Junior physician's use of Web 2.0 for information seeking and medical education: A qualitative study

https://doi.org/10.1016/j.ijmedinf.2009.04.008Get rights and content

Abstract

Background

Web 2.0 internet tools and methods have attracted considerable attention as a means to improve health care delivery. Despite evidence demonstrating their use by medical professionals, there is no detailed research describing how Web 2.0 influences physicians’ daily clinical practice. Hence this study examines Web 2.0 use by 35 junior physicians in clinical settings to further understand their impact on medical practice.

Method

Diaries and interviews encompassing 177 days of internet use or 444 search incidents, analyzed via thematic analysis.

Results

Results indicate that 53% of internet visits employed user-generated or Web 2.0 content, with Google and Wikipedia used by 80% and 70% of physicians, respectively. Despite awareness of information credibility risks with Web 2.0 content, it has a role in information seeking for both clinical decisions and medical education. This is enabled by the ability to cross check information and the diverse needs for background and non-verified information.

Conclusion

Web 2.0 use represents a profound departure from previous learning and decision processes which were normally controlled by senior medical staff or medical schools. There is widespread concern with the risk of poor quality information with Web 2.0 use, and the manner in which physicians are using it suggest effective use derives from the mitigating actions by the individual physician. Three alternative policy options are identified to manage this risk and improve efficiency in Web 2.0's use.

Section snippets

Background

The Internet has attracted considerable attention as a means to improve health care delivery through its use by both medical professionals and patients [1]. Physicians use the internet far more than the general public [2], and though physicians still prefer to consult with colleagues on complex cases [3], the internet is viewed as an increasingly important source of medical information [4]. This use of the internet is being impacted by Web 2.0, a term that represents a second generation of

Methods

Various procedures exist for examining online behaviours including log-files, screen recording devices, think aloud data (a major source of information on subject's cognitive processes), post-use interviews, or survey instruments amongst others [23], [24]. In particular, scholars have observed that log files are useful for describing detailed patterns of use (or the what), but are not useful in describing choice behaviours [24], as little information about specific cognitive choices can be

Results

Of the participants contacted, 90% (50/55) completed the questionnaire and 63% (35/55) completed all three components. Consequently, only information from this final group was used. The group worked across a variety of specialities, had an average age of 27 years, and a male to female ratio of 0.75 to 1. The diaries represented 177 days of recorded internet use and 444 search incidents on different sites.

Discussion

There are clearly a number of contradictions in Web 2.0 use. Although credibility of information was the most cited concern, tools such as Wikipedia or Google are used 3 times more in our sample than PubMed, the “official” best evidence tool introduced in medical school. This contradiction can be explained by the different types of information needed and the greater usability of Web 2.0 tools, where the tendency is to use Web 2.0 tools for open questions, and best evidence tools for closed

Conclusion

Internet tools not specifically designed for medical use, such as Google or user-generated content sites like Wikipedia, are being regularly employed in clinical practice by junior physicians. While information credibility remains a concern, these are viable medical tools, where Google's familiarity and reach makes it is an effective navigational gateway for physicians to access trusted sites (held in their mental inventory). This mental inventory of trusted sites also includes user-generated

Acknowledgments

West Hertfordshire Hospitals NHS trust aided the study, both in completing the initial ethical review (finally no ethics approval was required), and with selected physicians both aiding in the data collection and manuscript revision. All data was collected in the UK.

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