Cognitive modeling and intelligent tutoring
Artificial Intelligence - Special issue on artificial intelligence and learning environments
Emerging paradigms of cognition in medical decision-making
Journal of Biomedical Informatics
Identifying reasoning strategies in medical decision making: a methodological guide
Journal of Biomedical Informatics
Workflow modeling in critical care: Piecing together your own puzzle
Journal of Biomedical Informatics
Information Processing and Management: an International Journal
Journal of Biomedical Informatics
Position paper: The coming of age of artificial intelligence in medicine
Artificial Intelligence in Medicine
Artificial Intelligence in Medicine
Journal of Biomedical Informatics
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Objective: Information in critical care environments is distributed across multiple sources, such as paper charts, electronic records, and support personnel. For decision-making tasks, physicians have to seek, gather, filter and organize information from various sources in a timely manner. The objective of this research is to characterize the nature of physicians' information seeking process, and the content and structure of clinical information retrieved during this process. Method: Eight medical intensive care unit physicians provided a verbal think-aloud as they performed a clinical diagnosis task. Verbal descriptions of physicians' activities, sources of information they used, time spent on each information source, and interactions with other clinicians were captured for analysis. The data were analyzed using qualitative and quantitative approaches. Results: We found that the information seeking process was exploratory and iterative and driven by the contextual organization of information. While there was no significant differences between the overall time spent paper or electronic records, there was marginally greater relative information gain (i.e., more unique information retrieved per unit time) from electronic records (t(6)=1.89, p=0.1). Additionally, information retrieved from electronic records was at a higher level (i.e., observations and findings) in the knowledge structure than paper records, reflecting differences in the nature of knowledge utilization across resources. Conclusion: A process of local optimization drove the information seeking process: physicians utilized information that maximized their information gain even though it required significantly more cognitive effort. Implications for the design of health information technology solutions that seamlessly integrate information seeking activities within the workflow, such as enriching the clinical information space and supporting efficient clinical reasoning and decision-making, are discussed.