psy302

Which of the following is most appropriate for representing clinical datasets containing patients' family histories? A. A node-link hierarchy B. A time-series hierarchy C. A tree-map hierarchy D. A space-filling hierarchy

Answer: A. A node-link hierarchy

All of the following refer to different types of data visualizations, except: A. Graphs B. Charts C. Maps D. Caricatures

Answer: D. Caricatures

Identify five (5) of the barriers to prescriber decision-making identified by Russ and colleagues (2009) and provide a description of each.

Acceptable Answers: -Poor screen display (Alert display does not support alert resolution and/or prescriber workflow) -Inadequate alert specification (Alert does not provide information on why it was triggered and/or the potential problem) -Actual or perceived lack of evidence (Alert is not evidence-based, does not provide a reference to existing evidence) -Unclear level of risk (Alert does not provide clear information on relative risk of harm for a given patient) -Redundancy (Repeated alerts within the same encounter or over multiple encounters for a given patient) -Low alert signal to noise ratio (Numerousness of alerts leads to information overload, prescriber desensitization, and potential for missing key alerts) -Inadequate allergy logic (Alert system does not distinguish between true allergies and bothersome, but non-serious, side effects) -Duplicate workload (Alert duplicates other required work processes) -Paper prescriptions & limited CPOE (Some medications are not or cannot be entered electronically, and therefore are not reviewed by the alert system) -Unclear system capabilities (Alert system does not adequately reveal its capabilities/limitations to the prescriber; full functionality of the alert system is ambiguous)

List seven (7) of Michael Shabot's "Ten Commandments for Clinical Information Systems (CIS)."

Acceptable Answers: Speed is everything Realize that doctors won't wait for the computer's pearls Deliver "just-in-time" information Fit into the user's workflow Respect physicians' sense of autonomy Monitor implementation in real time and respond "right now" Beware of unintended consequences Be wary of uncovering long-standing process flaws Don't disrupt "magic nursing glue"

There are 2 main ways in which errors can be viewed: 1) the person approach (also known as the "perfectibility" model), and 2) and the systems approach. For each approach, complete the following sentences by filling in the blank. The goal of the person approach is to __ The goal of the systems approach is to __ In the person approach, errors can be avoided by __ In the systems approach, errors can be avoided by __ In the person approach, errors are blamed on __ In the systems approach, errors are blamed on __

Acceptable Answers: The goal of the person approach is to be perfect. The goal of the systems approach is to anticipate and avoid errors. In the person approach, errors can be avoided by clinicians who receive training and work hard. In the systems approach, errors can be avoided by building a resilient system that detects and recovers from error. In the person approach, errors are blamed on a single source (e.g., the clinician). In the systems approach, errors are blamed on multiple sources (e.g., the work environment).

List five (5) mechanisms of support provided by Clinical Decision Support Systems (CDSS).

Acceptable answers: Alerts, reminders, structured order forms; pick lists, patient-specific dose checking, guideline support.

The following are considered success factors of context-aware computing, EXCEPT for which one? A. Available network connectivity within the system B. Accuracy of context information sensed by the system C. Correctness of interpretation of a particular context D. Consequence of performing this action

Answer: A. Available network connectivity within the system

Which of the following is NOT one of the guiding principles for participatory design? A. Continuous iterative design is crucial to the design process B. All stakeholders can contribute to the design process C. There is much to learn from observing the practices of workers D. A system is more than a wired network of computers and technology E. We need to find concrete ways to improve the working lives of participants

Answer: A. Continuous iterative design is crucial to the design process

Which of the following is NOT an example of a natural input modality? A. Fingerprint recognition B. Voice recognition C. Gesture recognition D. Handwriting recognition

Answer: A. Fingerprint recognition

Which of the following best describes what a conceptual model is used for? A. Outlines the possible applications and prerequisite concepts for a product B. Provides a diagram or prototype that embodies the design concept C. Describes an abstraction or metaphor of the user interface D. Defines the mappings between concepts and affinity diagrams

Answer: A. Outlines the possible applications and prerequisite concepts for a product

Which of the following is NOT an example of a design principle emphasized by "recognition, not recall"? A. Provide visible cues to reduce automation errors B. Minimize users' memory load C. Make objects, actions, and options visible D. Make instructions visible or easily retrievable E. Make steps sequential

Answer: A. Provide visible cues to reduce automation errors

Fish-eye view is an example of: A. Scaling, focusing on variation in space B. Scaling, focusing on variation in time C. Scaling, using a bifocal display D. Scaling, using a perspective wall

Answer: A. Scaling, focusing on variation in space

From the top, Zhang's taxonomy of medical errors categorizes human errors as which of the following? A. Slips and mistakes, each divided into evaluation and execution B. Goal, intention, action specification, and execution slips C. Goal, intention, action specification, and execution mistakes D. Large errors and small errors E. Action errors and interpretation errors

Answer: A. Slips and mistakes, each divided into evaluation and execution

The purpose of information visualization is to: A. Support cognitive processes such as reasoning and decision-making B. Improve the usability of a computing system C. Enhance the aesthetic properties of a design D. Develop a schematic diagram of a web application

Answer: A. Support cognitive processes such as reasoning and decision-making

Which of the following is the best definition for clinical decision support systems? A. Tools that provide patient-specific information to enhance health-related decisions at the point of care B. A suite of tools that facilitates the ordering of treatment and laboratory tests for hospitalized patients C. Computer tools that support patient-related decisions based on highly optimized Bayesian algorithms D. None of the above

Answer: A. Tools that provide patient-specific information to enhance health-related decisions at the point of care

8. Patient safety is a driving factor behind many ubiquitous computing applications in healthcare. A. True B. False

Answer: A. True

Indicate whether true or false. Computing by the inch, foot, and yard refer to form factor for ubiquitous computing platforms. A. True B. False

Answer: A. True

Which of the following best describes a pie menu? A. Useful for small sets of selection B. Makes use of conscious memorization C. Cannot be nested D. Is often not available as a standard interface E. Is slower than regular linear menus

Answer: A. Useful for small sets of selection

Ubiquitous computing can take many forms. All of the following are forms of ubiquitous computing EXCEPT for which one? A. Virtual computing B. Mobile computing C. Wearable computing D. Environmentally-embedded computing

Answer: A. Virtual computing

Based on the module, which of the following is NOT an example of a barrier due to poor screen display? A. Alert text that is in all capital letters B. Alerts that are presented one at a time C. Multiple alerts that are presented in one window D. Alerts that are presented several at a time

Answer: B. Alerts that are presented one at a time

A clinician sets a dial between two numbers, failing to realize that the scale is discrete rather than continuous. What kind of error is this? A. An execution slip, of action specification type B. An execution mistake, of intention type C. An evaluation mistake, of perception type D. An evaluation mistake, of action evaluation type E. None of the above

Answer: B. An execution mistake, of intention type

An important philosophical consideration in trying to reduce errors is: A. Increasing individuals' expert knowledge and training so that they can have perfect performance B. Creating a system which can promote identification and recovery from situations leading to errors C. Identifying who is responsible so that they can be made accountable D. Isolating the step immediately before the error occurred E. All of the above

Answer: B. Creating a system which can promote identification and recovery from situations leading to errors

A clinician is faced with the task of making a high-risk drug order. Which of the following design features would NOT help the clinician make the choice safely? A. Alternate drug choices are grayed out or excluded after the choice is made B. Default drug choices are pre-selected to minimize work involved C. Only drugs that are appropriate for the patient's sex are allowed D. Only drugs that the patient is not allergic to are allowed

Answer: B. Default drug choices are pre-selected to minimize work involved

A parallel coordinates plot is an example of: A. Univariate data visualization B. Hypervariate data visualization C. Application design schematic D. Scientific visualization

Answer: B. Hypervariate data visualization

Which of these statements is true about "confirmation bias" as used in this module? A. It occurs when decision makers inflate the probability of a prior judgment (e.g., diagnosis of a patient) based on subsequent information B. It reflects overconfidence in one's judgment, causing one hypothesis to be favored over another C. It leads one to selectively attend to faulty decision options D. It reflects overconfidence in one's use of affinity decision diagra

Answer: B. It reflects overconfidence in one's judgment, causing one hypothesis to be favored over another

Which of the following is/are examples of factors that technologies take into account when considering context? A. The identity of individuals or objects B. The type of ubiquitous computing device used C. Position or location of individuals, objects, or events D. The sequence or temporality of events

Answer: B. The type of ubiquitous computing device used

A user-centered approach is characterized by ALL these elements EXCEPT for which one of the following? A. Considers users' tasks and goals from inception through development B. Uses a linear lifecycle model to clearly delineate tasks C. Is based on empirical measurements of user performance D. Is developed via an iterative design process

Answer: B. Uses a linear lifecycle model to clearly delineate tasks

Koppel and colleagues identified 2 super-ordinate classes of error associated with the use of CPOE systems. Identify the 2 errors from the list below. i) Automation bias errors ii) Hindsight bias errors iii) Information errors generated by fragmentation of data and failure to integrate the hospital's information systems iv) Errors that are a consequence of egregious violations of patient safety vi) Concentric workflow errors characterized by geometric progressions of usability violations vii) Human-machine interface flaws A. i and ii B. iii and vii C. iii and v D. ii and iv

Answer: B. iii and vii iii) Information errors generated by fragmentation of data and failure to integrate the hospital's information systems vii) Human-machine interface flaws

Which of the following does NOT describe the primary use of prototypes? A. A concrete artifact used to facilitate communication B. A model used to test novel ideas and hypotheses C. A model used to develop robust conceptual models D. An aid used to help designers choose between alternatives E. An instrument used for early stage usability evaluation

Answer: C. A model used to develop robust conceptual models

Which of the following best characterizes the notion of "biases" as given in this module? A. Biases are rules of thumb for making decisions B. Biases reflect usability violations in the design of clinical decision support systems C. Biases reflect systematic deviations from normative standards D. Biases provide explicit criteria of a normative standard for decision excellence

Answer: C. Biases reflect systematic deviations from normative standards

Based on the module, which of the following is NOT one of the three levels of situation awareness? A. Projection of future status B. Perception of environmental awareness C. Communication with support staff D. Comprehension of information

Answer: C. Communication with support staff

Which of the following is an example of computing by the yard? A. Voice recorders B. Tablet computers C. Electronic whiteboards D. Overhead projectors

Answer: C. Electronic whiteboards

Which of the following is NOT one of the design principles necessary to support usability as defined by Dix and colleagues (2004)? A. Predictability B. Learnability C. Graphicality D. Flexibility E. Robustness

Answer: C. Graphicality

Which of the following best characterizes the concept of "decision heuristics" in this module? A. Heuristics are systematic deviations from normative standards B. Heuristics reflect usability violations in the design of clinical decision support systems C. Heuristics are rules of thumb people use for making decisions D. Heuristics provide explicit normative standards for decision-making

Answer: C. Heuristics are rules of thumb people use for making decisions

. The three waves of computing include ALL of the following EXCEPT for which of these? A. Mainframe computing B. Personal computing C. Portable computing D. Ubiquitous computing

Answer: C. Portable computing

All of the following are examples of data types except: A. Nominal data B. Numeric data C. Scientific data D. Meta data E. Ordinal data

Answer: C. Scientific data

Which combination of the following (i-iv) best describes the two components of information visualization? i. Understanding the different cognitive tasks underlying comprehension ii. Selecting a method of representation that best supports analysis, comprehension, and decision making iii. Mapping items without direct physical correspondence to physical space iv. Using a graph to identify and highlight outliers among data points A. i and iii B. i and iv C. ii and iii D. ii and iv

Answer: C. ii and iii ii. Selecting a method of representation that best supports analysis, comprehension, and decision making iii. Mapping items without direct physical correspondence to physical space

Time-series data sets: A. Can be univariate B. Can be hypervariate C. Use a single outcome measurement D. A and B E. A and C

Answer: D. A and B A. Can be univariate B. Can be hypervariate

Use of checklists has demonstrated which of these to be true? A. Reductions in mortality can be accomplished by incorporating them into clinical procedures B. Extensive training and expertise by themselves do not guarantee maximal safety C. It is important to have people follow the hierarchy and not question the doctor's actions D. A and B E. A, B, and C

Answer: D. A and B A. Reductions in mortality can be accomplished by incorporating them into clinical procedures B. Extensive training and expertise by themselves do not guarantee maximal safety

According to Chittaro (2001), why is information visualization important in medicine? A. It presents medical data in a way that is intuitive, comprehensible, and manageable B. It highlights subtleties of patient care that might otherwise be missed C. It allows clinical staff to master large quantities of information without overload D. All of the above

Answer: D. All of the above

Design of dynamic queries should follow these general guidelines: A. Actions performed should be rapid, incremental, and reversible B. Should allow for direct manipulation of data C. Should display results immediately upon query D. All of the above

Answer: D. All of the above

There are many challenges to designing and interpreting 3-D visualizations. They include: A. Difficult to design B. Computationally expensive C. Difficult to interpret D. All of the above

Answer: D. All of the above

Which of the following is NOT a characteristic of decision-making in naturalistic clinical settings? i) Multiple players use multiple, high-volume streams of information to coordinate decisions and actions ii) Goals are ill-defined, changing, and/or competing iii) Decision-action cycle is affected by monitoring and feedback iv) Involves high levels of stress, time pressure, and risk A. i and ii B. i, ii, and iii C. ii and iv D. All of the above are characteristics of decision-making in naturalistic clinical settings

Answer: D. All of the above are characteristics of decision-making in naturalistic clinical settings

Which of the following is NOT a lifecycle model of software development? A. Waterfall B. Spiral C. Star D. Cluster

Answer: D. Cluster

Which of the following is NOT an example of a method of designing a safe system? A. Incorporating typical users early in the process B. Conducting formative evaluations with realistic scenarios C. Using specific and meaningful performance measures D. Conducting qualitative surveys to see whether clinicians like the aesthetics

Answer: D. Conducting qualitative surveys to see whether clinicians like the aesthetics

Based on the module, which of the following is NOT a principle of CPOE/CDSS usability and design? A. Alerts should be timed properly and displayed prominently B. Screen elements should be organized into logical groups C. Layers of screens should be kept to a maximum of 3 layers D. Data should be separated into multiple systems for clarity

Answer: D. Data should be separated into multiple systems for clarity

Which of the following is NOT an example of a challenge associated with ubiquitous computing applications? A. Developing accurate, efficient, and natural input modalities B. Developing systems that can correctly sense, interpret, and act on context information C. Developing efficient systems for indexing and retrieval of captured records D. Developing products that can work seamlessly with traditional interaction modalities

Answer: D. Developing products that can work seamlessly with traditional interaction modalities

Which of the following best describes ubiquitous computing? A. Each user interacts with one computer B. Many users interact with one computer C. Many users interact within a wired network system D. Each user interacts with many computers

Answer: D. Each user interacts with many computers

Apply principles underlying the design of healthcare systems for safety, Slide 5c. 9. Important safety considerations in designing order sets include which of the following? A. Trying them out before committee discussion on standardization B. Having all the members of the committee be from the same or similar disciplines C. Retaining all the sets created D. Having a means for the author to explain his/her intent E. Recognizing that once created they will not need to change very much

Answer: D. Having a means for the author to explain his/her intent

Which of the following best describes "retrospective incident analysis"? A. It is used to analyze incident history to determine factors leading to adverse conditions B. It is only applicable to near misses C. It shows that once a near-miss or adverse has occurred there is no possibility of recovery D. It is used to analyze and identify opportunities and mechanisms for recovery from errors E. It pertains to planned recovery opportunities

Answer: D. It is used to analyze and identify opportunities and mechanisms for recovery from errors

Which of the following is NOT true of the usability engineering lifecycle model? A. In this model, usability goals are integrated into all phases of design B. Both qualitative and quantitative goals are considered during design C. Requirements analysis is one of the two major phases of the model D. The practices that correspond to this model are very cost effective E. All of the above

Answer: D. The practices that correspond to this model are very cost effective

Which of the following is NOT a primary reason for doing requirements analysis? A. To translate prototypes into requirements for subsequent development B. To ensure the clarity and specificity of communication about needs C. To attempt to avoid future usability problems and user frustration D. To reduce the time and costs involved in developing a system E. To evaluate the functions of a system during testing

Answer: D. To reduce the time and costs involved in developing a system

Which of the following are examples of unintended consequences of CPOE? i. Less work for clinicians and smoother workflow ii. Reduction of the total number of errors iii. Changes in the power structure iv. Generation of new kinds of errors A. i and ii B. i, ii, and iii C. ii, iii, and iv D. iii and iv

Answer: D. iii and iv iii. Changes in the power structure iv. Generation of new kinds of errors

A disadvantage of speech recognition includes: A. Potential incompatibility with existing EHRs B. Potential inaccuracy due to misinterpretations by the software C. The software engines change over time D. One must assess the technology based on current software E. A and B F. A and C

Answer: E. A and B A. Potential incompatibility with existing EHRs B. Potential inaccuracy due to misinterpretations by the software

Essential features of competent medication safety must include which of the following? A. The five 'rights' - right drug, right dose, right route, right administration, etc. B. Even distribution of medication stations throughout the hospital C. Correct labeling and use of drug names familiar and intelligible to those ordering D. A, B, and C E. A and C

Answer: E. A and C A. The five 'rights' - right drug, right dose, right route, right administration, etc. C. Correct labeling and use of drug names familiar and intelligible to those ordering

Why are input methods important considerations in the design of health technology? A. All Computer Information Services (CIS) units depend on the accuracy of information input B. One must choose methods suitable to the context and user C. Costs can be affected by choice of input method D. It is important to have the latest technology E. A, B, and C F. All of the above

Answer: E. A, B, and C A. All Computer Information Services (CIS) units depend on the accuracy of information input B. One must choose methods suitable to the context and user C. Costs can be affected by choice of input method

Which of the following best describe(s) the advantages of speech recognition capabilities in health technology? A. Allows for rapid input speed B. Feels natural and requires little training to use C. Allows for hand-held use in some environments D. Can be used in noisy environments E. A, B, and C F. None of the above

Answer: E. A, B, and C A. Allows for rapid input speed B. Feels natural and requires little training to use C. Allows for hand-held use in some environments

Which of the following is/are advantages of using context-sensitive computing in an acute care setting? A. Enables hands-free lookup of pertinent patient data B. Encourages communication among clinicians C. Draws clinicians' attention to potential hazards D. A and B E. A, B, and C

Answer: E. A, B, and C A. Enables hands-free lookup of pertinent patient data B. Encourages communication among clinicians C. Draws clinicians' attention to potential hazards

An advantage of keyboard and mouse input is: A. Potential high speed with experienced users B. It is useful in bedside nursing C. It is risk-free D. A and B only E. A, B, and C

Answer: E. A, B, and C A. Potential high speed with experienced users B. It is useful in bedside nursing C. It is risk-free

A central problem with the waterfall model is that: (multiple choice) A. It does NOT allow for iterative design with user feedback B. It does NOT allow for changes in requirements that ensue during development C. It does NOT consider software designers' work practices D. A and b only E. All of the above

Answer: E. All of the above

A disadvantage of pop-up digital keyboards is: A. They require more cognitive processing if used with a mouse B. They do not offer tactile feedback C. They are slow D. There is a danger of inaccuracy due to incorrect keypresses E. All of the above

Answer: E. All of the above

As information management problems increase, mental workload increases. Which of the following are reasons why there is a need for well-designed decision support systems to help clinicians cope with high mental workload conditions? (multiple choice) A. Under time pressure, clinicians have less time and patience to navigate through poorly designed technology B. Under more significant mental workload, individuals can no longer adapt or compensate in order to maintain cognitive performance C. When demands imposed by the system are too great, they actually exceed the attentional resources or mental capacity of the person D. A and c E. All of the above

Answer: E. All of the above

Resilience engineering involves which of the following tasks? A. Assessing organizational risk and holes in decision making B. Assessing technical hazards C. Balancing production and protection D. Open reporting E. All of the above

Answer: E. All of the above

The principle of error handling suggests that a well-designed system should: A. Help users recognize, diagnose, and recover from errors B. Express error messages in plain language C. Precisely indicate the problem D. Suggest a solution E. All of the above

Answer: E. All of the above

Ubiquitous patient-centric technologies allow for which one(s) of the following? A. Remote monitoring of individuals' health and adjustments to care B. Improved communication between providers and patients C. Education of patients and families regarding care plans D. A and B only E. All of the above

Answer: E. All of the above

Which of the following present(s) technical challenges in ubiquitous computing? A. Accuracy of natural input modalities B. Continuous reliable connectivity C. Small form factor of displays D. A and C E. All of the above

Answer: E. All of the above

Which of the following best describes gestural interfaces? A. Require physical contact with a device B. Are a mature well-developed area of technology C. Cannot have multiple input and output forms D. Are always prominent in the environment E. Can be used to prevent infection

Answer: E. Can be used to prevent infection

You are consulting for a healthcare facility that requires kiosks in public areas for giving visitors and patients information they will need while visiting. What issues regarding input methods and facilities are important to bear in mind? A. Speed of data entry, how easily detectable are mistakes, how critical are inaccuracies? B. Is infection control required, how much motor control is required, how much training is required? C. Does it make the user uncomfortable, does it feed into other systems, will it be used walking around? D. Will frequent cleaning be required, will solvents affect it, does it create distance from clinicians? E. Does it make the user uncomfortable, will it require disinfection, are there special setup provisions?

Answer: E. Does it make the user uncomfortable, will it require disinfection, are there special setup provisions?

In a clap-based gestural interface for lighting, users were becoming annoyed because the mechanism took action when small sounds occurred, even if the user did not clap. This is likely an example of: A. Wrong coding in the microprocessor B. Oversensitivity in the light bulb C. Excessive output in the actuator D. Not accommodating the user's being hard of hearing E. Excessive sensitivity in the sensor

Answer: E. Excessive sensitivity in the sensor

Form factor, construction and weight are important for tablet devices because: A. They affect suitability of the device for bedside nursing B. They must have adequate screen space C. They can be fragile D. Tablets are increasingly common E. A and B only F. A, B, and C

Answer: F. A, B, and C A. They affect suitability of the device for bedside nursing B. They must have adequate screen space C. They can be fragile

Which of the following is NOT one of the objectives of decision support systems? a. Reduce medication errors and adverse medical events b. Improve management of specific acute and chronic conditions c. Facilitate interpersonal communication between physicians and patients d. Ensure best clinical practices consistent with medical evidence e. Lead to cost-effective and appropriate prescription medication use

Answer: c. Facilitate interpersonal communication between physicians and patients

Which of the following is NOT true about Computerized Provider Order Entry Systems? a. Supports electronic entry of clinical orders for the treatment of patients b. Automates the medication ordering process c. Orders are communicated over a network to the medical staff or to the departments d. All of the above are true e. B and C are true

Answer: d. All of the above are true

Match each type of data set (A-D) with the most appropriate form(s) of data representation by writing the appropriate letter in the blank next to Items i-vi. Note that each answer A-D may be used more than once Answer options (A-D): A. univariate B. bivariate C. trivariate D. hypervariate Items (i-vi). i_______metaphor ii_______ line graph iii_______ scatter plot iv_______ star plot v_______ 3-D scatter plot vi_______ bar graph

Answer: i___D___metaphor ii___A___ line graph iii___B___ scatter plot iv___D___ star plot v___C___ 3-D scatter plot vi___A___ bar graph