Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation
DOI:
https://doi.org/10.5195/jmla.2020.875Keywords:
Evidence-Based Medicine, Information Seeking Behaviors, Medical Students, Optimal Foraging TheoryAbstract
Objective: Evidence-based medicine practices of medical students in clinical scenarios are not well understood. Optimal foraging theory (OFT) is one framework that could be useful in breaking apart information-seeking patterns to determine effectiveness and efficiency of different methods of information seeking. The aims of this study were to use OFT to determine the number and type of resources used in information seeking when medical students answer a clinical question, to describe common information-seeking patterns, and identify patterns associated with higher quality answers to a clinical question.
Methods: Medical students were observed via screen recordings while they sought evidence related to a clinical question and provided a written response for what they would do for that patient based on the evidence that they found.
Results: Half (51%) of study participants used only 1 source before answering the clinical question. While the participants were able to successfully and efficiently navigate point-of-care tools and search engines, searching PubMed was not favored, with only half (48%) of PubMed searches being successful. There were no associations between information-seeking patterns and the quality of answers to the clinical question.
Conclusion: Clinically experienced medical students most frequently relied on point-of-care tools alone or in combination with PubMed to answer a clinical question. OFT can be used as a framework to understand the information-seeking practices of medical students in clinical scenarios. This has implications for both teaching and assessment of evidence-based medicine in medical students.References
Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet. 2017 Jul;390(10092):415–23.
Green ML, Ruff TR. Why do residents fail to answer their clinical questions? a qualitative study of barriers to practicing evidence-based medicine. Acad Med. 2005 Feb;80(2):176–82.
McCord G, Smucker WD, Selius BA, Hannan S, Davidson E, Schrop SL, Rao V, Albrecht P. Answering questions at the point of care: do residents practice EBM or manage information sources? Acad Med. 2007 Mar;82(3):298–303.
van Dijk N, Hooft L, Wieringa-de Waard M. What are the barriers to residents’ practicing evidence-based medicine? a systematic review. Acad Med. 2010 Jul;85(7):1163–70.
Bhandari M, Montori V, Devereaux PJ, Dosanjh S, Sprague S, Guyatt GH. Challenges to the practice of evidence-based medicine during residents’ surgical training: a qualitative study using grounded theory. Acad Med. 2003 Nov;78(11):1183–90.
Twiss-Brooks AB, Andrade R Jr., Bass MB, Kern B, Peterson J, Werner DA. A day in the life of third-year medical students: using an ethnographic method to understand information seeking and use. J Med Libr Assoc. 2017 Jan;105(1):12–9. DOI: http://dx.doi.org/10.5195/jmla.2017.95.
Maggio LA, Capdarest-Arest N. Practising evidence-based medicine (EBM): a descriptive analysis of medical students’ whole-task EBM assignments. Evid Based Med. 2017 Apr;22(2):41–4.
Brennan N, Edwards S, Kelly N, Miller A, Harrower L, Mattick K. Qualified doctor and medical students’ use of resources for accessing information: what is used and why? Health Inf Libr J. 2014 Sep;31(3):204–14.
Cooper AL, Elnicki DM. Resource utilisation patterns of third-year medical students. Clin Teach. 2011 Mar;8(1):43–7.
Pirolli P. Information foraging theory: adaptive interaction with information. Oxford, UK: Oxford University Press; 2007.
Pirolli P, Card S. Information foraging. Psychol Rev. 1999 Oct;106(4):643–75.
Sandstrom PE. An optimal foraging approach to information-seeking and use. Libr Q. 1994 Oct;64(4):414–49.
Dwairy M, Dowell AC, Stahl JC. The application of foraging theory to the information searching behaviour of general practitioners. BMC Fam Pract. 2011;12(1):90.
Kalet A, Zabar S, Szyld D, Yavner SD, Song H, Nick MW, Ng G, Pusic MV, Denicola C, Blum C, Eliasz KL, Nicholson J, Riles TS. A simulated “Night-onCall” to assess and address the readiness-for-internship of transitioning medical students. Adv Simul (Lond). 2017 Aug 14;2:13.
Slawson DC, Shaughnessy AF, Bennett JH. Becoming a medical information master: feeling good about not knowing everything. J Fam Pract. 1994 May;38(5):505–13.
Maggio LA. Educating physicians in evidence based medicine: current practices and curricular strategies. Perspect Med Educ. 2016 Dec;5(6):358–61.
Maggio LA, Durieux N, Tannery NH. Librarians in evidence-based medicine curricula: a qualitative study of librarian roles, training, and desires for future development. Med Ref Serv Q. 2015;34(4):428–40.
Pirolli P. Information foraging theory: framework and method. In: Pirolli P. Information foraging theory. New York, NY: Oxford University Press; 2007.
Tilson JK, Kaplan SL, Harris JL, Hutchinson A, Ilic D, Niederman R, Potomkova J, Zwolsman SE. Sicily statement on classification and development of evidence-based practice learning assessment tools. BMC Med Educ. 2011 Oct 5;11:78.
