the awareness and utility of not only the TEHIP databases but also other toxicology and environmental health information resources.

TRAINING

For health professionals to efficiently search toxicology and environmental health databases and effectively use the information in those resources, there are several educational requirements. Health professionals need a working knowledge of computers, especially online searching skills, and an understanding of the strengths and weaknesses of the information available in this field.

Training in the Use of Computers and Online Database Searching

As discussed in Chapter 4, computer use is largely a matter of demographics. Younger health professionals are more likely to feel comfortable with computer use and to have become accustomed to retrieving information through computers. There is, however, a continuing need to train health professionals about specific databases and the use of health-related information resources.

Koschmann (1995) categorized computer training into three types: (1) learning about computers, (2) learning with computers (i.e., computer-assisted instruction and the use of computers as specialized tools for instruction), and (3) learning through computers (i.e., incorporating computers into student's work and assignments on a daily basis). The author concluded that although there is a place for each of these in the educational process, it is learning through computers that is most effective in preparing for lifelong learning.

A 1984 report by the Association of American Medical Colleges recommended the introduction of computer training into medical education (AAMC, 1984; Matheson and Lindberg, 1984). Although most medical schools now teach basic computer skills (e.g., literature searching and word processing), a survey of 1992 medical school graduates found that 39 percent believed that the computer training that they had received was inadequate (Anderson, 1993; Hersh, 1992). Medical, nursing, and other health professional schools use a number of computer-assisted instruction programs for tutorials and computer simulations of clinical decision points (Hoffer and Barnett, 1990). Additionally, recognizing the vastness of the biomedical knowledge base and the necessity of lifelong learning, many health professional schools are using approaches, such as problem-based learning, that focus on independent learning and that incorporate learning through computers by emphasizing the frequent use of information resources, such as online databases, to solve clinical problems (Earl et al., 1996; Rankin, 1992; Schilling et al., 1995). Approaches to computer training vary between institutions. Some medical schools require an informatics or literature-



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