Systematically Assessing the Situational Relevance of Electronic Knowledge Resources: A Mixed Methods Study
- Affiliations of the authors: Department of Family Medicine (PP, RMG, MD), Information Technology Primary Care Research Group (NM, JJ-L), Department of Social Studies of Medicine (LK), McGill University, Montreal, Quebec, Canada
- Correspondence and reprints: Pierre Pluye, Department of Family Medicine, McGill University, 517 Pine Avenue West, Montreal, Quebec, Canada, H2W 1S4; e-mail: <Pierre.Pluye{at}mcgill.ca>
- Received 13 July 2006
- Accepted 20 May 2007
Abstract
Electronic Knowledge Resources (EKRs) are increasingly used by physicians, but their situational relevance has not been systematically examined.
Objective Systematically scrutinize the situational relevance of EKR-derived information items in and outside clinical settings.
Background Physicians use EKRs to accomplish four cognitive objectives (C1-4), and three organizational objectives (O1-3): (C1) Answer questions/solve problems/support decision-making in a clinical context; (C2) fulfill educational-research objectives; (C3) search for personal interest or curiosity; (C4) overcome limits of human memory; (O1) share information with patients, families, or caregivers; (O2) exchange information with other health professionals; (O3) plan-manage-monitor tasks with other health professionals.
Methods Longitudinal mixed methods multiple case study: Cases were 17 residents’ critical searches for information, using a commercial EKR, during a 2-month block of family practice. Usage data were automatically recorded. Each “opened” item of information was linked to an impact assessment questionnaire, and 1,981 evaluations of items were documented. Interviews with residents were guided by log files, which tracked use and impact of EKR-derived information items. Thematic analysis identified 156 critical searches linked to 877 information items. For each case, qualitative data were assigned to one of the seven proposed objectives.
Results Residents achieved their search objectives in 85.9% of cases (situational relevance). Additional sources of information were sought in 52.6% of cases. Results support the seven proposed objectives, levels of comparative relevance (less, equally, more), and levels of stimulation of learning and knowledge (individual, organizational).
Conclusion Our method of systematic assessment may contribute to user-based evaluation of EKRs.
Footnotes
-
This study was funded by the Canadian Institutes of Health Research (CIHR). Pierre Pluye holds a New Investigator Award from the "Fonds de la recherche en santé Québec" (FRSQ). The authors gratefully acknowledge the help and thoughtful advice given by Marie-Ève Beauchamp (Department of Epidemiology and Biostatistics, McGill University), and by Michael Shulha (Information Technology Primary Care Research Group, McGill University).
