Electronic Knowledge Resources and Point-of-Care Learning: A Scoping Review

Abstract

Purpose The authors sought to summarize quantitative and qualitative research addressing electronic knowledge resources and point-of-care learning in a scoping review. Method The authors searched MEDLINE, Embase, PsycINFO, and the Cochrane Database for studies addressing electronic knowledge resources and point-of-care learning. They iteratively revised inclusion criteria and operational definitions of study features and research themes of interest. Two reviewers independently performed each phase of study selection and data extraction. Results Of 10,811 studies identified, 305 were included and reviewed. Most studies (225; 74%) included physicians or medical students. The most frequently mentioned electronic resources were UpToDate (88; 29%), Micromedex (59; 19%), Epocrates (50; 16%), WebMD (46; 15%), MD Consult (32; 10%), and LexiComp (31; 10%). Eight studies (3%) evaluated electronic resources or point-of-care learning using outcomes of patient effects, and 36 studies (12%) reported objectively measured clinician behaviors. Twenty-five studies (8%) examined the clinical or educational impact of electronic knowledge resource use on patient care or clinician knowledge, 124 (41%) compared use rates of various knowledge resources, 69 (23%) examined the quality of knowledge resource content, and 115 (38%) explored the process of point-of-care learning. Two conceptual clarifications were identified, distinguishing the impact on clinical or educational outcomes versus the impact on test setting decision support, and the quality of information content versus the correctness of information obtained by a clinician–user. Conclusions Research on electronic knowledge resources is dominated by studies involving physicians and evaluating use rates. Studies involving nonphysician users, and evaluating resource impact and implementation, are needed.

Impact of Clinicians' Use of Electronic Knowledge Resources on Clinical and Learning Outcomes: Systematic Review and Meta-Analysis

“…They have been trained, and often attempt, to answer these questions using a variety of resources, including increasing use of electronic resources [2-4]. Electronic knowledge resources have been defined as “electronic (computer-based) resources comprising distilled (synthesized) or curated information that allows clinicians to select content germane to a specific patient to facilitate medical decision making” [5]. Commonly used electronic knowledge resources include commercial products, such as UpToDate, Micromedex, and Epocrates [6,7]; locally developed products, such as McMaster Premium LiteratUre Service (PLUS) [8]; and crowdsourced resources, such as Wikipedia [9].…”

Use of online knowledge base in primary health care and correlation to health care quality: An observational study

“…Previous research has focused on interventions to either increase the use of, or nd new ways of using, electronic knowledge sources, whereas this study speci cally examined the effect of the use of a knowledge base on patient outcome measures in two nationwide registries. Earlier studies have found that use of register data may play a vital role in patient care (12,15,36). Furthermore, an excess of research has been devoted to evaluating electronic knowledge sources by employing self-reported use, which is prone to biases (37-39).…”

The exploration of use of an online knowledge base on patient experiences and health care quality: An observational cohort study in primary health care

“…Previous research has focused on interventions to either increase the use of, or find new ways of using, electronic knowledge sources, whereas this study specifically examined the effect of the use of a KB on patient outcome measures in two nationwide registries. Earlier studies have found that use of register data may play an vital role in patient care (12,15,32). Furthermore, an excess of research has been devoted to evaluating electronic knowledge sources by employing self-reported use, which is prone to biases (33)(34)(35).…”

“…In this study, we used Lobach's definition of a KB: "Electronic (computer-based) resources comprising distilled (synthesized) or curated information that allows clinicians to select content germane to a specific patient to facilitate medical decision making" (14). The use of KBs is associated with a positive impact on clinician behavior and patient outcomes, and evidence suggests that use of KBs may be associated with improved knowledge and patient outcomes (12,15,16).…”