Nudging healthcare professionals towards evidence-based medicine: A systematic scoping review

Abstract

Translating medical evidence into practice is difficult. Key challenges in applying evidence-based medicine are information overload and that evidence needs to be used in context by healthcare professionals. Nudging (i.e. softly steering) healthcare professionals towards utilizing evidence-based medicine may be a feasible possibility. This systematic scoping review is the first overview of nudging healthcare professionals in relation to evidence-based medicine. We have investigated a) the distribution of studies on nudging healthcare professionals, b) the nudges tested and behaviors targeted, c) the methodological quality of studies and d) whether the success of nudges is related to context. In terms of distribution, we found a large but scattered field: 100 articles in over 60 different journals, including various types of nudges targeting different behaviors such as hand hygiene or prescribing drugs. Some nudges – especially reminders to deal with information overload – are often applied, while others - such as providing social reference points – are seldom used. The methodological quality is moderate. Success appears to vary in terms of three contextual characteristics: the task, organizational, and occupational contexts. Based on this review, we propose future research directions, particularly related to methods (preregistered research designs to reduce publication bias), nudges (using less-often applied nudges on less studied outcomes), and context (moving beyond one-size-fits-all approaches).