Computers and Biomedical Research
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Emergency Department (ED) residents perceive Internet resources as reliable and regularly search the Internet to answer clinical questions in the ED. To determine the validity of the Internet and the Google® Search Engine, as a source for accurate information to answer clinical questions in ED, a single blinded prospective study was conducted. The search strategies used by Emergency Medical (EM) Residents and Internet resources most frequently visited to find answers to clinical questions were reviewed. Residents completed a PreTest consisting of questions that might routinely occur in ED, and were instructed to answer questions without outside resources, and if they were confident the information was suitable for patient care. Questions that EMR were unsure of, or had answered incorrectly on the PreTest, were used to create a Google® Test. On the pretest 32% of the questions that residents answered were correct, while 28% were incorrect. Residents were unsure of 40% of the questions that they responded to. On the Google® Test 59% of residents' responses were correct, 33% were incorrect and residents were unsure of 8%. Percent of unsure answers dropped significantly when residents searched Google®. Results indicated EM Residents are naive searchers who use single word or short phrase searches and derive query terms directly from the questions; advanced search features of Google® were not used; and websites frequently visited were designed for laypersons, sites for publishers, medical journals, and Google® Scholar and Google® Books. Results also indicated that while EM Residents often retrieved inaccurate information using Google® they believed the information was reliable enough to use in patient care. Findings have major implications for medical informatics, medical practice, and patient safety. Providing Internet access in ED should be carefully reviewed for reliability as a tool for teaching and clinical decision-making. Also, education of EM Residents should include training on Internet and database searching.