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J Med Libr Assoc. Oct 2003; 91(4): 490–492.
PMCID: PMC209516

Teaching health informatics: designing a course for a new graduate informatics program

Sara Anne Hook, J.D., Associate Dean of the Faculties and Professor of Dental Informatics1

INTRODUCTION

The burgeoning field of informatics provides a host of possibilities for teaching and curriculum development for librarians and information technology professionals. In a new school or program, there may not be any standardized curricula or set course syllabi that one must follow, which leaves considerable room for creativity and innovation [1–7]. This paper describes the development, implementation, and assessment of a new graduate course in health informatics.

HISTORY

In January 1999, Indiana University created a new school, the School of Informatics, and appointed an inaugural faculty representing a wide range of disciplines from both the Bloomington and Indianapolis campuses. Although the plan was to hire a cadre of full-time faculty over the next few years, the school was envisioned primarily as a “virtual” organization, relying on the expertise of existing faculty throughout the Indiana University system for teaching and school governance. In my case, appointment as an inaugural faculty member gave me the opportunity to design and teach one of the required courses in the health informatics graduate program.

COURSE DEVELOPMENT

According to the graduate bulletin, the course, I530 Seminar in Health Informatics Applications (3 credit hours), would present “an overview of the various professional applications and research directions taken in health informatics” [8]. The new course request form stated that the course would examine “the basic concepts of the design, evaluation and use of interactive applications in health informatics” [9]. These vague course descriptions presented a golden opportunity to design a course from its inception. The course is required for students seeking a master's degree in health informatics and is also an elective for graduate students in the Indiana University School of Nursing. Given the academic backgrounds and educational goals of the students, it seemed to the instructor that the course should have a practical rather than a theoretical focus and that it should offer real-world knowledge and expertise.

In September 2001 it was confirmed that the course would be offered in spring semester 2002 and that I would be the instructor; there was less than a four-month period to plan the course. I met with Anna McDaniel, D.N.S., director of the health informatics program and also a full-time professor in the Indiana University School of Nursing. Prior to becoming associate dean for the Indiana University Purdue University Indianapolis (IUPUI) campus and professor in the School of Informatics, the instructor was head of the Indiana University School of Dentistry Library and also worked in hospital and chemistry libraries. During the meeting, a preliminary list of the topics for the course was drafted while discussing a vision for the course and how the course would fit within the health informatics curriculum. Because I have a legal background, I advocated for copyright, patent, trademark, and privacy law to be included in the course content. These topics were not being addressed in other informatics courses and, yet, they are significant considerations in the development and deployment of information technology tools.

The course syllabus directly reflected the list of topics that was originally suggested. I also obtained the syllabus for the introductory informatics course, which the students in the graduate health informatics course would have taken, to avoid duplication and searched the Web to see whether similar courses were being taught at the graduate level. This yielded some useful information, including a few syllabi, but none of the syllabi seemed to closely match the content that had been decided on, particularly since this was not intended to be an introductory course. After searching library catalogs and databases and reviewing books in the campus libraries, Informatics for Healthcare Professionals [10] and Medical Informatics: Computer Applications in Health Care and Biomedicine [11] were selected as the course textbooks. Since these texts do not cover intellectual property law in depth, several months were spent gathering supplemental readings in this area, along with other interesting articles and materials on consumer health, health care research, the impact of illiteracy on health care utilization, and information technology.

It was relatively simple to construct a weekly schedule for the course. After subtracting dates for an orientation session, midterm, spring break, course review, and final exam, there were just enough class sessions to cover the topics on the preliminary list, beginning with some of the foundation topics and ending the semester with those topics offering a more specialized view. Course sessions before the midterm were devoted to an overview of health informatics, patent and trademark, copyright, telemedicine, evidence-based medicine, privacy and confidentiality, and health informatics systems. After the midterm and spring break, course sessions included consumer health informatics, clinical-decision support systems and research applications, hospital information systems, and dental informatics. The last class session was to be a capstone for the course, featuring a guest speaker from the Regenstrief Institute, a leading organization in health informatics research. Colleagues from around the campus with expertise in many of these subjects agreed to be guest speakers. OnCourse, Indiana University's online course management system was used to communicate with students and to post the course syllabus.

Since the School of Informatics is new, it did not yet have laboratory facilities that could be used for the course, although a state-of-the-art facility is now under development. During this interim period, before the new building is available, it is challenging to craft assignments that can give students practical experience in health informatics without a laboratory for hands-on work. A combination of research papers and presentations seemed to be the most logical approach. For the first paper, students selected their own topics in health care. They were to do a thorough literature review, using a number of print, electronic, and in-person sources; to evaluate the usefulness of these sources; discuss any unique informatics or information technology applications, including human factors; place the subject on a continuum of informatics development; suggest how gaps in applying information technology could be filled; describe the steps in the process of implementing this information technology and what resources would be needed; and then to project where their chosen aspects of health care would be in 2020 in regards to informatics. They shared their results with the class in five-minute presentations.

For the second paper, students were randomly assigned a particular disease and asked to develop a number of educational tools for patients, clinicians, family members, or community audiences. These tools were to be presented in a table-clinic format accompanied by bibliographies and concise written summaries of the assigned disease. The table-clinic format is often used in the IU School of Dentistry and consists of a background “poster,” various handouts and brochures, laptops or three-dimensional objects, and a brief presentation. (I had often been a judge for table-clinic presentations at the School of Dentistry.) Several students designed compelling and elaborate educational tools, including Websites and resources guides. The midterm and final were composed entirely of essay questions.

RESULTS AND FUTURE PLANS

The course was first offered in spring semester 2002, with eight students: four from graduate nursing programs and four from the health informatics program. Student evaluations were conducted using a 10-question short-answer form from the IU School of Informatics. The evaluation forms were uniformly positive; however, students did note that the amount of reading was excessive, and they also wanted one or two short assignments earlier in the semester so that they could have feedback on their course performance before the midterm. Students liked the diversity of topics covered in the course and the guest speakers provided the real-world expertise needed to make the course meaningful. The technique of reflective teaching was practiced throughout the semester. After each class session, I wrote self-evaluative comments in my instructor's notebook to address portions of the session that were particularly strong and areas in which opportunity for improvement remained. At the end of the semester, a follow-up meeting was held with the director of the health informatics program, who also suggested adding some shorter assignments prior to the midterm. Guests who attended the table-clinic presentations provided feedback on student performance that was useful for future course planning.

The course was offered again in spring semester 2003 with some minor modifications. Although the syllabus was the same, the number of supplemental readings was reduced, and the readings included a few carefully selected items on intellectual property and the Health Insurance Portability and Accountability Act (HIPAA), topics that are not covered in the two required texts. A book-review assignment and a journal-article critique were added. These assignments were due in the first half of the semester to provide students with early feedback on their progress. The OnCourse system was used extensively to communicate with students, including posting assignments, uploading articles and weekly lecture notes, and entering grades and grade calculations. A new guest speaker offered his expertise on trademark law. For student evaluations, a computerized form provided by the School of Informatics was used, with results due to the instructor after final grades were submitted. Reflective teaching was used once again as a tool for self-evaluation and course improvement. The plans call for adding a problem-based learning (PBL) component to the course, again borrowing from my experiences at the School of Dentistry, which implemented a PBL curriculum several years ago.

A proposal for another course on business and legal issues in informatics has been approved for fall semester 2003. This will be a three-credit-hour graduate course and will be appropriate for students in chemical informatics, bioinformatics, and new media programs, as well for students in health informatics. This course is a direct result of what students expressed in the health informatics course: the need for more in-depth information on copyright, trademark, and patent. Student answers on the midterm examination indicated that they were just beginning to grasp the basic tenets of intellectual property law. In addition, the course responds to a lack of attention to the legal and business aspects of informatics in the graduate curriculum, covering important topics in a school where many of its students will pursue careers as inventors, innovators, and entrepreneurs.

CONCLUSIONS

Although the field of health informatics encompasses disciplines and subject areas that are familiar and long standing, the field itself is still in a formative state that allows librarians to contribute to the field through teaching and curriculum development in a way that may not be possible in more established educational programs. Health sciences librarians may discover many opportunities to participate in the emergence of this new field by teaching its first generation of future practitioners and researchers.

REFERENCES

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