title: Comparing the information seeking strategies of residents, nurse practitioners, and physician assistants in critical care settings.
abstract: OBJECTIVE
  Critical care environments are information-intensive environments where effective decisions are predicated on successfully finding and using the 'right information at the right time'. We characterize the differences in processes and strategies of information seeking between residents, nurse practitioners (NPs), and physician assistants (PAs).
  
  
  METHODS
  We conducted an exploratory study in the cardiothoracic intensive care units of two large academic hospitals within the same healthcare system. Clinicians (residents (n=5), NPs (n=5), and PAs (n=5)) were shadowed as they gathered information on patients in preparation for clinical rounds. Information seeking activities on 96 patients were collected over a period of 3 months (NRes=37, NNP=24, NPA=35 patients). The sources of information and time spent gathering the information at each source were recorded. Exploratory data analysis using probabilistic sequential approaches was used to analyze the data.
  
  
  RESULTS
  Residents predominantly used a patient-based information seeking strategy in which all relevant information was aggregated for one patient at a time. In contrast, NPs and PAs primarily utilized a source-based information seeking strategy in which similar (or equivalent) information was aggregated for multiple patients at a time (eg, X-rays for all patients).
  
  
  CONCLUSIONS
  The differences in the information seeking strategies are potentially a result of the differences in clinical training, strategies of managing cognitive load, and the nature of the use of available health IT tools. Further research is needed to investigate the effects of these differences on clinical and process outcomes.
authors.affiliation: Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Kannampallil
authors.affiliation: Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Jones
authors.affiliation: Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, USA.
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
authors.affiliation: Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Buchman
authors.affiliation: School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Franklin
mesh_terms: D000046:Academic Medical Centers; D057286:Electronic Health Records; D006801:Humans; D057226:Information Seeking Behavior; D007362:Intensive Care Units; D007396:Internship and Residency; D009722:Nurse Practitioners; D010361:Patients; D010823:Physician Assistants; D000078329:Workforce
keywords: Exploratory Sequential Analysis; Health Information Management; Information Seeking Behavior; Intensive Care