How well prepared is the next generation of health professionals to use health care informatics? A qualitative study of stakeholders’ views about health informatics curricula in the UAE

Abstract

The term health informatics (HI) refers to the management and use of healthcare information, via technological innovations to improve health care. With the exponential increase in HI it is crucial that health graduates are well prepared to use the variety of technological resources in the workplace. In order to determine the degree of preparedness, this research investigated the perceptions and experiences of relevant stakeholders at an academic setting, about the inclusion of HI in health science curricula. The setting was a tertiary academic institution in the United Arab Emirates. Healthcare facilities in the region had included an electronic health information system in their strategic and operational planning. It is therefore necessary for academic institutions to equip its graduates with requisite competencies in HI. However, initial review of matrices indicated this was not the case. This investigation focused on factors contributing to the delay in development of informatics curriculum.

The purpose of this study was to identify differences in perceptions between various stakeholders and to determine what impact these differences might have on the development of HI curricula. Inherent in this was the exploration for potential to mitigate any differences between and amongst stakeholders. A study of stakeholder knowledge, perception and acceptance of HI would facilitate an understanding of how successfully HI curricula might be integrated into the college network. Accordingly, attention was paid to commonalities and differences in beliefs of stakeholders within each division. Knowledge gained from this research would facilitate the development of relevant HI curricula to support each specialty within the program.

This was a qualitative study involving focus groups with key stakeholders of HI education. These included the ‘providers’; academic management and faculty (or staff) and the ‘consumers’; Students and Alumni. Findings were analysed using thematic analysis and the differences between providers and consumer perspectives were explored.

Data were analysed using three pre-determined core categories pertaining to HI; perceptions, preparedness, and future plans. Iterative review of data subsequently identified four distinct sub-themes: communication, confidence, responsibility, and curriculum. The findings suggest that communication, confidence and responsibility are key issues affecting the experiences of all stakeholders in relation to HI.

(1) Communication: The process of communication between healthcare providers and consumers had become quite complex partly due to the tendency to function in silos, which was identified as a barrier to communication. Methods of integrating informatics applications in health science curricula had been initiated in some programs within this college network. However, often the discussion of design, implementation and learning outcomes were shared for the first time during the focus group.

(2) Responsibility: Uncertainty about where to assign responsibility for HI was also a key finding. Alumni suggested both the health sector and academia “didn’t know what to do with it” suggesting this was due to a lack of policy and governance. In the absence of such guidance, responsibility had neither been given nor taken.

(3) Confidence: The findings indicated that most stakeholders lacked confidence in their understanding of and preparedness for HI in their salient health-related academic profession.

(4) Curriculum: The findings indicate that there is an urgent need to incorporate HI curricula. Most noteworthy was the impact of the focus group forum itself, in fostering dialogue to operationalize these discussions.

Applying the tenets of diffusion of innovations theory to this study enhanced the interpretation of findings. The characteristics of each stage of diffusion aptly fit various participants, facilitating an understanding in appropriate context. This theory explores the manner in which new or unfamiliar concepts are disseminated amongst members of a social system over time. Rogers’ (2003) diffusion of innovation theory suggests adoption and diffusion of the innovation are dependent upon end-user “awareness, interest,
evaluation, trial and adoption” (Ward, 2013, p. 223). The interface between information technology, healthcare and academia is of key significance to this research. Application of this theoretical framework guided analysis of findings; focus group discussions were examined using these tenets of diffusion of an innovation, in this case, health information technology in academia. Successful adoption of information technology applications is determined by four key constructs: communication channels, attributes of the innovation, characteristics of the adopters and the social system (Zhan, Yu, Yan, & Spil, 2015). These four determinants of adoption are embedded in the diffusion of innovation theory and were the basis of the thematic analysis of findings. Methods of communication regarding HI amongst and between academia and healthcare provided valuable insight into the diffusion and adoption of this new concept.

There are five key attributes of an innovation: relative advantage, compatibility, complexity, trialability and observability (Zhan et al., 2015). Conducting the analysis of focus group discussions through this lens enabled enhanced understanding of the three key issues: communication, responsibility and confidence.

Characteristics of the adopters are based on attitudes towards the innovation. Rogers suggested there were five such characteristics: innovators, early adopters, earlier majority, later majority and laggards (Sahin, 2006). Each of these characteristics was observed throughout the focus groups. This structure and definition facilitated detailed analysis of findings as elements of each characteristic were studied.

The social system, as a determinant of adoption, focuses on the “set of interrelated units engaged in joint problem solving to accomplish a common goal” (Rogers, 2003, p. 23). This social system contributes to the perception, adoption and assimilation of the innovation. Each tenet of Rogers’ (2003) diffusion of innovation theory facilitated detailed conceptualization of adoption in the context of health informatics curricula.

The health sector had demonstrated its commitment to improving health outcomes by adopting the latest developments in HI applications. The manner in which academia had aligned tuition, ensuring graduates were equipped with salient knowledge and skills, was the focus of this study. The findings of this research suggest that much work remains to be done in order to adequately prepare the next generation of healthcare professionals for the effective use of HI in the workplace.

Date of Award	8 Sept 2021
Original language	English
Awarding Institution	University of Bath
Supervisor	Alan Buckingham (Supervisor) & Fiona Fox (Supervisor)