Piecing Together the Mosaic of Rural Clinician Information Practices over a Twenty Year Period

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Objectives: The purpose of this study is to determine how the information practices of rural clinicians in fifteen counties have changed over the last twenty years. This data is needed to design programs to meet the information needs of the population.

Methods: This study is a longitudinal cross-sectional study. A validated survey methodology was used to gather data at a specific point in time. Physicians’ names were gathered from the state licensing verification database and librarians’ personal knowledge. Advanced practice and registered nurses were identified from a list from the state center for nursing. The questionnaires were sent by mail with a self-addressed stamped return envelope with a cover letter explaining the purpose of the survey. Returned surveys were accepted for a 6 week period. The physicians surveyed were the complete population of a fifteen county area and nurse/nurse practitioners were a random sample of the population. Previous iterations were done in 1998 and 2009.

Results: In 1997, names of physicians and nurses in 17 rural Tennessee counties were obtained. A random sample (p=.05) was surveyed for a total of 707-(357 RNs and 350 MDs). In 2009, this exact procedure was replicated with slight adjustments to the survey instrument (477 RNs and 312 MDs=789). Eighteen percent (125) of the information questionnaires were returned in 1997. In 2009, sixteen percent (124) of usable surveys were returned. In 2015,one hundred thirty useful surveys were collected. Clinicians were measured as to information barriers, resources, access points, smartphone use, and practice demographics.

Conclusions: We need to be out in the community improving access to health information. A longitudinal, cross-sectional study is a good methodology to map progress and trends. Making changes in the community is hard. Hospital purchases by large corporations affect outreach opportunities.


Toronto, Ontario

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