title: Comparing narrative versus numerical display of functional information: impact on sense-making.
abstract: Contextual information consists of functional, social, and financial information about patients. Physicians routinely have difficulty incorporating contextual information into clinical decision-making despite the emphasis on patient-centered care and functional status. One reason for this difficulty is that such information is not well-represented in the patient medical record. This study assesses the impact of a "story-form" model versus a "medical" model on a practitioner's ability to recall and incorporate contextual information. We assessed this question through the analysis of responses of 30 clinicians to 2 vignettes presenting contextual information in both formats. Overall, there was a statistically significant difference between the narrative and numerical form with those receiving the narrative form for contextual information being more likely to consider it a top issue. Reference to goals in the report of key clinical factors was also significantly higher for the group receiving goal information. Implications for sharing contextual information in EMRs are discussed.
authors.affiliation: SLC VA IDEAS Center of Innovation, SLC, UT.
authors.forename: Charlene
authors.initials: C
authors.lastname: Weir
authors.affiliation: Department of Biomedical Informatics, University of Utah, SLC, UT.
authors.forename: Robert
authors.initials: R
authors.lastname: Dunlea
authors.affiliation: School of Nursing, University of Maryland, Baltimore, MD.
authors.forename: Nancy
authors.initials: N
authors.lastname: Staggers
authors.affiliation: Department of Biomedical Informatics, University of Utah, SLC, UT.
authors.forename: Kristina
authors.initials: K
authors.lastname: Dooing-Harris
authors.affiliation: SLC VA IDEAS Center of Innovation, SLC, UT.
authors.forename: Teresa
authors.initials: T
authors.lastname: Mccormick
authors.affiliation: SLC VA IDEAS Center of Innovation, SLC, UT.
authors.forename: Robyn
authors.initials: R
authors.lastname: Barrus
mesh_terms: D032882:Comprehension; D003626:Data Display; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D057286:Electronic Health Records / Q000458:organization & administration*; D016247:Information Storage and Retrieval / Q000379:methods*; D033262:Narration; D009323:Natural Language Processing; D014584:User-Computer Interface; D014956:Writing