Interventions to improve question formulation in professional practice and self-directed learning

Article type
Authors
Horsley T, O’Neill J, Campbell C
Abstract
Background: With the proliferation of biomedical information and technologies in the 21st century, both the knowledge and skills acquired through formal education are insufficient to sustain competence over a career. Thus, healthcare workers are expected to remain current in practice through efficient knowledge seeking (evidence-informed practice) and self-directed learning strategies (lifelong learning and reflection). Objectives: To assess the effectiveness of interventions to increase the frequency, quality and answerability of question formulation by healthcare providers in practice within the context of self-directed learning. Methods: Interventions (RCTs, CCTs, CBAs and ITS) designed to increase the frequency and/or quality of healthcare professionals question formulation will be considered for this review. All healthcare providers, including physicians, nurses and allied health professionals (e.g. physiotherapists, speech pathologists, social workers, respiratory therapists, etc.) involved in providing direct patient care will be included. Results: We identified seven studies (within eight publications) examining interventions to improve question formulation in healthcare professionals within the context of EBM. We did not identify any studies with a contemporaneous comparator examining changes in frequency of questions formulated by healthcare professionals. Interventions to increase the quality of questions formulated by physicians and residents in practice produced mixed results when compared to the intervention group at short-and moderate-term follow-up (immediately following intervention, up to nine months). Within-study risk of bias was generally rated to be high risk (defined as one or more key domains scoring high risk) resulting in across-study bias estimated to be considered enough of a concern to affect the overall interpretation of findings. Conclusions: Intervention approaches were diverse with many studies examining question formulation as a component of a much larger EBM or knowledge-seeking intervention. Thus, true effects of targeted question-formulation interventions are challenging to discern and results should be interpreted within this context.