Using medical knowledge sources on handheld computers – A qualitative study among junior doctors

Background: The emergence of mobile computing could have an impact on how junior doctors learn. To exploit this opportunity it is essential to understand their information seeking process. Aim: To explore junior doctors’ experiences of using medical knowledge sources on handheld computers. Method: Interviews with five Swedish junior doctors. A qualitative manifest content analysis of a focus group interview followed by a qualitative latent content analysis of two individual interviews. Results: A focus group interview showed that users were satisfied with access to handheld medical knowledge sources, but there was concern about contents, reliability and device dependency. Four categories emerged from individual interviews: (1) A feeling of uncertainty about using handheld technology in medical care; (2) A sense of security that handhelds can provide; (3) A need for contents to be personalized; (4) A degree of adaptability to make the handheld a versatile information tool. A theme was established to link the four categories together, as expressed in the Conclusion section. Conclusion: Junior doctors’ experiences of using medical knowledge sources on handheld computers shed light on the need to decrease uncertainty about clinical decisions during medical internship, and to find ways to influence the level of self-confidence in the junior doctor's process of decision-making.

[1]  R. Leipzig,et al.  The impact of E-learning in medical education. , 2006, Academic medicine : journal of the Association of American Medical Colleges.

[2]  Michael A. Grasso,et al.  Survey of handheld computing among medical students , 2006, Comput. Methods Programs Biomed..

[3]  Johanna I. Westbrook,et al.  Research Paper: Do clinicians use online evidence to support patient care? a study of 55, 000 clinicians , 2003, J. Am. Medical Informatics Assoc..

[4]  Michael E. Raynor,et al.  The Innovator's Solution: Creating and Sustaining Successful Growth , 2003 .

[5]  J. Morse.  Determining Sample Size , 2000 .

[6]  Paul N. Gorman,et al.  Information needs of physicians , 1995 .

[7]  B. Lundman,et al.  Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. , 2004, Nurse education today.

[8]  Klaus Krippendorff,et al.  Content Analysis: An Introduction to Its Methodology , 1980 .

[9]  Ville Harkke,et al.  Knowledge Freedom for Medical Professionals - An Evaluation Study of a Mobile Information System for Physicians in Finland , 2006 .

[10]  M. Patton,et al.  Qualitative evaluation and research methods , 1992 .

[11]  K. Seltman.  Marketing for management. , 2004, Marketing health services.

[12]  Hangwi Tang,et al.  Googling for a diagnosis—use of Google as a diagnostic aid: internet based study , 2006, BMJ : British Medical Journal.

[13]  N. Britten.  Qualitative Research: Qualitative interviews in medical research , 1995 .

[14]  R A Bankowitz,et al.  Physicians' use of computer software in answering clinical questions. , 1993, Bulletin of the Medical Library Association.

[15]  K. Krippendorff.  Krippendorff, Klaus, Content Analysis: An Introduction to its Methodology . Beverly Hills, CA: Sage, 1980. , 1980 .

[16]  Sunil Kripalani,et al.  Use of handheld computers in medical education. A systematic review. , 2006, Journal of general internal medicine.

[17]  E. Tolley,et al.  Qualitative Methods in Public Health: A Field Guide for Applied Research , 2004 .

[18]  M. Smith.  Disruptive Innovation: Can Health Care Learn From Other Industries? A Conversation With Clayton M. Christensen , 2007 .

[19]  M. Sandelowski.  Sample size in qualitative research. , 1995, Research in nursing & health.

[20]  R. Barbour.  Making sense of focus groups , 2005, Medical education.

[21]  Clayton M. Christensen.  Disruptive innovation: can health care learn from other industries? A conversation with Clayton M. Christensen. Interview by Mark D. Smith. , 2007, Health affairs.

[22]  Sunil Kripalani,et al.  Use of handheld computers in medical education , 2006, Journal of General Internal Medicine.

[23]  Martin Dawes,et al.  Knowledge management in clinical practice: a systematic review of information seeking behavior in physicians , 2003, Int. J. Medical Informatics.

[24]  C. Webb,et al.  Focus groups as a tool for critical social research in nurse education. , 2001, Nurse education today.

[25]  Joel T. Johnson,et al.  Students’ and Residents’ Perceptions Regarding Technology in Medical Training , 2006, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry.

[26]  E. Fess,et al.  Determining sample size. , 1995, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[27]  Stephen B. Johnson,et al.  Accessing Heterogeneous Sources of Evidence to Answer Clinical Questions , 2001, J. Biomed. Informatics.

[28]  Ruth Endacott,et al.  Clinical research 4: qualitative data collection and analysis. , 2008, International emergency nursing.

[29]  Margaret Volante.  Qualitative research. , 2008, Nurse researcher.

[30]  Peter D. Stetson,et al.  Approach to mobile information and communication for health care , 2004, Int. J. Medical Informatics.

[31]  Scott M. Strayer,et al.  Assessing medical residents' usage and perceived needs for personal digital assistants , 2004, Int. J. Medical Informatics.

[32]  Lois W. Sayrs.  Interviews : an introduction to qualitative research interviewing , 1996 .

[33]  C. Russell,et al.  Evaluation of qualitative research studies , 2003, Evidence-based nursing.

[34]  G. Leung,et al.  Randomised controlled trial of clinical decision support tools to improve learning of evidence based medicine in medical students , 2003, BMJ : British Medical Journal.

[35]  J. Kitzinger,et al.  Qualitative Research: Introducing focus groups , 1995 .

[36]  E. Balas,et al.  Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success , 2005, BMJ : British Medical Journal.

[37]  Jon O. Ebbert,et al.  Case Report: Survey Assessment of Personal Digital Assistant Use among Trainees and Attending Physicians , 2003, J. Am. Medical Informatics Assoc..

[38]  A. McAlearney,et al.  Doctors' experience with handheld computers in clinical practice: qualitative study , 2004, BMJ : British Medical Journal.