Family physicians' selection of informal peer consultants: implications for continuing education.

INTRODUCTION: Studies of physicians' preferred sources of clinical information suggest that many rely heavily on advice from colleagues. This study examines the criteria that a sample of physicians used to select informal educational consultants, the characteristics of participants adhering to these criteria and those of the peers they consult, and the participants' approaches toward evaluating information gathered from peers.
METHOD: In-depth interviews were conducted with 45 family physicians from three mid-sized Ontario cities. A typology of participants' approaches for selecting informal peer consultants was developed from participants' selection criteria. Seven themes emerged from analysis across the interviews, and three types of approaches to selecting peer consultants are characterized with respect to these themes.
RESULTS: When seeking clinical information, most participants reported that their first resource was informal consultation with peers. Fifty-four percent turned to readily available and approachable peers, and 24% asked only those peers they considered to be experts. The remaining participants (22%) searched the literature before or in conjunction with consulting expert specialists or innovators. Participants who sought advice from their most readily accessible peers asked for advice most frequently, rarely consulted innovators, and were least critical of the advice they received. DISCUSSION: The profiles of those who sought clinical information from their most accessible peers suggested that the quality of informal peer consultations could be improved through explicit guidelines within formal continuing education programs. Longitudinal studies are needed to examine the effectiveness of this strategy in increasing the translation of research into family physicians' clinical practices and patient outcomes.