title: A simple heuristic for Internet-based evidence search in primary care: a randomized controlled trial.
abstract: BACKGROUND
  General practitioners (GPs) are confronted with a wide variety of clinical questions, many of which remain unanswered.
  
  
  METHODS
  In order to assist GPs in finding quick, evidence-based answers, we developed a learning program (LP) with a short interactive workshop based on a simple three-step-heuristic to improve their search and appraisal competence (SAC). We evaluated the LP effectiveness with a randomized controlled trial (RCT). Participants (intervention group [IG] n=20; control group [CG] n=31) rated acceptance and satisfaction and also answered 39 knowledge questions to assess their SAC. We controlled for previous knowledge in content areas covered by the test.
  
  
  RESULTS
  Main outcome - SAC: within both groups, the pre-post test shows significant (P=0.00) improvements in correctness (IG 15% vs CG 11%) and confidence (32% vs 26%) to find evidence-based answers. However, the SAC difference was not significant in the RCT.
  Most workshop participants rated "learning atmosphere" (90%), "skills acquired" (90%), and "relevancy to my practice" (86%) as good or very good. The LP-recommendations were implemented by 67% of the IG, whereas 15% of the CG already conformed to LP recommendations spontaneously (odds ratio 9.6, P=0.00). After literature search, the IG showed a (not significantly) higher satisfaction regarding "time spent" (IG 80% vs CG 65%), "quality of information" (65% vs 54%), and "amount of information" (53% vs 47%).
  
  
  CONCLUSIONS
  Long-standing established GPs have a good SAC. Despite high acceptance, strong learning effects, positive search experience, and significant increase of SAC in the pre-post test, the RCT of our LP showed no significant difference in SAC between IG and CG. However, we suggest that our simple decision heuristic merits further investigation.
authors: Department of Family and Community Medicine, Philipp University of Marburg, Marburg, Germany.
authors: Andreas
authors: A
authors: Eberbach
authors: Department of Family and Community Medicine, Philipp University of Marburg, Marburg, Germany.
authors: Annette
authors: A
authors: Becker
authors: Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
authors: Justine
authors: J
authors: Rochon
authors: Department of Family and Community Medicine, Philipp University of Marburg, Marburg, Germany.
authors: Holger
authors: H
authors: Finkemeler
authors: Department of Sport Medicine, Justus-Liebig-University of Giessen, Giessen, Germany.
authors: Achim
authors: A
authors: Wagner
authors: Department of Family and Community Medicine, Philipp University of Marburg, Marburg, Germany.
authors: Norbert
authors: N
authors: Donner-Banzhoff
keywords: continuing medical education; decision making; evidence-based practice; medical informatics