Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment
BACKGROUND: Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN: This is a mixe...
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2022
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| author | Helen E. Noble Willy Jesús Neumann Ordoñez Gabriela Zavala Wong Manuel J Rodríguez David Ortega Checa Maria Warne Kirsten Senturia Ying Jin Ryan Peterson Lacey N. LaGrone |
| author_browse | David Ortega Checa Gabriela Zavala Wong Helen E. Noble Kirsten Senturia Lacey N. LaGrone Manuel J Rodríguez Maria Warne Ryan Peterson Willy Jesús Neumann Ordoñez Ying Jin |
| author_facet | Helen E. Noble Willy Jesús Neumann Ordoñez Gabriela Zavala Wong Manuel J Rodríguez David Ortega Checa Maria Warne Kirsten Senturia Ying Jin Ryan Peterson Lacey N. LaGrone |
| author_sort | Helen E. Noble |
| collection | Producción científica |
| description | BACKGROUND: Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN: This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes. RESULTS: Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency. CONCLUSIONS: Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/1370 |
| institution | UPeU |
| language | English |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
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| spelling | oai:cris.upeu.edu.pe:20.500.15037/13702026-10-30T16:15:40ZDoes Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random AssignmentHelen E. NobleWilly Jesús Neumann OrdoñezGabriela Zavala WongManuel J RodríguezDavid Ortega ChecaMaria WarneKirsten SenturiaYing JinRyan PetersonLacey N. LaGroneMedicineOddsUsabilityIntervention (counseling)Reading (process)Odds ratioPoint of careFamily medicineMedical educationNursingLogistic regressionInternal medicineLawComputer scienceHuman–computer interactionPolitical scienceMedicineOddsUsabilityIntervention (counseling)Reading (process)Odds ratioPoint of careFamily medicineMedical educationNursingLogistic regressionInternal medicineHumansHumansHumansHumansHumansHumansHumansResearch DesignResearch DesignResearch DesignResearch DesignResearch DesignResearch DesignResearch DesignStudentsStudentsStudentsStudentsStudentsStudentsStudentsPoint-of-Care SystemsPoint-of-Care SystemsPoint-of-Care SystemsPoint-of-Care SystemsPoint-of-Care SystemsPoint-of-Care SystemsPoint-of-Care SystemsEvidence-Based PracticeEvidence-Based PracticeEvidence-Based PracticeEvidence-Based PracticeEvidence-Based PracticeEvidence-Based PracticeEvidence-Based PracticeSurgeonsSurgeonsSurgeonsSurgeonsSurgeonsSurgeonsSurgeonsHealth Sciences Health Professions General Health Professions Health Sciences Research and EducationHealth Sciences Health Professions General Health Professions Health Policy Implementation ScienceHealth Sciences Medicine Public Health, Environmental and Occupational Health Global Health and SurgeryBACKGROUND: Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN: This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes. RESULTS: Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency. CONCLUSIONS: Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems.Articlehttps://pubmed.ncbi.nlm.nih.gov/36729680https://doi.org/10.1097/xcs.000000000000053010.1097/xcs.0000000000000530https://hdl.handle.net/20.500.15037/1370W4318930021enJournal of the American College of Surgeons1072-75151879-11902022-12-152026-06-13T09:55:48Z2026-06-13T09:55:48Z |
| spellingShingle | Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Law Computer science Human–computer interaction Political science Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Humans Humans Humans Humans Humans Humans Humans Research Design Research Design Research Design Research Design Research Design Research Design Research Design Students Students Students Students Students Students Students Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Health Sciences Health Professions General Health Professions Health Sciences Research and Education Health Sciences Health Professions General Health Professions Health Policy Implementation Science Health Sciences Medicine Public Health, Environmental and Occupational Health Global Health and Surgery Helen E. Noble Willy Jesús Neumann Ordoñez Gabriela Zavala Wong Manuel J Rodríguez David Ortega Checa Maria Warne Kirsten Senturia Ying Jin Ryan Peterson Lacey N. LaGrone Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title | Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title_full | Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title_fullStr | Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title_full_unstemmed | Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title_short | Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment |
| title_sort | does access to point of care medical information improve trauma and general surgeons clinical knowledge in a middle income country a mixed methods study with random assignment |
| topic | Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Law Computer science Human–computer interaction Political science Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Humans Humans Humans Humans Humans Humans Humans Research Design Research Design Research Design Research Design Research Design Research Design Research Design Students Students Students Students Students Students Students Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Health Sciences Health Professions General Health Professions Health Sciences Research and Education Health Sciences Health Professions General Health Professions Health Policy Implementation Science Health Sciences Medicine Public Health, Environmental and Occupational Health Global Health and Surgery |
| topic_facet | Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Law Computer science Human–computer interaction Political science Medicine Odds Usability Intervention (counseling) Reading (process) Odds ratio Point of care Family medicine Medical education Nursing Logistic regression Internal medicine Humans Humans Humans Humans Humans Humans Humans Research Design Research Design Research Design Research Design Research Design Research Design Research Design Students Students Students Students Students Students Students Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Point-of-Care Systems Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Evidence-Based Practice Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Surgeons Health Sciences Health Professions General Health Professions Health Sciences Research and Education Health Sciences Health Professions General Health Professions Health Policy Implementation Science Health Sciences Medicine Public Health, Environmental and Occupational Health Global Health and Surgery |
| url | https://pubmed.ncbi.nlm.nih.gov/36729680 https://doi.org/10.1097/xcs.0000000000000530 https://hdl.handle.net/20.500.15037/1370 |
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