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Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment

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dc.contributor.author Noble, Helen
dc.contributor.author Ordoñez, Willy Jesús Neumann
dc.contributor.author Zavala Wong, Gabriela
dc.contributor.author Rodríguez Castro, Manuel Jorge Augusto
dc.contributor.author Ortega Checa, David
dc.contributor.author Warne, Maria
dc.contributor.author Senturia, Kirsten
dc.contributor.author Jin, Ying
dc.contributor.author Peterson, Ryan
dc.contributor.author Nicole LaGrone, Lacey
dc.coverage.spatial Lima, Perú
dc.date.accessioned 2023-04-16T04:38:13Z
dc.date.available 2023-04-16T04:38:13Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13366
dc.description.abstract BACKGROUND: Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN: This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes. RESULTS: Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency. CONCLUSIONS: Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems. Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Journal of the American College of Surgeons
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Point-of-Care en_US
dc.subject Trauma Surgeons en_US
dc.subject General Surgeons en_US
dc.subject Clinical Knowledge en_US
dc.subject Middle-Income Country en_US
dc.title Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/XCS.0000000000000530
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.11
dc.relation.issn 1879-1190


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