Related Experiment Videos
Obstacles to answering doctors' questions about patient care with evidence: qualitative study
John W Ely1, Jerome A Osheroff, Mark H Ebell
1Department of Family Medicine, University of Iowa College of Medicine, Iowa City, IA 52242, USA. john-ely@uiowa.edu
Objective:
To describe the obstacles encountered when attempting to answer doctors' questions with evidence.
Design:
Qualitative study.
Setting:
General practices in Iowa.
Participants:
9 academic generalist doctors, 14 family doctors, and 2 medical librarians.
Main Outcome Measure:
A taxonomy of obstacles encountered while searching for evidence based answers to doctors' questions.
Results:
59 obstacles were encountered and organised according to the five steps in asking and answering questions: recognise a gap in knowledge, formulate a question, search for relevant information, formulate an answer, and use the answer to direct patient care. Six obstacles were considered particularly salient by the investigators and practising doctors: the excessive time required to find information; difficulty modifying the original question, which was often vague and open to interpretation; difficulty selecting an optimal strategy to search for information; failure of a seemingly appropriate resource to cover the topic; uncertainty about how to know when all the relevant evidence has been found so that the search can stop; and inadequate synthesis of multiple bits of evidence into a clinically useful statement.
Conclusions:
Many obstacles are encountered when asking and answering questions about how to care for patients. Addressing these obstacles could lead to better patient care by improving clinically oriented information resources.