2004 OPEN FORUM Abstracts
DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF A COMPUTERIZED CLINICAL COMPETENCY PROGRAM IN AN UNDERGRADUATE ALLIED HEALTH SCIENCE PROGRAM.
Hall
CR, MS RRT-NPS RPFT, Reyes JJ, BS RRT-NPS, Taft AA, PhD RRT,
Dennison FH, M.ED RRT RPFT, Hernlen KM, MBA RRT, Baker RR, PhD RRT
RPCT. Medical College of Georgia, Augusta, Georgia.
Background:
Educational programs in allied health science require effective
methods for evaluating and documenting clinical competencies. Many
programs continue to use standardized paper-based forms and written
manuals for this process. These methods are frequently cumbersome and
inefficient for collecting and analyzing point-of-care competency
data from the clinical setting. Advances in portable computer
technology may now offer a viable option to increase efficiency and
effectiveness when documenting and evaluating clinical competencies.
Methods: A clinical competency program for baccalaureate
undergraduate respiratory therapy students (n=26) was developed using
personal data assistants (PDAs) and access to WebCT™. HanDbase™
and Document To Go™ software was used as the platform to
develop the clinical data base and supporting reference documents,
respectively. Clinical competency areas included patient assessment,
oxygen delivery, hyperinflation therapy, bronchial hygiene therapy
and critical care areas in the neonatal, pediatric and adult
populations. The software was loaded onto faculty and students’
PDAs and a centrally located desktop computer for data base
maintenance by the Director of Clinical Education (DCE). Two report
formats, Microsoft Excel™ and web page, were used to provide
competency updates to faculty and students.. Students and faculty
were trained to use the PDAs during clinical rotations. Students
were required to enter the procedures and tasks they observed or
performed at the point-of-care into their PDAs. Faculty or preceptors
verified competencies by electronic signature and students were
required to sync their PDAs to the desktop computer following
clinical rotations. Data analysis was routinely performed by the DCE
to verify student and faculty compliance with the program and to
identify deficiencies in the students’ clinical experiences. In
addition, clinical resource software including drug references and
clinical practice guidelines were also installed
onto the
PDAs.
Results: PDAs and associated software were incorporated
successfully into the clinical setting and allowed faculty and
preceptors to document clinical competencies in a timely manner. The
developed PDA database program, which includes menus with imbedded
submenus, lends itself to the use of many combinations of tasks or
procedures without the large number of pages required to detail the
same information on paper. The PDA allowed unlimited numbers of
competency verification signatures as compared to only 3 on a
previous paper-based manual. Also, students were able to easily
document clinical observations and practices of required tasks and
procedures in the PDA. Electronic physician interaction forms were
also successfully incorporated and utilized. Evaluations demonstrate
that 100% of the students preferred the PDA format versus a
paper-based format to include the valued use of clinical practice
guidelines (AARC), drug references (Epocrates™) and medical
mathematical software (MedCalc™). The DCE was able perform data
analysis of clinical procedures performed on an ongoing basis.
Problems encountered were minimal and included PDA memory
deficiencies, syncing difficulties, and battery power failures, which
were alleviated through initiation of battery charging mechanisms. No
permanent data loss was recorded due to routine software backup
integrated into the syncing process.
Conclusion: Our
experience demonstrated that using computer technology, to include
versatile PDA devices, relevant software, and web-based access
offered a viable option for recording and managing clinical
competency data obtained at the point-of care. Efficiency was
increased by allowing the DCE to review and manipulate the database
on an ongoing basis with minimal effort. This allowed for any
deficiencies in the program to be identified and adjustments to be
made immediately to the clinical rotations to provide for continued
quality improvement of the students’ clinical experience.