Objective: Few studies have examined the impact of a single clinical evidence technology (CET) on provider practice or patient outcomes from the provider’s perspective. A previous cluster-randomized controlled trial with patient-reported data tested the effectiveness of a CET (i.e., VisualDx) in improving skin problem outcomes but found no significant effect. The objectives of this follow-up study were to identify barriers and facilitators to the use of the CET from the perspective of primary care providers (PCPs) and to identify reasons why the CET did not affect outcomes in the trial.Methods: Using a convergent mixed methods design, the authors had PCPs complete a post-trial survey and participate in interviews about using the CET for managing patients’ skin problems. Data from both methods were integrated.Results: PCPs found the CET somewhat easy to use but only occasionally useful. Less experienced PCPs used the CET more frequently. Data from interviews revealed barriers and facilitators at four steps of evidence-based practice: clinical question recognition, information acquisition, appraisal of relevance, and application with patients. Facilitators included uncertainty in dermatology, intention for use, convenience of access, diagnosis and treatment support, and patient communication. Barriers included confidence in dermatology, preference for other sources, interface difficulties, presence of irrelevant information, and lack of decision impact.Conclusion: PCPs found the CET useful for diagnosis, treatment support, and patient communication. However, the barriers of interface difficulties, irrelevant search results, and preferred use of other sources limited its positive impact on patient skin problem management.
The article discusses the role of interprofessional education (IPE) and interprofessional collaborative practice (IPCP) in the delivery of service to a young child with autism spectrum disorder (ASD) and his family. An introduction to the concepts is provided with an outline of the strengths and challenges evident in implementing an IPCP approach to quality care. The core competencies for IPE and IPCP are also explained with examples of their application to children with ASD and their families. After reading this article, health care providers should be able to summarize their role in IPE and IPCP and identify their responsibility as a member of a collaborative team. The value of an interprofessional team in practice is emphasized, and ways to build successful teams are explained.
Recreation is a large part of the human experience at any age, and in the form of play, it is especially critical to children's development. Across the life span, recreation has many known benefits, most notably a positive impact on people's sense of well‐being. There is growing evidence that people with ASD experience decreased richness in their patterns of recreational engagement, participating in less diverse activities while remaining closer to home with a narrower circle of other people. An interdisciplinary, family‐centered, and context‐based approach to promoting the development of a richer recreational life for those with ASD is described with practical examples.
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