title: GP trainees' in-consultation information-seeking: associations with human, paper and electronic sources.
abstract: BACKGROUND
  Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic).
  
  
  OBJECTIVE
  To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources.
  
  
  METHODS
  A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy.
  
  
  RESULTS
  Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training organization and information-seeking for management rather than diagnosis.
  
  
  CONCLUSIONS
  Trainee information-seeking is mainly from GP colleagues and electronic sources. Human information-sources are preferentially sought for more complex problems, even by these early-career GPs who have trained in the 'internet era'.
authors.affiliation: Discipline of General Practice, University of Newcastle, Newbolds Building, University Drive, Callaghan, NSW 2308, General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304, parker.magin@newcastle.edu.au.
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.affiliation: General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304.
authors.forename: Simon
authors.initials: S
authors.lastname: Morgan
authors.affiliation: Academic Unit of General Practice, Australian National University Medical School, Canberra, ACT 2606, Department of Health, Health Workforce Division, Woden Town Centre, Canberra, ACT 2606.
authors.forename: Susan
authors.initials: S
authors.lastname: Wearne
authors.affiliation: General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304.
authors.forename: Amanda
authors.initials: A
authors.lastname: Tapley
authors.affiliation: General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304.
authors.forename: Kim
authors.initials: K
authors.lastname: Henderson
authors.affiliation: Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle, School of Medicine and Public Health, University of Newcastle University Drive, Callaghan, NSW 2308.
authors.forename: Chris
authors.initials: C
authors.lastname: Oldmeadow
authors.affiliation: Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle.
authors.forename: Jean
authors.initials: J
authors.lastname: Ball
authors.affiliation: General Practice Training Valley to Coast, Corner of Gavey and Frith Streets, Mayfield NSW 2304.
authors.forename: John
authors.initials: J
authors.lastname: Scott
authors.affiliation: Victorian Metropolitan Alliance General Practice Training, 15 Cato Street, Hawthorn, VIC 3122, Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, VIC 3053.
authors.forename: Neil
authors.initials: N
authors.lastname: Spike
authors.affiliation: Adelaide to Outback General Practice Training, Lower Level, 183 Melbourne Street, North Adelaide, SA 5006 and.
authors.forename: Lawrie
authors.initials: L
authors.lastname: McArthur
authors.affiliation: Discipline of General Practice, School of Medicine, The University of Queensland, L8 Health Sciences Building, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Mieke
authors.initials: M
authors.lastname: van Driel
mesh_terms: D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000193:education* / Q000706:statistics & numerical data*; D006801:Humans; D057226:Information Seeking Behavior; D033183:Interdisciplinary Communication; D020407:Internet / Q000706:statistics & numerical data; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D011340:Problem Solving; D012014:Reference Books, Medical
keywords: Australia; evidence-based medicine; family practice; general practitioners; information seeking behaviour; internet; internship and residency; primary health care.