Nudging healthcare professionals towards evidence-based medicine: A systematic scoping review

Abstract

Translating medical evidence into practice is difficult. Key challenges in applying evidence-based medicine are information overload and that evidence needs to be used in context by healthcare professionals. Nudging (i.e. softly steering) healthcare professionals towards utilizing evidence-based medicine may be a feasible possibility. This systematic scoping review is the first overview of nudging healthcare professionals in relation to evidence-based medicine. We have investigated a) the distribution of studies on nudging healthcare professionals, b) the nudges tested and behaviors targeted, c) the methodological quality of studies and d) whether the success of nudges is related to context. In terms of distribution, we found a large but scattered field: 100 articles in over 60 different journals, including various types of nudges targeting different behaviors such as hand hygiene or prescribing drugs. Some nudges – especially reminders to deal with information overload – are often applied, while others - such as providing social reference points – are seldom used. The methodological quality is moderate. Success appears to vary in terms of three contextual characteristics: the task, organizational, and occupational contexts. Based on this review, we propose future research directions, particularly related to methods (preregistered research designs to reduce publication bias), nudges (using less-often applied nudges on less studied outcomes), and context (moving beyond one-size-fits-all approaches).

Designing to Debias: Measuring and Reducing Public Managers’ Anchoring Bias

“…One category includes strategies that modify the environment , which either makes the bias irrelevant or mitigates its effect. People could, for instance, use nudging or hold public employees accountable for their decisions (Aleksovska, Schillemans, and Grimmelikhuijsen 2019; Nagtegaal et al 2019). The second category involves modifying the decision maker , which can be done by providing education on the bias at hand and the consequences that a bias might have and/or providing tools to mitigate the effect of the bias (Lilienfeld, Ammirati, and Landfield 2009).…”

Nudging Public Employees Through Descriptive Social Norms in Healthcare Organizations

“…In contrast, most behavioral public administration literature conducts research on samples of citizens in non-organizational settings (e.g., Baekgaard and Serritzlew 2016; Barrows et al 2016;Jilke et al 2016;Linos 2018;Linos et al 2020;Marvel 2016;Olsen 2017). Our work joins recent efforts (e.g., Belle et al 2017Belle et al , 2018Belle et al , 2019Cantarelli et al 2020;Meier et al 2015;Nagtegaal et al 2019) in speaking to choice architects who intend to nudge desirable behaviors in which public employees may engage in at suboptimal levels.…”

Active learning for screening prioritization in systematic reviews - A simulation study

“…From the field of computer science, the Software dataset contains publications from a review on fault prediction in software engineering [51]. The Nudging dataset [52] belongs to a systematic review on nudging healthcare professionals [35], stemming from the social sciences. From the same research area, the PTSD dataset contains publications on studies applying latent trajectory analyses on posttraumatic stress after exposure to traumatic events [36].…”

“…Models were assessed by conducting a simulation on six systematic review datasets. To assess generalizability of the models across research contexts, datasets containing previous systeamtic reviews were collected from the fields of medical science [32,33,34], computer science [11], and social science [35,36]. The models, datasets and simulations are implemented in a pipeline of active learning for screening prioritization, called…”