Haynes R B, Johnston M E, McKibbon K A, Walker C J, Willan A R
Health Information Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Online J Curr Clin Trials. 1993 May 11;Doc No 56:[4005 words; 39 paragraphs].
To determine if a preceptor and individualized feedback improves the performance of physicians in searching MEDLINE in clinical settings.
Randomized controlled trial with 2 to 10 months follow-up.
A 300-bed teaching hospital.
All 392 physicians and physicians-in-training from 6 major clinical departments were invited to participate if they made patient-care decisions during the study period; 79.4% agreed.
All participants were given 2 hours of basic training, then randomized to a control group (no further intervention) or an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback from a study librarian on each of their 1st 10 searches.
The number and proportion of relevant and irrelevant references retrieved for 1st, 4th, and 8th searches of participants were compared with independent librarian searches on the same topics.
Intervention group members did not search more often than controls (5.9 searches per month versus 4.7, respectively; P = 0.26) and there were no significant differences in the quality of searches. Rather, search performance for both groups improved, with the average number of relevant references retrieved per search increasing from 4.5 to 7.4 (P < 0.01). The librarian retrieved more relevant citations than participants for the 1st search (P = 0.001) but not for the 4th (P = 0.60) or 8th (P = 0.76) searches.
A program of assigning preceptors and providing feedback on individual searches did not enhance the quantity or quality of searches. Soon after a basic introduction to searching, however, clinicians in both groups improved their search performance.
确定带教老师和个性化反馈是否能提高临床环境中医师检索医学文献数据库（MEDLINE）的能力。
进行为期2至10个月随访的随机对照试验。
一家拥有300张床位的教学医院。
邀请了来自6个主要临床科室的所有392名医生和实习医生参与研究，条件是他们在研究期间需做出患者护理决策；79.4%的人同意参与。
所有参与者均接受2小时的基础培训，然后随机分为对照组（无进一步干预）或干预组，干预组中每个人选择一名在检索MEDLINE方面经验丰富的临床带教老师，并从研究馆员那里获得关于其前10次检索中每次检索的个性化反馈。
将参与者第1次、第4次和第8次检索中检索到的相关和不相关参考文献的数量及比例与独立馆员就相同主题进行的检索结果进行比较。
干预组成员的检索频率并不高于对照组（分别为每月5.9次检索和4.7次检索；P = 0.26），检索质量也无显著差异。相反，两组的检索表现均有所提高，每次检索中检索到的相关参考文献的平均数量从4.5增加到了7.4（P < 0.01）。对于第1次检索，馆员检索到的相关引文比参与者更多（P = 0.001），但对于第4次检索（P = 0.60）和第8次检索（P = 0.76）并非如此。
安排带教老师并针对每次检索提供反馈的方案并未提高检索的数量或质量。然而，在接受基本的检索介绍后不久，两组临床医生的检索表现均有所改善。
