Reference: Patel VL, Arocha JF, Diermeier M, How J, and Mottur-Pilson C, Cognitive Psychological Studies of Representation and Use of Clinical Practice Guidelines. International journal of Medical Informatics, Vol 63( 3) 147-168, 2001.
Abstract: Clinical practice guidelines provide a means to enhance
physician performance. This
investigation was undertaken in an attempt to understand the nature
of impact of guideline
use on physician performance. We investigated the impact of (a) algorithmic-based
and (b)
text-based practice guidelines on clinical decision making by physicians
at varying levels of
expertise. Data were collected using clinical scenarios and a think-aloud
paradigm, both
with (primed) and without (spontaneous) the use of the guidelines.
The two guidelines used
in the study were management of diabetes and screening for thyroid
disease.
The results show that guidelines were used as reminders for both experts
and non-experts.
Guidelines acted as an educational tool for non-experts by assisting
in knowledge
reorganization, particularly for the non-experts. Text and algorithmic
guideline formats
were both useful to physician performance depending on the purpose
of use—solving
clinical problems or learning.
These results provide insights into how guidelines can be fine-tuned
for different users and
for different purposes. Empirical research, coupled with design principles
from the
cognitive sciences can form an essential component of guideline design
and development.
Notes:
Keywords:
Full Paper: Full paper available in PDF here .