ObjectivesHigh rates of depression and suicide and a lack of trained psychiatrists have emerged a... more ObjectivesHigh rates of depression and suicide and a lack of trained psychiatrists have emerged as significant concerns in the low-income and middle-income countries (LMICs) such as the Pacific Island Countries (PICs). Readily available smartphones were leveraged with community health nurses (CHNs) in task-sharing for early identification of suicide and depression risks in Fiji Islands, the largest of PICs. This investigation examines how CHNs can efficiently and effectively process patient information about depression and suicide risk for making diagnostic and management decisions without compromising safety. The research is driven by the theoretical framework of text comprehension (knowledge representation and interpretation) and decision-making.MethodsMobile health (mHealth) Application for Suicide Risk and Depression Assessment (ASRaDA) was designed to include culturally useful clinical guidelines for these disorders. A representative sample of 48 CHNs was recruited and presente...
The fields of behavioral medicine and biomedical informatics, each with its own theories and meth... more The fields of behavioral medicine and biomedical informatics, each with its own theories and methods, have been developing in parallel with little connection until recently. The convergence of research in these disciplines, cognitive informatics, provides enormous opportunities and challenges in addressing the prevention of public health problems and managing disease, as well as in maintaining healthy lifestyles. The limitations of such models in addressing digital health interventions are discussed within the context of cognitive models of behavior and methods of encouraging behavioral change.
Abstract: This article reports a study comparing the problem-solving performance of housestaff wi... more Abstract: This article reports a study comparing the problem-solving performance of housestaff with undergraduate medical training in either conventional or problem-based schools. After reading two clinical cases, residents were required to write differential diagnoses and pathophysiological explanations. Biomedical and clinical knowledge used and reasoning strategies were identified. The results suggest that housestaff performance is influenced by the nature of instruction. Housestaff trained in a conventional curriculum (CC) focused on patient information, separated biomedical from clinical knowledge, and used data-driven strategies. Housestaff from problem-based learning curricula (PBLC) organized their knowledge around generated inferences, integrated biomedical and clinical knowledge, and used hypothesis-driven strategies. Data-driven reasoning appears to be impeded in PBLC, suggesting that PBLC students have difficulties in acquiring problem schemata. Previous investigations a...
Clinical and investigative medicine. Médecine clinique et experimentale, 2000
The cognitive study of expertise in knowledge domains has generated a great deal of knowledge tha... more The cognitive study of expertise in knowledge domains has generated a great deal of knowledge that can be used in the education and training of health care providers. This research has looked at the development and characteristics of expert performance. Design of medical and health education systems that are informed by this research can be powerful tools to improve the quality of medical education.
Despite the increasing global interest in information technology among health care institutions, ... more Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the ge...
DIAGNOSTIC REASONING AND MEDICAL EXPERTISE Vimla L. Patel, Jose F. Arocha, and David R. Kaufman I... more DIAGNOSTIC REASONING AND MEDICAL EXPERTISE Vimla L. Patel, Jose F. Arocha, and David R. Kaufman I. Introduction The study of medical cognition has been the subject of formal inquiry for more than 30 years. The term medical cognition refers to studies of cogni-tive ...
ObjectivesHigh rates of depression and suicide and a lack of trained psychiatrists have emerged a... more ObjectivesHigh rates of depression and suicide and a lack of trained psychiatrists have emerged as significant concerns in the low-income and middle-income countries (LMICs) such as the Pacific Island Countries (PICs). Readily available smartphones were leveraged with community health nurses (CHNs) in task-sharing for early identification of suicide and depression risks in Fiji Islands, the largest of PICs. This investigation examines how CHNs can efficiently and effectively process patient information about depression and suicide risk for making diagnostic and management decisions without compromising safety. The research is driven by the theoretical framework of text comprehension (knowledge representation and interpretation) and decision-making.MethodsMobile health (mHealth) Application for Suicide Risk and Depression Assessment (ASRaDA) was designed to include culturally useful clinical guidelines for these disorders. A representative sample of 48 CHNs was recruited and presente...
The fields of behavioral medicine and biomedical informatics, each with its own theories and meth... more The fields of behavioral medicine and biomedical informatics, each with its own theories and methods, have been developing in parallel with little connection until recently. The convergence of research in these disciplines, cognitive informatics, provides enormous opportunities and challenges in addressing the prevention of public health problems and managing disease, as well as in maintaining healthy lifestyles. The limitations of such models in addressing digital health interventions are discussed within the context of cognitive models of behavior and methods of encouraging behavioral change.
Abstract: This article reports a study comparing the problem-solving performance of housestaff wi... more Abstract: This article reports a study comparing the problem-solving performance of housestaff with undergraduate medical training in either conventional or problem-based schools. After reading two clinical cases, residents were required to write differential diagnoses and pathophysiological explanations. Biomedical and clinical knowledge used and reasoning strategies were identified. The results suggest that housestaff performance is influenced by the nature of instruction. Housestaff trained in a conventional curriculum (CC) focused on patient information, separated biomedical from clinical knowledge, and used data-driven strategies. Housestaff from problem-based learning curricula (PBLC) organized their knowledge around generated inferences, integrated biomedical and clinical knowledge, and used hypothesis-driven strategies. Data-driven reasoning appears to be impeded in PBLC, suggesting that PBLC students have difficulties in acquiring problem schemata. Previous investigations a...
Clinical and investigative medicine. Médecine clinique et experimentale, 2000
The cognitive study of expertise in knowledge domains has generated a great deal of knowledge tha... more The cognitive study of expertise in knowledge domains has generated a great deal of knowledge that can be used in the education and training of health care providers. This research has looked at the development and characteristics of expert performance. Design of medical and health education systems that are informed by this research can be powerful tools to improve the quality of medical education.
Despite the increasing global interest in information technology among health care institutions, ... more Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the ge...
DIAGNOSTIC REASONING AND MEDICAL EXPERTISE Vimla L. Patel, Jose F. Arocha, and David R. Kaufman I... more DIAGNOSTIC REASONING AND MEDICAL EXPERTISE Vimla L. Patel, Jose F. Arocha, and David R. Kaufman I. Introduction The study of medical cognition has been the subject of formal inquiry for more than 30 years. The term medical cognition refers to studies of cogni-tive ...
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