A characterization of clinical questions asked by rehabilitation therapists

Kloda, Lorie A and Bartlett, Joan C. A characterization of clinical questions asked by rehabilitation therapists. Journal of the Medical Library Association, 2014, vol. 102, n. 2, pp. 69-77. [Journal article (Paginated)]

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English abstract

Objective: This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. Methods: The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Results: Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Conclusions: Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Implications: Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.

Item type: Journal article (Paginated)
Keywords: evidence-based practice, rehabilitation therapists, occupational therapists, physical therapists, physiotherapists, speech-language pathologists, stroke, clinical questions, information needs, information behaviour, health professionals, qualitative research
Subjects: B. Information use and sociology of information > BH. Information needs and information requirements analysis.
C. Users, literacy and reading. > CB. User studies.
Depositing user: Lorie A. Kloda
Date deposited: 28 May 2014 15:15
Last modified: 02 Oct 2014 12:31
URI: http://hdl.handle.net/10760/23131

References

1. Kronenfeld M, Stephenson PL, Nail-Chiwetalu B, Tweed EM, Sauers EL, McLeod TCV, Guo R, Trahan H, Alpi KM, Hill B, Sherwill-Navarro P, Allen MP, Hartman LM, Burnham J, Fell D, Pavlick R, MacNaughton EW, Ratner NB. Review for librarians of evidence-based practice in nursing and the allied health professions in the United States. J Med Lib Assoc. 2007 Oct;95(4):394–407. DOI: http://dx.doi.org/10.3163/1536-5050.95.4.394. [PMC free article] [PubMed]

2. Pettigrew KE, Fidel R, Bruce H. Conceptual frameworks in information behavior. Annu Rev Inf Sci Technol. 2001;35:43–78.

3. Case DO. Looking for information: a survey of research on information seeking, needs, and behavior. 3rd ed. Bingley, UK: Emerald; 2012.

4. Coumou HC, Meijman FJ. How do primary care physicians seek answers to clinical questions? a literature review. J Med Lib Assoc. 2006 Jan;94(1):55–60. [PMC free article] [PubMed]

5. Davies KS, Harrison J. The information-seeking behaviour of doctors: a review of the evidence. Health Inf Lib J. 2007 Jun;24(2):78–94. [PubMed]

6. Dawes M, Sampson U. Knowledge management in clinical practice: a systematic review of information seeking behavior in physicians. Int J Med Inform. 2003 Aug;71(1):9–15. DOI: http://dx.doi.org/10.1016/S1386-5056(03)00023-6. [PubMed]

7. Gorman PN. Information needs of physicians. J Amer Soc Inf Sci. 1995 Dec;46(10):729–36.

8. Haug JD. Physicians' preferences for information sources: a meta-analytic study. Bull Med Lib Assoc. 1997 Jul;85(3):223–32. [PMC free article] [PubMed]

9. Hersh WR, Hickam DH. How well do physicians use electronic information retrieval systems?: a framework for investigation and systematic review. JAMA. 1998 Oct;280(15):1347–52. [PubMed]

10. Marshall JG. Issues in clinical information delivery. Lib Trends. 1993 Summer;42(1):83–107.

11. Kloda LA, Bartlett JC. Clinical information behavior of rehabilitation therapists: a review of the research on occupational therapists, physical therapists, and speech-language pathologists. J Med Lib Assoc. 2009 Jul;97(3):194–202. DOI: http://dx.doi.org/10.3163/1536-5050.97.3.008. [PMC free article] [PubMed]

12. Fell DW, Burnham JF, Dockery JM. Determining where physical therapists get information to support clinical practice decisions. Health Inf Lib J. 2012 Mar;30(1):35–48. DOI: http://dx.doi.org/10.1111/hir.12010. [PubMed]

13. Jansen L, Rasekaba T, Presnell S, Holland AE. Finding evidence to support practice in allied health: peers, experience, and the Internet. J Allied Health. 2012 Winter;41(4):154–61. [PubMed]

14. Guyatt GH, Sackett DL, Cook DJ. User's guide the to the medical literature II: how to use an article about therapy or prevention: A. are the results of the study valid. JAMA. 1993 Dec 1;270(21):2598–601. [PubMed]

15. Jaeschke R, Guyatt GH, Sackett DL. User's guides to the medical literature: III. how to use an article about a diagnostic test: B. what are the results and will they help me in caring for my patients. JAMA. 1994 Mar 2;271(9):703–7. [PubMed]

16. Levine M, Walter S, Lee H, Holbrook A, Moyer V. Evidence Based Working Group. User's guides to the medical literature: IV. how to use an article about harm. JAMA. 1994 May 25;271(20):1615–9. [PubMed]

17. Laupacis A, Wells G, Richardson SW, Tugwell P. User's guides to the medical literature: V. how to use an article about prognosis. JAMA. 1994 Jul 20;272(3):234–7. [PubMed]

18. Straus SE, Glasziou P, Richardson SW, Haynes RB. Evidence-based medicine: how to practice and teach it. 4th ed. Toronto, ON, Canada: Churchill Livingstone; 2011.

19. Bennett S, Bennett JW. The process of evidence-based practice in occupational therapy: informing clinical decisions. Aust Occup Ther J. 2000 Dec;47(4):171–80.

20. Richardson SW, Wilson M, Nishikawa J, Hayward R. The well-built clinical question: a key to evidence-based decisions. ACP J Club. 1995 Nov–Dec;123(3):A12–A13. [PubMed]

21. Taylor MC. Evidence-based practice for occupational therapists. 2nd ed. Malden, MA: Blackwell; 2007.

22. Dawes M, Summerskill W, Glasziou P, Cartabellotta A, Martin J, Hopayian K, Porzsolt F, Burls A, Osborne J. Sicily statement on evidence-based practice. BMC Med Educ. 2005;5:1. [PMC free article] [PubMed]

23. Cabell CH, Schardt C, Sanders L, Corey GR, Keitz SA. Resident utilization of information technology: a randomized trial of clinical question formation. J Gen Int Med. 2001 Dec;16(12):838–44. [PMC free article] [PubMed]

24. Booth A, O'Rourke AJ, Ford NJ. Structuring the pre-search reference interview: a useful technique for handling clinical questions. Bull Med Lib Assoc. 2000 Jul;88(3):239–46. [PMC free article] [PubMed]

25. Hoogendam A, Robbe PFDV, Overbeke AJPM. Comparing patient characteristics, type of intervention, control, and outcome (PICO) queries with unguided searching: a randomized controlled crossover trial. J Med Lib Assoc. 2012 Apr;100(2):121–6. DOI: http://dx.doi.org/10.3163/1536-5050.100.2.010. [PMC free article] [PubMed]

26. Schlosser RW, Koul R, Costello J. Asking well-built questions for evidence-based practice in augmentative and alternative communication. J Commun Disord. 2007 May–Jun;40(3):225–38. [PubMed]

27. Wildridge V, Bell L. How CLIP became ECLIPSE: a mnemonic to assist in searching for health policy/management information. Health Inf Lib J. 2002 Jun;19(2):113–5. DOI: http://dx.doi.org/10.1046/j.1471-1842.2002.00378.x. [PubMed]

28. ADAPTE Collaboration. 2009 [cited 5 Jul 2013]. ADAPTE resource toolkit for guideline adaptation. Version 2.0 [Internet]. < http://www.g-i-n.net/document-store/adapte-resource-toolkit-guideline-adaptation-version-2/view>.

29. Kloda LA, Bartlett JC. Formulating answerable questions: question negotiation in evidence-based practice. J Can Health Lib Assoc. 2013 Aug;34(2):55–60.

30. Davies KS. Formulating the evidence based practice question: a review of the frameworks. Evid Based Lib Inf Pract. 2011;6(2):75–80.

31. Merriam SB. Designing the study and selecting a sample. In: Qualitative research and case study applications in education. San Francisco, CA: Jossey-Bass; 1998. pp. 44–67.

32. Braun LMM, Wiesman F, van den Herik HJ, Hasman A, Korsten E. Towards patient-related information needs. Int J Med Inform. 2006 Feb–Mar;76(2–3):246–51. [PubMed]

33. Timpka T, Arborelius E. The GP's dilemmas: a study of knowledge need and use during health care consultations. Meth Inf Med. 1990;29:23–9. [PubMed]

34. Kvale S, Brinkmann S. InterViews: learning the craft of qualitative research interviewing. Thousand Oaks, CA: Sage Publications; 2009.

35. Zimmerman DH, Wieder DL. The diary: diary-interview method. J Contemp Ethnography. 1977 Jan;5(4):479–98.

36. Gibbs G. Analyzing qualitative data. Los Angeles, CA: Sage; 2007.

37. King N. Using templates in the thematic analysis of text. In: Cassell S, Symon G, editors. Essential guide to qualitative methods in organizational research. Thousand Oaks, CA: Sage; 2004. pp. 256–70.

38. Cao Y, Liu F, Simpson P, Antieau L, Bennett A, Cimino JJ, Ely JW, Yu H. AskHERMES: an online question answering system for complex clinical questions. J Biomed Inform. 2011 Apr;44(2):277–88. DOI: http://dx.doi.org/10.1016/j.jbi.2011.01.004. [PMC free article] [PubMed]

39. Yu H, Cao Y. Automatically extracting information needs from ad hoc clinical questions. AMIA Annu Symp Proc. 2008:96–100. [PMC free article] [PubMed]

40. Chase HS, Kaufman DR, Johnson SB, Mendonça EA. Voice capture of medical residents' clinical information needs during an inpatient rotation. J Am Med Inform Assoc. 2009 May–Jun;16(3):387–94. DOI: http://dx.doi.org/10.1197/jamia.M2940. [PMC free article] [PubMed]

41. Florance V. Medical knowledge for clinical problem solving: a structural analysis of clinical questions. Bull Med Lib Assoc. 1992 Apr;80(2):140–9. [PMC free article] [PubMed]

42. Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians' clinical questions: obstacles and potential solutions. J Am Med Inform Assoc. 2005 Mar–Apr;12(2):217–24. [PMC free article] [PubMed]

43. Sackett DL, Straus SE, Richardson SW, Rosenberg WM, Haynes RB. Evidence-based medicine: how to practice and teach EBM. New York, NY: Churchill Livingstone; 1997.

44. Ely JW, Osheroff JA, Ebell MH, Bergus GR, Levy BT, Chambliss ML, Evans ER. Analysis of questions asked by family doctors regarding patient care. BMJ. 1999 Aug 7;319(7206):358–61. [PMC free article] [PubMed]

45. Ely JW, Osheroff JA, Gorman PN, Ebell MH, Chambliss ML, Pifer EA, Stavri PZ. A taxonomy of generic clinical questions: classification study. BMJ. 2000 Aug 12;321(7258):429–32. [PMC free article] [PubMed]

46. Huang X, Lin J, Demner-Fushman D. Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annu Symp Proc. 2006:359–63. [PMC free article] [PubMed]

47. Bergus GR, Randall CS, Sinift SD, Rosenthal DM. Does the structure of clinical questions affect the outcome of curbside consultations with specialty colleagues. Arch Fam Med. 2000 Jun;9(6):541–7. [PubMed]

48. Dawes M, Pluye P, Shea L, Grad RM, Greenberg A, Nie JY. The identification of clinically important elements within medical journal abstracts: patient–population–problem, exposure–intervention, comparison, outcome, duration and results (PECODR) Inform Prim Care. 2007;15(1):9–16. [PubMed]

49. Schlosser RW, O'Neil-Pirozzi T. Problem formulation in evidence-based practice and systematic reviews. Contemp Issues Commun Sci Disord. 2006 Spring;33:5–10.

50. Guba EG, Lincoln YS. Fourth generation evaluation. Newbury Park, CA: Sage; 1989.

51. Hyldegård J. Using diaries in group based information behavior research—a methodological study. In: Ruthven I, editor. Proceedings of the 1st International Conference on Information Interaction in Context (IIiX), 2006. Copenhagen, Denmark: Association for Computing Machinery; 2006. pp. 153–61.

52. Horsley T, O'Neill J, McGowan J, Perrier L, Kane G, Campbell C. Interventions to improve question formulation in professional practice and self-directed learning. Cochrane database of systematic reviews. Chichester, UK: John Wiley & Sons; 2010 May. DOI: http://dx.doi.org/10.1002/14651858.CD007335.pub2. [PubMed]

53. Schardt C, Adams MB, Owens T, Keitz SA, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Dec Mak. 2007 Jan;7:16. DOI: http://dx.doi.org/10.1186/1472-6947-7-16. [PMC free article] [PubMed]


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