Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2007

Open Access 01-12-2007 | Research article

Group differences in physician responses to handheld presentation of clinical evidence: a verbal protocol analysis

Authors: Danielle M Lottridge, Mark Chignell, Romana Danicic-Mizdrak, Nada J Pavlovic, Andre Kushniruk, Sharon E Straus

Published in: BMC Medical Informatics and Decision Making | Issue 1/2007

Login to get access

Abstract

Background

To identify individual differences in physicians' needs for the presentation of evidence resources and preferences for mobile devices.

Methods

Within-groups analysis of responses to semi-structured interviews. Interviews consisted of using prototypes in response to task-based scenarios. The prototypes were implemented on two different form factors: a tablet style PC and a pocketPC. Participants were from three user groups: general internists, family physicians and medicine residents, and from two different settings: urban and semi-urban. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts of the testing sessions. Statistical relationships were investigated between staff physicians' and residents' background variables, self-reported experiences with the interfaces, and verbal code frequencies.

Results

47 physicians were recruited from general internal medicine, family practice clinics and a residency training program. The mean age of participants was 42.6 years. Physician specialty had a greater effect on device and information-presentation preferences than gender, age, setting or previous technical experience. Family physicians preferred the screen size of the tablet computer and were less concerned about its portability. Residents liked the screen size of the tablet, but preferred the portability of the pocketPC. Internists liked the portability of the pocketPC, but saw less advantage to the large screen of the tablet computer (F[2,44] = 4.94, p = .012).

Conclusion

Different types of physicians have different needs and preferences for evidence-based resources and handheld devices. This study shows how user testing can be incorporated into the process of design to inform group-based customization.
Appendix
Available only for authorised users
Literature
1.
Criswell DF, Parchman ML: Handheld Computer Use in U.S. Family Practice Residency Programs. J Am Med Inform Assoc. 2002, 9: 80-86. 10.1197/jamia.M1234.CrossRefPubMedPubMedCentral
2.
Egan DE: Individual differences in human-computer interaction. Handbook of Human-Computer Interaction. Edited by: Helander M. 1988, Amsterdam: Elsevier Science Publishers, 543-568.
3.
4.
Southon FC, Sauer C, Dampney C: Information technology in complex health services: organizational impediments to successful technology transfer and diffusion. J Am Med Inform Assoc. 1997, 4: 112-124.CrossRefPubMedPubMedCentral
5.
Rogers DW, Jobes HM, Hinshaw JR, Lanzafame RJ: Ergonomics of medical lasers: operator's viewpoint. J Clin Laser Med Surg. 1992, 10 (3): 199-206.PubMed
6.
Lu YC, Xiao Y, Sears A, Jacko JA: A review and a framework of handheld computer adoption in healthcare. Int J Med Inform. 2005, 74: 409-422. 10.1016/j.ijmedinf.2005.03.001.CrossRefPubMed
7.
Holzman TG, Griffith A, Hunter WG, Allen T, Simpson RJ: Computer-Assisted trauma care prototype. Medinfo. 1995, 8 (Pt 2): 1685-PubMed
8.
Kushniruk AW, Triola M, Stein B, Borycki E, Kannry J: The Relationship of Usability to Medical Error: An Evaluation of Errors Associated with Usability Problems in the Use of a Handheld Application for Prescribing Medications. Medinfo. 2004, 11 (Pt 2): 1073-1076.
9.
Aronow WS: Under-utilisation of lipid-lowering drugs on older persons with prior myocardial infarction at a serum low-density lipoprotein cholesterol greater than 125 mg/dL. Am J Cardiol. 1998, 82: 668-669. 10.1016/S0002-9149(98)00401-9.CrossRefPubMed
10.
Flaker GC, McGowan DJ, Boechler M, Fortune G, Gage B: Underutilization of antithrombotic therapy in elderly rural patients with atrial fibrillation. Am Heart J. 1999, 137: 307-312. 10.1053/hj.1999.v137.91403.CrossRefPubMed
11.
Krumholz HM, Radford MJ, Wang Y, Chen J: National use and effectiveness of Beta-blockers for the treatment of elderly patients after acute myocardial infarction. National Cooperative Cardiovascular Project. JAMA. 1998, 280: 623-629. 10.1001/jama.280.7.623.CrossRefPubMed
12.
Mendelson G, Aronow WS: Underutilization of warfarin in older person with chronic nonvalvular atrial fibrillation at high risk for developing stroke. J Am Geriatric Soc. 1998, 46 (11): 1423-1424.CrossRef
13.
Stafford RS, Singer DE: Recent national patterns of warfarin use in atrial fibrillation. Circulation. 1998, 97: 1231-1232.CrossRefPubMed
14.
Wong JH, Findlay JM, Suarez-Almazor ME: Regional performance of carotid endarterectomy: appropriateness, outcomes and risk factors for complications. Stroke. 1997, 28: 891-898.CrossRefPubMed
15.
Haynes RB: Where's the meat in clinical journals (editorial)?. Ann Intern Med. 1993, 119 (suppl): A22-
16.
Putman W, Twohig PL, Burge FI, Jackson LA, Cox JL: A qualitative study of evidence in primary care: what the practitioners are saying. CMAJ. 2002, 166 (12): 1525-1530.
17.
Sackett DL, Straus SE: Finding and Applying Evidence During Clinical Rounds: The "Evidence Cart". JAMA. 1998, 280: 1336-1338. 10.1001/jama.280.15.1336.CrossRefPubMed
18.
Gosling AS, Westbrook JI: Allied health professionals' use of online evidence: a survey of 790 staff working in the Australian public hospital system. Int J Med Inform. 2004, 73: 391-401.CrossRefPubMed
19.
Gosling AS, Westbrook JI, Braithwate J: Clinical Team Functioning and IT Innovation: A Study of the Diffusion of a Point-of care Online Evidence System. J Am Med Inform Assoc. 2003, 10: 244-251. 10.1197/jamia.M1285.CrossRefPubMedPubMedCentral
20.
Westbrook JI, Gosling AS, Coiera E: Do Clinicians Use Online Evidence to Support Patient Care? A Study of 55,000 Clinicians. J Am Med Inform Assoc. 2004, 11: 113-120. 10.1197/jamia.M1385.CrossRefPubMedPubMedCentral
21.
Medical Research Council: A Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Health. 2000
22.
Portoni L, Combi C, Pinciroli F: User-oriented views in health care information systems. IEEE Trans Biomed Eng. 2002, 49 (12): 1387-1398. 10.1109/TBME.2002.805455.CrossRefPubMed
23.
Boralv E, Goransson B, Olsson E, Sandblad B: Usability and efficiency. The HELIOS approach to development of user interfaces. Comput Methods Programs Biomed. 1994, S47-S64. 45 Suppl
24.
Ammenworth E, Buchauer A, Bludau B, Haux R: Mobile information and communication tools in the hospital. Int J Med Inf. 2000, 57: 21-40. 10.1016/S1386-5056(99)00056-8.CrossRef
25.
Manning B, Gadd CS: Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry. Proc AMIA Symp. 2001, 428-32.
26.
Beasley BW: Utility of palmtop computers in a residency program: a pilot study. South Med J. 2002, 95 (2): 207-211.CrossRefPubMed
27.
Gillingham W, Holt A, Gillies J: Hand-held computers in healthcare: what software programs are available?. N Z Med J. 2002, 115 (1162): U185-PubMed
28.
29.
Lu YC, Lee JK, Xiao Y, Sears A, Jacko JA, Charters K: Why don't physicians use their personal digital assistants?. Proc AMIA Annu Symp. 2003, 404-405.
30.
McLeod TG, Ebbert JO, Lymp JF: Survey assessment of personal digital assistant use among trainees and attending physicians. J Am Med Inform Assoc. 2003, 10 (6): 605-607. 10.1197/jamia.M1313.CrossRefPubMedPubMedCentral
31.
Barrett JR, Strayer SM, Schubart JR: Assessing medical residents' usage and perceived needs for personal digital assistants. Int J Med Inf. 2004, 73 (1): 25-34. 10.1016/j.ijmedinf.2003.12.005.CrossRef
32.
Brilla R, Wartenberg KE: Introducing new technology: handheld computers and drug databases. A comparison between two residency programs. J Med Syst. 2004, 28 (1): 57-61. 10.1023/B:JOMS.0000021520.50986.48.CrossRefPubMed
33.
Busch JM, Barbaras L, Wei J, Nishino M, Yam CS, Hatabu H: A mobile solution: PDA-based platform for radiology information management. Am J Roentgenol. 2004, 183 (1): 237-242.CrossRef
34.
Carroll AE, Christakis DA: Pediatricians' use of and attitudes about personal digital assistants. Pediatrics. 2004, 113 (2): 238-242. 10.1542/peds.113.2.238.CrossRefPubMed
35.
Choi J, Chun J, Lee K, Lee S, Shin D, Hyun S, Kim D, Kim D: MobileNurse: hand-held information system for point of nursing care. Computer Methods and Program in Biomed. 2004, 74: 245-254. 10.1016/j.cmpb.2003.07.002.CrossRef
36.
Joy S, Benrubi G: Personal digital assistant use in Florida obstetrics and gynecology residency programs. South Med J. 2004, 97 (5): 430-433. 10.1097/00007611-200405000-00002.CrossRefPubMed
37.
McAlearney AS, Schweikhart SB, Medow MA: Doctors' experience with handheld computers in clinical practice: qualitative study. BMJ. 2004, 328 (7449): 1162-10.1136/bmj.328.7449.1162.CrossRefPubMedPubMedCentral
38.
Ericsson K, Simon HA: Protocol Analysis: Verbal Reports as data. 1984, Cambridge, MA: MIT Press
39.
Jaspers MW, Steen T, van den Bos C, Geenen M: The think aloud method: a guide to user interface design. Int J Med Inform. 2004, 73 (11–12): 781-795. 10.1016/j.ijmedinf.2004.08.003.CrossRefPubMed
40.
Sackett DL, Straus SE: Bringing evidence to the point of care. JAMA. 1999, 281: 1171-1172. 10.1001/jama.281.13.1171.CrossRef
41.
Straus SE, Evans M, Davis DA, Goel V: Bringing evidence to the point of care: needs of clinicians. JGIM. 2002, 17: 213-10.1046/j.1525-1497.2002.20102.x.CrossRef
42.
Takeshita H, Davis D, Straus SE: Clinical Evidence at the Point of Care in Acute Medicine: A Handheld Usability Case Study. Proc HFES Ann Mtg. 2002, 1409-1413.
43.
Wiggins RH: Personal Digital Assistants. J Digital Imag. 2004, 17,1: 5-17. 10.1007/s10278-003-1665-8.CrossRef
44.
Lottridge DL, Chignell MC, Straus SE: Requirements Analysis for Customization using Large Sample User Testing: A Case Study of Mobile Computing in Healthcare. Int J Human Comp Studies accepted.
45.
Straus SE, Evans M, Goel V, Davis D: Bringing evidence to the point of care: what do clinicians want [Abstract]. Biomed Central Meeting Abstracts: 4th International Cochrane Colloquium. 2001, 1: op047-
46.
Kushniruk AW, Patel VL, Cimino JJ: Usability testing in medical informatics: cognitive approaches to evaluation of information systems and user interfaces. Proc AMIA Annu Symp. 1997, 218-222.
47.
CE, Clinical Evidence [monograph on CD-ROM]. 2001, London: BMJ Publishing Group Ltd, 6:
48.
Straus SE, Hsu SI, Ball CM, Phillips RS: Evidence-Based On-Call: Acute Medicine. 2001, Edinburgh: Churchill Livingstone
49.
Straus SE, Richardson WS, Glasziou P, Haynes RB: Evidence-Based Medicine; How to practice and teach EBM. 2005, Edinburgh: Churchill Livingstone, Third
50.
DeYoung C, Spence I: Profiling information technology users: En route to dynamic personalization. Comp in Hum Beh. 2004, 20: 55-65. 10.1016/S0747-5632(03)00045-1.CrossRef
51.
52.
Lottridge DL, Chignell MC, Straus SE: Physicians Responses to Handheld Presentation of Clinical Evidence: Analysis of Group Differences. Proc HFES Ann Mtg. 2004, 1783-7.
53.
Ridderikhoff J, van Herk B: Who is afraid of the system? Doctors' attitude towards diagnostic systems. Int J of Med Inform. 1999, 53: 91-100. 10.1016/S1386-5056(98)00145-2.CrossRef
54.
Lottridge DM, Chignell M, Danicic-Mizdrak R, Straus SE: The When, Where and Why of Mobile Access to Medical Evidence: A Socio-Technical Analysis of a Field Trial. Proc Int'l Conf ITHC. 2004, #61: 5-
55.
León SA, Fontelo P, Green L, Ackerman M, Liu F: Evidence-based medicine among internal medicine residents in a community hospital program using smart phones. BMC Med Informatics and Decision Making. 2007, 7: 5-10.1186/1472-6947-7-5.CrossRef
56.
Kushniruk AW, Patel VL: Cognitive and usability engineering methods for the evaluation of clinical information systems. J Biomed Infor. 2004, 37: 56-76. 10.1016/j.jbi.2004.01.003.CrossRef
Metadata
Title
Group differences in physician responses to handheld presentation of clinical evidence: a verbal protocol analysis
Authors
Danielle M Lottridge
Mark Chignell
Romana Danicic-Mizdrak
Nada J Pavlovic
Andre Kushniruk
Sharon E Straus
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2007
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/1472-6947-7-22

Other articles of this Issue 1/2007

BMC Medical Informatics and Decision Making 1/2007 Go to the issue

Research article

Julius – a template based supplementary electronic health record system

Research article

Automated real time constant-specificity surveillance for disease outbreaks

Software

Indivo: a personally controlled health record for health information exchange and communication

Research article

Effect of electronic patient record use on mortality in End Stage Renal Disease, a model chronic disease: retrospective analysis of 9 years of prospectively collected data

Research article

An automatic method to generate domain-specific investigator networks using PubMed abstracts

Software

Clinical decision modeling system