2006 HP Technology for Teaching - Worldwide Higher Education Conference From Learning to...

2006 HP Technology for Teaching -

Worldwide Higher Education Conference

From Learning to Professional Training and BackHISS & MoPS Prof. Michele Crudele

Prof. Giulio Iannello Dr. Rossana Alloni

Dr. Maria Cinque



Campus Bio-Medico University

Founded in Rome in 1991

School of Medicine and Faculty of Engineering

Degrees in Medicine (6 years) Nursing (3 years) Dietetics (3 years) Degree plus Master in Biomedical Engineering

(5 years)

822 students (480 females, 322 males), 90 tutors, 65 teachers

Students’ and Patients’ Centered



Scenario

the Degree in Biomedical Engineering is closely related to the Faculty of Medicine

a teaching Hospital (15 departments - 124 beds) is near to the University building

we were able to carry out the projects in real working conditions

The ideal stage



Contents

HISS September 2003 – July 2004HP Grant “Applied Mobile Technology Solutions in Learning Environments – 2003”

MoPSOctober 2005 – September 2006

“HP Technology for Teaching Grant Initiative 2005”

CompanionProjects



BeforeThe ‘old way’



Our goalsLearning and working

To enhance the technological level of both the university campus and the teaching hospital

To teach our students the use of new technologies they will encounter in the future

To give our students a better tool to learn the medical topics they were dealing in the wards

To define the user interface for medical applications on handheld computers

We used the students’ feedback to develop new approaches for a real operational

Hospital Information System for handheld computers



Three years agoThe introduction of wireless technologies



HISSHospital Information System for Students

Funded by HP GrantApplied Mobile Technology Solutions in Learning Environments – 2003”

Students of Medicine, Nursing and Dietetics practicing in the wards were trained to use handheld devices connected through a WLAN to record patients’ data.

Not a simulation but real data



HISSPhases

Sep-Dec 2003development of a simulated Hospital Information System restricted to clinical information, leaving aside all the administrative modules and some specialized areas (radiology, laboratory etc.)

Jan-Mar 2004first users’ trial; analyses of the first results and of students’ feedback

Apr-May 2004development of a new version of HISS

Jun-Jul 2004 second testing phase and gathering of proposals for the

implementation of a Mobile Hospital Information System

HISS

students ofBioEngineering

patients’ electronic records

students ofNursing

set up hardware and software,help desk, monitoring

students ofMedicine

students ofDietetics



HISS dataStudents collecting records

Bedside data collection:

patients history and physical examination (medicine students) collaborative problems, vital signs and fluid balance (nursing students) patient appreciation of hospital food, daily change of diets (dietetics students)

Technical work set up hardware and software, help desk, usage monitoring (bioengineering students)



ChallengesProblems to overcome

Conversion of the written note into an Electronic Patient Record (EPR) suitable for handheld computers

Designing of new interfaces for small devices to collect and examine data at the bedside

Frequent changes in contents due to users’ feedback



HISS SolutionsFlexible user-oriented design

We developed the structure and contents of EPR studying some existing models and addressing the specific needs of our Hospital

To achieve a higher acceptance degree of both teachers and students we used the existing paper models and added predefined answers to make the data entry easier

Using a few XML tags we were able to build more than 30 different data entry masks and change rapidly their contents, without rewriting the code



HISS SolutionsTechnicalities and freedom

Since we were not bound to real production, we were free to try different solutions:

access trough WLAN, GPRS, UMTS XML and RDBM interface adaptation for pocket and desktop PC’s on-line and off-line

Actually, we based our system on ASP.NET, C#, XML and SQL Server



HISS ArchitectureFrom data to the device

• Windows Mobile 2003

• Pocket IE

• integrated WLAN

DataBase

SERVER

• 3 for each ward

• WEP 64 bit

• MAC filtering

• Win 2000 Server

• .NET Framework

• IIS 5.0

• DBMS: SQL Server 2000

ACCESS POINT

The HISS DB collects basic in-patients data from the actual HISthrough a limited read-only access



XML SchemaTechnicalities and freedom

From XML to the device

Measuring the impact

• 143 students + 27 teachers = 170 participants495 medical records243 nursing records193 dietetic records (+ 919 by tutors)

• 1500 patients• 30 different tasks

HISS Results



Speed in finding the answers

Time spared in the transcription of data from paper to PC

Usability “The palm computer does not need a stand” “It is not uncomfortable”

Dietetics students positive comments

HISS Feedback (1)



The students using handheld devices for data entry in structured masks were more accurate than those writing on a blank piece of paper

They noticed more things (having different questions to answer) and they were more precise

Nursing students accuracy

HISS Feedback (2)



After an extensive phase, the project was carried out intensively in those departments that had a positive attitude:cardiology and general surgery (Companion Project)

Medicine students

HISS Feedback (3)



FeedbackFrom another perspective

Prof. Crudele illustrates the results of the HISS project and the passage to MoPS

MoPSMobile Problem Solving

October 2005-September 2006

Videoconferencing tools

Collaborative tools environments



MoPSOriginally addressed to Bio-engineering Students

Problem Solving is a core course of Bio-Engineering curriculum

The fundamental learning and teaching issues that the project addresses are both ethical and technological

Instructors can test students ability to solve problems and to react to users difficulties

Students equipped with Tablet PCs can participate in periodical briefings held in the classroom, then go to the hospital for observation, taking notes and images of the problems, and sending them to the tutors when needed.

The project involved more users than expected (250)



MoPSA typical day at Campus Bio-Medico University

The images and the opinions of the people participating in the project



Companion ProjectsBetween HISS and MoPS

Dieticians (Apr 2004-Feb 2005) conversion of all the activities (such as bedside-kitchen communication, menu planning etc) to an electronic version

Catering School (Oct 2004-Mar 2005) MOWECS (Mobile Wireless Education in a Catering School)

Surgeons (May 2004-May 2005) the surgery department physicians and residents changed the way of rapid data entry at the bedside (previously done on a paper sheet placed on a wooden tablet)



ResultsMeasuring the impact

GANNT Charts

Numbers

Users’ feedback

Monitoring the diffusion of innovation



GANNT Charts



NumbersSummary

HISS: 10 months, 170 users

MAIA: 11 months, 10 users Surgeons: 6 months, 15 users

SAFI: 12 months, 40 users (30 students + 10 tutors and teachers)

MOPS: 12 months, 270 users (250 students: 200 medicine + 50 bioengineering; 20 tutors and teachers)



In all these projectsLearning and Working

Learning on the job: i.e. learning in communities of practice

In this context knowledge is not an asset of the individuals or the groups, but rather of the community as a whole

Mobile and Ubiquitous Technology (MUT) can support the interchange between learning and working

To bridge the knowledge dimension (University, School) with the professional training (Wards, Kitchen)

Focus on:

Mobility• use of handheld devices in complex

environments like hospitals, hotels, residences; in this context the promise of PPC lies in the possibility of enabling location-specific tasks

User-interface• adaptation or creation of teaching

materials to be displayed on pocket or tablet PCs

Educationuse of mobile wireless devices in

hospitals and catering schools, as in all the activities which need a training ‘on the field’

CommunicationIn both domains rapidity of

communication and interaction is a key element

We involved the users in the design process



Understanding users’ work

Our point of viewwas more ethnographic than technological

From anthropology method of participant observation

Distributed co-ordination: distributed nature of the tasks & activities

Plans and procedures: organisational support for the work

Awareness of work: how people keep themselves aware of others’ work



Users’ feedback1. Indicators

Techniques indicated by theorists of interaction design (Preece et al. 2004):

interviews where they were free to express any opinion about the new system;

indicators concerning the activities performed (time needed to accomplish a task, accuracy degree, the possibility to prevent mistakes);

indicators concerning the difficulties in using the device and the improvements in training and learning



Users’ feedback2. Indicators

Monitoring the diffusion of innovation usingEVERETT ROGERS’ categories

Relative Advantage

Compatibility

Complexity

Trialability

Observability

Usability

Scalability



CampusMonitoring through EVERETT ROGERS’ categories

17,21

35,2

13,15

45,4

12,2

5,5

12,21

11,2

33,22

0

5

10

15

20

25

30

35

40

45

50

Professionals Students Teachers

ADVANTAGE

COMPATIBILITY

COMPLEXITY

TRIALABILITY

OBSERVABILITY

SAFI

0

10

20

30

40

50

60

70

80

90

Relativeadvantage

Compat-ibility

Usability Scalability

Students

Teachers

Tutors

2006 HP Technology for Teaching - Worldwide Higher Education Conference

Monitoring through EVERETT ROGERS’ categories

89,8%



Diffusion of innovation Different models

Gabriel Tarde (1903)

Mark Granovetter (1970)

Duncan Watts (1990)



Innovations An upside-down revolution

HISS & MoPS



FutureMoPS possible future issues

Prof. Iannello highlights the most important issues of both projects



Future

Mutual enforcement of new technologies and services for supporting e-learning, exploiting devices already familiar to the students

System of mobile learning must allow greater integration and versatility, using technologies already familiar and pervasive (PDA, Tablet PC, cellular phones)

Sustainability of the projects:1. Using different devices2. Offering students the possibility to access

wireless technologies at low cost

Student centered



FuturePatient centered

REASEARCH PROGRAMS - 2005 - funded by the Italian Ministry of Education and Research

prot. 2005069450

Clinical, nursing and economic outcomes in patients undergoingmajor surgery: role of intensity of care, clinical and instrumental

parameter evaluation, genetic profiling and standardisation of health care



Future

Services for the patients affected with deafness, so that they can be independent from a translator.

Visual clinical record, or a pocket translator available on PDA

Patient centered

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