Situational Cues Surrounding Family Physicians Seeking External Resources While Self-Monitoring in Practice

Autor/inn/en	Lee, Linda; King, Gillian; Freeman, Thomas; Eva, Kevin W.
Titel	Situational Cues Surrounding Family Physicians Seeking External Resources While Self-Monitoring in Practice
Quelle	In: Advances in Health Sciences Education, 24 (2019) 4, S.783-796 (14 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-019-09898-1
Schlagwörter	Cues; Physicians; Self Management; Help Seeking; Clinical Diagnosis; Family Practice (Medicine); Decision Making; Physician Patient Relationship; Medical Services; Expertise + Suchen Sie Ihr Suchwort? Stichwort; Physician; Doctor; Arzt; Selbstmanagement; Help-seeking behavior; Help-seeking behaviour; Hilfe suchendes Verhalten; Decision-making; Entscheidungsfindung; Arzt-Patient-Beziehung; Expert appraisal
Abstract	Many models of safe and effective clinical decision making in medical practice emphasize the importance of recognizing moments of uncertainty and seeking help accordingly. This is not always done effectively, but we know little about what cues prompt health professionals to call on resources beyond their own knowledge or skill set. Such information would offer guidance regarding how systems might be designed to offer better individual support. In this study, the authors explored the situational factors that are present during moments of uncertainty that lead primary care physicians to access external resources. To do so, a generic qualitative exploratory analysis was conducted on 72 narratives collected through audio recorder-based, self-observational, journaling completed by 12 purposively selected family physicians. Participants were asked to provide a detailed descriptive account of the circumstances surrounding their consultation of external resources immediately after 6 sequential patient encounters in which they felt compelled to seek such support. Thematic analysis of the transcripts was performed to better understand participants' experiences of the social, contextual, and personal features surrounding decisions to seek support. When doing so we observed that specific features of patient encounters were routinely present when physicians decided to access external sources for help. These included medical aspects of the case (e.g., complex presentations), social aspects (e.g., the presence of another individual), and personal factors (e.g., feeling a need for reassurance). External resources were seen as an opportunity for verification, a mechanism to increase patient satisfaction, and a means through which to defend decision-making. Accessing such resources appeared to influence the physician-patient relationship for various reasons. Recognition and further study of the cues that prompt use of external information will further our understanding of physicians' behavioural responses to challenging/uncertain situations, highlight mechanisms through which a culture of self-directed assessment seeking might be encouraged, and offer guidance regarding ways in which physicians can be encouraged to practice mindfully. Our results make it clear that reasons for which primary care physicians seek the support of external resources may be multifactorial and, therefore, one should be cautious when inferring reasons for the pursuit of such support. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01