Enhancing Evidence Translation Through Structured Clinical Reasoning: A Mixed-Methods Controlled Feasibility Study of Peer Visibility and Readiness Mechanisms in Applied Learning.

Abstract

In clinical environments, evidence translation is often stalled by the incomplete bridge between clinicians' agreement with evidence and its implementation. In community oncology, where time constraints and variable resources shape care, this "know-do" gap reflects decision readiness under uncertainty. Clinicians can know the guidelines and still hesitate to act. Closing that practice gap requires more than awareness. Digital applied learning that makes peer clinical reasoning visible may support readiness mechanisms, but feasibility and mechanism signals for scalable peer visibility remain under-characterised. We evaluated feasibility and hypothesis-generating signals from clinician learners' engagement in a digital learning experience and explored plausible mechanisms by which peer visibility may influence clinician readiness for evidence translation. We conducted a mixed-methods, controlled feasibility evaluation among NPI-verified medical oncologists (N = 104) completing a digital applied learning experience with peer visibility (n = 80) or without (n = 24). Peer-facing content was generated by clinicians as responses to questions within the education. Assessed outcomes included feasibility, engagement, and readiness for application in practice. Open-text responses were characterised descriptively. Participation was high across modules in both variants (83-96%). Median total engagement time was higher in the peer visibility variant (37.3 minutes; IQR 13.4-70.7) versus the no-peer variant (20.2 minutes; IQR 8.4-44.2). Readiness-to-apply items show a mixed/directional pattern, though ceiling effects limited the precision of between-arm comparisons. The peer visibility variant produced 1,115 structured entries versus 315 in the no-peer variant (n = 75 versus n = 22), a comparable rate per contributor in both variants. Descriptive content characterisation identified categories consistent with confidence calibration and feasibility imagining. Integrating structured peer visibility into a digital applied learning experience appears to be practical at scale and yielded hypothesis-generating signals of higher engagement and plausible readiness mechanisms. Findings support future research to isolate active components, validate readiness constructs, and test mechanism pathways supporting translation to clinical action.