Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload.
Document Type
Article
Publication Date
9-2019
Identifier
DOI: 10.1016/j.acap.2019.03.001; PMCID: PMC6732014
Abstract
OBJECTIVE: To evaluate the individual-level impact of an electronic clinical decision support (ECDS) tool, PedsGuide, on febrile infant clinical decision making and cognitive load.
METHODS: A counterbalanced, prospective, crossover simulation study was performed among attending and trainee physicians. Participants performed simulated febrile infant cases with use of PedsGuide and with standard reference text. Cognitive load was assessed using the NASA-Task Load Index (NASA-TLX), which determines mental, physical, temporal demand, effort, frustration, and performance. Usability was assessed with the System Usability Scale (SUS). Scores on cases and NASA-TLX scores were compared between condition states.
RESULTS: A total of 32 participants completed the study. Scores on febrile infant cases using PedsGuide were greater compared with standard reference text (89% vs 72%, P = .001). NASA-TLX scores were lower (ie, more optimal) with use of PedsGuide versus control (mental 6.34 vs 11.8, P < .001; physical 2.6 vs 6.1, P = .001; temporal demand 4.6 vs 8.0, P = .003; performance 4.5 vs 8.3, P < .001; effort 5.8 vs 10.7, P < .001; frustration 3.9 vs 10, P < .001). The SUS had an overall score of 88 of 100 with rating of acceptable on the acceptability scale.
CONCLUSIONS: Use of PedsGuide led to increased adherence to guidelines and decreased cognitive load in febrile infant management when compared with the use of a standard reference tool. This study employs a rarely used method of assessing ECDS tools using a multifaceted approach (medical decision-making, assessing usability, and cognitive workload,) that may be used to assess other ECDS tools in the future.
Journal Title
Acad Pediatr
Volume
19
Issue
7
First Page
828
Last Page
834
MeSH Keywords
Adult; Cell Phone; Cognition; Decision Support Systems, Clinical; Female; Fever; Guideline Adherence; Humans; Infant; Infant, Newborn; Male; Mental Fatigue; Middle Aged; Patient Simulation; Workload; Young Adult
Keywords
electronic clinical decision support; febrile infant; mental workload; pediatrics; usability
Recommended Citation
Richardson KM, Fouquet SD, Kerns E, McCulloh RJ. Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload. Acad Pediatr. 2019;19(7):828-834. doi:10.1016/j.acap.2019.03.001
COinS
Comments
Grant support