September 2012

Document Type


Degree Name



Dept. of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


This Capstone project is a qualitative study exploring the out-of-hospital clinical information seeking habits of residents-in-training (residents) in an era of work-hour restrictions. Since 2003, these restrictions were mandated by the Accreditation Council for Graduate Medical Education (ACGME). These rules were placed with an aim to promote patient safety and high quality learning. An updated and more restrictive work-hour schedule took effect in July 2011. Other forces bearing on medical education include information technology, economics, and politics of healthcare. Information technology practices have largely changed in the last decade, whereas the education curriculum and teaching techniques are bogged down in 20th Century paradigms. Based on grounded theory we used semi structured interviews to identify how residents seek clinical information outside the work environment. In particular, we are interested in identifying how information seeking habits and technology intersect with medical education practices. Results: We interviewed 33 residents from 4 distinct residency programs (Internal Medicine, Family Practice, Orthopedics, General Surgery) and from the Transitional 1 year internship at Eisenhower Army Medical Center in Augusta, GA. Using a semi-structured interview format, we explored variables that may influence residents clinical information seeking habits outside routine work hours. Codes and themes from the interviews were transcribed and then analyzed. In the context of duty-hour restrictions, we discuss the major themes related to residents' information seeking habits. Thematic interactions, like personal growth strategies, secondary effects of work-duty hour restrictions, and access to information resources, influence residents motivation for seeking clinical information seeking habits of residents. Embedded in our discussion are recommendations that may assist faculty and residents in easing the burden of transitioning from a 20th Century to a 21st Century information culture for Graduate Medical Education. Conclusions: Graduate medical education in the 21st Century should be resilient to adapt and change in face of the challenges imposed by regulatory, cultural, and information technologies. Stakeholders should devote more attention to understanding the effects of changes in the variables affect resident learning and in particular, their clinical information seeking habits.




School of Medicine



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