2023-09-28 14:46:10 +00:00
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abstract: 'BACKGROUND: Investing in continued medical education strengthens
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surgical systems. This study assessed the effectiveness of an
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evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to
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improve EBP and understand how and why providers practice using
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evidence.STUDY DESIGN: This is a mixed-methods, implementation study at
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9 public hospitals in Peru consisting of a didactic session for surgeons
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on EBP and Google Translate and support of applications for UTD access.
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Change in clinical knowledge scores (CKS), access and use of UTD, and
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impact of language pre-and postintervention were measured. Qualitative
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interviews uncovered rea-sons for these changes.RESULTS: Intervention
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participants had lower CKS at follow-up compared with baseline (odds
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ratio {[}OR] of higher score 0.41 {[}0.18,0.98]; p = 0.044), and this
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effect was modified (p = 0.003) to the extent that the reverse was true
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for control participants (OR 2.30 {[}1.13,4.71]; p = 0.022).
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Participants with 1 to 20 years of experience had significantly improved
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CKS compared with students/residents (1 to 10 years: OR 4.5 {[}1.1,18];
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11 to 20 years: OR 4.9 {[}1.4,17]); there was no evidence of a different
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CKS between providers with > 20 years of experience compared with
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students/residents (OR 1.3 {[}0.5,3.7]). Administrative disconnect,
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usability, motivation, edu-cation, time, resources, and age influenced
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point-of-care medical information systems impact on knowledge and EBP.
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Participants reporting low English proficiency translated medical
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literature mostly used Google Translate. Those with low/no English
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reading proficiency had higher odds of reporting a negative impact on
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research than those with working (p = 0.007) or professional (p < 0.001)
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proficiency.CONCLUSIONS: Providing education on EBP, free UTD access,
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and translation solutions did not correlate with increased CKS due to
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complex barriers to using point-of-care medical information systems. (J
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Am Coll Surg 2023;236:484-494. (c) 2022 The Author(s). Published by
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Wolters Kluwer Health, Inc. on behalf of the American College of
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Surgeons. This is an open-access article distributed under the terms of
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the Creative Commons Attribution-Non Commercial-No Derivatives License
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4.0 {[}CCBY-NC-ND], where it is permissible to download and share the
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work provided it is properly cited. The work cannot be changed in any
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way or used commer-cially without permission from the journal.)'
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affiliation: 'Noble, H (Corresponding Author), 22 S Greene St, Baltimore, MD 21231
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USA.
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Noble, Helen, Univ Washington, Northern Pacific Global Hlth Fogarty Int Program,
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Seattle, WA USA.
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Senturia, Kirsten, Univ Washington, Dept Hlth Serv, Seattle, WA USA.
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Ordonez, Willy Jesus Neumann; Checa, David Ortega, Soc Cirujanos Gen Peru, Lima,
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Peru.
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Wong, Gabriela Zavala, Univ Peruana Cayetano Heredia, Med Sch, Lima, Peru.
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Rodriguez, Manuel J., Univ Peruana Cayetano Heredia, Dept Surg, Lima, Peru.
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Checa, David Ortega, Hosp Rebagliati, Dept Surg, Lima, Peru.
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Warne, Maria; LaGrone, Lacey Nicole, Univ Colorado Hlth, Med Ctr Rockies, Dept Surg,
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Loveland, CO USA.
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Jin, Ying; Peterson, Ryan, Univ Colorado, Anschutz Med Campus, Aurora, CO USA.'
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author: Noble, Helen and Ordonez, Willy Jesus Neumann and Wong, Gabriela Zavala and
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Rodriguez, Manuel J. and Checa, David Ortega and Warne, Maria and Senturia, Kirsten
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and Jin, Ying and Peterson, Ryan and LaGrone, Lacey Nicole
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author-email: Helen.Noble@umm.edu
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author_list:
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- family: Noble
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given: Helen
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- family: Ordonez
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given: Willy Jesus Neumann
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- family: Wong
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given: Gabriela Zavala
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- family: Rodriguez
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given: Manuel J.
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- family: Checa
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given: David Ortega
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- family: Warne
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given: Maria
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- family: Senturia
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given: Kirsten
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- family: Jin
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given: Ying
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- family: Peterson
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given: Ryan
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- family: LaGrone
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given: Lacey Nicole
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da: '2023-09-28'
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doi: 10.1097/XCS.0000000000000530
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eissn: 1879-1190
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files: []
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issn: 1072-7515
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journal: JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
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keywords-plus: COST-EFFECTIVENESS; QUALITY
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language: English
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month: MAR
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number: '3'
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number-of-cited-references: '53'
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pages: 484-494
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papis_id: 8064d11b8f86e6b9cee512dce504f3b6
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ref: Noble2023doesaccess
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times-cited: '0'
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title: Does Access to Point-of-Care Medical Information Improve Trauma and General
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Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with
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Random Assignment
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000968088900007
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '236'
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web-of-science-categories: Surgery
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year: '2023'
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