The impact of an online evidence system on confidence in decision making in a controlled setting
The impact of an online evidence system on confidence in decision making in a controlled setting
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DOI：
10.1177/0272989x05275155
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发表时间：
2005-03-01
影响因子：
3.6
通讯作者：
Coiera, EW
中科院分区：
文献类型：
--
作者：
Westbrook, JI;Gosling, AS;Coiera, EW
Objective.研究在线证据检索对临床医生决策信心的影响，并确定这是否与有经验的医生和护士不同。44名医生和31名临床护士顾问（CNCs）的样本回答了8个临床情景（600个情景答案）之前和之后使用在线证据资源。临床医生评价他们的信心，在场景的答案和证据，他们发现使用信息系统。在使用在线证据之前，37%的医生和18%的CNCs正确回答了这些场景。这些临床医生对他们的答案更有信心（56%非常有信心或有信心），而不是那些不正确的答案（34%）。在搜索之前，回答错误的医生对自己的信心明显高于回答错误的护士。搜索后，两组人都正确回答了50%的场景。与那些回答错误的医生相比，回答正确的医生对发现的证据有更大的信心。医生比护士更有信心找到证据来证实最初正确的答案。超过50%的临床医生谁坚持一个不正确的答案后，搜索报告说，他们有信心或非常有信心的证据发现。临床医生谁不知道场景答案搜索前放置在证据，导致他们正确或不正确的信心。结论。从在线证据系统中获得的信息影响了临床医生对临床场景答案的信心。对答案的信心和正确性之间的关系是复杂的。现有的知识和专业角色是中介因素。许多临床医生对导致他们得出错误答案的信息充满信心，这一发现值得进一步调查。
Objective. To examine the impact of online evidence retrieval on clinicians' decision-making confidence and to determine if this differs for experienced doctors and nurses.Methods. A sample of 44 doctors and 31 clinical nurse consultants (CNCs) answered 8 clinical scenarios (600 scenario answers) before and after the use of online evidence resources. Clinicians rated their confidence in scenario answers and in the evidence they found using the information system.Results. Prior to using online evidence, 37% of doctors and 18% of CNCs answered the scenarios correctly. These clinicians were more confident (56% very confident or confident) in their answers than those with incorrect (34%) answers. Doctors with incorrect answers prior to searching rated their confidence significantly higher than did nurses who were incorrect. After searching, both groups answered 50% of scenarios correctly. Clinicians with correct answers had greater confidence in the evidence found compared to those with incorrect answers. Doctors were more confident in evidence found confirming an initially correct answer than were nurses. More than 50% of clinicians who persisted with an incorrect answer after searching reported that they were confident or very confident in the evidence found. Clinicians who did not know scenario answers before searching placed equal confidence in evidence that led them to a correct or incorrect answer.Conclusions. The information obtained from an online evidence system influenced clinicians' confidence in their answers to the clinical scenarios. The relationship between confidence in answers and correctness is complex. Both existing knowledge and professional role were mediating factors. The finding that many clinicians placed confidence in information that led them to incorrect answers warrants further investigation.