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How psychiatric trainees keep up to date: survey of psychiatric trainees' use of journals and other information sources

  • Tom Walker-Tilley (a1), John Bainton (a1), Matthew Fernando (a1), Yimlun Wong (a1), Ba Ko (a1), James Warner (a2) and Ramin Nilforooshan (a3)...
Abstract
Aims and method

To gather information about psychiatric trainees' use of different information sources and academic materials, a questionnaire was distributed at the London Deanery Annual Psychiatry Trainee Conference and the training programmes of two teaching trusts.

Results

Participants returned 202 out of a total of 300 completed questionnaires (67%). Websites were the most commonly accessed information source ahead of textbooks, abstracts and journals. Year of training correlated positively with journal use and negatively with textbook use. Year of training also correlated positively with frequency of reading three journals published by the Royal College of Psychiatrists and with specific reasons for consulting journals, namely to improve clinical practice and inform trainees' own research.

Clinical implications

Respondents reported consulting websites more frequently than more traditional information sources but journals are still a widely used source of information for trainee clinicians. It is important that trainees continue to be equipped with skills to identify and access high-quality information at the point of clinical uncertainty.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Ramin Nilforooshan (ramin.nilforooshan@nhs.net)
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Declaration of interest

None.

Footnotes
References
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1 General Medical Council. Good Medical Practice: Duties of a Doctor. GMC, 2006.
2 Royal College of Psychiatrists. A Competency Based Curriculum for Specialist Core Training in Psychiatry. Royal College of Psychiatrists, 2010.
3 Royal College of Psychiatrists. Specialist Training in Psychiatry: A Comprehensive Guide to Training and Assessment in the UK for Trainees and Local Educational Providers. Royal College of Psychiatrists, 2010.
4 Jones, T, Hanney, S, Buxton, M, Burns, T. What British psychiatrists read: questionnaire survey of journal usage among clinicians. Br J Psychiatry 2004; 185: 251–7.
5 Wolters Kluwer Health. Point-of-Care Survey Executive Summary. WKH, 2011. Available at http://www.wolterskluwerhealth.com/News/Pages/WhitePapers.aspx (accessed 16 February 2015).
6 Tang, H, Ng, JH. Googling for a diagnosis: use of Google as a diagnostic aid. Internet based study. BMJ 2006; 333: 1143–5.
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How psychiatric trainees keep up to date: survey of psychiatric trainees' use of journals and other information sources

  • Tom Walker-Tilley (a1), John Bainton (a1), Matthew Fernando (a1), Yimlun Wong (a1), Ba Ko (a1), James Warner (a2) and Ramin Nilforooshan (a3)...
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eLetters

Re: How psychiatric trainees keep up to date

Rachel Steele, Clinical Librarian, Tees, Esk and Wear Valleys NHS Foundation Trust
22 May 2015

I read with interest Walker-Tilley et al’s article on ‘How psychiatric trainees keep up to date: survey of psychiatric trainees’ use of journals and other information sources’ (1). The dissemination of written educational materials may form part of an effective approach to knowledge translation (2). It is therefore important to explore psychiatry trainees’ use of information sources as, by increasing our understanding of their reading habits, we may better target information to these trainees.

Although Walker-Tilley et al state that examining the reasons why psychiatry trainees accessed information sources was beyond the scope of the study, they suggest plausible reasons why advanced trainees consulted journals more frequently, and textbooks less frequently, than their more junior counterparts. In addition to the reasons the authors put forward, I would also suggest that the differing information habits of senior, and junior, trainees can be explained by the distinction made in the EBM literature between ‘background’ and ‘foreground’ knowledge (3) (4).

‘Background’ knowledge concerns well-established facts/general knowledge. The most suitable information sources for retrieving background knowledge are textbooks or electronic ‘point of care’ resources such as UpToDate, Clinical Evidence or DynaMed. It is primarily junior health professionals or students who require background knowledge, hence Walker-Tilley et al’s finding that the junior psychiatrists made more use of textbooks than their more senior colleagues (1).

Senior clinicians’ information needs typically relate to ‘foreground’ knowledge, which is usually needed to support a specific aspect of clinical decision making. Textbooks are not a recommended source to answer ‘foreground’ questions because these questions require a synthesis of the latest research and there is no way to ascertain which information in textbooks is, or is not, current (4).

It is plausible that advanced trainees are using textbooks less than more junior trainees (1) because they are posing more ‘foreground’ questions (due to the more advanced stage of their training). It is also likely that advanced trainees are posing more of these questions because they work with greater autonomy in their clinical practice than their more junior counterparts.

I did, however, find Walker-Tilley et al’s (1) categorisation of information sources somewhat confusing. In particular, the category of ‘websites’ seems imprecise because the term websites relates to a means of accessing and storing information (i.e. the Internet) as well as covering a great many types of information source. The authors (1) report that their psychiatry trainee respondents consulted websites via search engines more frequently than textbooks and journals. This accords with previous research which has found that clinicians commonly use Internet search engines to access research (5). This finding is not, however, an end in itself because search engines signpost their users to many information sources but it is not clear which sources (or what kinds of websites) the clinicians then choose to consult. Also, while it is argued (1) that Google may be a valuable tool to physicians in clarifying diagnosis, much of the information which Google finds is unfiltered, meaning that the burden of critical appraisal falls entirely on the clinician (4). Likewise, Wikipedia users must counterbalance the advantage of being able to find information quickly and easily with the disadvantage of this information being of variable quality (6).

It would be very valuable if future research could probe in more detail which websites/online resources psychiatry trainees are accessing in their clinical practice since, as Walker-Tilley et al (1) rightly point out, it is vital that trainees continue to possess the necessary skills to identify, access and appraise relevant information at the point of clinical need.

References:

1.Walker-Tilley T, Bainton J, Fernando M, Wong Y, Ko B, Warner J, et al. How psychiatric trainees keep up to date: survey of psychiatric trainees’ use of journals and other information sources. Psychiatr Bull 2015; DOI 10.1192/pb.bp.113.045682.

2.Giguère A, Légaré F, Grimshaw J, Turcotte S, Fiander M, Grudniewicz A, et al. Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012; 10: CD004398.

3.Guyatt GG, Rennie DO, Meade M, Cook DJ. Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice. McGraw-Hill Companies, 2008.

4.Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. Churchill Livingstone Elsevier, 2011.

5.Hider PN, Griffin G, Walker M, Coughlan E. The information-seeking behavior of clinical staff in a large health care organization. J Med Libr Assoc 2009; 97: 47-50.

6.Herbert VG, Frings A, Rehatschek H, Richard G, Leithner A. Wikipedia – challenges and new horizons in enhancing medical education. BMC Medical Education 2015; 15: 32.

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