McKibbon K Ann, Fridsma Douglas B
Health Information Research Unit, Clinical Epidemiology and Biostatistics, Faculty of Health Sciences McMaster University, Hamilton, Ontario, Canada.
J Am Med Inform Assoc. 2006 Nov-Dec;13(6):653-9. doi: 10.1197/jamia.M2087. Epub 2006 Aug 23.
To determine if clinician-selected electronic information resources improve primary care physicians' abilities to answer simulated clinical questions.
Observational study using hour-long interviews in physician offices and think-aloud protocols.
answered 23 multiple-choice questions and chose 2 to obtain further information using their own information resources. We established which resources physicians chose, processes used, and results obtained when looking for information to support their answers.
Correctness of answers before and after searching, resources used, and searching techniques.
23 physicians sought answers to 46 questions using their own information resources. They spent a mean of 13.0 (SD 5.5) minutes searching for information for the two questions using an average of 1.8 resources per question and a wide variety of searching techniques. On average 43.5% of the answers to the original 23 questions were correct. For the questions that were searched, 18 (39.1%) of the 46 answers were correct before searching. After searching, the number of correct answers was 19 (42.1%). This difference of 1 correct answer was attributed to 6 questions (13.0%) going from an incorrect to correct answer and 5 (10.9%) questions going from a correct to incorrect answer. We found differences in the ability of various resources to provide correct answers.
For the primary care physicians studied, electronic information resources of choice did not always provide support for finding correct answers to simulated clinical questions and in some instances, individual resources may have contributed to an initially correct answer becoming incorrect.
确定临床医生选择的电子信息资源是否能提高初级保健医生回答模拟临床问题的能力。
在医生办公室进行长达一小时的访谈并采用出声思考法的观察性研究。
回答23道多项选择题,并选择2道题使用他们自己的信息资源获取更多信息。我们确定了医生在寻找支持其答案的信息时所选择的资源、使用的过程以及获得的结果。
搜索前后答案的正确性、使用的资源和搜索技巧。
23名医生使用他们自己的信息资源寻找46道问题的答案。他们平均花费13.0(标准差5.5)分钟为两道问题搜索信息,每题平均使用1.8种资源,且使用了多种搜索技巧。最初23道问题的答案平均正确率为43.5%。对于搜索过的问题,46个答案中有18个(39.1%)在搜索前是正确的。搜索后,正确答案的数量为19个(42.1%)。这1个正确答案的差异归因于6道题(13.0%)从错误答案变为正确答案,以及5道题(10.9%)从正确答案变为错误答案。我们发现不同资源提供正确答案的能力存在差异。
对于所研究的初级保健医生而言,他们所选择的电子信息资源并不总是能为找到模拟临床问题的正确答案提供支持,在某些情况下,个别资源可能导致最初正确的答案变为错误答案。