Background: The use of personal digital assistants (PDAs) and electronic resources has rapidly increased throughout the years. Physician Assistants (PAs) are using PDAs for multiple purposes, such as medical references, drug dosage, and personal use. In the past, some of the resources available for the PDA were only available as texts. This is an area of interest to see what is being used, but poses a major challenge since there are so many resources available and no major studies have looked into this.
Hypothesis: More seasoned providers rely less on electronic resources and use technology less due to experience and tradition.
Study Design: Pilot Study.
Participants: The survey was opened for 1 month period in 2007. The population included Physician assistant students and practicing, both men and women, who were 18 years of age and older. It was anticipated that the study would include approximately 60 participants.
Exclusionary Criteria: Individuals were only excluded from the study if they were under the age of 18; or if they were unable to read English at a level which gave them an understanding of the consent process.
Recruitment: Individuals will be recruited via email through the Pacific University School of Physician Assistant Studies e-mail list, a snowball sampling of Physician Assistants from associates of this group, and members of the Portland Vancouver Physician Assistant Society.
Materials: The materials needed for this study was an e-mail recruiting Students and Alum of Pacific University School of Physician Assistant Studies and the Portland Vancouver Physician Assistant Group with directions to connect to an internet based survey on SurveyMonkey. The survey was designed by the principal investigator and was not modeled after any prior published survey of this type. The survey included 17 questions of which only 1 was for exclusionary criteria, 9 were for demographics, 6 were directly related to technology and decision making, and 1 was an open ended survey question for comments.
Data Management: The data was managed with Microsoft Excel, and was statistically analyzed with Statistix 8.0 software. The data was analyzed to evaluate the descriptive statistics, including mean, standard deviation, minimum, maximum and median. Two-Sample T-tests were performed to compare the data submitted by the participants as a whole. Two-Sample T -tests were also performed to compare the groups individually and a break down between student participants and practicing participants. Therefore, Chi Square analysis was performed to make comparisons of: Status vs. Influencing diagnosis; Status vs. Influencing diagnosis; Amount of time used vs. Status. The data for this investigation was collected as nominal and was translated to ordinal numbers for statistical analysis.
Demographics: The invitation to participate in the survey was sent out to Pacific University Physician Assistant students, alumni, and members of the Portland Vancouver Physician Assistant Society. The documented number of individuals who completed the survey online was 94. Three of the individuals neglected three or more questions within the survey, and were therefore not included in the data analysis. Of the rest of the respondents 91 completed all of the questions and were included in the assessment. Therefore, the number of respondents that were analyzed was 91. Amount of time per day: The student males (80%) time is use is 15-45 per day, the practicing males (58%) use 0-30 minutes per day, female students (63%) use 15-45 minutes per day, and the practicing females (92%) use 60 minutes per day. The practicing females seem to use the handhelds and computers the most for about 60-75 minutes per day. Affect on day With 75% of all groups answering that the affect on their day would be very little or able to survive. The female practitioners had 8 participants who answered that their day would be affected by a great deal. Age vs. Status: The mean for the students was 30.96 and the mean for practicing PAs was 32.83. With a p value of 0.01380 which is statistically significant, but of no clinical importance. Status vs. Affect: The students had an answer with a mean of 2.67 and the practicing PAs had a mean answer of3.11 with a p value of 0.0007. This means that the difference is significant between the two groups and that a practicing PAs day is more of a struggle when the internet or computer is down when compared to the students. Status vs. Influence: With a p value of 0.0067 for the two groups. This means that the students had a higher influence, with the clinicians just using it to back them selves up. With the majority of all students responding that sometimes it can be very helpful.
Conclusion: The goal of this study was to see if technology plays a role in influencing their patient decision making by what means out they doing it. The information that was provided by the respondents does show that students and practitioners alike are using many different resources and feeling that the resources are helpful in influencing clinical decision making. There are multiple different online references that have been listed, but the common theme is that most of the participants use UpToDate and Epocrates. Students do seem to use the online resources more than do the practitioners overall. Not only are the students using online resources more, it is also influencing there decisions more in a clinical setting. As for the practitioners there day is more of a struggle when the internet is down or they are unable to use there computer, this was likely due to practitioners relying to the use of treatment protocols and the EMR. In looking over the information from the survey it is not possible to completely answer the hypothesis. It would have been nice to see the data lead us to believe that more seasoned providers relied less on technology, but the average time in practice was only 1.89 years for all of the respondents. There is not a lot of separation between the students and the practitioners. Thus making it difficult to see how seasoned practitioners use technology.
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