Joi L. Moore

Content Analysis of Online Discussion Forums: A Comparative Analysis of Protocols

The discussion forum is a significant component of online courses. Instructors and students rely on these asynchronous forums to engage one another in ways that potentially promote critical thinking, meaningful problem sovving, and knowledge construction. In spite of the importance of these forums, predominantly used methods for assessing the content and outcomes of these forums has often been limited to frequency counts and other quantitative measures. Only recently have researchers developed protocols for conducting meaningful qualitative analysis of online discussion forums. This study compares the application of two content analysis protocols for online discussion boards by applying both to the content of a one-week student-led discussion. Our analysis provides a detailed description of how to use both protocols and evaluates each for its strengths and weaknesses toward the overall goal of providing educators and researchers with valid tools for assessing discussion forum content.

The effects and interaction of spatial visualization and domain expertise on information seeking

Abstract Information seeking skills are becoming increasingly important as rapid and widespread developments in technology have made information available in more formats and from more sources than ever before. Research in human computer interaction (HCI) has demonstrated that primary cognitive abilities represent a powerful predictor of information-seeking success in electronic information systems. Specifically, spatial visualization ability (SVA) seems to be particularly related to hierarchical menus systems navigation within databases, online learning environments, information archival systems, and virtually all internet web sites. Research indicates that individuals with low SVA take longer to complete tasks and experience more errors on first attempts to find information in hierarchical databases compared to those with high SVA. Understanding the influences of SVA as well as its interaction with other aspects of individual differences, such as domain expertise, is critical to the design of systems intended to accommodate individual differences in users. Thirty-five college students (23 males and 12 females) were selected from the general student body of two universities and assigned to groups based upon their self-reported membership in one of two specific disciplines: business ( n =26) or biology ( n =9). Participants were then assigned to groups based upon scores on tests of SVA using a median-split. Each participant conducted five searches: one neutral search, two searches for business related information, and two searches for biology related information using the FirstSearch archival search tool. A 2×2 factorial Analysis of Variance with one between-groups variable (high vs. low SVA) and one within-group variable (high vs. low domain expertise) indicated a significant main effect of SVA as well as a significant main effect of Domain Expertise on the time required to find their first relevant article on the search topic. The analysis also revealed that there was no main effect for SVA on the total number of relevant articles found during the search period but there was a significant main effect of Domain Expertise on the total total-number-of-relevant-articles found. There was no interaction between SVA and Domain Expertise on either time to first article or total number of articles found. Results of the study extend existing knowledge regarding the effects of SVA and domain expertise on information seeking by demonstrating a strong effect of SVA and domain expertise on information seeking skills. The results of this study also provide evidence in support of interface designs that are friendlier to information seekers who have low SVA. Related findings and suggestions for further research are discussed.

A Comparative Analysis of Online Discussion Participation Protocols

Abstract Thirty-seven graduate students in two course sections were required to contribute to the online discussion of an instructional design case study. The discussion forums required different participation protocols; students in section one implemented a constructive argumentation approach while students in section two had less structure for their postings. The results revealed that both sections exhibited co-construction of knowledge as measured using the content analysis protocol the Interaction Analysis Model (IAM), but the less structured section reached the highest phase of knowledge building. In addition we found that the constructive argumentation approach and the task-oriented nature of the discussion influenced the interactions and co-construction of knowledge. The findings reveal practical implications for effective design of online discussion that may improve the quality of learning.

Information needs and information-seeking behaviour analysis of primary care physicians and nurses: a literature review

BACKGROUND The increase in the adoption of electronic health records (EHR) has contributed to physicians and nurses experiencing information overload. To address the problem of information overload, an assessment of the information needs of physicians and nurses will assist in understanding what they view as useful information to make patient care more efficient. OBJECTIVE To analyse studies that assessed the information needs and information-seeking behaviour of physicians and nurses in a primary care setting to develop a better understanding of what information to present to physicians when they making clinical decisions. METHOD A literature review of studies was conducted with a comprehensive search in PubMed, cinahl, scopus, as well as examination of references from relevant papers and hand-searched articles to identify articles applicable to this review. RESULTS Of the papers reviewed the most common information needs found among physicians and nurses were related to diagnoses, drug(s) and treatment/therapy. Colleagues remain a preferred information source among physicians and nurses; however, a rise in Internet usage is apparent. CONCLUSION Physicians and nurses need access to the Internet and job-specific resources to find practitioner-oriented information. In addition, effective usage of resources is important for improving patient care.

A Diabetes Dashboard and Physician Efficiency and Accuracy in Accessing Data Needed for High-Quality Diabetes Care

PURPOSE We compared use of a new diabetes dashboard screen with use of a conventional approach of viewing multiple electronic health record (EHR) screens to find data needed for ambulatory diabetes care. METHODS We performed a usability study, including a quantitative time study and qualitative analysis of information-seeking behaviors. While being recorded with Morae Recorder software and “think-aloud” interview methods, 10 primary care physicians first searched their EHR for 10 diabetes data elements using a conventional approach for a simulated patient, and then using a new diabetes dashboard for another. We measured time, number of mouse clicks, and accuracy. Two coders analyzed think-aloud and interview data using grounded theory methodology. RESULTS The mean time needed to find all data elements was 5.5 minutes using the conventional approach vs 1.3 minutes using the diabetes dashboard (P <.001). Physicians correctly identified 94% of the data requested using the conventional method, vs 100% with the dashboard (P <.01). The mean number of mouse clicks was 60 for conventional searching vs 3 clicks with the diabetes dashboard (P <.001). A common theme was that in everyday practice, if physicians had to spend too much time searching for data, they would either continue without it or order a test again. CONCLUSIONS Using a patient-specific diabetes dashboard improves both the efficiency and accuracy of acquiring data needed for high-quality diabetes care. Usability analysis tools can provide important insights into the value of optimizing physician use of health information technologies.

Developing a Case-Based Reasoning Knowledge Repository To Support a Learning Community--An Example from the Technology Integration Community

People have long relied on storytelling for communicating ideas, transferring knowledge, and consequently making decisions. This paper describes the design and development of a case-based reasoning (CBR) knowledge repository including its case library and the search engine to support the technology integration community. CBR assumes that community knowledge can be captured in the form of stories (cases) so that the community members learn and solve problems by applying the lessons preserved in the stories to the current situation. The process and results of formative evaluation following the concept of participatory design are reported to set the context for further research and development.

Health information needs, sources, and barriers of primary care patients to achieve patient-centered care: A literature review

To synthesize findings from previous studies assessing information needs of primary care patients on the Internet and other information sources in a primary care setting. A systematic review of studies was conducted with a comprehensive search in multiple databases including OVID MEDLINE, CINAHL, and Scopus. The most common information needs among patients were information about an illness or medical condition and treatment methods, while the most common information sources were the Internet and patients’ physicians. Overall, patients tend to prefer the Internet for the ease of access to information, while they trust their physicians more for their clinical expertise and experience. Barriers to information access via the Internet include the following: socio-demographic variables such as age, ethnicity, income, education, and occupation; information search skills; and reliability of health information. Conclusion: Further research is warranted to assess how to create accurate and reliable health information sources for both Internet and non-Internet users.

Physician Information Needs and Electronic Health Records (EHRs): Time to Reengineer the Clinic Note

Background: Primary care physicians face cognitive overload daily, perhaps exacerbated by the form of electronic health record documentation. We examined physician information needs to prepare for clinic visits, focusing on past clinic progress notes. Methods: This study used cognitive task analysis with 16 primary care physicians in the scenario of preparing for office visits. Physicians reviewed simulated acute and chronic care visit notes. We collected field notes and document highlighting and review, and we audio-recorded cognitive interview while on task, with subsequent thematic qualitative analysis. Member checks included the presentation of findings to the interviewed physicians and their faculty peers. Results: The Assessment and Plan section was most important and usually reviewed first. The History of the Present Illness section could provide supporting information, especially if in narrative form. Physicians expressed frustration with the Review of Systems section, lamenting that the forces driving note construction did not match their information needs. Repetition of information contained in other parts of the chart (eg, medication lists) was identified as a source of note clutter. A workflow that included a patient summary dashboard made some elements of past notes redundant and therefore a source of clutter. Conclusions: Current ambulatory progress notes present more information to the physician than necessary and in an antiquated format. It is time to reengineer the clinic progress note to match the workflow and information needs of its primary consumer.

Using semantic search to reduce cognitive load in an electronic health record

As electronic health records (EHRs) become more prevalent in health care further research is needed to understand the efficacy within clinical contexts from a human-computer interaction viewpoint. Participants (N=10) were given two authentic scenarios that required users to search for patient information. In the first scenario, participants responded to a patient-specific information need as they normally would. In the second scenario, participants were given a semantic search tool that indexed terms within a patient EHR. Upon completion, participants were then asked questions in a semi-structured interview about current usage of the EHR. Statistically significant results revealed that participants were able to more efficiently navigate through an EHR in terms of time (semantic search M=140 vs. browsing M=239 seconds) and number of clicks (semantic search M=11 vs. browsing M=35). This study suggests that semantic search capabilities may be a good way to reduce cognitive load within clinical settings for similar patient-specific information needs.

Addressing human computer interaction issues of electronic health record in clinical encounters

Electronic Health Records (EHRs) are known to reduce medical errors and store comprehensive patient information, and they also impact the physician-patient interaction during clinical encounters. This study reviewed the literature to (1) identify the most common challenges to patient-physician relations while using an EHR during a clinical visit, (2) discuss limitations of the research methodologies employed, and (3) suggest future research directions related to addressing human computer interaction issues when physicians use an EHR in clinical encounters.