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Information seeking as self-directed learning in the lives of rural practitioners: A multi-case study

Posted on:2011-09-02Degree:Ph.DType:Dissertation
University:University of IdahoCandidate:Hill, Elizabeth KFull Text:PDF
GTID:1447390002469193Subject:Education
Abstract/Summary:
In this multi-case study, perceptions of information seeking for patient care decision making have been gathered through the process of surveying physicians, physician assistants and nurse practitioners practicing in the critical access hospitals of four northwestern states. Two hundred and eleven survey responses from rural practitioners identified that the information served to refresh their memories of details or facts, was often a source of new information, and contributed to both higher quality care and better informed clinical decisions. The information they accessed positively contributed to decisions around the choice of tests, drugs and other treatments, as well as diagnosis decisions, and advice given to their patients. While the survey findings revealed print materials to be the most used format, seventeen semi-structured interviews cited clinical information acquired through personal subscriptions to online databases, and accessed by hand-held devices, as most frequently used.;Rural practitioners were presented daily with multiple opportunities for learning. Typically, practitioners would have two or three patient care questions arise per patient day, yet chose to pursue only a quarter of those questions. Learning episodes ended when the practitioner felt comfortable that the information they found was congruent with their own knowledgebase. Rural practitioners preferred learning by reading on their own. Finding answers to specific patient care questions often changed their thinking, but practice was only changed through more intense study or formal CME.;Rural practitioners must take more responsibility for reflecting on their current knowledgebase and skill level, and for actively determining learning goals. They should take advantage of the professional expertise of human resources or medical staff services personnel to assist them in creating their self-directed learning plans.;Critical access hospital administrators should use knowledge of rural practitioners' preferred learning style of reading on their own to support self-directed learning activities at the point of care, and by working to make clinical information resources more readily available. Two recommendations are for the purchase of clinical decision support tools for integration into the electronic health record, and for the development of state-sponsored clinical information portals, such as the HEAL-WA resource.
Keywords/Search Tags:Information, Rural practitioners, Self-directed learning, Patient care
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