Friday, March 18, 2011

Module 6: Policy and Ethical Issues in IT

When listening to the podcast for module 6, I never truly realized how the definition and idea of plagiarism has changed throughout time. I was unaware that Shakespeare and other famous writers have been known to take ideas and works from other individuals. Isn’t it amazing that we do not accuse Shakespeare of plagiarism! Societal views related to plagiarism have changed throughout the course of history, becoming more of an issue in our present day.

I have always feared being accused of plagiarism. The speaker in the podcast introduces a concept that I have heard in the past, but have simply forgotten over time. Are we considered plagiarizing when we “take” ideas from others based on previous research that we have simply forgotten? During my graduate studies thus far, I feel as though I am continually trying to find where I obtained thoughts in my mind. Did I create this thought based on my knowledge base, or have I read it somewhere and simply cannot remember where the information was obtained? 

The speaker also discusses a play that was produced which was very similar to works from a well known writer without the writer’s permission (copyright infringement). I found it amazing that this writer did not accuse the producer of the play of plagiarism for “something new was created.” The producer took the idea of the writer and created something new with it. He also discusses “intellectual property” and that individuals “can’t claim to hang on forever.” I enjoyed listening to the writer’s perspective because I share many of his same beliefs related to plagiarism.

Wednesday, March 16, 2011

Module 5: Decision Support for Care Delivery

The readings for this module truly made me reassess how I make clinical decisions. Listening to the lecture by Daniel Kahneman, issues that were at one point in the back of my mind, "out of sight, out of mind mentality," were resurfaced. I enjoyed his representation of the nurses intuition. There are many times when I simply "know" something is not right with a child in the neonatal intensive care unit (NICU), even though there may not be direct clinical indicators. Is this intuition? Knowledge from experiences? Possibly something in the middle or both? When I first began working in the NICU, I had no clinical experience in this area. I had worked with adults in the cardiothoracic intensive care unit (CICU), but never this specialized population. When looking back, did I simply not recognize things as early as I do now? It is difficult to think about situations when you sit there and say, "What could I have done differently? What did I miss?" Unfortunately, this is part of medicine, and you may have had all your things in order and not missed a piece of the puzzle, but something unfortunate happened. I have learned not to dwell on such experiences, but take them in strides and learn from them. 

The use of clinical support decision systems may be extremely useful, depending on the appropriateness of the system. I examined the DXplain system for the assignment of this module, and concluded that this system may not be beneficial in the NICU. If systems were developed with the specialized population of those in the NICU, they may be extremely useful. 

Finally, appropriate education related to clinical decision support systems must be implemented. Personally, many coworkers "dread" implementing new and updated computerized medical charting. We must continue to educate each other regarding the need for such changes as well as the benefits associated. Not everything is going to be perfect the first time, but with appropriate communication, we can make the necessary modifications  in such systems that will benefit specialized populations of patients, such as the NICU.