Dataset Information

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones.

ABSTRACT:

Background

This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities.

Methods

We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones.

Results

The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities.

Conclusion

In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality.

SUBMITTER: Leon SA

PROVIDER: S-EPMC1805745 | biostudies-literature | 2007 Feb

REPOSITORIES: biostudies-literature

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Publications

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones.

León Sergio A SA Fontelo Paul P Green Linda L Ackerman Michael M Liu Fang F

BMC medical informatics and decision making 20070221

<h4>Background</h4>This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resource ...[more]

PMID: 17313680

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Project description:BackgroundMedical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital.ObjectiveTo examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility.DesignMulti-site, cross-sectional 24-question survey delivered via email or paper-based form.ParticipantsInternal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States.Main measuresPerceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors.Key resultsOf 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments.ConclusionsInternal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was consistently associated with level of training, program type, career path, or burnout, suggesting there may be unmeasured factors such as professional role modeling that shape these perceptions.

Project description:BACKGROUND: Few studies have examined residents' retained knowledge and confidence regarding essential evidence-based medicine (EBM) topics. OBJECTIVE: To compare postgraduate year-3 (PGY-3) residents' confidence with EBM topics taught during internship with that of PGY-1 residents before and after exposure to an EBM curriculum. METHODS: All residents participated in an EBM curriculum during their intern year. We surveyed residents in 2009. PGY-1 residents completed a Likert-scale type survey (which included questions from the validated Berlin questionnaire and others, developed based on input from local EBM experts). We administered the Berlin questionnaire to a subset of PGY-3 residents. RESULTS: Forty-five PGY-3 (88%; n = 51) and 42 PGY-1 (91%; n = 46) residents completed the survey. Compared with PGY-1 residents pre-curriculum, PGY-3 residents were significantly more confident in their knowledge of pre- and posttest probability (mean difference, 1.14; P = .002), number needed to harm (mean difference, 1.09; P = .002), likelihood ratio (mean difference, 1.01; P = .003), formulation of a focused clinical question (mean difference, 0.98; P = .001), and critical appraisal of therapy articles (mean difference, 0.91; P = .002). Perceived confidence was significantly lower for PGY-3 than post-curriculum PGY-1 residents on relative risk (mean difference, -0.86; P = .002), study design for prognosis questions (mean difference, -0.75; P = .004), number needed to harm (mean difference, -0.67; P = .01), ability to critically appraise systematic reviews (mean difference, -0.65, P = .009), and retrieval of evidence (mean difference, -0.56; P = .008), among others. There was no relationship between confidence with and actual knowledge of EBM topics. CONCLUSIONS: Our findings demonstrate lower confidence among PGY-3 than among PGY-1 internal medicine residents for several EBM topics. PGY-3 residents demonstrated poor knowledge of several core topics taught during internship. Longitudinal EBM curricula throughout residency 5 help reinforce residents' EBM knowledge and their confidence.

Dataset Information

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones.

Background

Methods

Results

Conclusion

Publications

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones.

Similar Datasets

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