First national survey on the use of the Internet and other electronic resources among Spanish intensivists

Objective

To assess Spanish intensivists' knowledge and use of different electronic resources; the Internet, electronic mail, mailing lists and portable electronic devices (PDAs).

Design

A cross-sectional survey.

Participants

Eight hundred and twenty Spanish intensivists were contacted by hospital commercial delegates of a pharmaceutical company. The survey was simultaneously published in electronic forums.

Methods and results

A total of 682 responses were obtained (response rate: 73.9%). The Internet was used autonomously by 95.7% (n = 653) of responding physicians and 78.8% (n = 513) were autodidactic in this field. Learning gaps were reported by 66.7% (n = 451) of the respondents and up to 58.3% (n = 398) acknowledged at least two deficit areas. The responses from female intensivists showed lower Internet use and greater learning gaps in at least one area (odds ratio [OR] 2.44; confidence interval [CI] 1.5–3.95).

The Internet was the second most frequent source for clinical consultation (60.9%; n = 409), only preceded by peer consultation with ICU colleagues (65.2%; n = 438). The most frequently visited webpages were bibliographical databases (64.5%; n = 412) and electronic journals (63.4%; n = 405). EBM pages were rarely visited (18.9%; n = 421). In fact, the number of different types of websites was the main factor associated with solving clinical questions by the Internet (OR 1.37; CI 1.25–1.5).

Email correspondence was used by 92.4% (n = 630) of those surveyed and 89.6% (n = 611) used it for professional purposes, but 25.3% (n = 159) admitted to ignoring its full potential. Email correspondence as a resource correlated inversely with age (OR 0.95; CI 0.92–0.99; P = 0.015).

Electronic mailing lists were used by 62.3% (n = 425) of the intensivists. Of the remainder, 41.7% (n = 113) were not familiar with them and 31.7% (n = 86) reported insufficient expertise to manage them correctly. Only 20.1% (n = 136) own portable electronic devices. However, 63.5% (n = 416) considered these devices would be a useful tool for immediate consultations at the bedside. Female respondents were less predisposed towards their use (OR 2.44; CI 1.5–3.95; P = 0.0002).

An index of five punctuated items was elaborated to summarize in a single variable the use of all resources: preferable access to the Internet to solve clinical questions (one point); Internet consultation two or more times per week (one point); electronic mailing list consultation two or more times per week (one point); intensive care mailing list consultation (one point); and use of at least one medical software program in the PDA (one point). The variables associated with a low score in this index were: female gender, increase of age, educational character of the hospital and being a resident physician.

Conclusions

A majority of Spanish intensivists uses the Internet and electronic mail. Important educational deficits exist and a clear underuse of fundamental webpage sources has been observed. Mailing lists and portable devices are not prevalent electronic resources. Training courses and educational programs are needed to encourage and facilitate the use of these resources and to promote email lists. Special attention needs to be directed at female intensivists who seem to be more reluctant to access these resources.