Information experiences and practices of paediatric physicians in Nigeria: a phenomenological case study
2016-12-13T14:05:26Z (GMT) by
Adequate access to and appropriate use of medical evidence by clinicians have been posited as influencing the quality of clinical decisions and outcomes of patient care. The broad aim of this case study of a tertiary hospital was to provide understanding of how the information experiences and practices of paediatric physicians in Nigeria influenced their information practices and the potential implications for patient care. To achieve the research aim and objectives, a qualitative exploratory study was conducted using multiple sources of data: interviews, diaries, observation and social network chats. Overall, twenty semi-structured interviews were conducted, and seven clinicians provided a week-long information activity self-reports through diaries. Supplementary data were gained via the researcher's personal observation and social media chats with some participants. Paediatricians in the cadre of: Consultants, Senior Registrars, Registrars and Residents provided the data which was analysed using the interpretative method. The results indicate that the paediatricians' information needs were on: managing challenging cases, supporting diagnostic decisions, managing evolving diseases, managing illnesses in the tropical context, drugs and dosage, refreshing the memory, keeping updated, and passing professional examinations. In general: i)there was haphazard approach to information literacy tuition for the clinicians during professional education resulting in varied information capabilities, and inadequacy of knowledge and skills for good information practice; ii) obtaining medical information from colleagues was the predominant feature of paediatricians' information practices; iii) printed textbooks were the paediatricians preferred source for obtaining medical evidence, however, there was a growing popularity in the use of electronic medical information sources, including at the point of care; iv) a perception of inadequacy of the hospital library services resulted in the paediatricians developing rejection behaviour towards the services, labelled in this study as information service rejection behaviour (ISRB); v) there was general perception by the paediatricians that access to, and use of medical information supports patient care and achievement of better treatment outcomes. This perception instilled a sense of value for information use, demonstrated through the clinicians' dedication to the self-provision of information resources; vi) a dearth of medical resources germane to the contextual management of illnesses led to inadequate clinician knowledge in a good number of cases. A new model of information behaviour entitled 'the knowledge production model of the paediatricians' information behaviour has been developed from the findings of this study, thereby extending existing scholarly perspectives on people's information behaviour. The Kpro model enunciates the concept of 'knowledge-based information behaviour' (KIB) which was exhibited by the paediatricians. The study recommends that i) the information literacy skills training (ILST) model developed from the findings, be used as a practical tool for inculcating information literacy to the paediatricians at the level of residency training; ii) the hospital management/librarians prioritise the improvement of information resources, services and infrastructure e.g. reliable internet service, e-library at wards and consulting rooms, and clinical librarian services, to enhance good information practices among the clinicians; iii) retraining of the hospital librarians for increased service delivery effectiveness; iv) increased local research through the establishment of Journal Clubs by the paediatricians to enhance local publishing of medical literature.