Purpose: Computerised clinical decision support systems (CDSS) are implemented within healthcare settings as a method to improve clinical decision quality, safety and effectiveness, and ultimately patient outcomes. Though CDSSs tend to improve practitioner performance and clinical outcomes, relatively little is known about specific impact of inaccurate CDSS output on clinicians. Although there is high heterogeneity between CDSS types and studies, reviews of the ability of CDSS to prevent medication errors through incorrect decisions have generally been consistently positive, working by improving clinical judgement and decision making. However, it is known that the occasional incorrect advice given may tempt users to reverse a correct decision, and thus introduce new errors. These systematic errors can stem from Automation Bias (AB), an effect which has had little investigation within the healthcare field, where users have a tendency to use automated advice heuristically. Research is required to assess the rate of AB, identify factors and situations involved in overreliance and propose says to mitigate risk and refine the appropriate usage of CDSS; this can provide information to promote awareness of the effect, and ensure the maximisation of the impact of benefits gained from the implementation of CDSS. Background: A broader literature review was carried out coupled with a systematic review of studies investigating the impact of automated decision support on user decisions over various clinical and non-clinical domains. This aimed to identify gaps in the literature and build an evidence-based model of reliance on Decision Support Systems (DSS), particularly a bias towards over-using automation. The literature review and systematic review revealed a number of postulates - that CDSS are socio-technical systems, and that factors involved in CDSS misuse can vary from overarching social or cultural factors, individual cognitive variables to more specific technology design issues. However, the systematic review revealed there is a paucity of deliberate empirical evidence for this effect. The reviews identified the variables involved in automation bias to develop a conceptual model of overreliance, the initial development of an ontology for AB, and ultimately inform an empirical study to investigate persuasive potential factors involved: task difficulty, time pressure, CDSS trust, decision confidence, CDSS experience and clinical experience. The domain of primary care prescribing was chosen within which to carry out an empirical study, due to the evidence supporting CDSS usefulness in prescribing, and the high rate of prescribing error. Empirical Study Methodology: Twenty simulated prescribing scenarios with associated correct and incorrect answers were developed and validated by prescribing experts. An online Clinical Decision Support Simulator was used to display scenarios to users. NHS General Practitioners (GPs) were contacted via emails through associates of the Centre for Health Informatics, and through a healthcare mailing list company. Twenty-six GPs participated in the empirical study. The study was designed so each participant viewed and gave prescriptions for 20 prescribing scenarios, 10 coded as “hard” and 10 coded as “medium” prescribing scenarios (N = 520 prescribing cases were answered overall). Scenarios were accompanied by correct advice 70% of the time, and incorrect advice 30% of the time (in equal proportions in either task difficulty condition). Both the order of scenario presentation and the correct/incorrect nature of advice were randomised to prevent order effects. The planned time pressure condition was dropped due to low response rate. Results: To compare with previous literature which took overall decisions into account, taking individual cases into account (N=520), the pre advice accuracy rate of the clinicians was 50.4%, which improved to 58.3% post advice. The CDSS improved the decision accuracy in 13.1% of prescribing cases. The rate of AB, as measured by decision switches from correct pre advice, to incorrect post advice was 5.2% of all cases at a CDSS accuracy rate of 70% - leading to a net improvement of 8%. However, the above by-case type of analysis may not enable generalisation of results (but illustrates rates in this specific situation); individual participant differences must be taken into account. By participant (N = 26) when advice was correct, decisions were more likely to be switched to a correct prescription, when advice was incorrect decisions were more likely to be switched to an incorrect prescription. There was a significant correlation between decision switching and AB error. By participant, more immediate factors such as trust in the specific CDSS, decision confidence, and task difficulty influenced rate of decision switching. Lower clinical experience was associated with more decision switching (but not higher AB rate). The rate of AB was somewhat problematic to analyse due to low number of instances – the effect could potentially have been greater. The between subjects effect of time pressure could not be investigated due to low response rate. Age, DSS experience and trust in CDSS generally were not significantly associated with decision switching. Conclusion: There is a gap in the current literature investigating inappropriate CDSS use, but the general literature supports an interactive multi-factorial aetiology for automation misuse. Automation bias is a consistent effect with various potential direct and indirect causal factors. It may be mitigated by altering advice characteristics to aid clinicians’ awareness of advice correctness and support their own informed judgement – this needs further empirical investigation. Users’ own clinical judgement must always be maintained, and systems should not be followed unquestioningly.

The thesis focussed on the need to understand the nature of design processes in innovative, multi-domain, organisational information systems design. A cross-disciplinary, interpretive investigation of organisational IS design was based upon multiple literatures: information system development and methodologies, human-computer interaction, situated action, social psychology, psychology of programming, computer-supported co-operative work, computer science, design 'rationale' and organisational behaviour. Three studies were performed: 1. A case study of a user-centred design project, employing grounded theory analysis. 2. A postal survey of IS development approaches in large UK companies. 3. A longitudinal field study, involving participant observation over a period of 18 months in a cross-domain design team, employing ethnography, discourse analysis and hermeneutics. The main contributions of this research were to provide rich insights into the interior nature of IS design activity, situated in the context of the organisation (a perspective which is largely missing from the literature); to provide conceptual models to explain the management of meaning in design, and design framing activity; to produce a social action model of organisational information system development which may form the basis for communicating the situated nature of design in teaching; and to suggest elements of a process model of design activity in multi-domain, organisational information system development. The implications of the research findings for IS managers and developers are also considered a significant contribution to practice. Detailed findings from these studies relate to: I. Disparities between the technology-centred view of organisational IS development found in the literature and the business and organisation-based approaches reported in the survey. 2. The role of pre-existing 'investment in form' in shaping the meaning of design processes and outcomes for other team members and its implications for the management of expertise and for achieving double-loop leaming. 3. The detailed processes by which design is framed at individual and group levels of analysis. These findings indicated a mismatch between "top down" models of organisational IS design and observed design "abstraction" processes, which were grounded in concrete analogies and local exemplars; this finding has significant implications for organisational design approaches, such as Business Process Redesign. 4. The distributed nature of group design, which has implications for achieving a 'common vision' of the design and for the division of labour in design groups. Intersubjectivity with respect to process objectives may be more critical to design success than intersubjectivity with respect to the products of design. - 5. The political nature of design activity: it was concluded that an effective design process must manage conflict between the exploration of organisational possibilities and influential, external stakeholders' expectations of efficiency benefits. 6. Design suffers from legitimacy problems related to the investigation of a "grey area" between explicit system design goals and boundary and emergent definitions of design goals and target system boundaries; this issue needs to be managed both internally to the design-team and externally, in respect of stakeholders and influential decision-makers. It is argued that the situated nature of design requires the teaching of design skills to be achieved through simulated design contexts, rather than the communication of abstract models. It is also suggested that the findings of this thesis have implications for knowledge management and organisational innovation. If organisational problem-investigation processes are seen as involving distributed knowledge, then the focus of organisational learning and innovation shifts from sharing organisational knowledge to accessing distributed organisational knowledge which is emergent and incomplete.

The findings of this multi-site study emphasise the importance of Organisational Culture for integrating clinical information systems into intensive care units. A novel model, the Iterative Systems Integration Model, has two principle components, these being Organisational Culture and the Actual Usefulness of the clinical information system. The model is derived from empirical data collected in four intensive care sites in England and Denmark, with one site being used to validate the model. The model highlights clinical information systems as directly affecting the work processes of the sites investigated, which in turn affect the Organisational Culture and Actual Usefulness of the clinical information system used, and these features affect clinical information system integration. This forms an iterative process of change as clinical information systems are introduced and integrated. Intensive care units are complex organisations, with complex needs and work processes. The impact of clinical information systems on these work processes is investigated in this thesis using Role Activity Diagrams. These diagrams are analysed to show that although clinical work processes are consistent at each site, the information processes differ. Intensive care information processes are found to have the potential to be much simplified with the introduction of seamless clinical information systems. Qualitative data collectio n methods were deployed, i. e., observations, interviews, and shadowing of clinical staff, together with a questionnaire at each site for further validation. Data were analysed using grounded theory to extract salient variables, which informed the development of the model. These factors were indicative of the Organisational Culture of the sites investigated and the Actual Useftilness of the clinical information systems being used. It was posited that clinical information systems that reconcile expectations of both hospital management and clinical staff - and that have the potential to adapt to their organisational environment - have a greater chance of surviving in complex environments such as intensive care. Despite decades of Health Infon-flatics, no such systems exist in their entirety; this research shows that 'ancient problems' of clinical information systems integration are still prevalent, and presents the Iterative Systems Integration Model, the application of which may assist with the integration of clinical information systems in intensive care.

Knowledge management (KM) is an emerging discipline that promises to capitalize on organizations intellectual capital. KM refers to the process of managing the life-cycle of knowledge relevant to areas that are mission critical to the organization. This includes efforts to capture, store, and deploy knowledge using a combination of information technology and business processes. In recent years, KM has become a critical subject of discussion in the business literature. Both business and academic communities believe that by leveraging knowledge, an organization can sustain its long-term competitive advantage. Approaches to KM varied form emphasizing the capabilities of information and communication technologies to the focus on social systems such as employee training and motivation. Engineering organizations led the way in KM initiatives realizing the potential of successful KM implementation in decreasing production time and cost, increasing quality, making better decisions as well as improve organizations' performance and provide a competitive advantage. Although some engineering organizations reported early KM success, other organizations have tried and failed to implement KM. These failures have been linked to the lack of a generally accepted framework and methodology to guide successful implementation of KM in organizations. This primary aim of this research is to produce a model for a successful implementation of KM in engineering organizations which integrates the various approaches and key factors to implementing KM. The study has produced a model which provides a framework that identifies the different types of knowledge available in engineering organizations, the KM life-cycle which is needed to manage this knowledge, and the key factors that facilitate this process. The model also provides management with guidance for implementing KM in their organizations. In order to achieve the aims and objectives of this research, a triangulation nonexperimental approach is adopted using qualitative in-depth case study with triangulation of data collection methods that uses observation, structured interviews, unstructured interviews, historical data collection, and document review. This is followed by a quantitative approach with the use of a questionnaire to further validate and generalize the proposed KM model. In building the KM model a thorough review of previous related literature from different disciplines was conducted. The literature reviewed included various issues relating to KM, such as KM approaches, perspectives, frameworks, and methodologies as well as strategic planning, human resources, instructional design theories, organizational learning, information technology, etc.

Unrestricted accessible scholarly resources are increasingly considered essential to knowledge creation and socio-economic development. In order to facilitate this, university libraries at National Research Universities (NRUs) in Thailand have established institutional repositories (IRs). The development of the Open Access publishing movement also provides opportunities and challenges to NRUs’ IRs and scholarly community. Like others, the IR projects in Thailand have experienced low awareness and content contribution from stakeholders. Accordingly, this study aims to optimize the established IR projects in NRUs in Thailand by exploring the stakeholders’ research publishing behaviour, and the perception, participation, and utilisation of IRs. This study advances the understanding of IRs in NRUs in Thailand from the perspectives of multiple stakeholder groups. This inductive qualitative study employs Constructivist Grounded Theory as a research methodology. Theoretical sampling, convenient sampling, and purposive sampling were used to recruit key participants in Thai scholarly communication at three NRUs. An in-depth semi-structured interview method was used to collect data and Charmaz’s Grounded Theory Method of Open coding and Focused coding was used to analyse it. The analysis resulted in the generation of the 4Cs (/foresee/) Model for the Development of University-based IRs. It composes of “Communication” “Collaboration”, “Copyright understanding”, “Control” and “Local academic culture”. This innovative model provides an explanatory framework identifying the factors for the availability and accessibility of full-text digital research publications in Thai university-based IRs. Moreover, the 3Rs – Rethinking, Redefining, and Re-collaborating- are recommended as key activities to be considered when confronting the difficulties in the development of IRs. In addition, this study also proposes the “2PSC model for operational excellence – Policies, Procedure, Services, and Competencies” as a practical and effective mechanism for managing IRs. Further, the study offers theoretical, methodological, and empirical contributions to the understanding of IRs in NRUs in Thailand from the perspectives of multiple stakeholder groups.

The Web has changed the face of scientific communication; and the Semantic Web promises new ways of adding value to research material by making it more accessible to automatic discovery, linking, and analysis. Institutional repositories contain a wealth of information which could benefit from the application of this technology. In this thesis I describe the problems inherent in the informality of traditional repository metadata, and propose a data model based on the Semantic Web which will support more efficient use of this data, with the aim of streamlining scientific communication and promoting efficient use of institutional research output.

e-Science technologies and tools have been applied to the facilitating of the accumulation, validation, analysis, computation, correlation and dissemination of chemical information and its transformation into accepted chemical knowledge. In this work a number of approaches have been investigated to address the diffeerent issues with recording and preserving the scientific record, mainly the laboratory notebook. The electronic laboratory notebook (ELN) has the potential to replace the paper notebook with a marked-up digital record that can be searched and shared. However it is a challenge to achieve these benefits without losing the usability and flexibility of traditional paper notebooks. Therefore using a blog-based platform will be investigated to try and address the issues associated with the development of a flexible system for recording scientific research.

New information and communications technologies, such as mobile phones and social media, have presented the humanitarian community with a dilemma: how should humanitarian organisations integrate information from crisis-affected communities into their decision-making processes whilst guarding against inaccurate information from untrustworthy sources? Advocates of crisis mapping claim that, under certain circumstances, crowdsourcing can increase the accuracy of crisis information. However, whilst previous research has studied the geography of crisis information, the motivations of people who create crisis map mashups, and the motivations of people who crowdsource crisis information, the geography of, and the uncertainty associated with, crowdsourced crisis information has been ignored. As such, the current research is motivated by the desire to explore the geographic uncertainty associated with, and to contribute a better understanding of, crowdsourced crisis information. The current research contributes to the fields of GISc (Geographic Information Science) and crisis informatics; crisis mapping; and geovisualisation specifically and information visualisation more generally. These contributions can be summarised as an approach to, and an understanding of, the geographic uncertainty associated with crowdsourced crisis information; three geovisualisation software prototypes that can be used to identify meaningful patterns in crisis information; and the design, analysis, and evaluation model, which situates the activities associated with designing a software artefact-and using it to undertake analysis-within an evaluative framework. The approach to the geographic uncertainty associated with crowdsourced crisis information synthesised techniques from GISc, geovisualisation, and natural language processing. By following this approach, it was found that location descriptions from the Haiti crisis map did not 'fit' an existing conceptual model, and, consequently, that there is a need for new or enhanced georeferencing methods that attempt to estimate the uncertainty associated with free-text location descriptions from sources of crowdsourced crisis information.

The main purpose of this project is to investigate the state of the art of the Algerian National Archives (ANA) so as to design an automated system that responds to the needs of this institution. The concept of archives is defined. The effects of computerisation on archives are investigated. Some automated archives systems, around the world, are examined. The various obstacles impeding the development of a technology capable of processing Arabic script are reviewed. Some solutions are also discussed. The case of Algeria in the context of the Arab world is taken as en example. A number of problems hampering the transfer of technology are identified. The study is concentrated on the state of the art of the ANA. It is carried out using a variety of data collection techniques; including questionnaires, interviews, observation and the author's own experience of the ANA. Severel problem areas are identified; including: the lack of resource sharing between the various institutions and the access speed to documents, to name just a few. The objectives of the system to be designed and implemented ere identified. A prototype user-friendly system, using the Query language, dBASE III PLUS and Clipper, is developed to simulate some of the various tasks carried out within records management institutions. An explanation of how can the system be operated is provided. An evaluation of the prototype system is carried out. A number of recommendations to improve the system are presented. Amongst these, is the necessity to provide a much faster system. The prototype system is thus redeveloped using, this time, Turbo Pascal. Apart from speed, no alterations or additions are introduced to the one developed using dBASE. Because the project has not been taken to the last stages of the System Development Life Cycle (SDLC), a number of recommendations are made regarding the steps that the ANA should observe to ensure a smooth system implementation and maintenance.

This study investigates the conceptions of information literacy held by student nurses on a BSc Nursing Studies course and asks whether the information skills sessions taught are successful from the students’ viewpoint. Additionally, it compares attitudes to, and use of information literacy within the artificial environment of the university and the ‘real world’ of the nurse as perceived by participants on their clinical and community placements. The inquiry introduces the concept of information literacy and charts its development before discussing it in relation to the changing context of nurse education and evidence-based practice. The research adopts the interpretive paradigm with phenomenography as its methodology. It uses focus groups and twenty-one individual interviews to obtain rich data from a purposive sample of students across the three years of the course. Such data were analysed to produce categories of description representing the collective experience of information literacy across the sample. The thesis questions whether learning to nurse effectively is best achieved through training along traditional lines, education, or a combination of both. For the latter it is imperative to find an appropriate balance between academic and clinical skills. The findings reveal a tension between the academic and clinical aspects of learning to be a nurse which some students struggle to resolve. The study concludes that while information literacy is perceived as part of a nurse’s professional role in supporting evidence-based practice, participant observations suggest that its use is context dependent and variable. The thesis recognizes that the adoption of evidence-based practice may depend on the presence or absence of particular personal and organisational barriers. Suggestions for further research include the relationship between academic and clinical learning, the importance and influence of informal learning, and the nature of the transition from student nurse to autonomous practitioner.