Professional Use of the Internet by Physical Therapists in Michigan

Journal of Physical Therapy Education, Fall 2004 by Marcoux, Beth C, Barlage, Amy, Davies, Rachel, Heller, Megan

Purpose. The impact of the Internet on health care in growing, therefore emphasizing the need for physical therapists to become knowledgeable about using and evaluating this technology as a source of information. As the profession of physical therapy moves toward online education and evidence-based practice, skill in the use of the Internet will be essential. While clinicians have always been encouraged to use the latest research in clinical practice, the Internet makes access to that information immediate. The purpose of this descriptive study was to determine access, current skill, criteria used to evaluate Web sites, and professional use of the Internet by physical therapists in Michigan. Methods. Five hundred licensed physical therapists from the three largest counties in Michigan were randomly selected to participate. One hundred ninety-three surveys were completed and returned (38.6% response rate). Results. Sixty percent of physical therapists reported they have Internet access at work, with physical therapists working in public schools reporting the greatest access. Infty-three percent reported they had little experience in using the Internet for professional purposes. The most commonly used professional resource was MEDLINE (45.5%). The top criteria used to evaluate the quality of information found on the Internet were personal knowledge (61%) and site sponsorship (39.5%). Conclusions. This study suggests a need to increase the knowledge and comfort of physical therapists in using and evaluating the Internet for professional purposes.

Keywords: Physical therapy, Internet, World Wide Web, Health care.

INTRODUCTION

The introduction of the Internet has greatly affected our society and health care worldwide. Computers used to access the Internet have been integrated into the school, home, and work place at a faster rate than television and the videocassette recorder, and have also been incorporated into health care al a similarly rapid rale, transforming the delivery of care.1-6 The Internet contains vast amounts of medical information, which may benefit health care professionals and palients alike, as it offers immediate access to current medical information and peer-reviewed publications.1,7-10

Like all health professions, the field of physical therapy is rapidly advancing. One major change is the integration of evidence in clinical decision making, and in particular, the use of evidence-based practice. As described by Sackett, evidence-based medicine "is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research."11(p2) Sackett describes five steps in this model of patient care. These include: "developing the clinical question, finding the best available evidence to answer your question, critically appraising the evidence, integrating the critical appraisal with your clinical expertise and the patient's situation and values, and, finally, evaluating your effectiveness and efficiency in the first four steps."12(p4) As noted, the second step in this process is locating the best evidence available. The use of the Internet is currently the most expeditious means to locate evidence in the peer-reviewed literature.

Use of the Internet in physical therapy is relatively new, and much of the literature related to the Internet and physical therapy addresses educating physical therapists in its use and suggesting possible uses in the future. In a paper describing Web resources for physical therapists, Singer and Tan13 provide basic information on search engines, medical databases, and professional LISTSERVS. Sherrington, Herbert, Maher, and Moseley14 describe the Physiotherapy Evidence Database (PEDro) that contains randomized clinical trials and systematic reviews of the literature in physical therapy. This Web site is an invaluable resource to physical therapists using evidence in clinical decision making.14 Walker-Dilks15 used a case scenario to describe methods for searching the Internet using large databases such as Internet Grateful Med and PubMed to gather medical information for use in clinical decision making. Ciccone16 demonstrates the use of the Internet to gather information used to answer a clinical question regarding ambulation and the risk of pulmonary embolism. All of these articles aim at educating physical therapists about the potential impact the Internet can have in providing the latest evidence for quality patient care.

Physicians' use of the Internet has also expanded in recent years, helping to improve the overall quality of health care.14 General online activity of physicians increased 42% in the last 3 months of 1999, as 85% of the physicians reported using the Internet.14 Physicians have been using the Internet to obtain information from medical research, gather product information, ensure more efficient communication with patients and other physicians, educate patients, manage records, assist with scheduling, aid in research, etc.7,14,15