+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Evaluation of a handheld clinical decision support tool for evidence-based learning and practice in medical undergraduates



Evaluation of a handheld clinical decision support tool for evidence-based learning and practice in medical undergraduates



Medical Education 38(6): 628-637



Handheld computers (PDAs) uploaded with clinical decision support software (CDSS) have the potential to facilitate the adoption of evidence-based medicine (EBM) at the point-of-care among undergraduate medical students. Further evaluation of the usefulness and acceptability of these tools is required. All 169 Year 4 undergraduate medical students at the University of Hong Kong completed a post-randomised controlled trial survey. Primary outcome measures were CDSS/PDA usefulness, satisfaction, functionality and utilisation. Focus groups were also conducted to derive complementary qualitative data on the students' attitudes towards using such new technology. Overall, the students found the CDSS/PDA useful (mean score = 3.90 out of 6, 95% confidence interval (CI) = 3.78, 4.03). They were less satisfied with the functional features of the CDSS (mean score = 3.45, 95% CI = 3.32, 3.59) and the PDA (mean score = 3.51 95% CI = 3.40, 3.62). Utilisation was low, with the average frequency of use less than once per week. Although students reported a need for information in patient care at least once daily, they infrequently used the CDSS in a clinical setting (20.4 +/- 10.4% of the time), with an average information retrieval success rate of 37.6 +/- 22.1% requiring 63.7 +/- 86.1 seconds. Multivariable regression shows that higher perceived CDSS/PDA usefulness was associated with more supportive faculty attitudes, greater knowledge of EBM, better computer literacy skills and increased use in a clinical setting. Greater satisfaction with the CDSS/PDA was associated with increased use in a clinical setting and higher successful search rates. Qualitative results were consistent with these quantitative findings and yielded additional information on students' underlying feelings that may explain the observations. While PDAs uploaded with the CDSS are able to provide students with better access to high quality information, improvements in faculty attitudes, students' knowledge of EBM and computer literacy skills, and having the CDSS specially designed for undergraduate use are essential to increasing student adoption of such point-of-care tools.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 048993448

Download citation: RISBibTeXText

PMID: 15189259

DOI: 10.1111/j.1365-2929.2004.01842.x


Related references

Learning at the point of care using evidence-based practice resources and clinical decision support. Journal of Evidence-Based Dental Practice 8(3): 181-185, 2008

Randomised controlled trial of clinical decision support tools to improve learning of evidence based medicine in medical students. Bmj 327(7423): 1090, 2003

Clinical decision support complements evidence-based decision making in dental practice. Journal of Evidence-Based Dental Practice 7(1): 1-5, 2007

Implementing an evidence-based clinical decision support tool to improve the detection, evaluation, and referral patterns of adult chronic kidney disease patients in primary care. Journal of the American Association of Nurse Practitioners 29(12): 741-753, 2017

Elsevier clinical practice model achieves milestone successes to advance clinical decision support and evidence-based practice. Computers Informatics Nursing 32(7): 303-304, 2014

CeMENT: evaluation of a regional development programme integrating hospital and general practice clinical teaching for medical undergraduates. The Community-Based Medical Education in North Thames. Medical Education 35(2): 160-166, 2001

Electronic clinical decision support tool for the evaluation of cardiovascular risk in general practice: A pilot study. Australian Family Physician 46(10): 764-768, 2017

Clinical decision support systems for the practice of evidence-based medicine. Journal of the American Medical Informatics Association 8(6): 527-534, 2001

Bridging the gap between evidence and practice: Development of a prototype tool to support clinical decision making in osteoporosis disease management at the point of care. Journal of General Internal Medicine 23(Suppl. 2): 259, 2008

Development of an electronic medical record-based clinical decision support tool to improve HIV symptom management. Aids Patient Care and Stds 23(7): 521-529, 2009

Clinical decision support chairside tools for evidence-based dental practice. Journal of Evidence-Based Dental Practice 8(3): 119-132, 2008

Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice. Oncology Nursing Forum 43(4): E170-E177, 2016

The knowledge based medical record immediate i a basis for clinical decision support in general practice. De Lotto, I. Stefanelli (ed.). Artificial Intelligence In Medicine; International Conference, Pavia, Italy, Sept. 13-14,: Amsterdam, Netherlands (dist. For The Usa And Canada By Elsevier Science Publishing Co., Inc: New York, N.y., Usa). Illus. 37-50, 1985

Impact of an electronic medical record-based clinical decision support tool for dysphagia screening on care quality. Stroke 43(12): 3399-3401, 2012

Clinical decision support systems in nursing: synthesis of the science for evidence-based practice. Computers Informatics Nursing 26(3): 151-158, 2008