Informatics Technology Learning in Primary Care Alpay et al.

The paper "Information technologies in Primary Care" from L. Alpay, L. and A. Russell describe the significance and role of information systems and the information training for primary healthcare settings. The authors pay special focus on the changing requirements and demands of patients, as well as multidimensional methods employed for primary health care. The most significant issue lies in the fact that nurses working as primary care don't have access to education in information systems which means they are not able to use the latest knowledge and technological advances to their job. The article discusses the PRACTIS (PRimary nurses in primary care Access to Communications Technology and Informatics Skills) project and its benefits for primary care environment.

The article clearly demonstrates that the main managerial issue in this scenario is to determine ways to reduce the human and financial costs of making the required changes to the organization and yet increase the speed of process so that the company is able to begin reaping gains in productivity. The following pages tackle that double challenge and offer management strategies to meet the challenge. In the field of healthcare, it's evident from research that the success of information systems is dependent on the organization's ability to innovate and its capacity to effectively produce the products it has developed. The old flexible-versus-efficient formula will not work because primary care units do not have resources and information systems to update their skills and introduce innovations. Modern healthcare demands aretwofold. First they have to develop technologically advanced products. Additionally, they need to improve their methods, as the success of their business is heavily dependent on developing and more advanced healthcare methods. This puts a strain on primary care units, which must be clearly organized for efficiency and changing organizational structures as caused by changes in technology and their environment. The old formulas for organizing are not effective because they overlook the complicated range of operations with which high tech organizations must compete to be successful and, consequently, for which they need to be coordinated simultaneously. The formulas of the past won't be effective for another reason.

To analyze and assess the outcomes in PRACTIS, in order to analyze and evaluate the results of PRACTIS project, the questionnaire technique was employed. A questionnaire was given to a limited sample of nurses. Each protocol was divided into units of meaning. This means that every message written by participants was split into a sequence of words that were read sequentially to correspond to the protocol in its original form. Then each meaning unit was distilled to its main theme. The central themes were then combined to form the final step of this qualitative study, specifically for this group of nurses. A summary of the data can provide an explanation of the characteristics that are nomothetic to the phenomenon. The educator and nursing groups are unified into one unit since the study of protocols makes any distinction arbitrary in this exploratory phase. The participants in this study stressed the positive benefits of information systems training. They felt relaxed, comfortable and optimistic; they had the same mind and emotions and were happy being alive. This also gave them the release of emotions to ease anxiety, stress and tension, as well as reduce nervousness until the subjects had a new strategy for coping. The method worked and allowed researchers to study the effects of attitudes and performance of the study.

It is possible to employ observation techniques and study perception and understanding of training from nurses. Facial validity can be described as a lower-level measure of validity, and is recommended only in the last instance in cases where no alternative valid estimates can be found because of three reasons. Participants' observation (in that the participant is visible to and interacting with the subject) is less reliable than the use of questionnaires for sensitive information. The observer's expectations influence what he perceives and reports, thus reducing the credibility of the information. The observations can either confirm or disprove their credibility. A sifting and weaving types of variables in order to establish the connections between them permits at a minimum the possibility of a claim of subjectivity of the researcher, and at best, an untrue interpretation of factual information (Pearlson and Saunders 77).

The main strength of this study is the fact that it examines a variety of aspects of learning and the impact it has on nurses. The ability to perform is the primary criterion for learning in the workplace and it requires a high level of efficiency in movements and perceptions, which can be learned through repetition and not instantly gained, but is developed. Industry is a place with a variety of perceptual and motor tasks that, in order to be successful, requires a steady improvement in skill and then be mastered to a certain quality. This process should not confuse with induction of a handful of simple movements that require little or no training, but that will satisfy an objective performance standard that is not concerned with the level of excellence. The value of practicing is undeniable, in fact its irresistible value is undeniable; however, for it to be effective, the practice must be conducted under the guidance of an instructor. The role of the instructor must extend beyond the initial training, with the aim of preparing the performer, to continue coaching when the student is engaged in actual execution. Naturally, further explanations and demonstrations can be used, as the trainee's performance improves, in order to highlight the other refinements to be made. However, when the student is completing the task, and the refinements are made, the instructor must be active in guiding the student about future actions and reacting to the actions by providing specific feedback on mistakes (accompanied by a demonstration in case the difficulty is complex) as well as with reinforcement (recognition and acceptance) of good or improved execution. As part of this process, the instructor must remove cues when the performances show less necessity for them. They should keep providing giving feedback (including reinforcement) with a consistent frequency until the overall performance is satisfactory and then switch to an irregular schedule of reinforcement with the aim of ensuring persistence. The goal of the coach is to offer assistance as needed but gradually transfer the responsibility of understanding the feedback messages to the student (Pearlson and Saunders 87).

The problem with the research doesn't take into consideration the people who are responsible for training implementations. The responsibility for developing and the implementation of a development and training program in an organisation vary across a spectrum. On the right are the training and development experts with no oversight responsibility and run programs, mostly that are oriented which is designed for semi-skilled or skilled employees. On the left are professionals in training and development who manage a large team in a department that is accountable for the entire training and development process at all levels, which includes the top management of the business. This type of role is likely to also have an organization-focused flavor to it. In the middle is the place where the majority of trainers and developers work. They may have some oversight for a smaller staff and are responsible for developing and running programmes for training and developing supervisors and clerical and other skilled personnel. After bringing the staff back to the present and developing ideas, the staff examines the different options available at currently available and creates an approach to recruitment that anticipates managing the changes in work force that are expected in the near future. The strategies you choose to implement could be focused on training existing employees to be more adaptable to future changes or on increasing the manpower scanning that you determine is crucial to recruiting as well as selection for the upcoming competitive future. The key thing to remember in this stage is to combine all the perspectives that have been offered regarding the issue and create strategies that are based on the different dynamics that have already been discovered.

Another advantage is that researchers can evaluate the process of learning and the stages of learning. Learning is an important aspect to consider when spacing out practices. It is not advisable for instance, to end a practice session at the point that the learner is finally starting to "get the art of" doing a difficult task. When that happens, persistence during practice is necessary to establish the task's execution as a habit. Overlearning, the aim of practice in training is the process of learning caused by repetition where the perceptual-motor structure of the task is so well-defined that it is able to resist interruptions from other activities and to guarantee retention (Pearlson and Saunders 44). It's not practical or even desirable to allow the student to practice the task under an instructor's constant supervision until the completion tasks has morphed into routine practice at the student's top ability level. It isn't wise to undervalue the trainee by limiting the amount of supervision. The instructor must give sufficient time and attention during the initial practice to ensure that the practice leads to the unstoppable progress towards higher-level "automatic" ability (Pearlson and Saunders 87).

Similar to other searchers (Pearlson as well as Saunders 54) success associated with the nursing profession or that results from it can be a powerful motivator. The anticipation of success may be a motivator and the instructor could positively influence the performance of the student by telling the student that performing the task in in this manner will result in the task being more smooth or less difficult or quicker or provide another evidence of the accomplishment. However, cautions must be taken into consideration when using the concept of the anticipation of successes as the basis for a reward. If the anticipated success doesn't is actually achieved, frustration and lower motivation are likely to be the result. Furthermore, it's difficult to determine success for a trainee's journey of mastering their job, especially one with complex or exact tasks. It is more likely that performance will improve over time but not be radically "successful." There are signs that improvement could be minimal as regards objective results or the perception of employees. This is especially true in times of stagnation in learning. Students may be starting to focus on feedback signals, but they are reading the messages at a slow pace. They may be transitioning to an efficient method of feedback, but might still not have the confidence to break away from the old one, and are still relying on both (typically using visual feedback until Kinesthetic feedback starts to take shape) In this case, the rate of execution is controlled through the slow channel. In these cases there is progress in skill development, however learners are unlikely to be aware of it or feel a sense that they have achieved "success" (indeed it is possible to experience frustration or discouragement instead). The instructor's suggested course is to be aware of the subtle aspects of employee performance that indicate "intangible" improvement as well as to affirm them through acknowledgments of gratitude until more tangible indicators of success emerge.

The issue with this article lies in the fact that it doesn't identify the shortcomings and challenges to initiatives for training in information systems. According to Pearlson as well as Saunders (2005, 75) the issue are only recognized and effectively managed in the event that they are predicted and are considered in those mental model that personnel of the organization have regarding the future. These mental models are constantly recurring images, descriptions of scenarios, and images that we have of our workplaces as well as the action plans of the organisations. In many instances conflict and training issues are a major influence on the outcomes of the study as well as efficiency of the training program.

There isn't any information on nursing expectations and needs that are recognized by them. It is well-known that employee expectations that aren't tied to what the employer would like from the employee is an easy source of discontent and its negative effects. The feeling of being successful can have a beneficial effects in the situations of young employees who are eager to work themselves , but are not able to be hopeful of success. The development of expectations for efficacy by providing instruction that moves from success to success and assures efficient achievement at every stage, is a crucial task for the instructor in the instruction of every learner. It is an essential element in the education of students whose lives have been characterized by failures and who are unsure of their abilities to succeed in an entirely new task. It could be part of the solution to the issue of dealing with learners who aren't prepared by their education to be successful in the job market.

It is useful to define and distinguish two different generations of nurses that are young adults and adults. A large portion of youngsters (between 20 and 30 years old) are proficient in computer use and do not require system training. This means that the older set of nurses requires additional education in the field of computer literacy. Of all the alleged characteristics of those who belong to"the "new Generation," probably the one that is most problematic to management at work as a cause of low productivity is the perception of some employees that they are able to be rewarded by the company with no commitment to earning these rewards. In the case of these employees - whether at work or in non-work at school, at home or at the factory-rewards were not contingent on performances, the problems that arise from their acceptance and adhering to the standards of performance on our jobs will be amplified. It is in this regard it is in this context that "high expectations" are a shrewd term. An increasing concern within the education community about even graduates of high school is the declining academic success in the form of tests. This is a concern for industries since in a lot of jobs the requirement for education-not necessarily by the number of marks earned however, but the knowledge gained is relatively high. And in many other occupations, with a less skilled an academic score of a minimum is deemed as a requirement to master the job. The result for industrial trainers of a trainee's lack of academic success is that they will have to confront the deficiencies in qualifications by increasing the training to ensure the entirety of job performance are brought to par, which will require a particular attention to areas for which the deficiencies in the background must be addressed or remediated. If there is a serious deficiency in the academic requirements for the job the company can't expect to provide the education that is missing. However, limited mathematical or verbal techniques that are not tied to a large academic field can be taught to competent employees in a successful job-training initiative. Furthermore to this, the use of tools to improve performance, like charts, tables and displays, calculators etc. can significantly reduce the dependence on academic knowledge and help enable job tasks to be completed by employees with low education. (I am thinking of a table designed to determine the uniform allocation of ends of warps on beams of loom to weave various sheeting designs that require different amounts of ends. This operation, which was previously an element of the "slashing" process, demanded calculations that could be performed almost exclusively with the help of the head slasher. using the table, the entire team of tenders and assisters regardless of their math capabilities, were able to determine the results.

The article talks about the design of organizational structures, but does not discuss the possibility of changes to organization structure or the type of work. The majority of manipulative tasks aren't as straightforward as lab exercises. They require manipulative skills that are not typical of the worker (though within their capabilities) and, the movements that are familiar to them must be incorporated with innovative ways to accomplish the performance of the new task. Furthermore, the sequence of actions and movements are to be connected by the chain of perceptual cues as well as feedback that, although beneficial for the student to be aware of, is not implemented in the performance until the trainee performs. If the refinement of the feedback and motion pattern is desired then the process must be repeated repeatedly and over and over again (Schermerhorn as well as Hunt 21).

Despite some flaws and limitations of research this study focuses on one of the major problems in primary health care settings. Without new training programs and education specifically designed for nurses will be difficult to implement information systems in the primary healthcare settings. What trainers can be certain of is that the ability to perform in manipulative work requires practicing. Of course, it's important to explain and demonstrate the work task to the student; the benefit of modeling can't be overemphasized. However, learning can't stop at an understanding of the steps involved in the job and the sequence movements and an encoding system to aid in resolving the memory of them. For simple tasks that require adjustments already within the repertoire of an employee to a large extent, modeling may be able to be considered to be a significant portion in the process of learning. Advanced technology in communication can typically be considered to be a subset of "communication technology". It's based on the application of advanced information management (generally communications-based) to allow multiparty participation in the organization. Electronic meetings systems can be described as an instance of the latest communication technologythat supports groups by combining the task-focused of group support systems as well as the focus on communication of computer-mediated communications systems. Modifications to the formal structure are among the primary instruments that an organization's leaders can ensure that they remain innovative, while being aware of the present and anticipated challenges that be faced by the business. Reorganizing the business is an adjustment to a changing situation and technological circumstances in which the current structure is no longer suitable instead of a flaw in the organization's structure that outsiders who don't understand the changing nature of business tend to believe. The most important thing in the article is a careful analysis and efficient methods of data collection (a questionnaire technique) as well as measurement and sample size. The basic principle is that rank-andfile training is not a program-based approach but should be designed to deal with the different learners and students. The authors concluded that programs like PRACTIS must be implemented within primary care settings to enhance the delivery of medical services and make nursing work easier.