Article type
Year
Abstract
Background: Over the past years the efficiency with which evidence from systematic reviews is transfered to general practice (GP) has been challenged. Clinical Evidence (CE), a collection of evidence mainly based upon Cochrane reviews, has been developed as an alternative product thought to be more useful to practitioners. In 2001 the Italian Ministry of Health launched a program to support 'independent information', an element of this program is the translation and free provision of CE to all Italian physicians. The implementation included the development of a free-access e-learning Continuing Medical Education (CME) system, based on CE, called ECCE. Doctors have access to an electronic version of CE and related clinical vignettes. Solving the vignettes provides CME credits.
Objective: To understand, in the GP setting, the factors influencing information transfer using a distance learning programme, based on clinical vignettes driven by the CE.
Design: Qualitative study with three physician focus groups (FGs) run in northern, southern and central Italy. One additional FG held at the Italian editorial house of CE. Participants: opportunistic sample of 26 clinicians: 12 GPs and 14 specialists. Each participant completed at least two vignettes before attending FGs. Purposive sample of 7 authors as developers of clinical vignettes.
Results: Participants identified the principal factors influencing information transfer as legibility of the content and provision of clinically relevant and reliable information. Positive comments about the ECCE outweighed the negative or neutral comments. Respondents felt that ECCE fitted well within the GP context. Information provided was considered reliable and relevant, but reading the CE full-text chapters was perceived as tedious. All participants identified the vignettes a useful tool for switching from a passive reading of CE to an active search of sources, simulating 'on-demand information need during consultation. Some clinicians suggested that ECCE might have limited scope as an information transfer tool, but be a potential attraction as a means of collecting CME credits.
Conclusions: Conveying evidence through a 'vignettes approach' may have an important role in helping the uptake of research results in GP. Key-issues include: relevance and independency of contents; educational role and imaginative presentation of clinical-vignettes; consistency with practice.
Objective: To understand, in the GP setting, the factors influencing information transfer using a distance learning programme, based on clinical vignettes driven by the CE.
Design: Qualitative study with three physician focus groups (FGs) run in northern, southern and central Italy. One additional FG held at the Italian editorial house of CE. Participants: opportunistic sample of 26 clinicians: 12 GPs and 14 specialists. Each participant completed at least two vignettes before attending FGs. Purposive sample of 7 authors as developers of clinical vignettes.
Results: Participants identified the principal factors influencing information transfer as legibility of the content and provision of clinically relevant and reliable information. Positive comments about the ECCE outweighed the negative or neutral comments. Respondents felt that ECCE fitted well within the GP context. Information provided was considered reliable and relevant, but reading the CE full-text chapters was perceived as tedious. All participants identified the vignettes a useful tool for switching from a passive reading of CE to an active search of sources, simulating 'on-demand information need during consultation. Some clinicians suggested that ECCE might have limited scope as an information transfer tool, but be a potential attraction as a means of collecting CME credits.
Conclusions: Conveying evidence through a 'vignettes approach' may have an important role in helping the uptake of research results in GP. Key-issues include: relevance and independency of contents; educational role and imaginative presentation of clinical-vignettes; consistency with practice.