Parker Magin1, Simon Morgan2, Susan Wearne3, Amanda Tapley2, Kim Henderson2, Chris Oldmeadow4, Jean Ball5, John Scott2, Neil Spike6, Lawrie McArthur7, Mieke van Driel8. 1. Discipline of General Practice, University of Newcastle, Newbolds Building, University Drive, Callaghan, NSW 2308, General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304, parker.magin@newcastle.edu.au. 2. General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304. 3. Academic Unit of General Practice, Australian National University Medical School, Canberra, ACT 2606, Department of Health, Health Workforce Division, Woden Town Centre, Canberra, ACT 2606. 4. Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle, School of Medicine and Public Health, University of Newcastle University Drive, Callaghan, NSW 2308. 5. Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle. 6. Victorian Metropolitan Alliance General Practice Training, 15 Cato Street, Hawthorn, VIC 3122, Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, VIC 3053. 7. Adelaide to Outback General Practice Training, Lower Level, 183 Melbourne Street, North Adelaide, SA 5006 and. 8. Discipline of General Practice, School of Medicine, The University of Queensland, L8 Health Sciences Building, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Abstract
BACKGROUND: Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic). OBJECTIVES: To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources. METHODS: A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy. RESULTS: Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training organization and information-seeking for management rather than diagnosis. CONCLUSION: Trainee information-seeking is mainly from GP colleagues and electronic sources. Human information-sources are preferentially sought for more complex problems, even by these early-career GPs who have trained in the 'internet era'.
BACKGROUND: Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic). OBJECTIVES: To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources. METHODS: A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy. RESULTS: Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training organization and information-seeking for management rather than diagnosis. CONCLUSION: Trainee information-seeking is mainly from GP colleagues and electronic sources. Human information-sources are preferentially sought for more complex problems, even by these early-career GPs who have trained in the 'internet era'.
Keywords:
Australia; evidence-based medicine; family practice; general practitioners; information seeking behaviour; internet; internship and residency; primary health care.
Authors: Michael Tran; Susan Wearne; Amanda Tapley; Alison Fielding; Andrew Davey; Mieke van Driel; Elizabeth Holliday; Jean Ball; Kristen FitzGerald; Neil Spike; Parker Magin Journal: BMC Med Educ Date: 2022-02-23 Impact factor: 2.463
Authors: Anneliese Willems; Amanda Tapley; Alison Fielding; Vivian Tng; Elizabeth G Holliday; Mieke L van Driel; Jean I Ball; Andrew R Davey; Kristen FitzGerald; Neil A Spike; Parker J Magin Journal: Dermatol Pract Concept Date: 2021-01-29
Authors: Jocelyn Ledger; Amanda Tapley; Christopher Levi; Andrew Davey; Mieke van Driel; Elizabeth G Holliday; Jean Ball; Alison Fielding; Neil Spike; Kristen FitzGerald; Parker Magin Journal: Fam Med Community Health Date: 2021-12