Kortekaas Marlous F, Bartelink Marie-Louise E L, Boelman Lia, Hoes Arno W, de Wit Niek J
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
Fam Pract. 2015 Oct;32(5):533-7. doi: 10.1093/fampra/cmv046. Epub 2015 Jun 18.
Earlier studies have shown that clinical queries are common among doctors. Data on the information-seeking behaviour of general practice (GP) trainees are scarce though, and numbers studied are small.
The objective of this study was to determine how often and how GP trainees search for answers to clinical queries encountered in daily clinical practice.
Third-year GP trainees kept logs on all patient contacts for eight consecutive practice days. Information was obtained on patient contacts (description), clinical queries (frequency, type), seeking behaviour (frequency, moment, reason not to search, resources used, duration of search) and answers (frequency, impact). Descriptive analyses were performed; frequencies and percentages were computed. We calculated the number of clinical queries per patient, the number of searches per query and the number of answers per search.
Seventy-six trainees reported 1533 clinical queries about 7300 patients presenting 7619 complaints [mean of 0.2 queries per patient, standard deviation (SD) 0.1]. For most of the queries trainees pursued an answer (mean of 0.8 per query, SD 0.2), mostly during consultation (61% of searches), and frequently retrieved answers (mean of 0.8 per search, SD 0.17) they reported to improve clinical decision making in 26%. Most common resources were colleagues or supervisors (28%), and national GP guidelines (26%). The median duration of a search was 4 minutes (interquartile range 3).
GP trainees have one clinical query per five patients. They often attempted to find answers and reported to succeed in most of the searches, primarily by consulting supervisors or colleagues and national GP guidelines.
早期研究表明,临床问题在医生中很常见。然而,关于全科医学(GP)实习生信息寻求行为的数据却很少,且研究的人数也不多。
本研究的目的是确定GP实习生在日常临床实践中搜索临床问题答案的频率和方式。
三年级GP实习生连续八个工作日记录所有患者接触情况。获取了有关患者接触(描述)、临床问题(频率、类型)、寻求行为(频率、时刻、不搜索的原因、使用的资源、搜索持续时间)和答案(频率、影响)的信息。进行了描述性分析;计算了频率和百分比。我们计算了每位患者的临床问题数量、每个问题的搜索次数以及每次搜索的答案数量。
76名实习生报告了1533个关于7300名患者的临床问题,这些患者提出了7619项主诉[每位患者平均0.2个问题,标准差(SD)0.1]。对于大多数问题,实习生寻求答案(每个问题平均0.8个,SD 0.2),大多在会诊期间(61%的搜索),并且经常检索到答案(每次搜索平均0.8个,SD 0.17),他们报告称在26%的情况下这些答案改善了临床决策。最常用的资源是同事或上级(28%)以及国家GP指南(26%)。搜索的中位持续时间为4分钟(四分位间距3)。
GP实习生每五名患者中有一个临床问题。他们经常试图寻找答案,并报告在大多数搜索中取得成功,主要是通过咨询上级或同事以及国家GP指南。