@文章{信息:doi/10.2196/10769，作者="Lander, Bryn和Balka, Ellen"，标题="通过两家教学医院的组织民族学研究如何在护理中使用证据"，期刊="J Med Internet Res"，年="2019"，月="3"，日="28"，卷="21"，数="3"，页数="e10769"，关键词="临床实践指南;循证医学;mindlines;背景:大量发表的文章表明临床医生不遵循临床实践指南(CPGs)。然而，一些研究探讨了临床医生考虑什么证据，以及他们如何在护理决策中使用不同形式的证据。许多现有的研究都发生在智能手机和先进的基于网络的信息检索技术出现之前。了解这些新技术如何影响临床医生在临床实践中使用证据的方式是很重要的。心理线是一个概念，探索临床医生如何利用不同的信息来源(包括背景、经验、医疗培训和证据)来制定集体加强的、内化的隐性指南。目的:本文的目的是探讨证据是如何整合到心理线发展和日常使用的心理线和证据在护理。方法:我们利用在2个教学医院跟踪内科团队收集的民族志数据。 Fieldnotes were tagged by evidence category, teaching and care, and role of the person referencing evidence. Counts of these tags were integrated with fieldnote vignettes and memos. The findings were verified with an advisory council and through member checks. Results: CPGs represent just one of several sources of evidence used when making care decisions. Some forms of evidence were predominately invoked from mindlines, whereas other forms were read to supplement mindlines. The majority of scientific evidence was accessed on the Web, often through smartphones. How evidence was used varied by role. As team members gained experience, they increasingly incorporated evidence into their mindlines. Evidence was often blended together to arrive at shared understandings and approaches to patient care that included ways to filter evidence. Conclusions: This paper outlines one way through which the ethos of evidence-based medicine has been incorporated into the daily work of care. Here, multiple Web-based forms of evidence were mixed with other information. This is different from the way that is often articulated by health administrators and policy makers whereby clinical practice guideline adherence is equated with practicing evidence-based medicine. ", issn="1438-8871", doi="10.2196/10769", url="//www.mybigtv.com/2019/3/e10769/", url="https://doi.org/10.2196/10769", url="http://www.ncbi.nlm.nih.gov/pubmed/30920371" }