摘要：Objective: Improving the process of evidence-based practice in primary health care requires an understanding of information exchange among colleagues. This study explored how clinically oriented research knowledge flows through multidisciplinary primary health care teams (PHCTs) and influences clinical decisions. Methods: This was an exploratory mixed-methods study with members of six PHCTs in Ontario, Canada. Quantitative data were collected using a questionnaire and analyzed with social network analysis (SNA) using UCINet. Qualitative data were collected using semi-structured interviews and analyzed with content analysis procedures using NVivo8. Results: It was found that obtaining research knowledge was perceived to be a shared responsibility among team members, whereas its application in patient care was seen as the responsibility of the team leader, usually the senior physician. PHCT members acknowledged the need for resources for information access, synthesis, interpretation, or management. Conclusion: Information sharing in interdisciplinary teams is a complex and multifaceted process. Specific interventions need to be improved such as formalizing modes of communication, better organizing knowledge-sharing activities, and improving the active use of allied health professionals. Despite movement toward team-based models, senior physicians are often gatekeepers of uptake of new evidence and changes in practice. Highlights Practitioners are often overwhelmed by the amount and frequency of knowledge and evidence in health care. Sharing new clinically oriented knowledge in primary health care teams (PHCTs) occurs most often through informal, nonstructured channels. Residents often facilitate information discovery and sharing. Implications This study demonstrates the current uneven pattern of knowledge flow among primary health care professionals and opens up the potential and important role of information specialists in PHCTs. Social network analysis can provide valuable insight into the knowledge flow of clinical teams. By seeing how information flows, barriers to and facilitators of improved processes and better use of knowledge in PHCTs can be seen. There is a lack of organization surrounding knowledge flow in PHCTs and a desire for more consistency in knowledge sharing. PHCTs and health care organizations need to consider making knowledge sharing a formal part of organizational activity and policy.
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