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Titolo:
Residents' medical information needs in clinic: Are they being met?
Autore:
Green, ML; Ciampi, MA; Ellis, PJ;
Indirizzi:
Waterbury Hosp, Yale Primary Care Residency Program, Waterbury, CT 06721 USA Waterbury Hosp Waterbury CT USA 06721 cy Program, Waterbury, CT 06721 USA St Marys Hosp, Waterbury, CT USA St Marys Hosp Waterbury CT USASt Marys Hosp, Waterbury, CT USA Yale Univ, Sch Med, Yale Primary Care Residency Program, Dept Internal Med, New Haven, CT USA Yale Univ New Haven CT USA Program, Dept Internal Med, New Haven, CT USA
Titolo Testata:
AMERICAN JOURNAL OF MEDICINE
fascicolo: 3, volume: 109, anno: 2000,
pagine: 218 - 223
SICI:
0002-9343(20000815)109:3<218:RMINIC>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY-CARE; PHYSICIANS; QUESTIONS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Green, ML Waterbury Hosp, Yale Primary Care Residency Program, 64 Robbins St, Waterbury, CT 06721 USA Waterbury Hosp 64 Robbins St Waterbury CT USA 06721 CT 06721 USA
Citazione:
M.L. Green et al., "Residents' medical information needs in clinic: Are they being met?", AM J MED, 109(3), 2000, pp. 218-223

Abstract

PURPOSE: Little is known about how often residents encounter unanswered clinical questions in their training. This knowledge would facilitate the development of curricula to help residents practice evidence-based medicine. This study was conducted to determine the frequency, characteristics, and pursuit of residents' clinical questions. SUBJECTS AND METHODS: Residents in a university-based primary care internal medicine program were observed in two hospital-based teaching clinics. Residents were interviewed after each patient encounter to determine whether they had any remaining clinical questions. At the end of each clinic session, they recorded their level of agreement with a series of statements aboutfactors that were expected to motivate residents to seek the answers to each question. One week later, residents were contacted to determine if they had pursued these questions. RESULTS: Sixty-four residents were interviewed after 401 (99%) of 404 patient encounters. They identified 280 new questions, approximately 2 questions for every 3 patients. The most common types of questions were related to therapy (38%) or diagnosis (27%). The residents were subsequently contactedabout 277 (99%) of their questions. Of these, only 80 (29%) were pursued, most commonly by consulting textbooks (31%), original articles (21%), or attending physicians (17%). In a multivariable analysis, belief that the patient expected the answer (odds ratio [OR] = 2.3, 95% confidence interval [CI]: 1.3 to 4.0, P = 0.004) and fear of malpractice exposure (OR = 2.1, 95% CI: 1.0 to 4.3, P = 0.05) were associated with information pursuit. Lack of time (60%) and forgetting the question (29%) were the most frequent reasonsfor failing to pursue a question. CONCLUSION: Residents frequently encountered new clinical questions in theoutpatient clinic, but infrequently answered them. Efforts to demonstrate the feasibility of timely searches, remind them of their questions, and reinforce the exigency (educational if not clinical) of all questions may reclaim missed opportunities for self-directed learning. (C) 2000 by Excerpta Medica, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 07:47:15