JMIR Publications

ABSTRACT

Background:

Lifelong learning is embedded in the culture of medicine, but there are limited tools currently available for many clinicians, including hospitalists, to try to improve their own practice. Although there are requirements for continued medical education, resources for learning new clinical guidelines, and developing fields aimed at facilitating peer to peer feedback, there is a gap in tools that allow clinicians to learn based on their own patients and decisions.

Objective:

This project aims to explore which technologies or modifications to existing systems could be used to benefit physicians in their pursuit of self-assessment and improvement by understanding their current practices of improvement and reactions to proposed possibilities.

Methods:

A qualitative study using semi-structured interviews occurred in two separate stages with analysis after each. First, interviews (n= 12) were conducted to understand the current ways that hospitalist physicians are gathering feedback about their practice. A thematic analysis of these interviews was completed and used to inspire a prototype to elicit responses in the second stage.

Results:

Clinicians actively look for feedback that they can apply to their practice, with much coming through self-assessment. Three themes around this were identified in the first round of semi-structured interviews: collaboration, self-reliance, and uncertainty, each with related subthemes. Using a wireframe, the second round of interviews led to identification of opinions and perspectives of data points and features that are currently challenging to use or could be made available with technology.

Conclusions:

Based on the results, we make targeted recommendations based on each theme and subtheme for use by relevant stakeholders like institutions, clinicians, and technologists. Most hospitalist self-assessments occur on a rolling basis using data in the Electronic Medical Record, with specific objective data points or subjective patient relationships drawing clinicians to review a patient case and assess their own prior judgement or performance. Current systems, however, are not built for these analyses or for clinicians to perform self-assessment, making this a burdensome and incomplete process. Building a platform that focuses on providing and more quickly curating the information used for self-assessment could help physicians make more accurately informed changes to their own clinical practice and decision making.