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