Everything I Know About Informatics, I Didn't Learn in Nursing School
To date, an environmental scan has been undertaken in the hope of obtaining representative samples of schools of nursing, medicine and pharmacy. Additionally, recent graduates were asked to participate in a survey of perceived readiness for the workplace in relation to the use of ICTs. Unfortunately, the response rates to both surveys were insufficient to yield any meaningful conclusions. Unless there has been a dramatic upturn in the integration of informatics among schools of nursing, one might assume that the findings from the 2003 Canadian Nursing Informatics Association (Nagle and Clarke 2004) study of 79 schools of nursing are likely still a reflection of the status quo. That study showed that less than 40% of the schools had addressed or integrated informatics content. I suspect that there is still much work to be done.
So where to begin? Within healthcare organizations, there are
now many experiences in the field with successful and failed
implementations. What is well known is the importance of user
engagement from the outset of any EHR initiative. What is yet
unknown is the effectiveness of the various models and strategies
being used within healthcare organizations to get practitioners
engaged, educated and trained in the use of EHR applications. Based
upon personal experience and discussion with many colleagues across
Canada, educators in healthcare organizations need
- multiple and flexible methods and tools for delivery,
- knowledge of adult learning principles and
- credibility among their peers. "Expert user" does not equate to "educator."
Clinician users want
- sustained support post-implementation,
- engaged leadership and
- extended opportunities to develop a comfort level with applications.
These are simple concepts, touted by many as key success factors, but they are not always evident. Among the many challenges within healthcare organizations is not only skillful integration of ICTs with existing practices, but also sufficient time to educate and train an already over-taxed workforce. Implementation ultimately comes down to the perceived value of the EHR tools to support clinical care delivery effectively - no value, no buy-in, no commitment to learn and use.
Canadian schools of nursing are of the highest calibre in the world; faculty are renowned worldwide for their programs of research and publications. Many are even conducting leading-edge research in the informatics realm. Whether recognized or not, in today's world, informatics is simply a part of every faculty member's tool kit. Therefore, it should not be offered or developed as a separate course. Rather, it should be integrated with approaches to the theoretical and practical teachings in every course. A student nurse recently lamented to me that his class was told they could not use electronic textbooks because of faculty discomfort with the medium. Today's students want their texts available on a handheld device; they want to use technology in their learning and practice. Educators need to encourage the integration of technology, understand the use and potential of EHRs and become champions in their own right. Otherwise, I fear we run the risk of discouraging the prospective technology-savvy student from pursuing a career in nursing. Hopefully, unlike my generation, nursing students and graduates of the future will know enough about informatics to position themselves in the emerging clinical world of ICTs.
While writing this column, I reflected upon the related contributions of the late Dr. Pat Griffin to this work. As Executive Director of the Canadian Association of Schools of Nursing (CASN) and a member of the Infoway Nursing Advisory Group, Pat brought thoughtful insights and her commitment to our discussions about engaging nurse educators in the informatics agenda. She was a self-proclaimed "non-techy," telephoning me in recent months to confess abashedly that she had misplaced my e-mail address - "it would have to be you, of all people!" Nonetheless, she recognized the importance of addressing the delivery of informatics knowledge and skills to nurses. In fact, the week prior to her death, she participated in her usual whole-hearted way in an all-day meeting of the advisory group and was planning for my participation in the CASN board meeting the following week. In her memory, I encourage all educators of nurses to boldly embrace this challenge!
About the Author
Lynn M. Nagle, RN, PhD
Senior Nursing Advisor
Canada Health Infoway
Hebert, M. 2000. "A National Education Strategy to Develop Nursing Informatics Competencies." Canadian Journal of Nursing Leadership 13(2): 11-14.
Infoway. 2007. "Results of Surveys of Canadian Schools of Nursing and Recent Nursing Graduates." Unpublished.
Kaminski, J. 2006. Nursing Informatics at Kwantlen University College. Retrieved August 14, 2007. <http://www.nursing-informatics.com/kwantlen/ >.
Nagle, L.M. 2001. Informatics Curriculum Task Force Report. Submitted on behalf of the Ontario Nursing Informatics Group to the Registered Nurses Association of Ontario. Unpublished.
Nagle, L.M. and H.F. Clarke. 2004. "Assessing Informatics in Canadian Schools of Nursing." Proceedings 11th World Congress on Medical Informatics, San Francisco, CA.
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