Clinician style and examination room computers: a video ethnography.
OBJECTIVE
The use of computers in medical examination rooms is growing. Advocates of this technology suggest that all family physicians should have and use examination room computers (ERCs) within the near future. This study explored how family physicians incorporate the use of ERCs in their interactions with patients.


METHODS
This qualitative study involved five family physicians, one family nurse practitioner, and a convenience sample of 29 patients. Data included videotaped visits, clinician interviews, and videotape reviews. The setting was an urban family practice with a 7-year history of viewing electronic medical records. The main outcome measures were themes emergent from videotaped data.


RESULTS
We identified three distinct practice styles that shaped the use of the ERC: informational, interpersonal, and managerial styles. Clinicians with an informational style are guided by their attention to gathering data as prompted by the computer screen. Clinicians with an interpersonal style focus their attention and body language on patients. Clinicians with a managerial style bridge informational and interpersonal styles by alternating their attention in defined intervals between patients and the computer.


CONCLUSIONS
Family physicians have varying practice styles that affect the way they use examination room computers during visits with patients.
Ventres
William
W
Multnomah County Health Department, Mid-County Health Center, Portland, OR 97236, USA. william.b.ventres@co.multnomah.or.us
Kooienga
Sarah
S
Marlin
Ryan
R
Vuckovic
Nancy
N
Stewart
Valerie
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003142:Communication; D003201:Computers / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008491:Medical Informatics Applications; D008875:Middle Aged; D009722:Nurse Practitioners; D010808:Physical Examination / Q000379:methods*; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011369:Professional-Patient Relations; D014743:Videotape Recording