Does instant access to compiled information undermine clinical cognition?

Abstract

The new forms of information that medical trainees cite in case-oriented clinical presentations should give us pause. Three to four decades ago, the only way to find relevant publications was to search many volumes of Index Medicus with awkward, stilted terms; house officers and students would cite original observations and clinical studies. Today, despite the immediate accessibility of original data from clinical trials or other original studies, they generally cite compiled electronic sources, practice guidelines, and compiled decision rules, and they rarely seek out and report original sources. As trainees rely more and more on instantly available information that has been extracted, summarised, and reorganised, they are increasingly learning the minimum they need to know when they need it—namely, the least amount of knowledge necessary for a particular task. 1 Gorry GA Technology, knowing and learning. Knowl Manage Res Pract. 2009; 7: 178-180 Crossref Scopus (2) Google Scholar As a consequence, I am concerned that their foundation knowledge of clinical medicine will be superficial and that their clinical reasoning skills will suffer. I posit that the immediate availability of compiled and condensed information (especially in electronic form) is making young physicians unintentionally lazy, as others have noted in undergraduates. 2 Ellis D Response to “Does Google make us stupid?”. Anderson JQ, Ranie L. Pew Internet and American Life Project. http://pewresearch.org/pubs/1499/google-does-it-make-us-stupid-experts-stakeholders-mostly-say-noDate: Feb 19, 2010 Google Scholar These recently qualified doctors have little need to remember pathophysiological mechanisms, data origins (the source of the original data or information), study designs, or results and flaws when summaries are instantly available on hospital information systems or hand-held computers. Rapid information retrieval has great value, but we are beginning to see important unintended consequences of relying almost exclusively on such sources. UK health, science, and overseas aid: not what they seemOn Oct 20, the UK's coalition Government released its spending review for the next 4 years with the aim of achieving long-term fiscal stability. The cuts to public spending set out in the review are the deepest in living memory, but the Chancellor George Osborne confirmed that spending on health and overseas aid would be ring-fenced. The coalition Government also shelved previous plans to take an axe to funding for scientific research. Taken at face value, the stay of execution granted to medicine, science, and development aid should be reassuring. Full-Text PDF