15 August 2011
An editorial in the BMJ highlighted the difficulties of coping with information overload in medicine and outlined various strategies that doctors use to deal with the problem. All of the possible strategies have disadvantages, but there are some good practice points that may help deal with this, in line with the NPC’s approach.
The NPC offers a wide variety of tools to help busy healthcare professionals cope with information overload, stay current with new developments and quickly sift the most useful information on interventions. These include Rapid Reviews, therapeutic e-learning materials, electronic current awareness bulletins (eCABs) and MeReC publications. The Evidence-informed decision-making e-learning materials include a section that specifically looks at dealing with information overload. Please see below for more details.
What does this editorial discuss?
The author, Richard Smith, a former editor of the BMJ, discusses a number of problems associated with information overload:
- The sheer volume of information being continually generated about different interventions makes it very difficult for healthcare professionals to keep up to date.
- Trying to keep up to date by reading primary research in journals is impossible.
- Practitioners feel guilty about this.
- It is easy to miss key evidence relevant to practice, and what is actually read may not be a true portrayal of the evidence base.
- Reading a critical summary of important information is probably better.
The author suggests that using a ‘machine’ may help clinicians cope with this.
What are the other issues here?
Evidence suggests that people actively construct mental maps of knowledge, preferentially acquired from brief reading of easily accessible information and, once established, those mindlines are changed or given up only reluctantly. In everyday practice there is a flood of information, and there is often little authority to direct practitioners towards the new information they need to acquire, or point out “those pieces of their hard earned knowledge that are no-longer correct”.1
How can healthcare professionals cope with information overload?
‘Information mastery’ describes a system by which busy practitioners can keep up to date with the clinical evidence base, and by extension, health policy and other types of information. This entails a ‘hunting’, a ‘foraging’ and a ‘hot synching’ approach.
- Hunting means having a reliable system to find relevant, valid information that answers specific questions quickly and efficiently.
- Foraging means having a reliable system to highlight new, important, relevant, valid information that requires a change in practice.
- Hot synching means purposefully checking and updating one’s personal mental map of knowledge and skills once or twice a year for each of the 30 to 40 conditions seen frequently.
An essential part of all three components (hunting, foraging and hot synching) is that healthcare professionals should preferentially use trustworthy, pre-appraised summaries of information which set it in the wider context, rather than reading and attempting to critically appraise primary research. Instead of advanced critical appraisal skills, health professionals need to be able to identify such summaries and understand the terms used in them to describe the results. Reputable sources include NICE, NHS Evidence, the Cochrane Library, Clinical Evidence, InfoPoems, MeReC and the Drug and Therapeutics Bulletin.
What tools does the NPC offer to help healthcare professionals?
The second section of the Evidence-informed decision-making e-learning materials on the NPC website, dealing with information overload, covers how to find high-quality evidence and avoid being misled by such data; how to successfully manage the huge quantity of published research; and the basic skills required to understand a summary of evidence and use diagnostic and screening tests logically and scientifically. In addition, there is an overview of Information Mastery in the first section; the third section looks at how individuals make decisions in any situation including in clinical settings; and the final section considers shared decision-making with patients, including translating the results of research into terms patients can understand and use in their choices — assuming they wish to have some involvement with selecting their care.
The NPC website offers a wide range of therapeutic e-learning materials to facilitate hot-synching. These address key clinical questions and issues in the management of common clinical conditions or situations in primary care. The resources provide summaries of the best available evidence relating to prescribing issues, placed in the context of the wider evidence base and guidance related to the topic. They aim to help healthcare professionals to critically review the evidence base for interventions and discuss the implications for the care of patients.
The NPC provides a foraging service in the form of electronic current awareness bulletins and MeReC Rapid Reviews. eCABs contain links to the latest health news, including clinical news, health and social care guidance, publications and policy. Subscribers can choose to receive the daily bulletin, the weekly bulletin, or both.
MeReC Rapid Reviews alert health professionals to the 2 or 3 most useful pieces of information on medicines each week, summarised, critiqued and placed into the context of the wider evidence base and official guidance. They provide timely advice on what, if anything, health professionals should do differently in the light of this. Other MeReC publications offer summaries of the most important and relevant rapid reviews and/or consider key questions on therapeutic and prescribing issues.
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1. Shaughnessy AF and Slawson DC. Are we providing doctors with the training and tools for lifelong learning? BMJ 1999;319:1280-2