title: Rural providers' access to online resources: a randomized controlled trial.
abstract: OBJECTIVE
  The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.
  
  
  METHODS
  In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes.
  
  
  RESULTS
  Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to "about right amounts of information" at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d.
  
  
  CONCLUSIONS
  Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Eldredge
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Hall
authors.forename: Karen R
authors.initials: KR
authors.lastname: McElfresh
authors.forename: Teddy D
authors.initials: TD
authors.lastname: Warner
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Stromberg
authors.forename: Jaren
authors.initials: J
authors.lastname: Trost
authors.forename: Devin A
authors.initials: DA
authors.lastname: Jelinek
mesh_terms: D022126:Access to Information / Q000523:psychology*; D000328:Adult; D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D019095:Point-of-Care Systems / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D011795:Surveys and Questionnaires
keywords: Clinical Decision Support Systems; Computer-Assisted Decision Making; Decision Making; Evidence-Based Library and Information Practice; Evidence-Based Practice; Health Care Disparities; Health Status Disparities; Information Divide; Information-Seeking Behavior; Medically Underserved Area; Nurse Practitioners; Nurses; Physician Assistants; Physicians; Public Health Nurses; Randomized Controlled Trial as Topic; Service Learning; Vulnerable Populations