Clinicians today face the challenge of applying rapidly expanding medical knowledge to particular patients. There would appear to be an information gap between physicians' needs for information and the delivery of such information. Continuing medical education has largely failed to meet this need. The best strategy probably is to pursue learning at the point of care, because retention of new information is much greater than when learners receive new information through lectures. Computer technology permits frequent updates and lacks the size and weight limitations of printed materials. The authors monitored the use by second-year medical students of an electronic medical textbook, UpToDate, during the transition from the preclinical to the clinical years. The students were surveyed anonymously at the end of the third year about their preferred courses of clinical information. Respondents numbered 116 students of a possible 154 for a response rate of 75%. When asked about what information resource they used most often when seeing patients, 85% mentioned either UpToDate (53%) or another medical information web site, MDConsult (38%). Only 14% of students gave paper textbooks as their first choice. The second most preferred resource was MDConsult (38%), followed by paper texts (27%). Medline was the preferred second choice for 15% of students. Most students preferred paper texts to electronic information sources only as their third choice. In general, the students reported using these resources on a daily basis. They required less than 15 minutes to get the answer to most clinical questions. Clearly, today's medical students use electronic information resources much more than do practicing clinicians. This makes it especially important for academic medicine to make certain that these resources meet the same high standards that are applied to paper textbooks and journals.
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