Wiring a nation: putting knowledge into action

Nylenna, Magne; Eiring, Øystein; Strand, Grete; Røttingen, John-Arne

doi:10.1016/s0140-6736(09)61832-8

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…In particularly, they were unsure about whether they had access to the best resources needed to apply EBP, although health workers in Norway have free internet at work and free access to scientific articles via the Norwegian Electronic Health Library [48]. Access to literature is seen as an important initiative for implementing EBP [49,50].…”

Section: Discussionmentioning

confidence: 99%

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

et al. 2014

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BackgroundHaving a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses.The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation.MethodWe carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used.ResultsIn total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r = 0.59, p = 0.001).There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r = 0.38, p < .0001). Participants who had learned about evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups.ConclusionThis study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between beliefs about evidence-based practice and implementation of evidence-based practice. Beliefs related to knowledge appear to have the greatest effect on implementation of evidence-based practice. Having knowledge and taking part in evidence-based practice working groups seem important.

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Section: Discussionmentioning

confidence: 99%

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

et al. 2014

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“…The 21 st Century evidence-based medicine movement has placed less emphasis on intuition and tacit knowing in forming sound clinical judgements [ 1 , 2 ]. Yet a growing debate about the evidence-practice divide in medicine over the last decade asserts the limited value of research for complex practitioner decision-making [ 3 - 6 ]. It has been argued that practitioner judgement must be better valued because guidelines synthesised from the ‘gold standard’ evidence of clinical trials, reviews and meta-analyses are about groups, not individuals [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Yet a growing debate about the evidence-practice divide in medicine over the last decade asserts the limited value of research for complex practitioner decision-making [ 3 - 6 ]. It has been argued that practitioner judgement must be better valued because guidelines synthesised from the ‘gold standard’ evidence of clinical trials, reviews and meta-analyses are about groups, not individuals [ 6 , 7 ]. Such evidence has been described as suffering from an insufficiency linked to the narrowness of its aims versus the breadth of clinical judgement required for ‘point of care’ complexities [ 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Evidence in clinical reasoning: a computational linguistics analysis of 789,712 medical case summaries 1983–2012

Seidel

Campbell

Bell

2015

BMC Med Inform Decis Mak

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BackgroundBetter understanding of clinical reasoning could reduce diagnostic error linked to 8% of adverse medical events and 30% of malpractice cases. To a greater extent than the evidence-based movement, the clinical reasoning literature asserts the importance of practitioner intuition—unconscious elements of diagnostic reasoning. The study aimed to analyse the content of case report summaries in ways that explored the importance of an evidence concept, not only in relation to research literature but also intuition.MethodsThe study sample comprised all 789,712 abstracts in English for case reports contained in the database PUBMED for the period 1 January 1983 to 31 December 2012. It was hypothesised that, if evidence and intuition concepts were viewed by these clinical authors as essential to understanding their case reports, they would be more likely to be found in the abstracts. Computational linguistics software was used in 1) concept mapping of 21,631,481 instances of 201 concepts, and 2) specific concept analyses examining 200 paired co-occurrences for ‘evidence’ and research ‘literature’ concepts.Results‘Evidence’ is a fundamentally patient-centred, intuitive concept linked to less common concepts about underlying processes, suspected disease mechanisms and diagnostic hunches. In contrast, the use of research literature in clinical reasoning is linked to more common reasoning concepts about specific knowledge and descriptions or presenting features of cases. ‘Literature’ is by far the most dominant concept, increasing in relevance since 2003, with an overall relevance of 13% versus 5% for ‘evidence’ which has remained static.ConclusionsThe fact that the least present types of reasoning concepts relate to diagnostic hunches to do with underlying processes, such as what is suspected, raises questions about whether intuitive practitioner evidence-making, found in a constellation of dynamic, process concepts, has become less important. The study adds support to the existing corpus of research on clinical reasoning, by suggesting that intuition involves a complex constellation of concepts important to how the construct of evidence is understood. The list of concepts the study generated offers a basis for reflection on the nature of evidence in diagnostic reasoning and the importance of intuition to that reasoning.

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“…It is marketed to health personnel, but not to the general public. The Library provides free access to important sources of knowledge intended for health personnel, including point-of-care tools (reference works), bibliographic databases, and a large number of scientific journals [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Examining the Use of an Open Digital Health Library for Professionals

Eggen¹,

Tjensvoll²,

Nylenna³

2014

JMIR Res Protoc

Self Cite

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BackgroundThe Norwegian Electronic Health Library (The Library) is a website for health personnel. Most of the content is also open to the public. Usage statistics have risen sharply in the years 2010-2013.ObjectiveWe wanted to find out whether the rise was caused by health personnel, the general public, or other factors.MethodsSince we lacked direct information, we had to use proxy data to shed light on our questions. We applied mixed methods (database of registered users, user survey, usage statistics, and statistics from suppliers), and triangulated between them.ResultsHealth personnel were our largest user group, but The Library was also accessed by students, patients, and other groups. Content in Norwegian was preferred to English language content. Concise, practical information was preferred to more comprehensive information. Patient leaflets were the most popular information type. Mobile phone visits differed from personal computer visits both in terms of time of day and what kind of information was viewed.ConclusionsThe Library was used mostly by health personnel, as intended, but our data are inconclusive regarding a possible change in user groups. There was a large degree of consistency in results when using different investigation methods. The survey points toward health personnel being the largest user group, and the usage statistics show that patient leaflets are the most popular content, being viewed by both health personnel and patients.

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Wiring a nation: putting knowledge into action

Cited by 11 publications

References 10 publications

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

Evidence in clinical reasoning: a computational linguistics analysis of 789,712 medical case summaries 1983–2012

Examining the Use of an Open Digital Health Library for Professionals

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