Journal article
Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment
Journal of the American College of Surgeons, Vol.236(3), pp.484-494
03/01/2023
DOI: 10.1097/XCS.0000000000000530
PMCID: PMC9924957
PMID: 36729680
Abstract
Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence.
This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes.
Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency.
Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems.
Details
- Title: Subtitle
- Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment
- Creators
- Helen Noble - Fogarty International CenterWilly Jesús Neumann Ordoñez - Centro Peruano de Estudios SocialesGabriela Zavala Wong - Universidad Peruana Cayetano HerediaManuel J Rodríguez - Universidad Peruana Cayetano HerediaDavid Ortega Checa - Department of Surgery, Hospital Rebagliati, Lima, Perú (Ortega Checa)Maria Warne - University of Colorado HealthKirsten Senturia - University of WashingtonYing Jin - University of Colorado Anschutz Medical CampusRyan Peterson - University of Colorado Anschutz Medical CampusLacey Nicole LaGrone - University of Colorado Health
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Surgeons, Vol.236(3), pp.484-494
- DOI
- 10.1097/XCS.0000000000000530
- PMID
- 36729680
- PMCID
- PMC9924957
- NLM abbreviation
- J Am Coll Surg
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Grant note
- D43 TW009345 / FIC NIH HHS
- Language
- English
- Date published
- 03/01/2023
- Academic Unit
- Biostatistics; Internal Medicine
- Record Identifier
- 9984914018702771
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