews with the residents using these checksheets should provide additional details of how utility of the resource disadvantages of the resource etc Specific Goals The goals of our current study include 1 direct observations of residents PDA usage to determine how this compares to our previous results above ts above 2 determine if PDA usage varies between outpatient and inpatient clinics 3 determine how different information sources are used in these clinics Our long range goal includes considering how PDAs might improve the information gathering processes by identifying useful PDA applications along with user interfaces residents find intuitive
- ItemInstitutional support for handheld computing: clinical and educational lessons learned.(2010-04-14) Stephens, Mark B; Waechter, Donna; Williams, Pamela M; Williams, Alan L; Yew, Kenneth S; Strayer, Scott MHandheld computing devices or personal digital assistants PDAs are used often in the health care setting They provide a convenient way to store and carry either personal or reference information and can be used to accomplish other tasks associated with patient care This article reports clinical and educational lessons learned from a longitudinal institutional initiative designed to provide medical students with PDAs to facilitate patient care and assist with clinical learning
- ItemLearning PDA skills online is feasible and acceptable to clerkship students.(2008-11-28) Strayer, Scott M; Williams, Pamela M; Stephens, Mark B; Yew, Kenneth SBACKGROUND The feasibility and acceptability of teaching medical students to use PDA clinical decision support tools via a Web based course have not been previously evaluated METHODS A total of 119 third year family medicine clerkship students completed a baseline survey on PDA use attended an introductory PDA lecture and were invited to voluntarily access a Web based course through Blackboard All students had been previously issued with PDAs in their second year RESULTS At baseline 95 of students reported having removed their PDA from its box 59 reported using it weekly and 71 had loaded medical applications From August 2006 March 2007 36 students accessed the course 610 times range 8 54 The PDA cases comprised 63 of hits course resources 30 of hits and course information 6 of hits Students evaluated the course equally to other clerkship didactics CONCLUSIONS It is feasible and acceptable to students to teach PDA decision support tools in an online course In our setting for the minority of students who chose to learn online the format was successful and met their needs
- ItemPatient attitudes toward physician use of tablet computers in the exam room.(2010-10-07) Strayer, Scott M; Semler, Matthew W; Kington, Marit L; Tanabe, Kawai OBACKGROUND AND OBJECTIVES Previous research has examined patients attitudes toward use of exam room computers by physicians Our objective was to determine patient attitudes toward physicians exam room use of new tablet computers METHODS A random sample of 96 patients was interviewed immediately following a visit to a physician at an outpatient family medicine clinic at a large academic medical center in central Virginia We excluded visits to first year residents Patients were asked about their attitudes toward technology use in the exam room using a previously validated 16 item structured questionnaire on patient attitudes toward technology use in the exam room RESULTS The response rate was 97 Survey results showed mostly positive patient perceptions of the tablets regardless of age gender race ethnicity and income There were differences in attitudes toward privacy by race and education use of tablets by the physician by education and age depersonalization of the office visit by race and speed of medical files overview by age CONCLUSIONS The use of tablet computers by physicians in the examining room is perceived positively by most patients
- ItemA PDA-based counseling tool for improving medical student smoking cessation counseling.(2010-05-12) Strayer, Scott M; Pelletier, Sandra L; Martindale, James R; Rais, Salehin; Powell, Jon; Schorling, John BBACKGROUND AND OBJECTIVES There is little research on training medical students in smoking cessation counseling SCC This study aimed to determine if a personal digital assistant PDA based SCC tool can improve medical student SCC METHODS We conducted a randomized controlled trial with third year medical students SCC behaviors comfort and knowledge were assessed using a validated survey before students attended a workshop on SCC Student groups were then randomized to receive a paper based reminder tool or the reminder plus a PDA based SCC tool The validated survey was repeated upon clerkship completion and a videotaped standardized patient interview was assessed by trained reviewers using a 24 item SCC checklist Focus groups assessed satisfaction with the PDA tool usability and barriers to use RESULTS SCC behaviors knowledge and comfort increased among all participants with no statistical differences between groups The PDA tool group performed 62 of key SCC activities during the videotaped interview while the control group performed 69 Students reported discomfort using the PDA with patients lack of time and lack of training as barriers to use of the tool CONCLUSIONS We demonstrated improvement of SCC skills by third year medical students using a workshop combined with a supplemental reference tool However a PDA based tool did not increase key SCC behaviors compared with a paper based reminder For a PDA intervention to be effective in this setting the tool must be simplified and additional training provided