Resident physicians as human information systems: sources yet seekers.
Resident physicians as human information systems: sources yet seekers.
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DOI：
10.1136/amiajnl-2012-001112
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Borowitz SM
中科院分区：
文献类型：
--
作者：
Bass EJ;DeVoge JM;Waggoner-Fountain LA;Borowitz SM
描述居民在夜班时收到的问题类型以及用于回答这些问题的信息来源。在30个夜班中，记录了向随叫随到的高级住院医师提出的问题、提问者的角色和住院医师的回答。注意到外部来源。在397个问题中，158个问题（39.8%）与护理计划有关，53个问题（13.4%）与医学知识有关，48个问题（12.1%）与任务知识有关，44个问题（11.1%）与患者的当前状况有关。对于351个问题（88.4%）居民提供了具体的，直接的答案或访问了病人。对于其中的16个，居民模拟或完成了任务。对于216个问题，住院医生使用以前的知识或自己的临床判断。居民征求外部信息来源的118个问题，只有一个单一的来源，其中77（65.3%）。对于118例患者，大多数问题涉及护理计划或患者当前状况，由实习生和护士（直接负责患者护理的人员）提出。住院医师作为一个信息系统，他们经常使用以前的知识或自己的临床判断来具体回答问题，这表明询问者正在联系一个有适当知识的人。但是，他们确实需要访问患者信息，例如护理计划。他们还担任教育者的角色，并回答许多与知识相关的问题。由于同步的口头通信仍然是信息流的重要途径，信息学家需要考虑这种通信和工作流程之间的关系，在医疗支持工具的发展。
To characterize question types that residents received on overnight shifts and what information sources were used to answer them. Across 30 overnight shifts, questions asked of on-call senior residents, question askers’ roles, and residents’ responses were documented. External sources were noted. 158 of 397 questions (39.8%) related to the plan of care, 53 (13.4%) to medical knowledge, 48 (12.1%) to taskwork knowledge, and 44 (11.1%) to the current condition of patients. For 351 (88.4%) questions residents provided specific, direct answers or visited the patient. For 16 of these, residents modeled or completed the task. For 216 questions, residents used previous knowledge or their own clinical judgment. Residents solicited external information sources for 118 questions and only a single source for 77 (65.3%) of them. For the 118, most questions concerned either the plan of care or the patient's current condition and were asked by interns and nurses (those with direct patient care responsibilities). Resident physicians serve as an information system and they often specifically answer the question using previous knowledge or their own clinical judgment, suggesting that askers are contacting an appropriately knowledgeable person. However, they do need to access patient information such as the plan of care. They also serve an educator role and answer many knowledge-related questions. As synchronous verbal communications continue to be important pathways for information flow, informaticians need to consider the relationship between such communications and workflow in the development of healthcare support tools.
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影响因子：
39.2
作者：
COVELL, DG;UMAN, GC;MANNING, PR
通讯作者：
MANNING, PR
影响因子：
6.2
作者：
Spencer, R;Coiera, E;Logan, P
通讯作者：
Logan, P
DOI：
10.1016/j.ijmedinf.2004.03.001
发表时间：
2004-05-01
影响因子：
4.9
作者：
Brown, PJ;Borowitz, SM;Novicoff, W
通讯作者：
Novicoff, W
影响因子：
--
作者：
Coiera, E;Tombs, V
通讯作者：
Tombs, V
DOI：
10.1197/jamia.m2940
发表时间：
2009-05-01
影响因子：
6.4
作者：
Chase, Herbert S.;Kaufman, David R.;Mendonca, Eneida A.
通讯作者：
Mendonca, Eneida A.