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Perceptions of Clinical Experience and Scientific Evidence in Medical Decision Making : A Survey of a Stratified Random Sample of Swedish Health Care Professionals

Dewitt, Barry LU orcid ; Persson, Johannes LU orcid and Wallin, Annika LU orcid (2024) In Medical Decision Making
Abstract
Background:
Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base.

Design:
We investigate how years in the profession influence health care professionals' beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was... (More)
Background:
Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base.

Design:
We investigate how years in the profession influence health care professionals' beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession's most recent occupational registry.

Results:
Participants (N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed.

Conclusions:
Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions.

Highlights:
Study participants, representing 5 health care professions-medicine, nursing, occupational therapy, dentistry, and dental hygiene-viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience.Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge.The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience.
(Less)
Abstract (Swedish)
Background Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base. Design We investigate how years in the profession influence health care professionals’ beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession’s most... (More)
Background Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base. Design We investigate how years in the profession influence health care professionals’ beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession’s most recent occupational registry. Results Participants ( N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed. Conclusions Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions. Highlights Study participants, representing 5 health care professions—medicine, nursing, occupational therapy, dentistry, and dental hygiene—viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience. Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge. The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Science and proven experience, decision making, Medical decision making, proven experience, clinical experience, epistemology, evidence-based medicine, health policy, medical education
in
Medical Decision Making
publisher
SAGE Publications
external identifiers
  • scopus:85187933227
ISSN
0272-989X
DOI
10.1177/0272989X241234318
language
English
LU publication?
yes
id
15f0b02a-4e4f-450f-b040-5e1865030b3d
date added to LUP
2024-03-17 16:54:16
date last changed
2024-04-08 09:52:24
@article{15f0b02a-4e4f-450f-b040-5e1865030b3d,
  abstract     = {{Background: <br/>Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base.<br/><br/>Design: <br/>We investigate how years in the profession influence health care professionals' beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession's most recent occupational registry.<br/><br/>Results: <br/>Participants (N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed.<br/><br/>Conclusions: <br/>Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions.<br/><br/>Highlights: <br/>Study participants, representing 5 health care professions-medicine, nursing, occupational therapy, dentistry, and dental hygiene-viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience.Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge.The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience.<br/>}},
  author       = {{Dewitt, Barry and Persson, Johannes and Wallin, Annika}},
  issn         = {{0272-989X}},
  keywords     = {{Science and proven experience; decision making; Medical decision making; proven experience; clinical experience; epistemology; evidence-based medicine; health policy; medical education}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{SAGE Publications}},
  series       = {{Medical Decision Making}},
  title        = {{Perceptions of Clinical Experience and Scientific Evidence in Medical Decision Making : A Survey of a Stratified Random Sample of Swedish Health Care Professionals}},
  url          = {{http://dx.doi.org/10.1177/0272989X241234318}},
  doi          = {{10.1177/0272989X241234318}},
  year         = {{2024}},
}