Peterson Michael W, Rowat Jane, Kreiter Clarence, Mandel Jess
Department of Medicine, University of California at San Francisco-Fresno Medical Education Program, Fresno, California 93702, USA.
Acad Med. 2004 Jan;79(1):89-95. doi: 10.1097/00001888-200401000-00019.
One of the many challenges clinicians face is applying growing medical knowledge to specific patients; however, there is an information gap between information needs and delivery. Digital information resources could potentially bridge this gap. Because most medical students are exposed to personal computers throughout their education, this study postulated that students may be more comfortable using computer-based information resources within clinical interactions.
In 2001, the authors monitored second-year medical students' use of a unique digital textbook, UpToDate, as they transitioned from preclinical to clinical years at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. In 2002, at the end of their third year, students were surveyed about their preferred clinical information resources.
Medical students rapidly adopted UpToDate as a clinical resource during their clinical clerkship as evidenced by a rapid growth in the electronic textbook's use. One hundred sixteen of a possible 154 students (75%) responded to the survey. More than 85% of respondents identified electronic sources as their primary resource (UpToDate 53%, MDConsult 33%; p <.001 when compared to paper resources). They also reported using the information resources on a daily basis and requiring less than 15 minutes to answer most of their clinical questions.
This study clearly demonstrates that medical students embrace and use electronic information resources much more than has been reported among practicing clinicians. The current generation of students may be the leaders in a medical culture shift from paper to electronic resources.
临床医生面临的众多挑战之一是将不断增长的医学知识应用于特定患者;然而,信息需求与信息传递之间存在差距。数字信息资源有可能弥合这一差距。由于大多数医学生在整个教育过程中都接触个人电脑,本研究推测学生在临床互动中可能更愿意使用基于计算机的信息资源。
2001年,作者监测了爱荷华大学罗伊·J.和露西尔·A.卡弗医学院二年级医学生从临床前阶段过渡到临床阶段时对独特数字教科书《UpToDate》的使用情况。2002年,在他们三年级结束时,对学生关于他们首选的临床信息资源进行了调查。
医学生在临床实习期间迅速将《UpToDate》用作临床资源,电子教科书使用量的快速增长证明了这一点。在可能的154名学生中,有116名(75%)回复了调查。超过85%的受访者将电子资源视为主要资源(《UpToDate》占53%,MDConsult占33%;与纸质资源相比,p<.001)。他们还报告说每天使用这些信息资源,回答大多数临床问题所需时间不到15分钟。
本研究清楚地表明,医学生比执业临床医生更多地接受和使用电子信息资源。当前这一代学生可能是医学文化从纸质资源向电子资源转变的引领者。