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


  • Ellen Brassil MSLS, MAT, AHIP, Director, Health Sciences Library, Baystate Health, 759 Chestnut Street, Springfield, MA 01199
  • Bridget Gunn MSLS, MS, AHIP, Information and Knowledge Services Librarian, Health Sciences Library, Baystate Health, 759 Chestnut Street, Springfield, MA 01199
  • Anant M. Shenoy MD, Medical Director of Informatics and Attending in Neurology, Baystate Health, 759 Chestnut Street, Springfield, MA 01199
  • Rebecca Blanchard PhD, Director of Healthcare Education, Baystate Health, and Assistant Professor, University of Massachusetts Medical School-Baystate, 759 Chestnut Street, Springfield, MA 01199




Decision Making, Education, Continuing, Evidence-Based Practice, Information Literacy, Information Seeking Behavior, Library Services, Nurse Practitioners, Physicians, Physician Assistants, Surveys and Questionnaires


Objective: With the myriad of cases presented to clinicians every day at the authors’ 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.

Methods: We 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.

Results: Most 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.

Conclusions: While 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.

 This article has been approved for the Medical Library Association’s Independent Reading Program.


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Surveys and Studies