Unanswered clinical questions: a survey of specialists and primary care providers

Abstract

ObjectiveWith the myriad of cases presented to clinicians every day at our integrated academic health system, clinical questions are bound to arise. Clinicians need to recognize these knowledge gaps and act on them. However, for many reasons, clinicians might not seek answers to these questions. Our goal was to investigate the rationale and process behind these unanswered clinical questions. Subsequently, we explored the use of biomedical information resources among specialists and primary care providers and identified ways to promote more informed clinical decision making.MethodsWe conducted a survey to assess how practitioners identify and respond to information gaps, their background knowledge of search tools and strategies, and their usage of and comfort level with technology.ResultsMost of the 292 respondents encountered clinical questions at least a few times per week. While the vast majority often or always pursued answers, time was the biggest barrier for not following through on questions. Most respondents did not have any formal training in searching databases, were unaware of many digital resources, and indicated a need for resources and services that could be provided at the point of care.ConclusionsWhile the reasons for unanswered clinical questions varied, thoughtful review of the responses suggested that a combination of educational strategies, embedded librarian services, and technology applications could help providers pursue answers to their clinical questions, enhance patient safety, and contribute to patient-based, self-directed learning.

Clinicians’ perceptions of usefulness of the PubMed4Hh mobile device application for clinical decision making at the point of care: a pilot study

“…The ability to use information-seeking behavior with specific clinical questions, methods, and reliable websites are important to clinicians [ 1 , 2 ]. A survey of clinicians by White et al [ 3 ] found that only 65% used PubMed often.…”

“…The most recent survey among clinicians shows that 79% of participants used mobile devices to access clinical information and 72% of participants used clinical applications on their devices [ 2 ]. There is substantial evidence of the effectiveness of mobile devices that support decision making in the clinical practice of physicians and educational training programs for medical students.…”

Topic search filters: a systematic scoping review

“…Widespread clinician awareness of the existence of high-quality primary research such as randomised controlled trials and research syntheses in the form of systematic reviews and clinical practice guidelines is an important factor in shortening the time lag between research production and its implementation into routine clinical practice (Fischer, Lange, Klose, Greiner, & Kraemer, 2016). Timelier identification of welldesigned, clinically relevant research evidence is also likely to minimise resource wastage and reduce the possibility of patients being administered ineffective, or even harmful, therapies (Brassil, Gunn, Shenoy, & Blanchard, 2017;Dunn, Marshall, Wells, & Backus, 2017;Klein, Ross, Adams, & Gilbert, 1994).…”

Evaluating the impact of clinical librarians on clinical questions during inpatient rounds

“…In fact, studies have shown that clinicians do not pursue or find answers for about half of their clinical questions that arise during everyday practice [ 5 – 8 ]. The greatest barrier to answering clinical questions, insufficient time, has also contributed to physician burnout and poor patient outcomes [ 9 , 10 ]. Indeed, time pressure may detract from physicians’ satisfaction and can stress their relationships with patients [ 10 , 11 ].…”

“…Of note, some CLs act as embedded librarians, saving physicians time by performing literature searches and assisting in answering clinical questions that arise while rounding during real-time patient care [ 15 , 22 , 23 ]. A recent study suggests that deploying CLs into clinical settings in this manner could encourage physicians to answer clinical questions, become lifelong learners, and ensure patient safety [ 9 ].…”