Hi Carlos
A good question. I suppose the outcome we'd like to know is how often 
their question answering strategy improved or degraded their decision. 
Ann McKibbon addressed this in her PhD work, and found that searching 
lead to almost as many questions going from right to wrong as from wrong 
to right! I think the folk were untrained in EBM though. But it 
illustrates the importance of being able to search and select well. But 
the area seems underresearched compared to its importance.
Best Wishes
Paul Glasziou

McKibbon KA, Fridsma DB.    Effectiveness of clinician-selected 
electronic information resources for answering primary care physicians' 
information needs. J Am Med Inform Assoc. 2006 Nov-Dec;13(6):653-9. Epub 
2006 Aug 23.
Health Information Research Unit, Clinical Epidemiology and 
Biostatistics, Faculty of Health Sciences McMaster University, Hamilton, 
Ontario, Canada. [log in to unmask]
OBJECTIVE: To determine if clinician-selected electronic information 
resources improve primary care physicians' abilities to answer simulated 
clinical questions.
DESIGN: Observational study using hour-long interviews in physician 
offices and think-aloud protocols.
PARTICIPANTS: answered 23 multiple-choice questions and chose 2 to 
obtain further information using their own information resources. We 
established which resources physicians chose, processes used, and 
results obtained when looking for information to support their answers.
MEASUREMENTS: Correctness of answers before and after searching, 
resources used, and searching techniques.
RESULTS: 23 physicians sought answers to 46 questions using their own 
information resources. They spent a mean of 13.0 (SD 5.5) minutes 
searching for information for the two questions using an average of 1.8 
resources per question and a wide variety of searching techniques. On 
average 43.5% of the answers to the original 23 questions were correct. 
For the questions that were searched, 18 (39.1%) of the 46 answers were 
correct before searching. After searching, the number of correct answers 
was 19 (42.1%). This difference of 1 correct answer was attributed to 6 
questions (13.0%) going from an incorrect to correct answer and 5 
(10.9%) questions going from a correct to incorrect answer. We found 
differences in the ability of various resources to provide correct answers.
CONCLUSION: For the primary care physicians studied, electronic 
information resources of choice did not always provide support for 
finding correct answers to simulated clinical questions and in some 
instances, individual resources may have contributed to an initially 
correct answer becoming incorrect.

Dr. Carlos Cuello wrote:
> Hi to all
>
> A quick and perhaps difficult to answer question
>
> I am writting for a local journal about a recent work of mine about 
> the residents preferences to answer clinical questions. In my work 
> residents preferred as the first choice the internet and different 
> databases to answer clinical questions during their clinical work, but 
> the second choice was different among two groups, one preferred the 
> regular texbook (on paper, and sometimes translated to spanish) and 
> the other group preferred their tutors and senior residents
>
> I have found no evidence whether one is better than the other 
> (textbooks vs expert/tutors/senior-clinicians)
>
> Any thoughts? any evidence?
>
> I think the answer may depend on the individual case / question
>
>
> PS.- The two groups are those who attend vs those who do not attend to 
> Journal Clubs
>
>
> Kind regards
> -- 
> Carlos A. Cuello-García, MD
> Director, Centre for Evidence-Based Practice-Tecnologico de Monterrey
> Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical 
> Research
> Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. 
> piso,Monterrey NL, México. CP64710
> Phone. +52(81)88882154 & 2141. Fax: +52(81)88882019
> www.cmbe.net <http://www.cmbe.net>
>  
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-- 
Paul Glasziou
Director, Centre for Evidence-Based Medicine,
Department of Primary Health Care,
University of Oxford www.cebm.net
ph - +44-1865-289298 fax +44-1865-289287