Systematically assessing the situational relevance of electronic knowledge resources: a mixed methods study.
Electronic Knowledge Resources (EKRs) are increasingly used by physicians, but their situational relevance has not been systematically examined.


OBJECTIVE
Systematically scrutinize the situational relevance of EKR-derived information items in and outside clinical settings.


BACKGROUND
Physicians use EKRs to accomplish four cognitive objectives (C1-4), and three organizational objectives (O1-3): (C1) Answer questions/solve problems/support decision-making in a clinical context; (C2) fulfill educational-research objectives; (C3) search for personal interest or curiosity; (C4) overcome limits of human memory; (O1) share information with patients, families, or caregivers; (O2) exchange information with other health professionals; (O3) plan-manage-monitor tasks with other health professionals.


METHODS
Longitudinal mixed methods multiple case study: Cases were 17 residents' critical searches for information, using a commercial EKR, during a 2-month block of family practice. Usage data were automatically recorded. Each "opened" item of information was linked to an impact assessment questionnaire, and 1,981 evaluations of items were documented. Interviews with residents were guided by log files, which tracked use and impact of EKR-derived information items. Thematic analysis identified 156 critical searches linked to 877 information items. For each case, qualitative data were assigned to one of the seven proposed objectives.


RESULTS
Residents achieved their search objectives in 85.9% of cases (situational relevance). Additional sources of information were sought in 52.6% of cases. Results support the seven proposed objectives, levels of comparative relevance (less, equally, more), and levels of stimulation of learning and knowledge (individual, organizational).


CONCLUSIONS
Our method of systematic assessment may contribute to user-based evaluation of EKRs.
Pluye
Pierre
P
Department of Family Medicine, McGill University, 517 Pine Avenue West, Montreal, Quebec, Canada, H2W 1S4. Pierre.Pluye@mcgill.ca
Grad
Roland M
RM
Mysore
Naveen
N
Knaapen
Loes
L
Johnson-Lafleur
Janique
J
Dawes
Martin
M
D003625:Data Collection; D019992:Databases as Topic / Q000706:statistics & numerical data; D005194:Family Practice / Q000193:education*; D016247:Information Storage and Retrieval / Q000706:statistics & numerical data*; D007396:Internship and Residency; D008137:Longitudinal Studies; D009862:Online Systems / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires