Evidence map›Paper›PMID 33262637›Full record

ArticleInternational journal of general medicine2020

Do Checklist-Induced Behavioral Changes Improve Self-Confidence in Fundoscopic Examination? A Mixed-Methods Study.

Daiki Yokokawa, Kiyoshi Shikino, Akiko Ikegami, Tomoko Tsukamoto, Kazutaka Noda, Takanori Uehara, Yoshiyuki Ohira, Masatomi Ikusaka

Open access · goldAbstract read
In one paragraph

Article in International journal of general medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Daiki YokokawaDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.ORCID 0000-0003-0944-8664
Kiyoshi ShikinoDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.ORCID 0000-0002-3721-3443
Akiko IkegamiDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.
Tomoko TsukamotoDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.
Kazutaka NodaDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.
Takanori UeharaDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.
Yoshiyuki OhiraDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.ORCID 0000-0002-2606-3611
Masatomi IkusakaDepartment of General Medicine, Chiba University Hospital, Chiba, Japan.ORCID 0000-0002-9760-5596
Chiba University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFundoscopic exams are conducted during outpatient consultations to assess intracranial disease and complications from chronic diseases. Low level of confidence in these skills which physicians have is one of the causes that implementation frequency is low. Research has not yet identified specific measures through which the healthcare system may increase the implementation of fundoscopic exams nor a qualitative process that enables physicians to gain confidence in their fundoscopic exam skills. We introduced a checklist and conducted a mixed-methods study.

methodsThis study is a before-and-after study, within an embedded-experimental mixed-methods design. We sampled 15 physicians in the department of general medicine at a university hospital assigned to initial consultation. We introduced a checklist to verify whether the fundoscopic exam was implemented. Measures are implementation ratio of the fundoscopic exam to the total number of indication cases, and Visual Analog Scale (VAS) values for the confidence in procedure are measured before and after the intervention. We obtained qualitative data from interviews and used the Modified Grounded Theory Approach.

resultsWe observed significant increases in the implementation ratio (19.2% (29/151 cases) vs 64.8% (105/162 cases), p<0.001) and in the VAS value for the confidence (1.89 mm vs 4.68 mm (p<0.001)). Analysis of the interviews revealed the following. To increase the implementation, it is necessary to reduce the <Lack of confidence> and <Forgetting>, which is prevented by the checklist. The <Lack of successful experiences in detecting abnormalities> leads to a <Lack of confidence>. Repeated executions result in <Successful experiences and confidence building>.

conclusionThe intervention increased the implementation ratio, thereby increasing successful experiences and confidence among physicians. The growth of confidence boosted motivations to implement fundoscopic exams.

Indexed as

checklistfundoscopic examinationmixed-methods studyself-confidence

Identifiers

PMID33262637
PMCPMC7695610
OpenAlexW3109020818

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.