Table 4 Description of the features available in the three interventions

A

Clinical Question Recorder (See also Figure 2)

Web-based interface, linked to MacPLUS FS account, and accessible on any smartphone, tablet and desktop computer.

Easy recording and listing of clinical questions.

Clicking the `Answer’ button next to each question triggers a comprehensive search in MacPLUS FS.

Browsing of citations retrieved according to the pyramid of EBM resources.

Bookmarking of links to relevant citations, saved along with the question.

Recording of short answer to the question.

Organizing of questions: setting priorities, sorting and classifying into folders.

Reminders and links to unanswered questions are sent on top of regular MacPLUS FS alerts to new evidence.

Answered questions and bookmarked evidence are saved and accessible in a virtual logbook of EBM practice.

B

Evidence Retrieval Coach (See also Figure 3)

Composed of eight short videos, embedded in MacPLUS FS.

Display is tailored to clinician’s patterns of behaviors according to predefined triggers, or sent on a weekly basis as the trial unfolds.

The title of each video (and gist of their content) are the following:

1. MacPLUS FS - Why use it? (Answering questions with information overload)

2. Enhancing Evidence-Based Clinical Practice (Using a parallel search in pre-appraised resources)

3. A pyramid of resources (Overview of the architecture of evidence)

4. Is one summary enough? (Top layers: Summaries)

5. New and critically appraised evidence (Middle layers: Pre-appraised research)

6. PubMed & the Clinical Queries (Bottom layers: Non-pre-appraised research)

7. Preparing searchable questions (Using the PICO framework)

8. Academic work (Using a federated search for presentations, grants and research)

C

Audit, Feedback & Gamification (See also Figure 4)

Allocation of badges, popping up online after a specific desired behavior, and also sent by email (about 50 badges available).

Each badge is associated with an increase in reputation score, depending on the desirability of the behavior.

It also provides a short, positively-framed feedback on the behavior, the number of times it was allocated to peers, and an upgraded reputation score.

Clicking on the badges lead to a Reputation tab in MacPLUS FS providing the following features:

Comparison of reputation with peers using pictographs (percentiles);

List of badges obtained, clicking on them displays the full badge again;

Graphical representation of daily reputation;

Frequency of access to each EBM resources and mapping according to the pyramid.