Certainty and systematicity of practice-derived evidence matter for its relative importance in professional decision-making: Survey results on the role of proven experience in Swedish medicine, nursing, OT, dentistry, and dental hygiene

Persson, Johannes; Wallin, Annika; Dewitt, Barry; Wahlberg, Lena

doi:10.1016/j.ijnsa.2022.100074

Cited by 1 publication

(6 citation statements)

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“…For example, correlation plots show that proven experience is positively correlated with both science and personal experience but that personal experience is largely uncorrelated with science, reinforcing our interpretation (and the intention of the survey design) that by asking about both personal and proven experience in a population in which the latter is a well-known concept, the former would capture the strictly individual aspects of clinical experience. References Persson et al, 10 , 18 Wahlberg and Persson, 19 Wallin et al, 20 and Dewitt et al 21 describe studies focusing on the proven experience data of the survey.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the two will vary also with respect to how systematic they are in how knowledge is generated, described, and substantiated. 9 , 10 (The Swedish word “systematisk” means precisely this).…”

Section: Introductionmentioning

confidence: 99%

“…Following the ideas of Persson et al 10 about balancing the evaluation of and the accessibility to evidence, we also expect the effect to vary by profession. In particular, we expect health care professions with a longer professional history—and consequently a presumably larger body of relevant scientific knowledge on which to draw, however defined—will perceive a larger difference between the two.…”

Section: Introductionmentioning

confidence: 99%

“…That is because a practitioner is forced to use whatever evidence is available when making decisions. We conjecture that if the body of scientific information is smaller, other types of information have to be relied upon, which will ultimately lead practitioners to view them as more important but also as being more similar to the scientific evidence (see also Persson et al 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…That year was approximately 1733 for physicians, approximately 1833 for dentists, 1958 for nurses, 1991 for dental hygienists, and 1999 for OTs (Swedish Board of Health and Welfare and Act 2010/659 17 ). In a previous study, 10 a similar hypothesis relating the history of a profession and the epistemological beliefs of its members was tested for the concept of proven experience. In that study, the perceived importance of the concept varied with the age of the profession, so that the relatively newer professions perceived proven experience to be closer to equally important to science than professions with a longer history (and arguably more accumulated scientific knowledge).…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of Clinical Experience and Scientific Evidence in Medical Decision Making: A Survey of a Stratified Random Sample of Swedish Health Care Professionals

Dewitt,

Persson,

Wallin

2024

Med Decis Making

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Background Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base. Design We investigate how years in the profession influence health care professionals’ beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession’s most recent occupational registry. Results Participants ( N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed. Conclusions Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions. Highlights Study participants, representing 5 health care professions—medicine, nursing, occupational therapy, dentistry, and dental hygiene—viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience. Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge. The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience.

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