Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload

Katherine M. Richardson, Sarah D. Fouquet, Ellen Kerns, Russell J. McCulloh

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)828-834
Number of pages7
JournalAcademic Pediatrics
Volume19
Issue number7
DOIs
StatePublished - Sep 1 2019

Fingerprint

Clinical Decision Support Systems
Guideline Adherence
United States National Aeronautics and Space Administration
Workload
Fever
Equipment and Supplies
Frustration
Cross-Over Studies
Physicians

Keywords

  • electronic clinical decision support
  • febrile infant
  • mental workload
  • pediatrics
  • usability

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload. / Richardson, Katherine M.; Fouquet, Sarah D.; Kerns, Ellen; McCulloh, Russell J.

In: Academic Pediatrics, Vol. 19, No. 7, 01.09.2019, p. 828-834.

Research output: Contribution to journalArticle

Richardson, Katherine M. ; Fouquet, Sarah D. ; Kerns, Ellen ; McCulloh, Russell J. / Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload. In: Academic Pediatrics. 2019 ; Vol. 19, No. 7. pp. 828-834.
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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.",
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