Ebook: Global Health Informatics Education

“Throughout the world, health care professionals often lack knowledge of the possibilities and limitations of systematically processing data, information and knowledge and of the resulting impact on quality decision-making. They are often asked to use information technologies of which they have limited appreciation, in order to enhance their practices through better use of information resources. However, for systematically processing data, information and knowledge in medicine and in health care, health care professionals who are well-trained in medical informatics or health informatics are needed. It will only be through improved education of health care professionals and through an increase in the number of well-trained workers in health and medical informatics that this lack of knowledge and associated skills can begin to be reversed.

Health and medical informatics education is of particular importance at the beginning of the 21st century for the following reasons …:

1 progress in information processing and information and communication technology is changing our societies;

2 the amount of health and medical knowledge is increasing at such a phenomenal rate that we cannot hope to keep up with it, or store, organise and retrieve existing and new knowledge in a timely fashion without using a new information processing methodology and information technologies;

3 there are significant economic benefits to be obtained from the use of information and communication technology to support medicine and health care;

4 similarly the quality of health care is enhanced by the systematic application of information processing and information and communication technology;

5 it is expected, that these developments will continue, probably at least at the same pace as can be observed today;

6 health care professionals who are well-educated in health or medical informatics are needed to systematically process information in medicine and in health care, and for the appropriate and responsible application of information and communication technology;

7 through an increase in scope and the provision of high quality education in the field of health and medical informatics, well-educated health care professionals world-wide are expected to raise the quality and efficiency of health care.”

These were the first paragraphs of the recommendations of the International Medical Informatics Association (IMIA) on health and medical informatics education

Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics. Methods Inf Med 2000; 39: 267-77. See also http://www.imia.org.

IMIA and in particular its working group on health and medical informatics education (www.IMIA.org) is the leading international society stimulating such educational activities in various ways. As part of these activities, the past and the current chairperson of IMIA's working group on health and medical informatics education, Professor Evelyn Hovenga, Central Queensland University, Rockhampton, Australia, and Professor John Mantas, National and Kapodistrian University of Athens, Greece, have now edited this book on global health informatics education. Their know-how and experience as well as that of the numerous authors of this book will especially be helpful for educators in the field of health/medical informatics. With the knowledge contained in this book, let us try to further improve education and with it, finally, the quality and efficiency of care.

Prof. Dr. Reinhold Haux, Rector of UMIT - the University for Health Sciences, Medical Informatics and Technology, Innsbruck, Austria, IMIA Vice-President for Services

There is a need to establish collaboration alliances or partnerships if we are to provide global Health Informatics educatics education. Agreements need to make provision for the existing diversity between country educational systems as well as variations in funding, legislation and political systems and a number of other issues including intellectual property and copyright. Four virtual University governance models were identified, 1) evolution of existing universities, 2) newly created organisations collectively delivering one type of program eg MBA, 3) a consortium of partners using a common portal and 4) a commercial enterprise. Collectively IMIA academic members need to be in a good position to respond to the global changes in higher education and minimise the risk of failure when establishing a virtual University to collectively deliver Health Informatics education. Others have undertaken a similar path in the past, some successful others not so, we need to learn from these experiences.

During recent years Europe has been engaged in an educational reform that tends to change the whole educational system concerning higher education. The main issues of this reform are related to the free movement of labour and students across the member states. Hence, the need of comparative educational systems, levels, and degrees. The European Union and its executive bodies the European Council and European Commission have issued a series of declarations that are amalgamated in this chapter. The ideas behind these declarations formulate the framework of comparative educational systems that can have a significant impact on the global health informatics education.

Various policies govern the way academic standards are managed and maintained. This includes organisational and program accreditation. Who decides what makes a program acceptable from a discipline and educational perspective? Should IMIA be developing accreditation guidelines for external program accreditation? Also the extent to which individual students are able to gain recognition for study undertaken elsewhere and thus reduce the length of the degree program undertaken varies by higher education provider. For example CQU provides credits based on study undertaken at the same level and where the content is similar as well as in line with overall program learning objectives for up to 50% of the total requirements. Internationally there are a number of governmental and not for profit private organisation providing an infrastructure to assist with the identification of legitimate educational certificates/degrees obtained overseas. In addition overseas skills recognition is undertaken by each University. This chapter examines these from a number of different international perspectives.

Student and teacher exchanges between countries and within the domain of informatics to support health are considered. The availability of guidance appears to be institution‐wide not country‐specific. It is also not related to the discipline within which the exchange will occur. Concerns and issues are considered here in order for potential participants to prepare better for such exchanges. The observations made will be of interest to the administration of the organisations within which exchanges may occur. The investigation of this topic was delphic and pragmatic rather then exhaustive. The author bears no liability for situations that occur in specific locations, but would be pleased to hear of your experiences by email jean@hcjean.demon.co.uk

The Health industry employs health professionals from many disciplines all of whom need to have a basic understanding of helath informaytics principles and how information technologies may be used to improved health service delivery and patient/community/population health outcomes. This is not well understood by the workforce as a whole resulting in a low demand for health informatics education. Many health service managers and policy makers do not appreciate the power and potential usefulness of all health related information and the many technologies now available. This impacts on decisions regarding their acquisition, implementation and staff training/education support. This chapter includes recommended strategies on how to best overcome such knowledge deficits so that greater support for Health Informatics education is achieved.

There is a need to be able to define a Health Informatician by their graduate attributes. Futhermore global health informatics education that facilitates student mobility requires a common understanding of educational outcomes. An internationally agreed health informatics education framework will facilitate us to meet these needs. This chapter provides an overview of a considerable amount of work undertaken in a number of countries and by IMIA's health and medical informatics education working group. We need to make good use of these foundations as they clarify the various health informatics roles and functions together with their associated health informatics competency requirements. We are now in a good position to progress this work by developing a health informatics qualifications and educational framework. This is expected to assist educational providers with curriculum development.

Education in medical informatics is needed not only for those who want to become specialist in this area but also for health professionals. Since students, depending on the program they are enlisted in, require different types of knowledge and skills in medical informatics, curricula should be adapted to those needs. The curriculum structure also depends on the expert level the students want to attain. This contribution presents the knowledge and skills levels for different groups of students and presents two examples of curricula.

This paper provides an overview and description of the processes that address the competencies and credentialing of nurses in the field of nursing informatics (NI). It provides the highlights of the informatics competencies that were proposed as the NI field advanced. It also provides an overview of the ANCC nursing informatics credentialing process. It will also present the credentialing process of the HIMSS organization which offers several different certifications. And finally it will address the new process for the international certification entitled Nursing Informatics Competency Recognition Certificate. The Nursing Informatics Special Interest Group of the International Medical Informatics Association (IMIA/NI‐SIG) approved this certificate at the general assembly meeting during NI'2003 in Rio de Janeiro, Brazil. The certification is based on a professional portfolio that demonstrates expertise in this field for nurses outside the USA and Canada.

Education is only one step towards being recognised as 'fit' to carry out an operational role in informatics to support health at any level. For many years there has been little real 'brand image'. Although significant bodies like IMIA and the BCS welcome a wide range of professionals, there is still confusion over what the discipline really means and does. In order to become a mature profession in the health domain, particularly in the UK, it is necessary to operate a registration process that recognises both qualification and competency, and the responsibility to keep skills and knowledge contemporary. This paper describes the steps taken to establish a registration and regulatory body to maintain high quality professionalism in operational care delivery, academic and commercial organisations in the health domain. The concepts described have resonance internationally.

Efficient and effective delivery of health care requires accurate and relevant knowledge, patient‐centred clinical data and medical information which is available to different actors and institutions in health care. Sharing data and knowledge means understanding the underlying concepts, terms, etc. Therefore a basic requirement in medical education is terminology, coding and classification.

Vocabularies, data sets, schemes are to be used for medical documentation, medical statistics, analysis and system operation. Communication between heterogeneous environments will be possible when common terminologies etc. are available and used during system development.

The following chapters give an overview on this important field of health telematics.

The Health Informatics field is becoming more challenging as the globalisation of economy, the advancement of the technology as well as innovative breakthroughs are being incorporated in the discipline. In Europe as well as in other countries the funding into the research areas of this field is increasing. In this chapter, a brief overview of the field as well the trends of Health Informatics are discussed with respect to the new dimensions that the education of the health care professionals has to tackle in the foreseeable future.

The University of the 21^st century provides learning experiences in a new way, using a variety of new technologies, online resources and new educational delivery methods to suit. Flexibility and the adoption of adult learning methodologies are key strategic directions adopted by many. This chapter provides an overview of student learning behaviours, learning styles and the relationship between these and various teaching technologies in terms of changing academic roles and workloads as well as the need for them to acquire new skills and knowledge to teach effectively in these new environments. The variety of teaching and learning options provided by technology allows education to be provided in an appropriate manner to a broader student demographic than ever before.

Cognitive development refers to a mental process by which knowledge is acquired, stored, and retrieved to solve problems. Therefore, cognitive developmental theories attempt to explain cognitive activities that contribute to students' intellectual development and their capacity to learn and solve problems. Cognitive developmental research has had a great impact on the constructivism movement in education and educational technology. In order to appreciate how cognitive developmental theories have contributed to the design, process and development of constructive e‐learning environments, we shall first present Piaget's cognitive theory and derive an inquiry training model from it that will support a constructivism approach to teaching and learning. Second, we will discuss an example developed by NASA that used the Web as an appropriate instructional delivery medium to apply Piaget's cognitive theory to create e‐learning environments.

Given the many changes that occur in medicine, health care and information technologies we need to prepare all our students to engage in self directed and life long learning. There is considerable opportunity for self‐directed and lifelong learning in health informatics bringing together students in exciting global learning environments, where they have much greater freedom and flexibility in their studies and potentially a wider variety of resources available to them. Self‐directed learning focuses on the process by which adults take control of their own learning, in particular how they set their own learning goals, locate appropriate resources, decide on which learning methods to use and evaluate their progress. Lifelong learning happens in a variety of formal and informal settings building on both intentional and incidental learning experiences.

In a lifelong learning situation the tutor must relinquish the role of expert and assume the role of facilitator, guiding learners to uncover their own knowledge. Against a back drop of rapid advances in technology which can be used to both deliver course materials and provide enhanced learning opportunities, this chapter outlines the pedagogic principles and practices which underpin self‐directed and lifelong learning.

We now have many different ways of delivering educational offerings, hopefully tailored to the educational environments and student characteristics. Programs vary based on country of origin and delivery location, organisational structures, development and delivery technologies, and the business arrangements made between providers and agents/students.

At Central Queensland University (CQU) we deliver the same courses domestically and internationally, often with more than 1000 students per offering, several times per year across 14 campuses located thousands of kilometres apart using face‐to‐face and/or virtual mode. The students are a mix of Australian distance and on campus plus international on campus. This chapter builds on the CQU experience managing these large classes, particularly within the Faculty of Informatics and Communication, using an evolving mix of technologies.

The economic realities of tertiary education require providers to focus on servicing international markets, including an emphasis on student preferences for language of instruction, preferred location (campus or distance delivery) and mode of instruction. Educational delivery requires development and delivery teamwork, maintenance of consistency (quality) in terms of offerings and assessment, appropriate use of technology and cultural awareness.

This paper is an attempt to define the main features of a new educational model aimed at satisfying the needs of a rapidly changing society. The evolutionary epistemology paradigm of culture diffusion in human groups could be the conceptual ground for the development of this model.

Multidimensionality, multi‐disciplinarity, complexity, connectivity, critical thinking, creative thinking, constructivism, flexible learning, contextual learning, are the dimensions that should characterize distance learning models aimed at increasing the epistemological variability of learning communities.

Two multimedia educational software, Dynamic Knowledge Networks (DKN) and Dynamic Virtual Learning Networks (DVLN) are described. These two complementary tools instantiate these dimensions, and were tested in almost 150 online courses.

Even if the examples are framed in the medical context, the analysis of the shortcomings of the traditional educational systems and the proposed solutions can be applied to the vast majority of the educational contexts.

The use of web‐based education has increased significantly. As a result there is a need to focus on methods, employed to evaluate teaching and learning outcomes, when technology is used to enhance learning. This chapter provides an overview of what, how, and why to assess, test and measure learning. The use of technology facilitates a combination of different perspectives within an evaluation process. Not only the knowledge and skills of students but also the learning arrangements are the focus of assessment. Evaluation generates information which can be used for different purposes e.g. planning, implementing and guiding teaching and learning processes timely and for the future as well. Based on experiences of teaching health informatics, an evaluation model for web‐based courses is described. The risks of dishonesty and misbehavior related to web‐based education are recognized.

The development and diffusion of distance learning programmes has made it possible for students to choose their preferred location to study and consequently, they are expected to be able to use new technologies in order to gain the necessary support in a wide range of areas. When universities implement distance learning a number of complex issues have to be considered.

This chapter presents a framework for identifying the most important issues. Furthermore, it examines some of the options and problems, which are necessary to consider.

The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics / medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware.

The IMIA recommendations centre on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three‐dimensional framework. The dimensions are: 1) professionals in health care (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree).

To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http://www.imia.org/wg1).