Resources and References
Features of Effective Medical Knowledge Resources to Support Point of Care Learning: A Focus Group Study
We identified nine features that influence users’ selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity), integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect), currency, and ability to support patient education. No single existing resource exemplifies all of these features.
Impact of Clinicians’ Use of Electronic Knowledge Resources on Clinical and Learning Outcomes: Systematic Review and Meta-Analysis
Use of electronic knowledge resources is associated with a positive impact on clinician behaviors and patient effects. We found statistically significant associations between the use of electronic knowledge resources and improved clinician behaviors and patient effects. When compared with other resources, the use of electronic knowledge resources was associated with increased success in answering clinical questions, with variable impact on speed. Comparisons of different implementation strategies of the same electronic knowledge resource suggest that there are benefits from allowing clinicians to choose to access the resource, versus automated display of resource information, and from integrating patient-specific information. A total of 4 studies compared different commercial electronic knowledge resources, with variable results. Resource implementation strategies can significantly influence outcomes but few studies have examined such factors.
Evaluating the Appropriateness of Electronic Information Resources for Learning
Compared to AccessMedicine and Wikipedia, UpToDate was associated with significantly higher values of eye metrics, suggesting learners experienced higher mental effort. No statistically significant difference between the amount of mental effort and learning outcomes was found. More so, descriptive statistical analysis of the knowledge test scores suggested similar levels of learning regardless of the information resource used.
Unanswered Clinical Questions: A Survey of Specialists and Primary Care Providers
Study results: Most of the 292 respondents encountered clinical questions at least a few times per week. While the vast majority often or always pursued answers, time was the biggest barrier for not following through on questions. Most respondents did not have any formal training in searching databases, were unaware of many digital resources, and indicated a need for resources and services that could be provided at the point of care. “Our study results indicate that our clinicians are receptive to new technology and that most already use mobile devices to access clinical information, opening the door for enhanced mobile interventions such as a search request app, current awareness alerts, and other clinical tools that could be readily accessed at the point of care when the need arises.”
Clinical Questions Raised by Clinicians at the Point of Care: A Systematic Review
Frequency of questions raised, pursued, and answered and questions by type according to a taxonomy of clinical questions. Thematic analysis of barriers to information seeking and the effects of information seeking on decision making. RESULTS In 11 studies, 7012 questions were elicited through short interviews with clinicians after each patient visit. The mean frequency of questions raised was 0.57 (95% CI, 0.38-0.77) per patient seen, and clinicians pursued 51% (36%-66%) of questions and found answers to 78% (67%-88%) of those they pursued. Overall, 34% of questions concerned drug treatment, and 24% concerned potential causes of a symptom, physical finding, or diagnostic test finding. Clinicians’ lack of time and doubt that a useful answer exists were the main barriers to information seeking.