Medical and Nursing Students' Evidence Retrieval Skills Clinical Trial
Official title:
Multifaceted Online Interventions to Increase Medical and Nursing Students Searching of Current Best Evidence to Answer Clinical Questions (MPFS-2)
Translation of new knowledge from research into evidence-informed health care is a shared
obligation of the clinical and the scientific communities. Unfortunately, studies of quality
of care continue to show that this goal is substantially unrealized. One main barrier is lack
of quick and easy identification, appraisal and synthesis of current best evidence. This
start with medical and nursing students, which have numerous clinical-related questions
daily, but face a large volume of 3000 articles published every day, accessible in many
scattered resources.
To address theses problems, McMaster's Health Information Research Unit (Hamilton, Ontario,
Canada) has developed and implemented "McMaster Premium LiteratUre Service Federated Search"
(MPFS), an online search engine that provides a unique 1-stop search and organized access to
current best evidence in daily practice. However additional barriers need to be overcome for
students to actually search and use this evidence in their learning and practice. Theses
include logistical barriers (time constraints, forgotten questions), as well as educational
barriers (eg, lack of awareness of the "architecture" of evidence, limited searching skills,
and lack of reference standards among peers for finding best evidence).
In a previous trial, the investigators tested 3 innovative online interventions among
clinicians registered to MPFS to overcome these barriers and increase the quantity and
quality of searching for current best evidence to answer clinical questions (NCT02038439).
The investigators seek to conduct a second randomized trial testing the same 3 interventions,
this time among medical and nursing students registered in MPFS.
1. Rationale & Objectives
One main barrier to achieving evidence-informed care by clinicians is lack of quick and
easy identification, appraisal and synthesis of current best evidence. Clinicians and
students information needs are considerable - but about 3000 articles are published in
Medline every day. Numerous evidence-based resources have been developed to filter and
process the evidence, but although increasingly used, each offer a fragmented and
scattered view of information, and none provides comprehensive topic coverage or
satisfactory updating.
To address theses problems, McMaster's Health Information Research Unit (Hamilton,
Ontario, Canada) has developed and implemented "McMaster Premium LiteratUre Service
Federated Search (MPFS)", an online search engine that provides a unique 1-stop search
and organized access to current best evidence in daily practice. MPFS provides both
alerts to users about new research, and a novel federated search function, with the
particular feature of organizing information according to the "pyramid of evidence-based
resources", with the most clinically applicable evidence at the top. Thus MPFS
simultaneously retrieves evidence from Studies ("Medline", both filtered and unfiltered,
at the bottom), then Systematic reviews; Synopses of studies and systematic reviews
(selected for methodological rigor and clinical relevance), and, at the top level,
online widely used Summaries (e.g."Best Practice").
Combining features of the current best evidence-based resources is not enough to
increase access and use of current best evidence. Additional well-known barriers that
need to be overcome include logistical barriers (time constraints, forgotten questions,
and simplicity of using one single albeit limited resource), as well as educational
barriers (eg, lack of awareness of the "architecture" of evidence and limits of other
single resources, lack of knowledge and experience of what federated searches can offer,
limited searching skills, and lack of reference standards among peers for finding best
evidence).
2. Hypothesis
This trial seeks to test 3 innovative online interventions among medical and nursing
students registered to MPFS to overcome these barriers and increase the quantity and
quality of searching for current best evidence to answer the learning needs and clinical
questions. These interventions build on effective models for the teaching of clinical
skills at the point of care, so that they are facilitated in using the search engine as
a clinical tool, and perceive evidence retrieval skills as true clinical skills.
3. Methods
1. Study design: Randomized Factorial Controlled Trial.
2. Setting and Participants: The trial will be conducted among medical and nursing
students registered in MPFS and working in the teaching hospitals and clinics of
McMaster University (see eligibility criteria below)
3. Participating clinicians will be randomized to 3 online interventions (see
description below) in a factorial design (A x B x C), whose permutation results in
8 allocation arms (A+B+C, A+B, A+C, B+C, A, B, C, no intervention, see details
below)
4. Randomization: will be computer-generated, and stratified for medical vs. nursing
students. Registrants will be randomly allocated to each study arms. Allocation
will be concealed from research staff.
5. Blinding and control group: Although participants cannot be blinded to the
interventions, they will not be told of the different features offered, and all
will receive usual searching features of MPFS.
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