Resident physicians as human information systems: sources yet seekers.

Area of Science:

• Medical Informatics
• Healthcare Systems
• Clinical Education

Background:

• Resident physicians are crucial for patient care during overnight shifts.
• Understanding the nature of questions asked and information sources used is vital for optimizing clinical workflows.
• Effective communication and information retrieval support resident decision-making and patient safety.

Purpose of the Study:

• To categorize the types of questions senior residents receive on overnight shifts.
• To identify the information sources residents utilize to answer these questions.
• To analyze the relationship between question types, asker roles, and resident responses.

Main Methods:

• A prospective observational study was conducted over 30 overnight shifts.
• Questions posed to on-call senior residents, asker roles, and resident responses were systematically documented.
• Use of external information sources was recorded for each question.

Main Results:

• The majority of questions (39.8%) concerned the plan of care, followed by medical knowledge (13.4%) and taskwork knowledge (12.1%).
• Residents primarily answered questions using prior knowledge or clinical judgment (88.4%), with external sources consulted for 118 questions.
• Questions requiring external information often related to the plan of care or patient condition and were typically asked by interns and nurses.

Conclusions:

• Resident physicians function as key information resources, often leveraging their expertise for direct answers.
• Accessing patient-specific data, such as the plan of care, is essential for resident decision-making.
• The findings underscore the importance of synchronous verbal communication in healthcare and inform the development of supportive clinical tools.