Multifaceted Online Interventions to Increase Clinicians Searching of Current Best Evidence to Answer Clinical Questions

Summary

Translation of new knowledge from research into evidence-informed health care is a shared obligation of the clinical and the scientific communities. Unfortunately, studies of quality of care continue to show that this goal is substantially unrealized. One main barrier is lack of quick and easy identification, appraisal and synthesis of current best evidence. Clinicians' information have 5 to 8 questions about individual patients per daily shift, but face a large volume of 3000 articles published every day, accessible in many scattered resources.

To address theses problems, McMaster's Health Information Research Unit (Hamilton, Ontario, Canada) has developed and implemented "McMaster Premium LiteratUre Service Federated Search" (MPFS), an online search engine that provides a unique 1-stop search and organized access to current best evidence in daily practice. However additional barriers need to be overcome for clinicians to actually search and use this evidence in their practice. Theses include logistical barriers (time constraints, forgotten questions), as well as educational barriers (eg, lack of awareness of the "architecture" of evidence, limited searching skills, and lack of reference standards among peers for finding best evidence).

This randomized trial seeks to test 3 innovative online interventions among clinicians registered to MPFS to overcome these barriers and increase the quantity and quality of searching for current best evidence to answer clinical questions. These interventions build on effective models for the teaching of clinical skills at the point of care, so that clinicians are facilitated in using the search engine as a clinical tool, and perceive evidence retrieval skills as true clinical skills.

Conditions

• Physicians Evidence Retrieval Skills

Interventions

BEHAVIORAL

Intervention A - Online Clinical Questions Recorder

Clinicians allocated to this intervention will receive access to an online recorder for the clinical questions at the point of care. The recorder is accessible across a wide range of devices including phones, tablets, and desktop computers.

BEHAVIORAL

Intervention B - Online Evidence Retrieval Coach

Clinicians allocated to this intervention will receive online guidance, embedded in the MPFS search engine, in the form of short videos, animations, demos and tips and tricks regarding evidence retrieval.

BEHAVIORAL

Intervention C - Online Audit and Feedback

Clinicians allocated to this intervention will receive feedback on their current search performance compared to their peers, both online when using MPFS as well as by e-mail.

Sponsors & Collaborators

• Canadian Institutes of Health Research (CIHR)

  collaborator OTHER_GOV

• McMaster University

  lead OTHER

Principal Investigators

• Thomas Agoritsas, MD · McMaster University

Study Design

Allocation

RANDOMIZED

Masking

SINGLE

Model

FACTORIAL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-01-31

Primary Completion

2014-10-31

Completion

2014-10-31

Countries

• Canada

Study Locations