Rural providers' access to online resources: a randomized controlled trial

Addressing Disparities in Physician Access to Information in Support of Evidence-based Practice

The purpose of this study is to determine if Minnesota physicians have access to information resources needed to support evidence-based practice (EBP), which supports a culture of safety and patient-centered care. A survey was used to determine Minnesota physicians' need for, and access to, evidence-based clinical information. A total of 877 responses (6.4% response rate) were included in the data analysis. Participants spent 24 min daily seeking answers to clinical questions and averaged 4.41 questions per day that could not be immediately answered. Physicians reported high levels of information needs met (85.8%), though they reported limited access to drug resources, citation databases, systematic reviews, and full-text books and articles. Results also showed use of unreliable sources to support decision-making. A key finding was the extent to which workplace affiliation broadens disparities in information access. National and regional approaches can work to support EBP by reducing the information gap caused by workplace affiliation and other barriers. Further research should be done to identify partnerships, funding, infrastructure, and support to address these gaps.

A library mobile device deployment to enhance the medical student experience in a rural longitudinal integrated clerkship

Objective

Investigators implemented the Rural Information Connection (RIC) project, a library-initiated deployment of iPad Mini 3s for third-year medical students who were enrolled in a seven-month rural longitudinal integrated clerkship (LIC) rotation. The research aims were to determine if devices preloaded with high-quality mobile health apps enhanced the experience and increased access to and awareness of mobile health information resources for the enrolled project participants.

Methods

Nine participants enrolled in this mixed methods research project. Pre- and post-survey and structured learning journals (SLJs) were used for data collection on device and app use. Descriptive statistics and thematic coding analysis included data from seven pre-surveys, nine post-surveys, and sixty-four SLJ prompts. The validated Technology Acceptance Model instrument was also incorporated to gauge the devices’ integration into the participants’ workflow.

Results

The investigation indicated that the iPad Mini 3 and resources were utilized and integrated at varying levels in the participants’ workflow. Reported use of health information apps suggests a preference for broad-based information sources rather than specific or specialized information resources. Participants performed several tasks on the device, including seeking background information, educating patients, and managing rotation schedules. Participant reflections indicated positive experiences utilizing the device and health information resources, which enhanced their rural LIC rotations.

Conclusions

The research analysis demonstrates the information-seeking behavior of medical students immersed in a rural environment and indicates an acceptance of mobile technology into the workflow of participants in this project. Mobile device deployments offer great opportunities for librarians to design innovative programming in medical education.

Barriers for Hospital-Based Nurse Practitioners Utilizing Clinical Decision Support Systems: A Systematic Review

There is a national focus on the adoption of healthcare technology to improve the delivery of safe, efficient, and high-quality patient care. Nurse practitioners fulfill an emerging strategic role in the hospital setting. A comprehensive literature review focused on the question: What are the barriers for nurse practitioners utilizing clinical decision support in the hospital setting? Nine studies conducted from 2011 to 2017 were the basis for this review, which identified 13 barriers for nurse practitioners utilizing clinical decision support in the hospital. Having the right information, including up-to-date evidence-based practice guidelines, accurate clinical pathways, and current clinical algorithms, was the most common barrier. Providing reliable clinical decision support is crucial as nurse practitioners become more dependent on hospital technology systems in the delivery of safe patient care. Eliminating barriers to the use of clinical decision support is important for informaticists and nurse practitioners because both groups concentrate on acceptance of decision support systems in the hospital to meet the goal of safe and high-quality patient care.