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What questions about patient care do physicians have during and after patient contact in the ED? The taxonomy of gaps in physician knowledge
  1. Mark A Graber1,2,
  2. Bradley D Randles1,
  3. Jay Monahan1,
  4. John W Ely2,
  5. Charles Jennissen1,
  6. Bobby Peters1,
  7. Dean Anderson1
  1. 1
    Departments of Emergency Medicine, University of Iowa Carver College Medicine, Iowa City, Iowa, USA
  2. 2
    Departments of Family Medicine, University of Iowa Carver College Medicine, Iowa City, Iowa, USA
  1. Mark A Graber, MD, Department of Emergency Medicine, UIHC, 200 Hawkins Drive, C43 GH, Iowa City, Iowa 52242, USA; mark-graber{at}uiowa.edu

Abstract

Objectives: To categorise questions that emergency department physicians have during patient encounters.

Methods: An observational study of 26 physicians at two institutions. All physicians were followed for at least two shifts. All questions that arose during patient care were recorded verbatim. These questions were then categorised using a taxonomy of clinical questions.

Results: Physicians had 271 questions in the course of the study. The most common questions were about drug dosing (35), what drug to use in a particular case (28), “what are the manifestations of disease X” (23), and what laboratory test to do in a situation (21). Notably lacking were questions about medication costs, administrative questions, questions about services in the community, and pathophysiology questions.

Conclusions: Emergency department physicians tend to have questions that cluster around practical issues such as diagnosis and treatment. In routine practice they have fewer epidemiologic, pathophysiologic, administrative, and community services questions.

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Footnotes

  • Competing interests: None declared.

  • Mark A Graber helped to design the study, analyse the data, adjudicate question categories, and had primary responsibility for project oversight and writing the paper. Bradley D Randles helped to design the study, collect the data and write the paper. John W Ely helped to design the study, helped to adjudicate question categories, write the paper and helped with study oversight. Jay Monnahan helped to collect the data. Bobby Peters, Charles Jennissen and Dean Anderson helped to categorise the questions.

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