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Dawkins, Brody, Komal N. Bhagudas, Joshua Hurwitz, J. Adrian Tyndall, Marcelo E. Guerra, Michael Falgiani, Thomas F. Payton, and Brandon R. Allen. "An Analysis of Physician Productivity and Self-Sustaining Revenue Generation in a Free-Standing Emergency Department Medical Scribe Model." Advances in Emergency Medicine 2015 (December 29, 2015): 1–9. http://dx.doi.org/10.1155/2015/518179.
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Objectives. A free-standing emergency department (FSED) is a facility that provides comprehensive emergency medical care similar to a traditional emergency department but is not attached to a hospital campus. Medical scribes are increasingly likely to work in free-standing emergency departments. The purpose of this study was to retrospectively investigate the benefits of a scribe program in an FSED. Methods. A retrospective, Institutional Review Board-approved analysis from December 1, 2013, to February 1, 2015, of free-standing emergency department medical data was extracted to determine if scribed charts resulted in increased revenue and improved throughput. Results. When scribes are present in the FSED there is a small, but statistically significant, decrease in time from patient arrival to provider by 2.74 minutes. Scribed charts collected $4.69 more per chart and resulted in an increase in productivity. Incremental cost effectiveness ratios resulted in proven cost-utility with a net-positive effect. Conclusion. While there are some gains in terms of operational metrics and provider productivity with the addition of scribes to a free-standing emergency department, there is a net-positive financial impact of scribes. Implementing a scribe program at a FSED is cost-effective and justified from both an operational and a financial analysis.
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Korogodina, Maria Vladimirovna. "Variation of the script in the East-Slavonic manuscripts of the 15th – 16th centuries." Studia Slavica et Balcanica Petropolitana 2(32) (2022): 60–75. http://dx.doi.org/10.21638/spbu19.2022.205.
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The scripts of the East-Slavonic manuscripts modify significantly in the 15th and 16th centuries. New types of scripts and styles of handwriting are appeared in that time. The multiplicity of the patterns makes up many scribes to master several styles of handwriting and to vary them depending on their goals. They often use another style of handwriting for the scribe’s note. It allows a scribe to differ the main text from the information about him. Various styles of handwriting, belonged to the same scribe, were used for coding different types of text and different genres. It led to the forming in the 16th century of the close connection of the style of the script not only with the genre of the book, but with its destination also. So appearance of new styles of scripts and variation of them testifies about shifts in the attitude to the culture heritage in East-Slavonic region. The ability of scribes to write in various handwritten styles poses the question of attribution of handwriting to researchers. Currently, there is no methodology for solving this applied problem. To date, studies of the functions and structure of the scribal manner, its relationship with the genre and purpose of the text are more promising. For example, to create a book the copyist takes into account the height of the line, its ratio to the proportions of the sheet, the mirror of the text, the width of the margins and even the thickness of this book. It is important not only the time and region of the appearance of new handwriting, but also their transition to those handwritten books whose writing had previously been standardized. Any changes in the design and appearance of the book – for example, the use of unusually small and dense handwriting, the appearance of pocket books that are copied into an eighth part of a sheet – speak of new functions of the book and the formation of new traditions.
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Cowan, Timothy Luke, William A. Dunlop, Michael Ben-Meir, Margaret Staples, Ainsley Treadwell, Eliza Gardner-Brunton, and Katherine Justice Walker. "Emergency consultants value medical scribes and most prefer to work with them, a few would rather not: a qualitative Australian study." Emergency Medicine Journal 35, no. 1 (September 29, 2017): 12–17. http://dx.doi.org/10.1136/emermed-2017-206637.
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ObjectiveThe utilisation of medical scribes in the USA has enabled productivity gains for emergency consultants, though their personal experiences have not been widely documented. We aimed to evaluate the consultant experience of working with scribes in an Australian ED.MethodsEmergency consultants working with scribes and those who declined to work with scribes were invited to participate in individual interviews (structured and semistructured questions) about scribes, scribe work and the scribe program in October 2016.ResultsOf 16 consultants, 13 participated in interviews, that is, 11 worked with scribes and 2 did not and 3 left Cabrini prior to the interviews. Consultants working with scribes found them most useful for capturing initial patient encounters, for finding information and completing discharge tasks. Scribes captured more details than consultants usually did. Editing was required for omissions, misunderstandings and rearranging information order, but this improved with increasing scribe experience. Consultants described changing their style to give more information to the patient in the room. Consultants felt more productive and able to meet demands. They also described enjoyment, less stress, less cognitive loading, improved ability to multitask, see complex patients and less fatigue.In interviews with the two consultants declining scribes, theme saturation was not achieved. Consultants declining scribes preferred to work independently. They did not like templated notes and felt that consultation nuances were lost. They valued their notes write-up time as time for cognitive processing of the presentation. They thought the scribe and computer impacted negatively on communication with the patient.ConclusionMedical scribes were seen to improve physician productivity, enjoyment at work, ability to multitask and to lower stress levels. Those who declined scribes were concerned about losing important nuances and cognitive processing time for the case.
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Graves, P. S., S. R. Graves, T. Minhas, R. E. Lewinson, I. A. Vallerand, and R. T. Lewinson. "LO55: A pilot evaluation of medical scribes in a Canadian emergency department." CJEM 19, S1 (May 2017): S46—S47. http://dx.doi.org/10.1017/cem.2017.117.
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Introduction: Improving emergency department productivity has been a priority across Canada. In the United States, medical scribes have been utilized to increase the number of patients seen per hour (PPH) per physician; however, it is not well known if these outcomes can be translated to Canada. The purpose of this pilot evaluation was to (a) establish proof-of-concept of medical scribes in Canada and (b) gain experience in scribe implementation so as to inform future directions for the use of scribes in Canada. It was hypothesized that use of medical scribes would result in a greater PPH per physician. Methods: We conducted a four-month pilot evaluation of medical scribes in the emergency department of the Queensway-Carleton Hospital in Ottawa, Ontario. Eleven scribes were utilized in the study ranging in age from 18 to 23 years old. Following scribe training and an initial two-month acclimation period for both scribes and physicians, data collection began January 2015. Twenty-two full or part time emergency physicians were followed in this study, who received shifts with and without a scribe over the next four months. Physician work hours as well as the number of patients seen by each physician on each shift was documented. From these metrics, PPH per physician was calculated for each shift. Across the four months, the average PPH was determined for each physician during shifts with a scribe and shifts without a scribe. Two-tailed paired-samples t-tests (α=0.05) were used to compare mean (SD) PPH within physicians based on presence or absence of a scribe. Results: A total of 463 physician hours were documented without use of a scribe and 693.75 physician hours were documented with use of a scribe. Across all 22 physicians in the study, 18 (81.8%) demonstrated a greater PPH with use of a scribe. Overall, PPH per physician was significantly greater (12.9%) during shifts with a scribe (mean 2.81, SD 0.78) compared to shifts without a scribe (mean 2.49, SD 0.60) (p=0.006). Sensitivity analyses revealed that PPH per physician during shifts without a scribe during the study period were similar to the year prior, before scribes were introduced to the hospital (p=0.315). Conclusion: Use of medical scribes resulted in an increased PPH per physician in our hospital. While these results were from an evaluation at a single centre, they support broader implementation and evaluation of scribes in more centres across Canada.
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Fulk, R. D. "The origin of the numbered sections in Beowulf and in other Old English poems." Anglo-Saxon England 35 (December 2006): 91–109. http://dx.doi.org/10.1017/s0263675106000056.
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AbstractMost observers now agree that the fitt numbers in Beowulf were not in the scribes' exemplar. A question less frequently addressed is whether the sectional divisions themselves are authorial or whether the poem was divided in the course of manuscript transmission. Several of the divisions in the portion of the poem copied by the second scribe make little narrative sense, while the divisions in the first scribe's work are sufficiently rational. The difference suggests that it is these scribes who are responsible for having introduced the divisions. A consideration of sectional divisions in other poems demonstrates that many of these divisions, too, are unlikely to be authorial.
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Popović, Mladen, Maruf A. Dhali, and Lambert Schomaker. "Artificial intelligence based writer identification generates new evidence for the unknown scribes of the Dead Sea Scrolls exemplified by the Great Isaiah Scroll (1QIsaa)." PLOS ONE 16, no. 4 (April 21, 2021): e0249769. http://dx.doi.org/10.1371/journal.pone.0249769.
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The Dead Sea Scrolls are tangible evidence of the Bible’s ancient scribal culture. This study takes an innovative approach to palaeography—the study of ancient handwriting—as a new entry point to access this scribal culture. One of the problems of palaeography is to determine writer identity or difference when the writing style is near uniform. This is exemplified by the Great Isaiah Scroll (1QIsaa). To this end, we use pattern recognition and artificial intelligence techniques to innovate the palaeography of the scrolls and to pioneer the microlevel of individual scribes to open access to the Bible’s ancient scribal culture. We report new evidence for a breaking point in the series of columns in this scroll. Without prior assumption of writer identity, based on point clouds of the reduced-dimensionality feature-space, we found that columns from the first and second halves of the manuscript ended up in two distinct zones of such scatter plots, notably for a range of digital palaeography tools, each addressing very different featural aspects of the script samples. In a secondary, independent, analysis, now assuming writer difference and using yet another independent feature method and several different types of statistical testing, a switching point was found in the column series. A clear phase transition is apparent in columns 27–29. We also demonstrated a difference in distance variances such that the variance is higher in the second part of the manuscript. Given the statistically significant differences between the two halves, a tertiary, post-hoc analysis was performed using visual inspection of character heatmaps and of the most discriminative Fraglet sets in the script. Demonstrating that two main scribes, each showing different writing patterns, were responsible for the Great Isaiah Scroll, this study sheds new light on the Bible’s ancient scribal culture by providing new, tangible evidence that ancient biblical texts were not copied by a single scribe only but that multiple scribes, while carefully mirroring another scribe’s writing style, could closely collaborate on one particular manuscript.
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Walker, Katherine, Matthew Johnson, William Dunlop, Margaret Staples, Hamish Rodda, Ian Turner, and Michael Ben-Meir. "Feasibility evaluation of a pilot scribe-training program in an Australian emergency department." Australian Health Review 42, no. 2 (2018): 210. http://dx.doi.org/10.1071/ah16188.
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Objective Medical scribes have an emerging and expanding role in health, particularly in Emergency Medicine in the US. Scribes assist physicians with documentation and clerical tasks at the bedside while the physician consults with his or her patient. Scribes increase medical productivity. The aim of the present study was to examine the feasibility of a pilot hospital-administered scribe-training program in Australia and to evaluate the ability of an American training course (Medical Scribe Training Systems) to prepare trainee scribes for clinical training in an emergency department in Australia. Methods The present study was a pilot, prospective, observational cohort study from September 2015 to February 2016 at Cabrini Emergency Department, Melbourne. Scribe trainees were enrolled in the pre-work course and then trained clinically. Feasibility of training scribes and limited efficacy testing of the course was undertaken. Results The course was acceptable to users and demand for training exists. There were many implementation tasks and issues experienced and resources were required to prepare the site for scribe implementation. Ten trainees were enrolled for preclinical training. Six candidates undertook clinical training, five achieved competency (required seven to 16 clinical shifts after the preclinical course). The training course was helpful and provided a good introduction to the scribe role. The course required adaptation to a non-US setting and the specific hospital setting. In addition, it needed more detail in some common emergency department topics. Conclusion Training scribes at a hospital in Australia is feasible. The US training course used can assist with preclinical training. Course modification is required. What is known about the topic? Scribes increase emergency physician productivity in Australia. There is no previous work on how to train scribes in Australia. What does this paper add? We show that implementing a scribe-training program is feasible and that a training package can be purchased from the US to train scribes in Australia and that it is useful. We also show the adaptation that the course may require to meet Australian emergency department needs. What are the implications for practitioners? Scribes could become an additional member of the emergency department team in Australia and can be trained locally.
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Gao, Rebecca W., Anisia Dugala, Janelle Maxwell, Patricia Falconer, Andrew C. Birkeland, Vasu Divi, and Eben L. Rosenthal. "Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center." JCO Oncology Practice 16, no. 2 (February 2020): e139-e147. http://dx.doi.org/10.1200/jop.19.00307.
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PURPOSE: The use of medical scribes has emerged as a strategy to increase clinic workflow efficiency and reduce physician burnout. While oncology clinics may be ideally suited to scribe integration because of the high burden of documentation, oncology-specific scribe research has been limited. The objective of this study was to determine the effect of scribe integration on clinic workflow efficiency and physician satisfaction and quality of life in outpatient oncology clinics. METHODS: We conducted a retrospective, concurrent qualitative and quantitative analysis of patient visit durations and survey data for 129 attending physicians affiliated with an academic hospital’s cancer center between January 2017 and January 2019. Thirty-three physicians were paired with scribes in each physician’s individual clinic or clinics. RESULTS: In terms of clinic efficiency, physicians with scribes had a 12.1% decrease in their overall average patient visit duration compared with their own time before receiving a scribe ( P < .0001) and spent significantly less time completing charts at the end of the day ( P = .04). Compared with their peers, oncologists with scribes showed a 10%-20% decrease in the duration of all patient visits. Scribes also contributed to patient care, as shown by 90% of physicians surveyed who strongly agreed that they spent less time at the computer and more time with patients; 100% of physicians surveyed strongly agreed that scribes improved their quality of life. CONCLUSION: The integration of medical scribes into oncology clinics across several oncologic disciplines has the potential to reduce burnout through increasing physician satisfaction and quality of life, improving patient care, and streamlining clinic workflow.
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Keefe, Katherine R., Jessica R. Levi, and Christopher D. Brook. "The Impact of Medical Scribes on Patient Satisfaction in an Academic Otolaryngology Clinic." Annals of Otology, Rhinology & Laryngology 129, no. 3 (October 22, 2019): 238–44. http://dx.doi.org/10.1177/0003489419884337.
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Objectives: Evidence shows that scribes can improve provider efficiency and satisfaction in several settings, but is mixed on whether scribes improve patient satisfaction. We studied whether scribes improved patient satisfaction in an academic otolaryngology clinic. Methods: The authors performed a retrospective review of patient responses to the Press Ganey survey between 12/2016 and 12/2017. Their responses about satisfaction with the provider and wait times were examined. Three providers worked with scribes during this year; each spent six months with a scribe and six without. The authors compared survey responses from periods with and without scribes using the Fischer exact test. Average overall provider ratings were compared using the Student’s t-test. Results: A total of 87 patients filled out Press Ganey surveys for the 3 providers over the year: 54 for visits without scribes, and 33 for visits with scribes. Fischer exact analysis demonstrated no significant difference in satisfaction with providers and wait times for both individual providers and all providers combined (all P > .05). There was also no difference in patients’ likelihood of recommending the provider’s office ( P = .91). Overall provider rating (0-10 scale) was high without scribes (9.48 ± 1.06) and was unchanged by the presence of scribes (9.53 ± 0.8) ( P = .97). Conclusion: Patient satisfaction with wait times and providers was high overall and was not affected by the presence of a medical scribe.
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Allen, Brandon, Ben Banapoor, Emily C. Weeks, and Thomas Payton. "An Assessment of Emergency Department Throughput and Provider Satisfaction after the Implementation of a Scribe Program." Advances in Emergency Medicine 2014 (September 3, 2014): 1–7. http://dx.doi.org/10.1155/2014/517319.
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Objectives. To assess the impact of a scribe program on an academic, tertiary care facility. Methods. A retrospective analysis of emergency department (ED) data, prior to and after scribe program implementation, was used to quantitatively assess the impact of the scribe program on measures of ED throughput. An electronic survey was distributed to all emergency medicine residents and advanced practice providers to qualitatively assess the impact of the scribe program on providers. Results. Several throughput time measures were significantly lower in the postscribe group, compared to prescribe implementation, including time to disposition. The left without being seen (LWBS) decrease was not statistically significant. A total of 30 providers responded to the survey. 100% of providers indicated scribes are a valuable addition to the department and they enjoy working with scribes. 90% of providers indicated scribes increase their workplace satisfaction and quality of life. Conclusions. Through evaluation of prescribe and postscribe implementation, the postscribe time period reflects many throughput improvements not present before scribes began. Scribe Program implementation led to improved ED throughput for discharged patients with further system-wide challenges needing to be addressed for admitted patients.
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Esten, Emily. "Scribes, Scholars, and Scripts: Reviewing Data from Scribes of the Cairo Geniza." Manuscript Studies: A Journal of the Schoenberg Institute for Manuscript Studies 5, no. 2 (2020): 312–24. http://dx.doi.org/10.1353/mns.2020.0016.
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Hornby, Emma, Marcus Jones, and Emily Wride. "SCRIBAL IDENTITY AND SCRIBAL ROLES IN EARLY MEDIEVAL IBERIA: A CASE STUDY OF SANTO DOMINGO DE SILOS, BIBLIOTECA DEL MONASTERIO MS 6." Early Music History 41 (October 2022): 181–231. http://dx.doi.org/10.1017/s0261127922000031.
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This article builds on a close palaeographical, liturgical and musicological reading of a single Old Hispanic manuscript (Santo Domingo de Silos, Biblioteca del Monasterio MS 6) to draw conclusions about scriptorium size, working practices and scribal mobility in early medieval Iberia. We identify eight music scribes who worked in four distinct layers of scribal engagement with the manuscript. These scribes used three different notational styles, and draw on elements of both the León and Rioja melodic dialects. In this manuscript, León notation is used to notate Rioja dialect; Rioja notation can be used to notate León dialect. The notational styles and melodic dialects tell us that different groups of scribes had distinct cultural identities and were likely working across two or three institutions, and at different times. Some scribes specialised in particular solo genres, as we explore, suggesting strongly that some music scribes were also trained as solo singers.
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ABAZOĞLU, Muhammet. "THE ROLE OF THE DIVAN CLERKS AND POLITICAL LETTERS IN THE DEVELOPMENT OF THE I. ABBASID PERIOD LITERATURE PROSE. AHMED BIN YOUSSEF'S ALHAMIS RESSALA AS AN EXAMPLE." RIMAK International Journal of Humanities and Social Sciences 04, no. 01 (January 1, 2022): 543–56. http://dx.doi.org/10.47832/2717-8293.15.38.
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Divan Scribe is a very old profession and it is said that it was one of the highest and most respected statures among worldly affairs, after the caliphate, when their positions in the state policy and judicial affairs are taken into account. Most of the time, the profession of the Divan Scribe was an important step to enter politics, as well as an important tool for reaching high positions such as Vizier. In general, Divan Scribes had a special role serving the Arab culture during the Abbasid period. Because the writing style of the Scribes had both lofty ideas and beautiful expression. As a matter of fact, as required by their statures, these people developed a dual-character expression that both emphasized the goals of the orders given from the administration and had the characteristics of Arabic rhetoric in the literal sense of the word. Their language was not a dry administrative language, on the contrary, it had brought together the requirements of the administrative language and the artistic beauties of the word. This study sheds light on the relations of the Divan Scribes with politics and the importance of this position during the Abbasid period. Again, in this study, the connection of the art of scribe with the vizier and the contributions of the scribes in service to the Arab-Islamic culture and especially in political thought are discussed despite the political crisis and troubles faced by the scribes.
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Gold, Jeffrey A., James Becton, Joan S. Ash, Sky Corby, and Vishnu Mohan. "Do You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow." Applied Clinical Informatics 11, no. 05 (October 2020): 807–11. http://dx.doi.org/10.1055/s-0040-1721396.
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Abstract Objective To understand the impact of the shift to virtual medicine induced by coronavirus disease 2019 (COVID-19) has had on the workflow of medical scribes. Design This is a prospective observational survey-based study. Setting This study was conducted at academic medical center in the United States. Participants Seventy-four scribes working in ambulatory practices within an academic medical center. Interventions All medical scribes received a survey assessing their workflow since beginning of COVID-19 restrictions. Primary and Secondary Outcomes To assess the current workflow of medical scribes since transition to virtual care. Secondary outcomes are to assess the equipment used and location of their new workflow. Results Fifty-seven scribes completed the survey. Overall 42% of scribes have transitioned to remote scribing with 97% serving as remote scribes for remote visits. This workflow is conducted at home and with personal equipment. Of those not working as scribes, 46% serve in preclinic support, with a wide range of EHR-related activities being reported. The remaining scribes have been either redeployed or furloughed. Conclusion The rapid transition to virtual care brought about by COVID-19 has resulted in a dramatic shift in scribe workflow with the adoption of a previously unreported workflow of remote scribing for virtual care. Additional work is now needed to ensure these new workflows are safe and effective and that scribes are trained to work in this new paradigm.
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Motte, Aurore. "Learning Through Practice: On How Kemyt Contributed to Crafting and Transmitting Scribal Knowledge." Zeitschrift für Ägyptische Sprache und Altertumskunde 151, no. 1 (May 24, 2024): 92–109. http://dx.doi.org/10.1515/zaes-2022-0005.
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Summary This paper is conceived as a first step towards the Kemyt (re)contextualization. By exploring the specific layout and paratext of Kemyt, it intends to shed light on the scribes who wrote the many partial copies of this letter-like composition and in which circumstances. I first address the layout, the ink choices, and the writing orientation. I then turn my attention to the text structure: dividers, ending marks, as well as colophons, dedications, and underwriting. The dated ostraca and their frequent identification as school exercises are discussed before moving on to the textual revision practices and looking for an explanation to the low proportion of corrected texts despite faulty content. All this enabled me to highlight a set of scribal practices, in which scribes draw, some being proper to the Kemyt, some being common to the rest of the text production. These practices revealed a complex network, from beginning students to senior scribes, through assistant scribes and early career scribes, which contributed to the crafting and the transmission of scribal knowledge during the New Kingdom.
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Ma, Tsang Wing. "Scribes, Assistants, and the Materiality of Administrative Documents in Qin-Early Han China: Excavated Evidence from Liye, Shuihudi, and Zhangjiashan." T’oung Pao 103, no. 4-5 (November 30, 2017): 297–333. http://dx.doi.org/10.1163/15685322-10345p01.
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As a result of the increasing administrative needs in the early imperial period, the profession of scribes was liberated from being the exclusive reserve of traditional hereditary families and opened to aspirants from non-hereditary families. Based on the excavated legal and administrative texts from Liye, Shuihudi, and Zhangjiashan, this paper explores the complementary nature of the scribes and assistants to understand the opening of the scribal profession. This paper also coins a concept of “administrative literacy,” which suggests that the materiality of written surfaces is a significant factor in understanding the literacy of administrative officials in early imperial China. Du fait des besoins croissants de l’administration aux débuts de l’époque impériale, la profession de scribe a cessé d’être l’apanage des familles qui traditionnellement en avaient l’accès exclusif, et a été ouverte à des candidats venus d’autres familles. En se fondant sur les documents administratifs et juridiques exhumés à Liye, Shuihudi et Zhangjiashan, cet article explore la nature complémentaire des rôles de scribe et d’assistant, en vue de comprendre une telle ouverture de la profession de scribe. Ce faisant, il propose le concept de “compétence administrative” et suggère que la matérialité des supports d’écriture était un facteur important pour comprendre les niveaux de compétence des fonctionnaires de l’administration aux débuts de l’ère impériale.
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Lanzillo, Amanda. "Translating the Scribe: Lithographic Print and Vernacularization in Colonial India, 1857–1915." Comparative Critical Studies 16, no. 2-3 (October 2019): 281–300. http://dx.doi.org/10.3366/ccs.2019.0331.
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Focusing on the lithographic print revolution in North India, this article analyses the role played by scribes working in Perso-Arabic script in the consolidation of late nineteenth-century vernacular literary cultures. In South Asia, the rise of lithographic printing for Perso-Arabic script languages and the slow shift from classical Persian to vernacular Urdu as a literary register took place roughly contemporaneously. This article interrogates the positionality of scribes within these transitions. Because print in North India relied on lithography, not movable type, scribes remained an important part of book production on the Indian subcontinent through the early twentieth century. It analyses the education and models of employment of late nineteenth-century scribes. New scribal classes emerged during the transition to print and vernacular literary culture, in part due to the intervention of lithographic publishers into scribal education. The patronage of Urdu-language scribal manuals by lithographic printers reveals that scribal education in Urdu was directly informed by the demands of the print economy. Ultimately, using an analysis of scribal manuals, the article contributes to our knowledge of the social positioning of book producers in South Asia and demonstrates the vitality of certain practices associated with manuscript culture in the era of print.
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Golob, Joseph F., John J. Como, and Jeffrey A. Claridge. "Trauma Surgeons Save Lives—Scribes Save Trauma Surgeons!" American Surgeon 84, no. 1 (January 2018): 144–48. http://dx.doi.org/10.1177/000313481808400137.
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With the advent of the electronic medical record, the documentation burden of the trauma surgeon has become overwhelming. To help, our trauma division added scribes to the rounding team. We hypothesized that scribe utilization would improve our documentation efficiency and offer a financial benefit to the institution. A review of trauma surgeon documentation and billing was performed at a Level I trauma center over two time periods: January to May 2014 (no scribes) and January to May 2015 (scribes). The number of notes written by trauma surgeons was obtained, as were documentation charges. Documentation efficiency was determined by noting both the hour of the day in which inpatient progress notes were written and the number of notes written after patient discharge. In the 2014 period, a total of 9726 notes were written by trauma attendings. In the 2015 period, 10,933 were written. Despite having 407 fewer trauma patient-days in the 2015 period, the group wrote 343 notes/week versus 298 notes/week ( P = 0.008). More inpatient progress notes were written earlier in the working day and fewer were written in the evening. Fewer notes were written after patient discharge (12.7 vs 8.4%). A total of 1,664 hours of scribe time were used over the 5-month period, generating an expense of $32,787. The additional notes generated by scribes resulted in $191,394 in charges. Conservatively, assuming a 20 per cent charge reimbursement, the cost of the scribes was covered. The addition of scribes to the daily trauma rounding team improved note efficiency and increased charge capture at our center.
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Hafer, Julia, Xibin Wu, and Steven Lin. "Impact of Scribes on Medical Student Education:." Family Medicine 50, no. 4 (April 6, 2018): 283–86. http://dx.doi.org/10.22454/fammed.2018.933777.
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Background and Objectives: Medical scribes are an increasingly popular strategy for reducing clerical burden, but little is known about their effect on medical student education. We aimed to evaluate the impact of scribes on medical students’ self-reported learning experience. Methods: We conducted a mixed-methods pilot study. Participants were medical students (third and fourth years) on a family medicine clerkship who worked with an attending physician who practiced with a scribe. Students did not work directly with scribes. Scribes charted for attending physicians during encounters that did not involve a student. Outcomes were three 7-point Likert scale questions about teaching quality and an open-ended written reflection. Qualitative data was analyzed using a constant comparative method and grounded theory approach. Results: A total of 16 medical students returned at least one questionnaire, yielding 28 completed surveys. Students reported high satisfaction with their learning experience and time spent face-to-face with their attending, and found scribes nondisruptive to their learning. Major themes of the open-ended reflections included more time for teaching and feedback, physicians who were less stressed and more attentive, appreciation for a culture of teamwork, and scribes serving as an electronic health records (EHR) resource. Conclusions: To our knowledge, this is the first study evaluating the effect of scribes on medical student education from the students’ perspective. Our findings suggest that scribes may allow for greater teaching focus, contribute to a teamwork culture, and serve as an EHR resource. Scribes appear to benefit medical students’ learning experience. Larger and more rigorous studies are needed.
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Sullivan, Paul. "Scribal Syncretism in Colonial Yucatan, Reconsidered." Estudios de Cultura Maya 56, no. 2 (June 29, 2020): 127–51. http://dx.doi.org/10.19130/iifl.ecm.2020.56.2.0005.
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Scholars have proposed that for decades after the conquest of Yucatan Maya scribes wielded competence in both the old hieroglyphic and the new Latin-based alphabetic scripts. During that time some scribes apparently worked furtively to transfer parts of their pre-conquest traditions, encoded in hieroglyphic codices, into new forms of alphabetic-based writing such as the Books of Chilam Balam and other forbidden works. Various types of evidence –historical and philological– have been offered to substantiate claims concerning the lingering effects of hieroglyphic writing practices upon Maya use of the alphabetic script in early colonial times. In the light of new evidence from twentieth-century Maya scribal practice, this paper demonstrates that previously published arguments, especially those developed in an influential series of papers by distinguished Mayanist Victoria Bricker, can no longer be considered valid.
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Gordon, Nehemia. "Blotting Out the Name." Textus 29, no. 2 (June 26, 2020): 111–55. http://dx.doi.org/10.1163/2589255x-bja10010.
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Abstract Part 1 of this study considered how the rabbinic prohibition against erasing the Tetragrammaton led to scribes performing diverse procedures to resolve scribal errors. In part 2 it will be shown that special procedures were performed in Torah scrolls, namely, skiving, excision, and removing sheets. Washing off the divine name was not found in the corpus examined. Despite the rabbinic prohibition, medieval Jewish scribes occasionally marked the Tetragrammaton with a strikethrough or erased it through abrasion. This may have been the handiwork of Karaite scribes who did not see themselves bound by the midrashic interpretation of Deut 12:4. The scribes who wrote the Aleppo Codex may have abraded erroneous instances of the Tetragrammaton in order to create a model codex. Scribes in the isolated Jewish community of Kaifeng, who erased erroneous instances of the Tetragrammaton, may not have been familiar with rabbinic strictures.
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Afros, Elena. "Some Distinctive Characteristics of the B Text of the Old English Bede." Amsterdamer Beiträge zur älteren Germanistik 82, no. 1 (January 17, 2022): 15–38. http://dx.doi.org/10.1163/18756719-12340245.
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Abstract The B text of the Old English Bede copied in the first half of the eleventh century into CCCC 41 by two scribes differs editorially, linguistically, and rhetorically from other witnesses. Although the two B scribes are generally credited with the alterations, Campbell (1951), Scragg (1990), and Waite (2014) point out that some of the distinctive traits of the B version may have originated in an anterior copy or copies. Waite (2014) also objects to the indiscriminate treatment of the work of the two B scribes as it obscures the contribution of each copyist. The present study examines seven distinctive linguistic characteristics of the B text. To determine which traits may derive from an anterior copy and which ones may be attributed to the B scribes, it compares and contrasts the Bede manuscripts and the B scribes’ practices. This inquiry not only sheds light on the methods of scribal revision but also the English of the first half of the eleventh century.
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Tran, Brian D., Yunan Chen, Songzi Liu, and Kai Zheng. "How does medical scribes’ work inform development of speech-based clinical documentation technologies? A systematic review." Journal of the American Medical Informatics Association 27, no. 5 (March 17, 2020): 808–17. http://dx.doi.org/10.1093/jamia/ocaa020.
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Abstract Objective Use of medical scribes reduces clinician burnout by sharing the burden of clinical documentation. However, medical scribes are cost-prohibitive for most settings, prompting a growing interest in developing ambient, speech-based technologies capable of automatically generating clinical documentation based on patient–provider conversation. Through a systematic review, we aimed to develop a thorough understanding of the work performed by medical scribes in order to inform the design of such technologies. Materials and Methods Relevant articles retrieved by searching in multiple literature databases. We conducted the screening process following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in guidelines, and then analyzed the data using qualitative methods to identify recurring themes. Results The literature search returned 854 results, 65 of which met the inclusion criteria. We found that there is significant variation in scribe expectations and responsibilities across healthcare organizations; scribes also frequently adapt their work based on the provider’s style and preferences. Further, scribes’ job extends far beyond capturing conversation in the exam room; they also actively interact with patients and the care team and integrate data from other sources such as prior charts and lab test results. Discussion The results of this study provide several implications for designing technologies that can generate clinical documentation based on naturalistic conversations taking place in the exam room. First, a one-size-fits-all solution will be unlikely to work because of the significant variation in scribe work. Second, technology designers need to be aware of the limited role that their solution can fulfill. Third, to produce comprehensive clinical documentation, such technologies will likely have to incorporate information beyond the exam room conversation. Finally, issues of patient consent and privacy have yet to be adequately addressed, which could become paramount barriers to implementing such technologies in realistic clinical settings. Conclusions Medical scribes perform complex and delicate work. Further research is needed to better understand their roles in a clinical setting in order to inform the development of speech-based clinical documentation technologies.
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Ghormley, Justus Theodore. "Scribal Revision. A Post-Qumran Perspective on the Formation of Jeremiah." Textus 27, no. 1 (August 28, 2018): 161–86. http://dx.doi.org/10.1163/2589255x-02701002.
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AbstractThis article describes the presence of three different degrees of scribal revision in Jeremiah: (1) multidimensional revision—the revision of multiple aspects of a text in a single moment by one scribe (such as relocating the Oracles Against the Nations and the addition of new headings); (2) single-dimensional revision—the revision of one aspect of a text (such as the addition of new headings by itself) again by one scribe in one moment; and, (3) incremental revision—the ongoing, piecemeal revision of one aspect of a text by an unknown number of scribes over a longer period of time. This article offers criteria for distinguishing these degrees of revision and applies the criteria to two categories of scribal expansion in Jeremiah: the insertion of names and titles and the addition of new headings. It concludes that these features took shape through a combination of all three degrees of revision.
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Müllneritsch, Helga. "The 'Who' of Manuscript Recipe Books: Tracing Professional Scribes." Sjuttonhundratal 14 (December 19, 2017): 40–59. http://dx.doi.org/10.7557/4.4155.
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The idea that female scribes – probably members of the middle or upper-classes – made manuscript recipe books for a fee, without being part of the owner’s family, has been discussed in English- and German-language countries for several years. The tradition of making manuscript recipe books for weddings and other important dates in the life of a woman justifies the idea that money was spent to provide such a present, for example, if time was scarce. If the owner did not want to make the effort to write the book on their own, a professional scribe was commissioned to carry out the task for them. In doing so, a personalised book could be made, that was probably more expensive than a printed book, but exclusive and tailored to the customer’s wishes. Three Austrian manuscripts examined in this study serve as a first attempt to reflect about the possibility of female scribes, drawing on examples of women working as paid and unpaid copyists and scribes in the eighteenth-century. One of the volumes gives clear evidence of a professional female scribe penning the book, either for a customer or herself, and the other two imply that professionals had been commissioned.
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Jamaatisomarin, Farzad, Ruqi Chen, Sajed Hosseini-Zavareh, and Shuting Lei. "Laser Scribing of Photovoltaic Solar Thin Films: A Review." Journal of Manufacturing and Materials Processing 7, no. 3 (May 10, 2023): 94. http://dx.doi.org/10.3390/jmmp7030094.
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The development of thin-film photovoltaics has emerged as a promising solution to the global energy crisis within the field of solar cell technology. However, transitioning from laboratory scale to large-area solar cells requires precise and high-quality scribes to achieve the required voltage and reduce ohmic losses. Laser scribing has shown great potential in preserving efficiency by minimizing the drop in geometrical fill factor, resistive losses, and shunt formation. However, due to the laser induced photothermal effects, various defects can initiate and impact the quality of scribed grooves and weaken the module’s efficiency. In this regard, much research has been conducted to analyze the geometrical fill factor, surface integrity, and electrical performance of the laser scribes to reach higher power conversion efficiencies. This comprehensive review of laser scribing of photovoltaic solar thin films pivots on scribe quality and analyzes the critical factors and challenges affecting the efficiency and reliability of the scribing process. This review also covers the latest developments in using laser systems, parameters, and techniques for patterning various types of solar thin films to identify the optimized laser ablation condition. Furthermore, potential research directions for future investigations at improving the quality and performance of thin film laser scribing are suggested.
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Bakshaeva, A. A. "Marginalia of the Apostolus Christinopolitanus of the XII Century: Composition, Paleography, and Orthography." Bulletin of Kemerovo State University 24, no. 2 (May 18, 2022): 211–19. http://dx.doi.org/10.21603/2078-8975-2022-24-2-211-219.
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The research features a manuscript of the Galician-Volynian Apostolus Christinopolitanus dated the XII century (The Lviv Historical Museum of Ukraine, No. 37). This manuscript is one of the earliest surviving copies of the Apostolus. It belongs to the Cyrillo-Methodian translation but contains a number of Preslavic readings. This paper focuses on the extratexts, i.e., inscriptions and in-junctions, in the Apostolus Christinopolitanus and presents a paleographic, orthographic, and phonetic analysis of the marginalia made by the three scribes of the manuscript. The author classified the marginalia made by the first scribe. The classification includes such types of postscripts as comments to facilitate the reading and edits to the main text, glosses, scholia, scribe's comments, etc. The analysis confirms that the extratexts were highly unified and standardized. The analysis of the linguistic features of the first scribe’s handwritten appendices shows the unified orthography of the main text and the marginalia, as well as reflects some features of the Old Russian of that time. The extratexts of the Apostolus Christinopolitanus also demonstrated a variety of pronunciations of Old Russian linguistic use. These texts prove the high degree of development of the book norm and the existence of normalizing aspirations in ancient Russian scriptoria.
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Zajac, Andrij. "Urzędnicy najemni i służba w miastach Wołynia w drugiej połowie XVI – pierwszej połowie XVII wieku." Krakowskie Pismo Kresowe 10 (November 30, 2018): 25–49. http://dx.doi.org/10.12797/kpk.10.2018.10.02.
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Officials and Servants in Towns and Cities of Volhynia in the Second Half of 16th and the First Half of the 17th CenturyThe article looks into activity of officials and servants hired in the Volhynian towns and cities. Among them scribes played a particularly important role. In smaller towns there was only one scribe, but in larger towns, primarily of the county town status , there were two scribes – one for the council and one for the vogt. In private towns scribes were mostly noblemen, but in royal cities burghers prevailed in the post. Some scribes worked also as lawyers as their side job. Municipal finances were managed by “shafars” and interests of the burghers were secured by the “instigator”. The vogt and municipal servants carried out the instructions and orders of the city council and the court. The announcements in the cities were made by the herald. In emergency cases church bells were used to alert the citizens. Public order in the city was maintained by day and night guards. Punishment in the cities was carried out by the executioner. The articles also makes a mention of lower-ranking city servants , such as: canons, locksmiths, shepherds, and trumpeters.
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Parman, Cindy. "Medical Scribes." Oncology Issues 29, no. 5 (September 2014): 12–14. http://dx.doi.org/10.1080/10463356.2014.11883960.
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Whitmarsh, Tim. "CHRISTIAN SCRIBES." Classical Review 52, no. 1 (March 2002): 87–88. http://dx.doi.org/10.1093/cr/52.1.87.
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Wang, Andrew, William Dunlop, Hamish Rodda, Michael Ben-Meir, Margaret Staples, and Katherine Walker. "The 9-Item Physician Documentation Quality Instrument (PDQI-9) score is not useful in evaluating EMR (scribe) note quality in Emergency Medicine." Applied Clinical Informatics 08, no. 03 (2017): 981–93. http://dx.doi.org/10.4338/aci2017050080.
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SummaryBackground: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine.Objective: The primary objective of the study was to determine if the quality of Emergency Department scribe notes was equivalent to physician only notes, using the Physician Documentation Quality Instrument, Nine-item tool (PDQI-9).Methods: This was a retrospective, observational study comparing 110 scribed to 110 non-scribed Emergency Physician notes written at Cabrini Emergency Department, Australia. Consultations during a randomised controlled trial of scribe/doctor productivity in 2016 were used. Emergency physicians and nurses rated randomly selected, blinded and de-identified notes, 2 raters per note. Comparisons were made between paired scribed and unscribed notes and between raters of each note. Characteristics of individual raters were examined. The ability of the tool to discriminate between good and poor notes was tested.Results: The PDQI-9 tool has significant issues. Individual items had good internal consistency (Cronbach’s alpha=0.93), but there was very poor agreement between raters (Pearson’s r=0.07, p=0.270). There were substantial differences in PDQI-9 scores allocated by each rater, with some giving typically lower scores than others, F(25,206)=1.93, p=0.007. The tool was unable to distinguish good from poor notes, F(3,34)=1.15, p=0.342. There was no difference in PDQI-9 score between scribed and non-scribed notes.Conclusions: The PDQI-9 documentation quality tool did not demonstrate reliability or validity in evaluating Emergency Medicine consultation notes. We found no evidence that scribed notes were of poorer quality than non-scribed notes, however Emergency scribe note quality has not yet been determined.Citation: Walker KJ, Wang A, Dunlop W, Rodda H, Ben-Meir M, Staples M. The 9-Item Physician Documentation Quality Instrument (PDQI-9) score is not useful in evaluating EMR (scribe) note quality in Emergency Medicine. Appl Clin Inform 2017; 8: 981–993 https://doi.org/10.4338/ACI2017050080
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Dahm, Margit. "Auf den Spuren des Schreibers." editio 34, no. 1 (November 1, 2020): 23–44. http://dx.doi.org/10.1515/editio-2020-0003.
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AbstractThis contribution addresses colophons, notes of the scribes which are mostly found at the end of premodern manuscripts respectively of the contained texts, as a specific form of paratexts. Besides pragmatical information like the name of the scribe or place and date of production, many colophons contain different forms of commenting, for example on the process of writing, the written text or on the scribe himself. With these comments, colophons are of high significance for they allow insights into the text comprehension and the self-conception of medieval scribes. The contribution outlines a project proposal that aims for a systematical collection and evaluation of colophons in German manuscripts of the 12th up to the 15th century in a digital data-collection. A web application with specifically tailored evaluation features enables the request and statistical analysis of various quantitative as well as qualitative parameters.
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Conejero, Alejandro. "escribanía del concejo de Teruel en la Baja Edad Media: evolución e injerencia monárquica." Aragón en la Edad Media, no. 30 (June 1, 2020): 295–324. http://dx.doi.org/10.26754/ojs_aem/aem.2019304506.
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Resumen: Los escribanos siempre han sido un engranaje imprescindible en la maquinaria de gobierno en cualquier época y circunstancia. A lo largo de este trabajo se analizará la figura del escribano del concejo de Teruel durante la Baja Edad Media. A la par, se estudiarán los diversos intentos por parte de la monarquía aragonesa de interferir en su designación, así como los enfrentamientos jurídicos que ello generó entre el municipio y la Corona. Palabras clave: Teruel, Baja Edad Media, concejo, escribano, escribanía. Abstract: Scribes have always been an important gear in the government machine in every age. Through these pages we will study the figure of the Turolean council’s scribe during the Late Middle Ages. At the same time, we will analyze different attempts carried out by the Aragonese monarchy in order to meddle in its designation, and juridical confrontations held up between the town and the Crown. Key words: Teruel, Late Middle Ages, town council, scribe, scribe’s court.
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Hjälm, Miriam L. "A Paleographical Study of Early Christian Arabic Manuscripts." Collectanea Christiana Orientalia 17 (July 20, 2020): 37–77. http://dx.doi.org/10.21071/cco.v17i.14516.
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The present paper presents an overview of the types of writing that were used by Christian Arabic scribes during the long ninth century. It categories them into three groups consisting of several subcategories and discusses the traits of such categories. It further aims at collecting extant shelf marks of early Christian Arabic manuscripts and research relating to these findings, add to the search for disjecta membra, and contribute to our knowledge of individual scribes and scribal activity in the early Christian Arabic manuscript production.
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Wagner, Esther-Miriam. "Script-switching between Hebrew and Arabic Scripts in Documents from the Cairo Genizah." Intellectual History of the Islamicate World 7, no. 2-3 (July 10, 2019): 351–80. http://dx.doi.org/10.1163/2212943x-00702007.
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Abstract In the multi-lingual world of the Cairo Genizah, Arabic (including Judaeo-Arabic), Hebrew and Aramaic were used in legal documents and letters. Jewish scribes excelled in Hebrew and Arabic penmanship. The mixing of Hebrew and Arabic alphabets in documents by particular writers affords important sociolinguistic insights. This article presents case studies of two Genizah writers, Daniel b. ʿAzaryah (11th century) and Ḥalfon b. Manasse (12th century), who were both highly innovative and exceptional in their use of scripts and vocalisation signs. Their scribal habits and decisions allow us to understand attitudes of writers towards the two scripts, and levels of literacy within the Jewish scriptorium, and provide an important contribution to our understanding of medieval allography and script-switching.
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Songchang, Chen. "Three Research Notes on the Silk Manuscript *Tianwen qixiang zazhan 天文氣象雜占." Bamboo and Silk 2, no. 2 (April 9, 2019): 274–89. http://dx.doi.org/10.1163/24689246-00202002.
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This paper specifically discusses three issues regarding the silk manuscript *Tianwen qixiang zazhan (Miscellaneous Prognostications Concerning Astronomy and Meteorology); they are its production and format, the scribes involved, and the date it was copied. Through comparison and analysis, I argue that the manuscript’s production was done by first drawing images and then by copying the text. The images and text were done by different scribes, and more than one scribe was involved in copying the text. Its date of copying was probably about the same time as the copying of the silk manuscript Xingde (Punishment and Virtue) A, that is, around the eleventh year of Emperor Gaozu of Han (195 b.c.e.).
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Michaels, Marc. "The Consequences of the Faulty Transmission of Sefer Tagin." Review of Rabbinic Judaism 26, no. 2 (October 10, 2023): 115–45. http://dx.doi.org/10.1163/15700704-12341408.
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Abstract Scribes are encouraged to maintain the tradition concerning the decorative tagin (tittles) and “strange” letter forms that adorn nearly two thousand letters in the Torah. Yet this tradition, detailed in Sefer Tagin, was relatively rarely followed and has all but died out in modern times. This article examines the faulty transmission of this Masoretic manual for sofrim (scribes) through core, compiled, and partial sources. It assesses the likely negative impact of its deployment through diversity caused by the transition to paraša format, error and innovation, and combination with other scribal rules.
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Hanson, Richard Simon. "Ancient Scribes and Scripts and the Clues They Leave." Biblical Archaeologist 48, no. 2 (June 1985): 83–88. http://dx.doi.org/10.2307/3209968.
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McAmis, Nicole E., Andrew S. Dunn, Richard S. Feinn, Aaron W. Bernard, and Margaret J. Trost. "Physician perceptions of documentation methods in electronic health records." Health Informatics Journal 27, no. 1 (January 2021): 146045822198939. http://dx.doi.org/10.1177/1460458221989399.
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This study sought to determine physician, specialty and practice factors influencing choice of method for electronic health record (EHR) documentation: direct typing (DT), electronic transcription (ET), human transcription (HT), and scribes. A survey assessing physician documentation practices was developed and distributed online. The primary outcome was the proportion of physicians using each method. Secondary outcomes were provider-rated accuracy, efficiency, and ease of navigation on a 1-5 Likert scale. Means were compared using linear mixed models with Bonferroni adjustment. The 818 respondents were mostly outpatient (46%) adult (79%) physicians, practiced for a mean 15.8 years, and used DT for EHR documentation (72%). Emergency physicians were more likely to use scribes ( p < 0.0001). DT was rated less efficient than all other methods ( p < 0.0001). ET was rated less accurate than DT ( p < 0.001) and HT ( p < 0.001). HT was rated less easy to navigate than DT ( p = 0.002) and scribe ( p < 0.001), and ET less than scribe ( p = 0.002). Two hundred and forty-three respondents provided free-text comments that further described opinions. DT was the most commonly used EHR method but rated least efficient. Scribes were rated easy to navigate and efficient but infrequently used outside of emergency settings. Further innovation is needed to design systems responsive to all physician EHR needs.
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Puzanov, D. V. "The Galician–Volhynian Chronicle and a decline in the interest in the omens in the Old Rus population of the 13th century." Rusin, no. 65 (2021): 9–24. http://dx.doi.org/10.17223/18572685/65/1.
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The Galician–Volhynian Chronicle contains almost no descriptions of natural phenomena that other Russian chronicles perceive as omens – eclipses, comets, meteorites, diffraction phenomena, thunderstorms, etc. Even when any of these phenomena appears in the chronicle, the scribe remains indifferent to its mystical significance. A decline in the interest in predictions is typical of Old Rus literature of the 13th century, so the attitude of the southwestern scribes to omens is sometimes seen as the greatest manifestation of these tendencies. The author analyzes all three cases when the Galician–Volhynian Chronicle describes omens, focusing on the reasons why the scribes describe them. The perception of natural phenomena by the Galician– Volhynian chroniclers is compared with that of the scribes from other Russian lands. In all cases, the chroniclers of Southwestern Russia describe omens to emphasize heavenly protection of the Galician–Volhynian land and its princes. Omens in Old Rus were closely related to the theory of “executions and God's mercies.” The specificity of this theory’s rendition in the Galician–Volhynian Chronicle influenced the description of the omens. If other Old Rus chroniclers are most interested in the disasters that occurred in their own land, God in the chronicles of South-Western Rus punishes the enemies of the Galician–Volhynian land. Omens also work against enemies: when the plague falls on the native land, it should be perceived with courage and hope in God. Unlike other chroniclers, the Galician–Volhynian scribes valued good spirits more than contritition of the heart. The description of the omens could also be influenced by the focus of the chronicle on the subjects that change the world. If a certain phenomenon could not be associated with subsequent events, the scribe might not mention it as irrelevant.
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Rotenstein, Lisa, Edward R. Melnick, Christine Iannaccone, Jianyi Zhang, Aqsa Mugal, Stuart R. Lipsitz, Michael J. Healey, et al. "Virtual Scribes and Physician Time Spent on Electronic Health Records." JAMA Network Open 7, no. 5 (May 24, 2024): e2413140. http://dx.doi.org/10.1001/jamanetworkopen.2024.13140.
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ImportanceTime on the electronic health record (EHR) is associated with burnout among physicians. Newer virtual scribe models, which enable support from either a real-time or asynchronous scribe, have the potential to reduce the burden of the EHR and EHR-related documentation.ObjectiveTo characterize the association of use of virtual scribes with changes in physicians’ EHR time and note and order composition and to identify the physician, scribe, and scribe response factors associated with changes in EHR time upon virtual scribe use.Design, Setting, and ParticipantsRetrospective, pre-post quality improvement study of 144 physicians across specialties who had used a scribe for at least 3 months from January 2020 to September 2022, were affiliated with Brigham and Women’s Hospital and Massachusetts General Hospital, and cared for patients in the outpatient setting. Data were analyzed from November 2022 to January 2024.ExposureUse of either a real-time or asynchronous virtual scribe.Main OutcomesTotal EHR time, time on notes, and pajama time (5:30 pm to 7:00 am on weekdays and nonscheduled weekends and holidays), all per appointment; proportion of the note written by the physician and team contribution to orders.ResultsThe main study sample included 144 unique physicians who had used a virtual scribe for at least 3 months in 152 unique scribe participation episodes (134 [88.2%] had used an asynchronous scribe service). Nearly two-thirds of the physicians (91 physicians [63.2%]) were female and more than half (86 physicians [59.7%]) were in primary care specialties. Use of a virtual scribe was associated with significant decreases in total EHR time per appointment (mean [SD] of 5.6 [16.4] minutes; P &lt; .001) in the 3 months after vs the 3 months prior to scribe use. Scribe use was also associated with significant decreases in note time per appointment and pajama time per appointment (mean [SD] of 1.3 [3.3] minutes; P &lt; .001 and 1.1 [4.0] minutes; P = .004). In a multivariable linear regression model, the following factors were associated with significant decreases in total EHR time per appointment with a scribe use at 3 months: practicing in a medical specialty (−7.8; 95% CI, −13.4 to −2.2 minutes), greater baseline EHR time per appointment (−0.3; 95% CI, −0.4 to −0.2 minutes per additional minute of baseline EHR time), and decrease in the percentage of the note contributed by the physician (−9.1; 95% CI, −17.3 to −0.8 minutes for every percentage point decrease).Conclusions and RelevanceIn 2 academic medical centers, use of virtual scribes was associated with significant decreases in total EHR time, time spent on notes, and pajama time, all per appointment. Virtual scribes may be particularly effective among medical specialists and those physicians with greater baseline EHR time.
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Jones, Owen H. "Language Politics and Indigenous Language Documents: Evidence in Colonial K'ichee’ Litigation in Seventeenth-Century Highland Guatemala." Americas 73, no. 3 (July 2016): 349–70. http://dx.doi.org/10.1017/tam.2016.65.
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Prevalent scholarly studies of indigenous language documents from Mesoamerica's colonial times include the predominant argument that they were written by native scribes to protect community interests. The belief is that scribes performed as notaries in municipal councils to generate native language notarial documents as indemnity against possible infractions of their communities’ rights to possess property. Notarial documentation was usually extrajudicial, created by the municipal scribe for community protection and not for any specific litigation before a Spanish magistrate. Their writings represented internal municipal administration and the jurisdiction of the nativecabildo(town council) within each republic of Indians. They could be utilized, if necessary, to bolster indigenous claims to their rights and privileges in litigation brought before Spanish officials.
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Houston, Stephen. "Ingenuity and Ambivalence in Maya Writing." Revista Española de Antropología Americana 49, Especial (July 5, 2019): 225–40. http://dx.doi.org/10.5209/reaa.64968.
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Scribal reception and status among the Classic Maya drew on subtle skills and playful games. But it also rested on an evident understanding that scribes (or sculptors) and their provincial patrons needed to obey their superiors. Certain clues indicate that the producers of script existed within established obligations of tribute, for written memorials as well. Elsewhere, myths provide enduring templates for humanity, and that was no less true for the Classic Maya. Historical figures merged with mythic scribes, and, to judge from unusual texts and images, the powers of the literate could be neutralized by physical replacement or even the threat of execution.
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Caldwell, Mary Channen. "Cueing Refrains in the Medieval Conductus." Journal of the Royal Musical Association 143, no. 2 (2018): 273–324. http://dx.doi.org/10.1080/02690403.2018.1507115.
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AbstractAs lyrical refrain forms flourished beginning in the twelfth century and increased attention was paid to the mise en page of song in manuscript sources, scribes faced the dilemma of how to cue frequent repetition of poetry and music. Owing to a lack of shared conventions among these scribes, the signalling of repetition varied greatly among sources, the resulting inconsistencies furnishing what Ardis Butterfield calls ‘glimpses of scribal thinking’. Nowhere is this more evident than in approaches to notating the Latin refrain, a structural feature in a range of genres and an inexact yet related parallel to the French refrain. I argue in this article that the graphic treatment of refrains in Latin song exposes assumptions that both scribes and performers made about form, genre and the realization of song in performance. Attending to the visual cueing of refrains clarifies textual and musical ambiguities arising from the simultaneously oral, written and performative milieu within which Latin song was cultivated and disseminated.
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Abelev, I., D. Lewis, J. Fraser, and P. Atkinson. "P142: Perspectives of medical students and undergraduate students on their experience as medical scribes in the Saint John Regional Hospital Emergency Department." CJEM 22, S1 (May 2020): S115—S116. http://dx.doi.org/10.1017/cem.2020.346.
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Introduction: Electronic medical records (EMR) have placed increasing demand on emergency physicians and may contribute to physician burnout and stress. The use of scribes to reduce workload and increase productivity in emergency departments (ED) has been reported. This objective of this study was to evaluate the educational and experiential value of scribing among medical and undergraduate students. We asked: “Will undergraduates be willing to scribe in exchange for clinical exposure and experience?”; and, “Should scribing be integrated into the medical school curriculum?” Methods: A mixed-methods model was employed. The study population included 5 undergraduate, and 5 medical students. Scribes received technical training on how to take physician notes. Undergraduate students were provided with optional resources to familiarize themselves with common medical terminology. Scribes were assigned to physicians based on availability. An exit interview and semi-structured interviews were conducted at the conclusion of the study. Interviews were transcribed and coded into thematic coding trees. A constructivist grounded theory approach was used to analyze the results. Themes were reviewed and verified by two members of the research team. Results: Undergraduate students preferred volunteering in the ED over other volunteer experiences (5/5); citing direct access to the medical field (5/5), demystification of the medical profession (4/5), resume building (5/5), and perceived value added to the health care team (5/5) as main motivators to continue scribing. Medical students felt scribing should be integrated into their curriculum (4/5) because it complemented their shadowing experience by providing unique value that shadowing did not. Based on survey results, five undergraduate students would be required to cover 40 volunteer hours per week. Conclusion: A student volunteer model of scribing is worthwhile to students and may be feasible; however, scribe availability, potentially high scribe turnover, and limited time to develop a rapport with their physician may impact any efficiency benefit scribes might provide. Importantly, scribing may be an invaluable experience for directing career goals and ensuring that students intrinsically interested in medicine pursue the profession. Medical students suggested that scribing could be added to the year one curriculum to help them develop a framework for how to take histories and manage patients.
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Taylor, Kimberly A., Deborah McQuilkin, and Ronda G. Hughes. "Medical Scribe Impact on Patient and Provider Experience." Military Medicine 184, no. 9-10 (February 27, 2019): 388–93. http://dx.doi.org/10.1093/milmed/usz030.
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Abstract Introduction The electronic health record (EHR) has created additional administrative burdens on providers to perform data entry while trying to engage with the patient during the health care visit. Providers have become frustrated and distracted with the documentation requirements which further hindered connectivity, and communication with the patient. The utilization of medical scribes in the outpatient clinical setting was a strategy shown to enhance patient and provider interaction, decrease clinician’s administrative tasks, and promote satisfaction among providers and patients. This was an innovative quality improvement pilot project to improve the patient and provider experience using scribes in an outpatient setting. Materials and Methods Two providers, to include one Family Medicine doctor and one Internal Medicine physician, and four hospital corpsmen participated in this pilot project. The four hospital corpsmen received a 2-week training of the fundamentals of the EHR and their role as scribes prior to the start of the project. Two corpsmen were designated for each provider and worked with their provider throughout the 12-week project period. The two primary aspects evaluated during the implementation of the scribes were the patient experience, and provider experience. Navy Medicine and the University of South Carolina Institutional Review Boards (IRB) considered this project exempt from full IRB review. Results The experience questionnaire results indicated a slight mean decrease, but did not negatively impact patient satisfaction or overall patient experience. The local Medical Treatment Facility patient satisfaction, obtained through the Interactive Customer Evaluation, and the Joint Outpatient Experience Survey, indicated that there was no decrease in patient satisfaction or overall experience during the project period. The providers’ experience improved with an average 50% decrease in time spent after hours documenting in the EHR, enhanced engagement with patient, staff, and ancillary team members, and improved work life balance. Additional findings of improved clinic efficiencies, completion of notes for both providers and positive qualitative comments from the scribes were identified. Conclusion In multiple settings, documentation requirements burden providers. The consideration of scribes could foster work life balance, retention, and wellness. The patient and provider experience was strengthened through the utilization of medical scribes, so future research centered on the provider and patient experience could be beneficial to organizations. Further study of the scribe’s experience, especially considering the positive comments from the hospital corpsmen that participated as scribes during the project, could provide beneficial outcomes. Navy Medicine is advancing every opportunity to strengthen clinical and operational readiness, health and partnerships to provide the highest quality care and promote wellness for our patients. This type of quality improvement initiative could positively support readiness, quality and wellness for our organization, providers, and patients.
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Arnaud, Daniel. "Scribes and Literature." Near Eastern Archaeology 63, no. 4 (December 2000): 199. http://dx.doi.org/10.2307/3210783.
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Moore, F. C. T. "Scribes and Texts." Monist 84, no. 3 (2001): 417–36. http://dx.doi.org/10.5840/monist200184325.
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Burnley, David. "Scribes and Hypertext." Yearbook of English Studies 25 (1995): 41. http://dx.doi.org/10.2307/3508817.
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Thomson, Andrew, Diana R. Hallman, and Mark Everist. "Scribes & Pharisees." Musical Times 144, no. 1883 (2003): 70. http://dx.doi.org/10.2307/3650686.
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