Understanding Skimming
Nygren and Heriksson (1992) noticed that physicians skimmed over parts of the paper medical record (P-MR) to assess their relevance, then either skipped to other parts or started reading.
Oxford’s definition of skimming is similar to what Nygren and Heriksson intended it to mean. Oxford defines skimming as to read through quickly, noting only the important points. The goal is to assess the relevance of text. In skimming we use as many clues as possible to assess relevance.(BBC) Therefore, skimming is a form of information relevance judgment. The search within health informatics literature did not reveal information on this process. Yet in library science there are similar concepts as the more general information triage and the more specific document triage and document relevance judgment. Buchanan and Loizides (2008) define information triage as the activity where a user determines the relevance of a piece of information for a particular information task.
The focus of literature in document relevance judgment went through three stages. (Buchanan and Loizides 2008) All of these three stages point to how skimming is performed and how we can support it through providing affordances. The three stages are:
1. Focusing on properties of the document as title and abstract. In this stage, there was no focus on how the properties of the document were assessed.
2. How to operationalize above document properties to support document retrieval and search.
3. Shifting the focus on the documents to the focus on the corresponding human processes.
To better understanding information triage, Cool et al (1993) conducted a study to assess document features that helped 300 freshmen student to assess the relevance of scholarly documents to their assignment topic. Cool et al were able to categories these features into six categories. Only two were directly related to the documents’ content. These two are the topic and content of the document. The remaining four features are as follows:
1. Format characteristics of the document. Features as the presence of diagrams, tables and sub-headings were categorized under this heading.
2. How document was written and presented. Features as precision, writing style and understandability were categorized under this heading.
3. Dimensions of judgment that modified other facets. Features as authority and biases of authors and age of document was placed hear.
4. Oneself relationship between person’s situation and the other facets. The need and desire of reader were placed here.
I can conclude that information triage literature can be used to understand how clinicians skim medical records, yet there should be studies that directly assess this within clinicians practice context.
Buchanan and Loizides (2007) study compared the behavior of document triage using paper and PDF documents. Their study adds to our understanding of human psychology and the affordances of paper and computers. In the coming post I will summarize their study.
Buchanan, G. & Loizides, F., 2007. Investigating Document Triage on Paper and Electronic Media. In Research and Advanced Technology for Digital Libraries: 11th European Conference, ECDL 2007, Budapest, Hungary, September 16-21, 2007, Proceedings. Springer-Verlag New York Inc, p. 416.
Cool, C., Belkin, N. J. , Frieder, O. , and Kantor, P., 1993. Characteristics of texts affecting relevance judgments. PROCEEDINGS OF THE 14TH NATIONAL ONLINE MEETING, 77–84.
Nygren, E. & Henriksson, P., 1992. Reading the medical record. I. Analysis of physicians’ ways of reading the medical record. Computer Methods and Programs in Biomedicine, 39(1-2), 1-12
