Since 2002, I have taught an introductory informatics course in a master’s degree program for clinical research. The course consists of two components: 1) a two-day summer workshop that covers searching (MEDLINE and general internet) and software collaboration tools and 2) a fall semester course that surveys biomedical informatics topics selected for their utility to clinical researchers. In addition, technical topics (hardware, networking, programming, etc.) are included to provide a basis for understanding information technology.
Learning objectives address the following topics:
- The Internet
- Evidence-based Medicine
- Hardware and Software
- Clinical Database Design
- Electronic Health Records/Clinical Information Systems
- Data Standards and Interoperability
- Decision Support/Practice Guidelines
- Quality Improvement and Patient Safety/Medical Errors
- Privacy, Security, and Confidentiality (HIPAA)
At the start of the semester, students are given a simple research question (the same for everyone) for which they are required to build a clinical database using informatics standards (ICD, CPT, SNOMED, etc.). This allows them to be introduced to data modeling and database design in a close to real-world setting. Each class meeting consists of a one-hour lecture and a two-hour “lab” session. This works well because it allows students to ask questions as they work on their database projects. It also aids retention because they can immediately apply what they have learned.
Lecture topics are ordered as listed above. This sequence allows students to become comfortable with data modeling/database design concepts and techniques as a prelude to studying clinical systems such as EHRs, data repositories, and data warehouses. The last four topics then focus on the use and protection of clinical data.
After eight years, here are a few observations that have held over time:
- Despite the ubiquity of the Internet and devices such as smart phones, few students are familiar with the advanced search features of sites such as Google and Bing.
- Students with clinical backgrounds are rarely proficient in MEDLINE searching. The searching skills gained from the two-day seminar are often cited as a significant aid to clinical practice.
- Students who have had the hands-on sessions seem to have a better grasp of both the limitations and capabilities of clinical systems than those who have had only lectures.
- Over the years, the level of computer literacy of incoming students does not seem to have changed appreciably. Students are familiar with limited aspects of specific software such as Facebook, MS Word, or email; but lack deeper knowledge of operating system features (keyboard shortcuts, built-in apps/accessories, etc.).
When I created this course, clinical research informatics was just getting underway as a formal discipline. At that time, an introductory course seemed to provide sufficient background for budding clinical researchers. Is this assumption still true? How much do clinical researchers need to know about informatics? I’d like to hear your thoughts.