Healthcare professionals are expected to remain professionally current and practice in accordance with evidence-based guidelines. However, they frequently encounter barriers such as time constraints, information overload, and limited institutional support. This study explores how physicians and nurses in Norwegian hospitals engage with scientific knowledge in their clinical practice, as well as how various factors at the individual, organizational, and contextual levels influence this engagement. The study draws on the integrated behavioral model, media richness theory, and media synchronicity theory to guide analysis and interpretation.
Semi-structured interviews were conducted with 12 physicians and 10 nurses from emergency, orthopedic, and surgical departments across three Norwegian hospitals. Thematic analysis was then conducted following Braun and Clarke’s six-phase approach, which was informed by the abovementioned theoretical frameworks.
Healthcare professionals relied on a combination of interpersonal communication, digital tools, clinical guidelines, and scientific literature to remain informed. Peer interactions and local protocols were the most frequently used resources. Engagement with scientific knowledge was typically reactive and context-driven, rather than planned. Barriers such as time constraints, cognitive and linguistic challenges, and limited self-efficacy influenced both the selection of information sources and the level of engagement. Clinicians preferred channels that were task-relevant, time-efficient, and easily accessible during clinical workflow.
The findings indicate that clinicians adaptively blend different communication channels, often using lean or asynchronous channels for sensemaking tasks traditionally associated with richer formats. While media richness and media synchronicity theories help explain the use of different channels, they may not fully account for how clinicians streamline communication tasks in practice. The integrated behavioral model explains various behavioral patterns, but does not fully capture spontaneous or internally motivated learning. These results emphasize the importance of aligning science communication and organizational support with clinicians’ real-world constraints and preferences.
Although clinicians are motivated to remain current, their engagement with scientific knowledge is influenced by environmental constraints, personal confidence, and cultural norms. Practice increasing scientific knowledge requires not only access to information, but also organizational and social structures that support flexible and responsive learning.
This study explores how physicians and nurses in Norwegian hospitals engage with scientific knowledge in their clinical practice, as well as how various factors at the individual, organizational, and contextual levels influence this engagement. Healthcare professionals are expected to work according to evidence-based practice, including keeping updated on scientific knowledge. However, fulfilling these expectations is challenging in everyday clinical work. Clinicians frequently encounter barriers such as time constraints, information overload, and limited institutional support. These challenges have been well documented in previous research. Studies over several decades have shown that healthcare professionals rely on colleagues alongside journals and textbooks to stay professionally current (
Both early and contemporary research highlight the barriers that impede health professionals’ information-seeking and implementation of new knowledge. Time constraints, limited search skills, and the overwhelming volume of information to sift through are frequently cited obstacles (
Taken together, the literature makes it clear that remaining current with scientific knowledge is not just a professional obligation, but a demanding and complex task influenced by profession-specific contexts, institutional limitations, and personal factors. In hospital settings where decisions must be made quickly and accurately, access to relevant, timely, and actionable scientific knowledge is not just a convenience; it is essential for patient safety and the quality of care. Globally, one in ten patients is harmed in healthcare settings, and unsafe care is estimated to cause over three million deaths annually (
Despite extensive research on barriers to keep current, there is limited understanding of how healthcare professionals in hospital settings actually engage with different sources of scientific knowledge in their everyday work, and why some sources are perceived as useful while others are ignored. This gap is particularly salient in hospitals, where complex organizational structures and demanding work conditions shape how information is accessed and used. This study addresses this gap by empirically examining how established behavioral and communication frameworks operate in everyday hospital practice. By integrating behavioral and communication perspectives, the study demonstrates how healthcare professionals adapt information sources and learning practices in ways that challenge key theoretical assumptions, particularly those emphasizing planned behavior and clearly separated communication functions in time-pressured clinical contexts.
To address these dynamics, the present study draws on the interdisciplinary field of science communication, which examines how scientific knowledge is shared, interpreted, and utilized across societal and professional contexts. Consistent with
Healthcare professionals have access to awide range of web-based information sources, including push-based resources (e.g., newsletters), active information-seeking tools (e.g., databases), collaborative platforms (e.g., social media), and synthesis tools (e.g., systematic reviews) (
To examine these dynamics, this study draws on three theoretical frameworks: the integrated behavioral model, media richness theory, and media synchronicity theory. At the heart of the framework lies the integrated behavioral model, developed by Fishbein and others (
According to the integrated behavioral model, behavior is determined primarily by an individual’s intention to perform it. Intention is influenced by three main constructs: attitude towards the behavior, perceived social norms, and personal agency, including self-efficacy and perceived control. The model also incorporates enabling or constraining factors that moderate the relationship between intention and action, such as time availability, skills, habits, and environmental constraints. In clinical contexts, this means that even highly motivated professionals may not engage with scientific knowledge if they lack time, confidence, or institutional support.
While the integrated behavioral model may help explain
By combining these frameworks, this study investigates how physicians and nurses in Norwegian hospitals engage with scientific knowledge in their everyday clinical practice. Engagement with scientific knowledge refers here as the ways which healthcare professionals interact with and utilize research evidence in their work. This study addresses the following research questions:
This qualitative study explored how healthcare professionals in hospitals engage with scientific knowledge in clinical practice. The study was part of an interdisciplinary [Project Number 313902] funded by the Norwegian Research Council and approved by the Norwegian Agency for Shared Services in Education and Research [Reference Number 320074].
A qualitative design using semi-structured interviews was chosen for its ability to elicit rich, detailed accounts of experiences, beliefs, behavior, and opinions (
The final sample included 22 participants, consisting of 12 physicians (nine male, three female) and 10 nurses (four male, six female) aged 25–67. These participants were employed in emergency, orthopedic, or surgical departments at three hospitals affiliated with the Central Norway Regional Health Authority: Hospital A (eight participants), Hospital B (seven participants), and Hospital C (seven participants). The physicians in the sample were chief physicians (six), resident physicians (four), and medical interns (two). Among the nurses, six had primary nursing education, while four had additional education in advanced nursing (three) or health management (one). As emphasized by
Participation was voluntary and based on informed consent. All participants received written and oral information prior to the interviews. Data were anonymized to guarantee confidentiality.
Interviews were conducted between April and June 2022 in Norwegian, and ranged from 34 to 70 min. To ensure participant comfort and confidentiality, the participants chose the interview locations (
A semi-structured interview guide with open-ended questions was used to encourage reflection and discussion. This format allowed for flexibility while ensuring that all key themes were explored among participants. The questions were formulated to be straightforward, neutral, and free of leading language, in line with the principles of qualitative interviews (
The interview transcripts were analyzed using thematic analysis, following Braun and Clarke’s six-phase framework (
In the first phase, each transcript was carefully read repeatedly to ensure a thorough familiarity with the content. In the second phase, initial codes were systematically generated across the dataset. A code represents a meaningful segment of data that relates to the research questions or theoretical constructs. For example, the statement “I can always ask [my colleagues] if I have any questions” was coded as an instance of peer-based learning, capturing a peer-supported learning opportunity.
In the third phase, the codes were examined for patterns and grouped into broader themes based on semantic and conceptual similarity. For example, codes related to informal on-the-job discussions and learning from peers were consolidated into a theme labeled “peer learning.” Similarly, codes highlighting time constraints, shift work, and lack of reading time were combined into a theme called “environmental constraints.” For example, one participant noted, “I could never sit in my office for an hour during work to read; I can’t set aside that $time,” which exemplified a time constraint code feeding into the broader environmental constraints theme of limited learning opportunities.
In the fourth phase, the preliminary themes were reviewed and refined to ensure they coherently reflected the coded data and were distinct from each other. In the fifth phase, each theme was clearly defined and named. In the sixth phase, the themes were integrated into an analytic narrative and the report was produced. This involved weaving together the themes and supporting data excerpts to tell a coherent story addressing the research questions. Illustrative quotes were carefully chosen to provide example and enhance the analysis. In this writing phase, the results of the thematic analysis were presented, demonstrating how each theme illuminates the research problem and connects to the underlying theoretical perspectives.
The analysis was iterative and reflexive throughout the process. The researcher moved back and forth between the raw data, codes, and themes, reflecting on and refining interpretations. This recursive approach ensured that the final themes were firmly rooted in the interview material and relevant in relation to the study’s research questions and theoretical framework.
Three theoretical frameworks guided the interpretation of findings: the integrated behavioral model (
The integrated behavioral model primarily informed the initial coding and categorization of data related to individual motivation, perceived norms, personal agency, and environmental constraints influencing engagement with scientific knowledge. Media richness theory and synchronicity theory were mainly used to interpret how the communicative characteristics of different communication formats—for example, peer conversations versus digital databases—were used in practice and the conditions under which they were deemed effective. These theoretical perspectives informed not only what was studied, but also how it was studied, providing insights into why certain sources were preferred and how they aligned with the demands of clinical routines. To strengthen the credibility of the results, the initial codes and themes were discussed with two academic supervisors for validation.
NVivo was used to manage and code the transcribed interviews. All analysis was conducted in Norwegian, which is the original language of the interviews and transcripts. Only the quotes included in this paper were translated into English. The author, who is fluent in both Norwegian and English, used ChatGPT to support the translation process and to enhance the overall language of the manuscript. All translations and language edits were reviewed and finalized by the author.
Participants described a diverse set of information sources used to remain professionally current. The majority of the 12 physicians and 10 nurses highlighted a combination of interpersonal interactions, institutional resources, scientific literature, and digital resources (including non-peer-reviewed tools such as online medical databases). The analysis identified five sub-themes under RQ1: interpersonal interactions and peer learning, formal education and training, scientific literature and summaries, clinical guidelines and protocols, and digital resources and
Across roles, respondents described colleagues and day-to-day clinical discussions as primary sources for remaining current. Nearly all participants emphasized the value of on-the-job learning through consulting peers. A medical intern in their 20s explained, “I talk to colleagues, discuss things all the time, and ask someone with more experience… I learn a lot from others.” Nurses also valued peer learning, often turning to more experienced colleagues for answers or practical know-how. A nurse in their 20s shared, “I can always ask [my colleagues] if I have any questions.” A nurse in their 30s elaborated, “We have many highly skilled colleagues here, both physicians and nurses, with a lot of expertise. It’s important to draw on that by asking questions, not just accepting things as they are.”
These informal consultations were described as both efficient and trustworthy, especially in a fast-paced hospital environment where quick practical guidance is needed. The preference for rich, synchronous channels such as face-to-face conversations aligns with the need to navigate task ambiguity and time constraints.
In addition to informal consultations, senior staff also acted as mentors. The medical intern in their 20s mentioned spending extra time with experienced colleagues because “they’re often the ones you ask questions and learn from.” These interactions not only provided immediate answers, but also granted access to tacit knowledge that is difficult to obtain from written or asynchronous sources.
Both physicians and nurses engaged in structured learning opportunities, although access and frequency varied. All the physicians described attending regular departmental educational meetings. These sessions, typically held weekly, were conducted in synchronous, interactive formats such as morning case discussions or rotating presentations on various topics. These were rich, real-time communication channels that facilitated knowledge exchange, clarification, and immediate feedback.
Nurses reported attending significantly fewer training sessions. Several noted that what used to be weekly nursing training sessions had been reduced to occasional “theme days” to accommodate shift work. Both groups participated in mandatory training, such as e-learning modules. However, these sessions were asynchronous and leaner formats that offered standardized information with fewer opportunities for interactive learning.
Many participants, particularly physicians, also looked for externally curated content, such as conferences or specialist courses. A chief physician in their 40s emphasized the benefits of this kind of mediated learning: “The simplest and most effective way, I think, is taking courses. Then someone else has already done the reading.”
Nurses, on the other hand, often faced challenges attending such events due to staffing and scheduling barriers. Despite this, some nurses still took the initiative to enroll in relevant courses.
Many participants mentioned using scientific literature as an information source, but there were notable differences between physicians and nurses in how they engaged with such material. Physicians were more likely to seek out and read original research and curated updates. Several described keeping up with key journals and using clinical knowledge databases. A resident physician in their 20s said, “I read the journals I receive. I have two – one for surgeons and one general one from the Medical Association. I also read MedScape.” Some physicians also subscribed to email alerts or newsletters that highlight new research in their field.
Nurses, by contrast, tended to rely primarily on filtered or summarized content. They frequently mentioned their union’s journal,
These differences may partly reflect educational backgrounds: physicians typically undergo extensive training in reading and evaluating scientific literature as part of their medical education, while nurses often hold bachelor’s degrees with less emphasis on critically appraising research. This distinction also appeared to be influenced by interest and confidence, which are factors that are further explored under RQ2.
Nurses often perceived in-depth research reading as less immediately necessary for day-to-day care unless directly relevant to a specific patient case. One nurse in their 40s admitted, with a self-deprecating laugh, “I’m not that good at keeping current. I read
Therefore, although scientific literature was respected in principle, actual engagement was selective and influenced by time constraints, perceived task relevance, and cognitive load. To manage this, many individuals relied on secondary sources to filter and simplify complex content, a form of triaging that allowed them to focus on information with immediate practical utility. This is consistent with media theories that propose individuals choose their information channels based on the requirements of the task: more detailed and complex media are used for high-ambiguity situations when time and motivation permit.
Participants expressed some guilt or ambivalence about not reading more, stating, for example, “I know I should read more papers,” but pointed to time constraints and the effort required to digest dense material. The role of attitudes and self-efficacy is examined later under RQ2.
International, national, and internal hospital guidelines emerged as universally important sources for remaining current. Both physicians and nurses emphasized the need to keep abreast of clinical recommendations, standard operating procedures, and protocols. A chief physician in their 50s was clear that “The most important thing is to be on top of national guidelines.” Physicians mentioned checking updates to guidelines that are relevant to their specialty. Nurses also emphasized the importance of following protocols for procedures and medications, often consulting local procedures for guidance.
These resources were typically accessed through local procedure databases. Participants generally found these systems to be a convenient way to access the “latest correct way” to perform tasks. Nurses explained that they routinely used these databases in their day-to-day care, often as their initial source for confirming procedures.
However, some reported limited use of these systems, citing difficulties related to accessibility, search functionality, and trust in the content. One resident physician explained that they preferred consulting national or international guidelines rather than local procedures, stating:
I use [the internal procedural system] very little. I usually check national or international guidelines instead. The search engine is extremely poor – unless you have looked it up before or know the archive number, it’s hard to find what you need.
While these databases were initially designed to be low-effort, standardized information tools, several participants noted obstacles in terms of access and usability. In addition, inconsistencies between institutions were mentioned by some participants, such as differing guidelines across hospitals or updates being made at different times, leading to uncertainty.
One nurse even likened the local procedural system to Wikipedia. However, it was still widely recognized that remaining current on guidelines and procedures was essential for ensuring safe practice. The majority of participants, regardless of their role, emphasized the importance of consulting protocols when uncertain or when encountering unfamiliar situations.
In addition to formal literature and scheduled training, physicians and nurses frequently relied on various digital tools for quick access to clinical information and problem-solving. Online point-of-care resources such as UpToDate and the Norwegian Electronic Health Library (Helsebiblioteket) were often used, especially by physicians, to obtain concise, evidence-based answers during clinical decision-making. A resident physician in their 20s stated, “If I’m doing an operation I haven’t done in a while, I’ll watch a surgical video or read up beforehand.”
Nurses reported using similar strategies. A nurse in their 50s noted, “I watch a lot of procedures on YouTube, especially from American and British hospitals.” The same nurse explained how she encouraged students to use such resources: “I’m not saying you shouldn’t read the textbooks – definitely do that. But if there’s something you’re really wondering about, like how it actually looks, try finding a video on YouTube.”
These examples illustrate how clinicians combined formal knowledge systems with accessible, visual, and often asynchronous media. This allowed them to enhance their core knowledge with situation-specific, on-demand content. Participants acknowledged the variability in information quality, particularly on open platforms such as YouTube. As one physician pointed out, “There’s a ton of content on YouTube, but you have to be a bit more critical about what you’re watching.” Nevertheless, the easy access and immediate availability of these resources made them valuable for addressing knowledge gaps in real time.
In general, participants prioritized learning that felt immediately relevant to patient care. Research on topics deemed more abstract or not directly applicable was usually set aside. As one nurse in their 20s admitted, “Research that isn’t about [day-to-day] procedures – I think that barely reaches us.” This reactive pattern does not reflect a lack of interest in learning so much as the reality of busy schedules and a pragmatic focus on “what I need to know now.” Even highly motivated professionals prioritized their learning efforts by balancing cognitive effort, relevance, and the availability of channels. Their choices suggest an intuitive awareness of media-channel fit: rich and interactive resources were preferred when time allowed, while leaner, easily accessible tools were used in the moment.
Responding to RQ2, both physicians and nurses described a range of individual, organizational, and contextual factors affecting their engagement with scientific knowledge in the hospital setting. To analyze these influences, the results have been categorized according to the integrated behavioral model (
Participants across all ages and roles expressed a strong sense of personal responsibility for remaining professionally current. This motivation was often rooted in ethical concerns, patient safety, and a desire to uphold professional standards, indicating a high level of intention to continue learning. A nurse in their 30s shared the following perspective:
You need to stay professionally current, or else you will fall behind. What was considered good 20 years ago, or what they thought was the best practice back then, might be the worst today. So, for the sake of our patients and to keep them as healthy as possible, we must stay current – for my part and my own conscience.
Physicians shared this view. A chief physician in their 50s remarked succinctly that ongoing learning is critical because “otherwise you stagnate.” These comments highlight how maintaining current knowledge was seen not just as a formal requirement, but as part of one’s professional identity and internal value system.
Some participants directly linked learning to clinical performance and diagnostic accuracy. A medical intern in their 20s explained that the motivation to continue learning was to avoid missing potential diagnoses, stating, “Because you are knowledgeable enough to understand what it’s about.”
However, despite shared values regarding lifelong learning, participants varied significantly in their level of engagement. Some adopted a proactive or mastery-oriented approach, driven by a desire to be perceived as skilled and reliable. One nurse in their 20s stated:
[My motivation is that] I want to become a better nurse than the others. Maybe not exactly like that, but there is definitely a desire to be the best. A desire to be skilled, and also to have people come to you when they have questions. To be a resource. There’s hardly anything more rewarding than being able to help people or coworkers and teach them something new.
Others described a more passive or compliance-based approach, engaging with new knowledge only when formally required. For example, an experienced nurse (40s) admitted to reading
In summary, attitudes towards remaining current ranged from highly committed to relatively passive. While most participants expressed strong intentions, their actual behavior was influenced by individual differences in motivation, self-efficacy, learning preferences, and situational constraints. From the perspective of the integrated behavioral model, these findings demonstrate that even when intentions are strong, taking action depends on both internal agency and external support.
When asked about barriers to remaining current, participants overwhelmingly pointed to contextual limitations such as time constraints, shift work, and high clinical workload. The hospital environment was described as fast-paced, task-heavy, and not conducive to focused study. A chief physician in their 40s stated, “I could never sit in my office for an hour during work to read; I can’t set aside that time.” A nurse in their 40s echoed this sentiment, noting that there is virtually “no time set aside during working hours, so continuing education only happens when there are training days.”
From the perspective of the integrated behavioral model, these factors function as environmental constraints that may weaken the relationship between intention and behavior. Even when participants expressed a clear intention to remain professionally up-to-date, their ability to act on this intention was often hindered external circumstances beyond their control. Many reported having to shift their learning to evenings or days off. A resident physician in their 20s stated:
We’re supposed to have maybe two study days a month, on average, meant for professional development or in-depth reading. But often those get spent in the operating room instead. So it ends up happening more at home. I’d say most of it actually gets done during my free time.
Such comments reflect the gap between intention and behavior, a core concept in information behavior models, where external demands constrain the ability to act on internal motivation.
In addition to time constraints, participants described interruptions and unpredictability as major obstacles. A nurse in their 60s noted being able to attend educational meetings only once every 3 months due to scheduling conflicts. A nurse in their 50s explained the tension between planned learning and clinical demands: “There are very good plans and ideas, but then they fall apart because an alarm suddenly goes off, and people run. No time of day fits.” These disruptions made learning fragmented and highly dependent on day-to-day circumstances.
Participants also reported frustration with mandatory e-learning modules, which were perceived as superficial or performative. A chief physician in their 50s remarked, “People click through and then jump straight to the quiz. If they pass the test, they get a green check on the portal and everyone’s happy. The learning outcome is probably very poor.” This reflects a disconnect between institutional effort and actual learning outcomes, especially when systems do not support effective engagement.
In addition, participants described skill-related and psychological barriers that intersected with the structural ones. Scientific texts were often perceived as demanding and time-consuming, especially due to academic jargon and the fact that most scientific literature is in English. A resident physician in their 30s noted, “It is hard to know where to read, be critical of sources for studies, and find the proper studies. It is not just a matter of reading a book.” Others admitted to avoiding technical content altogether. A chief physician in their 40s shared, “I do not read the results if they are presented in numbers. I skip that. Then maybe I just read the last two sentences.” A nurse in their 60s similarly reflected, “I find it difficult to read a scientific article due to the jargon used, and often it is written in English.” These challenges point to a lack of enabling factors such as sufficient training in academic reading or critical appraisal, which can hinder the translation of intention into action. These findings demonstrate that even highly motivated professionals may face difficulties in engaging with scientific knowledge without practical, cognitive, and institutional enablers in place.
Social and cultural norms in the workplace influenced how participants engaged with scientific knowledge. Most described a culture of open communication and mutual learning, through informal discussions. A nurse in their 30s said, “We ask if there is something, and there is no problem in discussing whether it is right or wrong. It is not dangerous to ask.” Similarly, a chief physician in their 50s explained that mistakes were discussed openly in meetings so that “others can learn,” reflecting a supportive social norm for peer-based, real-time learning.
In departments with regular educational sessions, this culture was reinforced through structured, low-threshold arenas for dialogue. A chief physician in their 60s described such meetings as safe spaces: “We can say whatever we want and embarrass ourselves as much as we want without it mattering.” These examples suggest that shared learning is valued, but primarily in real-time, interactive formats. The norm appears to favor discussion and peer-based exchange, not individual study or systematic engagement with scientific literature outside clinical tasks.
Despite this supportive social environment, most participants emphasized that remaining current was ultimately perceived as a personal responsibility. A resident physician in their 20s said, “The responsibility to remain current falls heavily on each individual. It’s not like someone at work is constantly informing you about every change.” A nurse in their 30s echoed this sentiment, saying, “You can get by without updating yourself professionally at all. It is just a matter of your conscience.” These comments point to a cultural norm of individual autonomy rather than institutional accountability. While knowledge sharing was socially supported, formal learning activities and engagement with scientific literature were largely left to personal initiative. There was no clear expectation, follow-up, or consequence for not engaging beyond immediate needs. From the perspective of the integrated behavioral model, this reflects low subjective norm pressure and limited perceived behavioral control—clinicians felt responsible, but not expected or enabled, to maintain up-to-date knowledge through formal means.
As demonstrated in Section 3.1, healthcare professionals reported using a combination of interpersonal communication, formal training, clinical protocols, scientific literature, and digital tools to remain professionally up to date. Their choices were closely linked to task urgency, complexity, and time constraints.
Among these sources, peers were the most frequently used and trusted, confirming earlier studies (
These interactions were not supplementary to formal learning, but often served as the primary mechanism for knowledge transfer, especially under time constraints. This supports literature from science communication emphasizing the value of dialogue-based models.
Structured education formats, such as departmental meetings and theme days, provided formal learning opportunities. However, access to these opportunities varied depending on professional roles. Physicians reported regular participation, while nurses faced limited access due to shift work and scheduling constraints. This discrepancy, as demonstrated in Section 3.1.2, is consistent with the concept of channel availability in media synchronicity theory. High-synchronicity formats require not only the appropriate medium, but also institutional time and support. While media synchronicity theory typically assumes that appropriate channels can be freely chosen, our data indicate that access is unevenly distributed. This highlights that perceived feasibility, rather than just theoretical fit, influences communication behavior in practice.
Clinical guidelines and procedures were used primarily as reference tools rather than for deeper reflection. From a media richness perspective, such sources are considered lean media, appropriate for low-ambiguity, routine tasks. However, as
Digital tools such as UpToDate, Helsebiblioteket, and YouTube were commonly used for
In summary, healthcare professionals use various channels to access scientific knowledge, and their preferences are influenced by the requirements of clinical tasks. While our findings are largely consistent with media richness and media synchronicity theory, they also reveal important theoretical blind spots: clinicians frequently adapt lean or asynchronous media to meet rich, responsive communication needs, and convergence and conveyance often occur simultaneously rather than sequentially.
Participants’ engagement with scientific knowledge was influenced by a dynamic interplay of personal, environmental, and social factors. The integrated behavioral model provides a useful framework for understanding how these factors influence the relationship between intention and behavior.
Time constraints were the most frequently cited barrier. Participants described how learning activities were consistently deprioritized due to patient care, shift schedules, and staffing shortages, confirming findings from previous studies (
Cognitive and linguistic barriers also hindered engagement. Scientific literature was often viewed as overly technical, filled with jargon, and difficult to digest, especially in English. These challenges support previous findings by
Social and cultural factors played a significant role in shaping engagement patterns. While informal learning was both accepted and encouraged, formal learning was viewed as a matter of personal responsibility. This indicates a weak subjective norm in terms of the integrated behavioral model: Clinicians did not perceive strong external expectations to engage with formal scientific knowledge. As the integrated behavioral model predicts, weak perceived norms reduce behavioral intention. However, some participants reported that their professional identity motivated them to remain current, even in low-pressure environments. This suggests that subjective norms may be internalized rather than externally enforced, an important nuance that the integrated behavioral model does not fully capture.
Finally, many learning activities were reactive rather than proactive. As illustrated in Section 3.1.5, clinicians often sought out knowledge in response to unfamiliar or urgent cases rather than as part of continuous, planned routines. While such reactive learning is contextually rational and often effective, it runs the risk of fragmenting knowledge over time. The integrated behavioral model emphasizes planned behavior and may not fully address these responsive, situational learning patterns. Without organizational structures in place, such as protected time, follow-up mechanisms, and cultural expectations, this adaptive intelligence may not be fully utilized.
In summary, the integrated behavioral model helps explain why clinicians may or may not follow through on intentions to engage with scientific knowledge, especially by highlighting the role of time constraints, perceived norms, and self-efficacy. However, the findings also reveal limitations in the model: it downplays spontaneous, in-the-moment learning and fails to distinguish between different levels of engagement. These gaps suggest that knowledge engagement in clinical settings is not only intentional and structured, but also adaptive, opportunistic, and influenced by internalized professional values.
The findings confirm the effectiveness of the integrated behavioral model, media richness theory, and media synchronicity theory in understanding clinician information behavior. However, they also highlight certain contextual limitations of these frameworks. Media richness theory suggests that richer media are better suited for complex or ambiguous tasks. In clinical settings, though, the use of high-richness channels is often limited by structural factors. Similarly, media synchronicity theory distinguishes between conveyance and convergence processes, but in reality these categories are often blurred by practical demands. For example, a brief hallway chat may serve both functions simultaneously. The integrated behavioral model emphasizes the importance of intention in predicting behavior. However, our results suggest that even clinicians with strong intention (e.g., who are highly motivated to learn) may fail to apply new scientific knowledge if key environmental constraints, such as time, support, and access, are not addressed. This highlights the importance of extending these theoretical models to better account for context. Future research could explore integrative approaches that combine behavioral and communication theories to examine how tailoring information delivery to context might improve knowledge uptake. For example, interventions that leverage richer media (e.g., interactive messaging platforms or brief team huddles) under supportive conditions could be tested to clarify how these theories operate in practice.
This study has several limitations. First, all interviews were conducted shortly after the lifting of COVID-19 restrictions, during a period when many hospital routines had not yet reverted to pre-pandemic scheduling. This unique context may have influenced how healthcare professionals engaged with various information sources, particularly those necessitating face-to-face interaction.
Second, the sample size was relatively small, consisting of 22 participants who were physicians and nurses from three Norwegian hospitals. Therefore, the findings are specific to this context and should not be generalized across all healthcare settings or professional groups. Rather, the results provide preliminary insights into communication practices and barriers within a specific healthcare setting.
Third, as is the case with all interview-based research, our findings rely on self-reported behaviors and perceptions, which may be influenced by recall bias or social desirability bias. Considering these limitations, future research should explore whether comparable preferences and barriers exist in various countries, types of hospitals, or healthcare positions. Expanding the scope to encompass other professions may reveal different patterns of engagement. Moreover, as digital resources continue to evolve, future studies should also examine the role of emerging technologies (e.g., platforms supported by artificial intelligence) in shaping how scientific knowledge is accessed and utilized in clinical practice.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
The studies involving humans were approved by Sikt – Norwegian Agency for Shared Services in Education and Research. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
VP: Writing – original draft.
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that Generative AI was used in the creation of this manuscript. The author, who is fluent in both Norwegian and English, used ChatGPT to support the translation process and to enhance the overall language of the manuscript. All translations and language edits were reviewed and finalized by the author.
Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
The Supplementary material for this article can be found online at:
Edited by:
Reviewed by: