Clinical information sources used by hospital doctors in Mongolia.

BACKGROUND: Information technology presents new opportunities to facilitate clinicians' access to up-to-date clinical information. Developing countries have special needs in this area and the problems encountered in obtaining clinical information have not been well researched, particularly for hospital doctors. No previous study has examined which clinical information sources Mongolian hospital doctors' use and the problems they may encounter in obtaining information. This study addressed an important knowledge gap by examining clinical information-seeking practices of Mongolian hospital doctors. The objectives of the study were to ascertain: (a) which clinical information sources were used in clinical decision-making; (b) the level of confidence in these information sources, and (c) the impact these information sources had on clinical decision-making. Also investigated was proficiency in English language and computer skills, as these factors could influence ability to obtain clinical information electronically.

METHODS: Self-administered questionnaires were given to 263 doctors from the two largest hospitals in Ulaanbaatar, the capital city of Mongolia. Respondents answered questions about 10 information sources: colleagues; local and foreign textbooks; local and foreign journals; personal notes; computer-aided literature searches; Mongolian clinical practice guidelines; and brief updates and health policies developed in Mongolia. Parameters of interest included: frequency of use; confidence in the sources; and perceived impact of the sources on clinical decision-making.

RESULTS: The response rate was 87% (229). The respondents indicated that discussion with colleagues was the most frequently used information source, foreign medical textbooks most commonly inspired high confidence, and discussion with colleagues was the source most often perceived as having a high impact on clinical decision-making. For all sources, high confidence and high impact were strongly associated with each other. Only 26% of respondents understood English well, and only 41% had excellent/good computer skills. English language and computer skills were strongly associated with undertaking computer-aided literature searches and with age. Female respondents were less likely than males to have excellent/good computer skills and less likely to undertake computer-aided literature searches.

CONCLUSIONS: Satisfying the clinical information needs of doctors in less developed countries is particularly challenging and even though improvements in information technology can facilitate access to knowledge, there still exist barriers. Health policies which promote computer skills and English language among doctors may contribute substantially to best medical practice in Mongolia.