Use of written cases to study factors associated with regional variations in referral rates

Langley, G. R.; Tritchler, David; Llewellyn‐Thomas, Hilary A.; Till, J. E.

doi:10.1016/0895-4356(91)90077-m

Cited by 48 publications

(28 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the use of clinical vignettes have been demonstrated to be an effective and useful tool for evaluating practice behavior and eliciting practitioner attitudes and beliefs. 56,57 Moreover, the rate of radiography use estimated from the survey responses appeared consistent with those of other studies, which further adds confidence to the validity of the preintervention survey results.…”

Section: Discussionsupporting

confidence: 83%

Implementing Evidence-Based Guidelines for Radiography in Acute Low Back Pain: A Pilot Study in a Chiropractic Community

Ammendolia

Hogg‐Johnson

Bombardier

et al. 2004

Journal of Manipulative and Physiological Therapeutics

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 83%

Implementing Evidence-Based Guidelines for Radiography in Acute Low Back Pain: A Pilot Study in a Chiropractic Community

Ammendolia

Hogg‐Johnson

Bombardier

et al. 2004

Journal of Manipulative and Physiological Therapeutics

View full text Add to dashboard Cite

“…Although paper patients are probably an effective measure for evaluating clinical competence [24,26], the clinical decision-making process [60], quality of care [61], and regional variation [25], our study suggests that paper patients are less likely to be useful in eliciting physicians' conscious beliefs or unconscious stereotypes about a patient and are not a valid measure of the effect of patients' gender on physicians' clinical decision making.…”

Section: Discussionmentioning

confidence: 67%

Patients' gender affected physicians' clinical decisions when presented with standardized patients but not for matching paper patients

Borkhoff¹,

Hawker²,

Kreder³

et al. 2009

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

“…Thus, our speaking up estimates are likely to be subject to hypotheticality and social desirability bias. Previous research into clinical decision making shows, that judgments made in response to vignettes are often similar to those made with actual patients [18]–[21]. To the contrary, actual speaking up decisions are likely to be affected by factors we could not simulate in our vignette approach.…”

Section: Discussionmentioning

confidence: 91%

Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals’ Likelihood of Speaking up about Safety Concerns

Schwappach

Gehring

2014

PLoS ONE

View full text Add to dashboard Cite

PurposeTo investigate the likelihood of speaking up about patient safety in oncology and to clarify the effect of clinical and situational context factors on the likelihood of voicing concerns.Patients and Methods1013 nurses and doctors in oncology rated four clinical vignettes describing coworkers’ errors and rule violations in a self-administered factorial survey (65% response rate). Multiple regression analysis was used to model the likelihood of speaking up as outcome of vignette attributes, responder’s evaluations of the situation and personal characteristics.ResultsRespondents reported a high likelihood of speaking up about patient safety but the variation between and within types of errors and rule violations was substantial. Staff without managerial function provided significantly higher levels of decision difficulty and discomfort to speak up. Based on the information presented in the vignettes, 74%−96% would speak up towards a supervisor failing to check a prescription, 45%−81% would point a coworker to a missed hand disinfection, 82%−94% would speak up towards nurses who violate a safety rule in medication preparation, and 59%−92% would question a doctor violating a safety rule in lumbar puncture. Several vignette attributes predicted the likelihood of speaking up. Perceived potential harm, anticipated discomfort, and decision difficulty were significant predictors of the likelihood of speaking up.ConclusionsClinicians’ willingness to speak up about patient safety is considerably affected by contextual factors. Physicians and nurses without managerial function report substantial discomfort with speaking up. Oncology departments should provide staff with clear guidance and trainings on when and how to voice safety concerns.

show abstract

Use of written cases to study factors associated with regional variations in referral rates

Cited by 48 publications

References 30 publications

Implementing Evidence-Based Guidelines for Radiography in Acute Low Back Pain: A Pilot Study in a Chiropractic Community

Implementing Evidence-Based Guidelines for Radiography in Acute Low Back Pain: A Pilot Study in a Chiropractic Community

Patients' gender affected physicians' clinical decisions when presented with standardized patients but not for matching paper patients

Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals’ Likelihood of Speaking up about Safety Concerns

Contact Info

Product

Resources

About