The use of EMR exerts both positive and negative impacts on physician-patient relationships. The negative impacts can be overcome by some simple means as well as better designs of EMR systems and medical education interventions. Physicians' everyday practices of integrating EMR use into the clinical encounter as well as better design of EMR systems and EMR and communication training may facilitate PDC in computerized settings.

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In contrast to the common negative views of HIT, it affects the clinical encounter in multiple ways. By applying identified strategies and best practices, HIT can support patient-clinician interactions rather than interfering with them.

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BackgroundQualitative research appears to be gaining acceptability in medical journals. Yet, little is actually known about the proportion of qualitative research and factors affecting its publication. This study describes the proportion of qualitative research over a 10 year period and correlates associated with its publication.DesignA quantitative longitudinal examination of the proportion of original qualitative research in 67 journals of general medicine during a 10 year period (1998–2007). The proportion of qualitative research was determined by dividing original qualitative studies published (numerator) by all original research articles published (denominator). We used a generalized estimating equations approach to assess the longitudinal association between the proportion of qualitative studies and independent variables (i.e. journals' country of publication and impact factor; editorial/methodological papers discussing qualitative research; and specific journal guidelines pertaining to qualitative research).FindingsA 2.9% absolute increase and 3.4-fold relative increase in qualitative research publications occurred over a 10 year period (1.2% in 1998 vs. 4.1% in 2007). The proportion of original qualitative research was independently and significantly associated with the publication of editorial/methodological papers in the journal (b = 3.688, P = 0.012); and with qualitative research specifically mentioned in guidelines for authors (b = 6.847, P<0.001). Additionally, a higher proportion of qualitative research was associated only with journals published in the UK in comparison to other countries, yet with borderline statistical significance (b = 1.776, P = 0.075). The journals' impact factor was not associated with the publication of qualitative research.ConclusionsDespite an increase in the proportion of qualitative research in medical journals over a 10 year period, the proportion remains low. Journals' policies pertaining to qualitative research, as expressed by the appearance of specific guidelines and editorials/methodological papers on the subject, are independently associated with the publication of original qualitative research; irrespective of the journals' impact factor.

BACKGROUND: Attitudes and barriers to implementing EBM have been examined extensively, but scant evidence exists regarding the impact of EBM teaching on primary care physicians' point of care behavior.OBJECTIVE: Gaining insight into behavioral and attitudinal changes of facilitators and participants during a multifaceted EBM educational intervention. DESIGN, SETTING, AND PARTICIPANTS:A qualitative study on primary care physicians and facilitators from a large HMO selected from the intervention arm of a parallel controlled trial using purposeful sampling. We conducted focus groups with 13 facilitators and 17 physicians and semi-structured interviews with 10 facilitators and 11 physicians.RESULTS: Both facilitators and participants believed EBM enhanced the quality of their practice. The intervention affected attitudes and knowledge, but had little impact on physicians' ability to utilize pre-appraised resources at the point of care. Using EBM resources during consultation was perceived to be a complex task and impractical in a busy setting. Conversely, a positive impact on using medication databases was noted. Medication databases were perceived as easy to use during consultations in which the benefits outweighed the barriers. The intervention prompted physicians to write down clinical questions more frequently and to search for answers at home. CONCLUSIONS:This study underlines the need not only to enhance EBM skills, but also to improve the ease of use of EBM resources at the point of care. Tasks should be simplified by tailoring evidence-based information retrieval systems to the busy clinical schedule. Participants' recommendations to establish an HMO decision support service should be considered.

PurposeThis paper seeks to describe and discuss a tagging experiment involving images related to Israeli and Jewish cultural heritage. The aim of this experiment was to compare freely assigned tags with values (free text) assigned to predefined metadata elements.Design/methodology/approachTwo groups of participants were asked to provide tags for 12 images. The first group of participants was asked to assign descriptive tags to the images without guidance (unstructured tagging), while the second group was asked to provide free‐text values to predefined metadata elements (structured tagging).FindingsThe results show that on the one hand structured tagging provides guidance to the users, but on the other hand different interpretations of the meaning of the elements may worsen the tagging quality instead of improving it. In addition, unstructured tagging allows for a wider range of tags.Research limitations/implicationsThe recommendation is to experiment with a system where the users provide both the tags and the context of these tags.Originality/valueUnstructured tagging has become highly popular on the web, thus it is important to evaluate its merits and shortcomings compared to more conventional methods.

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