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Evolving Physician Perception of World Wide Web Education

Posted Aug 31, 2007 Updated Apr 7, 2023
By Pamela T. Johnson MD , John Eng MD , Melissa R. Rowell MS , Elliot K. Fishman MD
11 min read

Introduction

As a profession driven by technologic advancement, medicine was destined to embrace the Internet. Progressive growth in availability and speed has increased Internet utilization in research, practice, and education. This review focuses on the use of the World Wide Web (Web) for education by practicing physicians. Particularly in radiology, where workloads are increasing, the Web represents a readily available educational resource for physicians with limited time. However, survey data from 2005 revealed that traditional educational resources are preferred by radiologists for both information retrieval and continuing medical education (CME) ( ). Accordingly, we sought to evaluate patterns of internet utilization for information seeking and use of web-based resources for CME over time, in an attempt to delineate how Web-based educational programs can best serve physicians.

Literature Search: Methods

A broad search of PubMed was performed using the words “physician” and “Internet” to include all English language publications between January 1, 1996, and July 1, 2006. This produced 1,359 publications; the title, abstract, or article text was reviewed to select only those studies that surveyed practicing physicians with respect to their Internet use for medical information seeking or medical education. A cutoff of at least 50 respondents was applied, and any study that represented subgroup analysis of a previous investigation was not considered separately ( n = 3), to yield a total of 29 studies that fulfilled the criteria.

Cognizance of other pertinent publications that were not included in these results prompted additional searches using the following phrases in varying combinations: Internet, information seeking, World Wide Web, physician, radiology, education, medical education, continuing medical education, survey, questionnaire. In addition, a “related search” option was used with one model study, and any previous or subsequent pertinent survey data described in an identified study were retrieved. These methods produced an additional 14 studies. Added to this compilation were the data from two survey investigations performed by our computed tomography (CT) division in 2005 ( ) and 2006, which surveyed radiologists at CME courses ( ) and online, respectively. These most recent data come from an unpublished online survey posted on our Web site ( www.ctisus.com ) for 11 weeks between January and March 2006. A total of 212 radiology professionals participated, with responses from 58 radiologists referred to as “current data” throughout this review.

Literature Search: Results

Information from 45 survey investigations was analyzed ( Fig 1 ). The data available in these studies include responses from more than 44,000 physicians worldwide ( , current data). An effort was made to include surveys only involving physicians; however, 7 of the 45 had some non-physician medical professionals respond in addition to physicians ( ). For the purposes of this review, “Internet use” is defined as use of the Web for medical information retrieval or education, or the use of e-mail to consult colleagues.

Figure 1, Forty-five survey investigations between 1996 and 2006 that queried physicians about Internet use for education or information retrieval. Note.—† = current data, GP = general practice, NP = nurse practitioner, PA = physician assistant, PM = practice manager, PC = primary care, ENT = otolaryngology, med. = medical.

The earliest survey was conducted between 1995 and 1996 ( ). For each subsequent year from 1997 through 2003, multiple investigations were identified, as well as at least one from 2004 and 2005 ( Fig 1 ). Four investigations did not indicate the year of distribution. All surveys analyzed were designed to study physician internet use for medical information retrieval or education. However, a variety of distribution methods were used, and the populations sampled were diverse ( Fig 1 ).

Findings

Internet Use for Information Retrieval and Education

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Figure 2, Chart comparing Internet access, Internet use for medical information retrieval, and Web use for continuing medical education (CME) by physicians over time. Despite a progressive increase in Internet access and use for information seeking, the Web has not been embraced with the same enthusiasm for CME. Data compiled from 28 postal, conference, and telephone surveys between 1997 and 2005 ( 1 3 4 5 7 8 12 14 15 16 17 18 22 23 24 25 26 28 29 30 34 35 38 39 40 41 42 43 ). Surveys distributed over the Internet were not included, as all participants use the Internet. For any year with more than one survey providing data, a mean value was calculated.

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Figure 3, Frequency of Web use for radiology education: comparison of a 2005 survey of 92 radiologists at continuing medical education conferences (1) and a 2006 online survey of 58 radiologists.

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Figure 4, Preferred resources for medical information: how the Web compares with traditional sources, as reported by six studies between 1998 and 2005 ( 1 8 20 24 36 39 ). In each investigation, the relative significance of each factor was ranked (with 1 being most important). A weakness of this analysis is that surveys often limited respondents to preselected choices. *Radiology survey.

Figure 5, Preferred educational content on a body computed tomography Web site, as revealed by an online survey of radiologists from January through March 2006.

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Figure 6, Data from the Accreditation Council for Continuing Medical Education (ACCME) ( 45 46 47 48 ). (a) CME Activities. Participation in Web-based CME materials has increased considerably between 1999 and 2001, but regularly scheduled conferences and courses remain the preferred CME activity. (Physician participation totals shown in the y axis of the table do not represent individual learners, but rather each instance of a physician’s participation in an activity.) (b) Hours of online CME programs available to physicians. Web-based CME materials offered have increased over time, particularly between 2001 and 2003.

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Obstacles to Web-Based CME

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Figure 7, Impediments to Web use for education, as reported by radiologists participating in an online survey from January through March 2006.

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Figure 8, Most important factors when viewing educational materials on the Web, as reported by radiologists participating in an online survey from January through March 2006.

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Figure 9, Radiologists’ perceptions of the most effective method of continuing medical education, as revealed by a 2006 online survey. Institutionally sponsored course and large medical conference were selected most commonly by participants.

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Optimizing the Design of Web-Based CME

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Conclusions

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Acknowledgments

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Academic Radiology, Volume 14, Issue 9
Journals General Radiology
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