Rural providers’ access to online resources: a randomized controlled trial

Authors

  • Jonathan D. Eldredge Associate Professor, School of Medicine, Health Sciences Library and Informatics Center, Family & Community Medicine, MSC09 5100, 1 University of New Mexico, Albuquerque, NM 87131-0001
  • Laura J. Hall Division Head, Resources, Archives and Discovery, and Lecturer II, Health Sciences Library and Informatics Center, MSC09 5100, 1 University of New Mexico, Albuquerque, NM 87131-0001
  • Karen R. McElfresh Resource Management Librarian, Health Sciences Library and Informatics Center, MSC09 5100, 1 University of New Mexico, Albuquerque, NM 87131-0001
  • Teddy D. Warner Research Professor, School of Medicine, Department of Family & Community Medicine, MSC09 5040, 1 University of New Mexico, Albuquerque, NM 87131-0001
  • Tiffany L. Stromberg Medical Student, University of New Mexico School of Medicine, MSC08 4700, 1 University of New Mexico, Albuquerque, NM 87131
  • Jaren Trost Medical Student, University of New Mexico School of Medicine, MSC08 4700, 1 University of New Mexico, Albuquerque, NM 87131
  • Devin A. Jelinek Medical Student, University of New Mexico School of Medicine, MSC08 4700, 1 University of New Mexico, Albuquerque, NM 87131

Keywords:

Clinical Decision Support Systems, Computer- Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide

Abstract

Objective: The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.

Methods: In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants’ attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen’s d statistic to compare pre- and post-study effects sizes.

Results: Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to ‘‘about right amounts of information’’ at the completion of the study. DynaMed users reported a Cohen’s d increase of þ1.50 compared to AccessMedicine users’ reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen’s d.

Conclusion: Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.

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Published

2016-01-01