OBJECTIVE
To understand the ways in which computer-mediated searching of the biomedical literature affects patient care and other professional activities. Undertaken to determine the ways in which on-line access to the biomedical literature via the National Library of Medicine's MEDLINE database "makes a difference" in what physicians do when confronted with a medical problem requiring new or additional information.
DESIGN
An adaptation of the Critical Incident Technique used to gather detailed reports of MEDLINE search results that were especially helpful (or not helpful) in carrying out the individual's professional activities. The individual physician was the source of the patient care incident reports. One thousand one hundred fifty-eight reports were systematically analyzed from three different perspectives: (1) why the information was sought; (2) the effect of having (or not having) the needed information on professional decisions and actions; and (3) the outcome of the search.
PARTICIPANTS AND SETTING
Telephone interviews were carried out with a purposive sample of 552 physicians, scientists, and other professionals working in a variety of clinical care and other settings. Of these, 65% were direct users of MEDLINE throughout the United States, and 35% had MEDLINE searches conducted for them either at a major health sciences center or in community hospitals.
RESULTS
Three comprehensive and detailed inventories that describe the motivation for the searches, how search results affected the actions and decisions of the individual who initiated the search, and how they affected the outcome of the situation that motivated the search.
CONCLUSIONS
MEDLINE searches are being carried out by and for physicians to meet a wide diversity of clinical information needs. Physicians report that in situations involving individual patients, rapid access to the biomedical literature via MEDLINE is at times critical to sound patient care and favorably influences patient outcomes.
[1]
M E DeBakey.
The National Library of Medicine. Evolution of a premier information center.
,
1991,
JAMA.
[2]
B L Humphreys,et al.
Bibliographic retrieval: a survey of individual users of MEDLINE.
,
1990,
M.D. computing : computers in medical practice.
[3]
K. A. McKibbon,et al.
Online access to MEDLINE in clinical settings. A study of use and usefulness.
,
1990,
Annals of internal medicine.
[4]
B. Meth,et al.
Methemoglobin, MEDLINE, and hyperlipemia.
,
1987,
Critical care medicine.
[5]
D. Covell,et al.
Information needs in office practice: are they being met?
,
1985,
Annals of internal medicine.
[6]
McClatchey Wm,et al.
The computer as a medical tool.
,
1985
.
[7]
N. Sohn,et al.
Computer-assisted surgery.
,
1985,
The New England journal of medicine.
[8]
E. Franken,et al.
Critical incident interviewing in evaluation of resident performance.
,
1984,
Radiology.
[9]
E. Berner,et al.
A study of board certification in child psychiatry as a valid indicator of clinical competence.
,
1977,
Journal of the American Academy of Child Psychiatry.
[10]
Paul J. Sanazaro,et al.
End Results of Patient Care: A Provisional Classification Based on Reports by Internists
,
1968
.
[11]
C. F. Schumacher,et al.
AN OBJECTIVE EVALUATION OF CLINICAL COMPETENCE. NEW TECHNICS USED BY THE NATIONAL BOARD OF MEDICAL EXAMINERS.
,
1965,
The New England journal of medicine.
[12]
J. C. Flanagan.
Psychological Bulletin THE CRITICAL INCIDENT TECHNIQUE
,
2022
.