title: Send it: study of e-mail etiquette and notions from doctors in training.
abstract: OBJECTIVE
  Worldwide, more than 247 billion e-mails are sent each day. Little empiric evidence is available to guide how e-mail presentation style, tone, and content affect e-mail recipients and whether these factors impact opinions about the sender and the rapidity of response. In a study of physicians in training assessing a series of 100 e-mail examples, we examined the following: (1) formatting characteristics most and least endorsed, (2) impression of the sender based on the e-mail itself, and (3) factors associated with the decision to respond. We reasoned that our study would provide empiric data to support recommendations for e-mail etiquette, focusing specifically on doctors in training.
  
  
  METHODS
  Cross-sectional survey study.
  
  
  METHODS
  Division of Orthopaedic Surgery at McMaster University, Hamilton, Ontario, Canada.
  
  
  METHODS
  After each e-mail, the participating surgical residents completed a series of questions focusing on their impression of the e-mail appearance, their perception of the sender, and their motivation to respond to the e-mail.
  
  
  RESULTS
  Thirty-two residents participated in this study. The responses indicate that the key negatively endorsed features of the e-mails included the use of colored backgrounds (84%), difficult-to-read font (83%), lack of a subject header (55%), opening salutations without recipient names (50%), or no salutation at all (42%). The senders of negatively endorsed e-mails were perceived by participants as inefficient (p = 0.03), unprofessional (p < 0.001), and irritating (p = 0.007). E-mails with overall positive endorsements were significantly more likely to have the participants perceive the e-mail senders as professional (p < 0.001), pleasant (p = 0.048), and kind (p = 0.059). The participants were 2.6-fold more likely to respond immediately when they perceived e-mails as favorable compared with disliking them (42% vs 16% of responses, respectively, p < 0.001).
  
  
  CONCLUSIONS
  The e-mails perceived as being disliked overall are likely to result in a negative perception of the sender and delays in response time.
authors.affiliation: Department of Population Medicine, University of Guelph, Ontario, Canada. sresende@uoguelph.ca
authors.forename: Sarah
authors.initials: S
authors.lastname: Resendes
authors.forename: Thammi
authors.initials: T
authors.lastname: Ramanan
authors.forename: Angela
authors.initials: A
authors.lastname: Park
authors.forename: Brad
authors.initials: B
authors.lastname: Petrisor
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003162:Competency-Based Education / Q000639:trends; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000592:standards* / Q000639:trends; D034742:Electronic Mail / Q000941:ethics* / Q000592:standards; D005260:Female; D006801:Humans; D007400:Interprofessional Relations / Q000941:ethics*; D008297:Male; D009864:Ontario; D009985:Orthopedics / Q000193:education*; D011786:Quality Control; D011795:Surveys and Questionnaires