Evaluation of a handheld clinical decision support tool for evidence-based learning and practice in medical undergraduates.

INTRODUCTION: Handheld computers (PDAs) uploaded with clinical decision support software (CDSS) have the potential to facilitate the adoption of evidence-based medicine (EBM) at the point-of-care among undergraduate medical students. Further evaluation of the usefulness and acceptability of these to...

Descripción completa

Detalles Bibliográficos
Publicado en:Medical Education Vol. 38; no. 6; pp. 628 - 638
Autores principales: Johnston JM, Leung GM, Tin KYK, Ho L, Lam W, Fielding R
Formato: clinical trial research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2004
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106635240&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 106635240
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        03080110
        ESF
      jtl: Medical Education
      issn: 03080110
      maglogo: Y
    pubinfo:
      dt: Jun2004
      vid: 38
      iid: 6
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        106635240
        2005082367
        10.1111/j.1365-2929.2004.01842.x
        NLM15189259
        106635240
      ppf: 628
      ppct: 10
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Evaluation of a handheld clinical decision support tool for evidence-based learning and practice in medical undergraduates.
      aug:
        au:
          Johnston JM
          Leung GM
          Tin KYK
          Ho L
          Lam W
          Fielding R
        affil: Department of Community Medicine, University of Hong Kong, Hong Kong
      sug:
        subj:
          Computers, Hand-Held Utilization
          Decision Support Systems, Clinical Evaluation
          Education, Medical Trends
          Learning Methods Evaluation
          Analysis of Variance
          Chi Square Test
          Clinical Trials
          Confidence Intervals
          Cross Sectional Studies
          Descriptive Statistics
          Focus Groups
          Funding Source
          Hong Kong
          Odds Ratio
          P-Value
          Purposive Sample
          Questionnaires
          Regression
          Research Instruments
          Self Report
          Students, Medical Psychosocial Factors
          Summated Rating Scaling
          Survey Research
          Human
      ab: INTRODUCTION: Handheld computers (PDAs) uploaded with clinical decision support software (CDSS) have the potential to facilitate the adoption of evidence-based medicine (EBM) at the point-of-care among undergraduate medical students. Further evaluation of the usefulness and acceptability of these tools is required. METHODS: All 169 Year 4 undergraduate medical students at the University of Hong Kong completed a post-randomised controlled trial survey. Primary outcome measures were CDSS/PDA usefulness, satisfaction, functionality and utilisation. Focus groups were also conducted to derive complementary qualitative data on the students' attitudes towards using such new technology. RESULTS: Overall, the students found the CDSS/PDA useful (mean score = 3.90 out of 6, 95% confidence interval (CI) = 3.78, 4.03). They were less satisfied with the functional features of the CDSS (mean score = 3.45, 95% CI = 3.32, 3.59) and the PDA (mean score = 3.51 95% CI = 3.40, 3.62). Utilisation was low, with the average frequency of use less than once per week. Although students reported a need for information in patient care at least once daily, they infrequently used the CDSS in a clinical setting (20.4 +/- 10.4% of the time), with an average information retrieval success rate of 37.6 +/- 22.1% requiring 63.7 +/- 86.1 seconds. Multivariable regression shows that higher perceived CDSS/PDA usefulness was associated with more supportive faculty attitudes, greater knowledge of EBM, better computer literacy skills and increased use in a clinical setting. Greater satisfaction with the CDSS/PDA was associated with increased use in a clinical setting and higher successful search rates. Qualitative results were consistent with these quantitative findings and yielded additional information on students' underlying feelings that may explain the observations. CONCLUSIONS: While PDAs uploaded with the CDSS are able to provide students with better access to high quality information, improvements in faculty attitudes, students' knowledge of EBM and computer literacy skills, and having the CDSS specially designed for undergraduate use are essential to increasing student adoption of such point-of-care tools.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N