Abstract:
In a prospective cohort study, 23 medical residents were allocated to receive a wireless-enabled PDA-style handheld to provide access to high-quality evidence based medicine (EBM) resources and a drug reference database or to receive access to usual resources through the hospital library. Usage of the evidence resources and the impact of the evidence on clinical decision making were recorded over a one month period. Multiple methodologies assessed the ergonomic, cultural, technical and content related suitability: questionnaires, client-side tracking software, pop-up surveys, interviews and a focus-group. EBM resources were accessed 370 times. Usage peaked in the first week of the study and overall usage was greatest at night. The residents’ reported wanting to use the system in areas not covered by the wireless network including the elevator and seminar rooms. At the completion of the study there were no significant differences in the use of the EBM resources between the intervention and control groups. However, when evidence was retrieved, it had a significant impact on clinical decision making. This study found that residents had an unmet software requirement: access to diagnostic test results.
