The Internet continues to be widely used to facilitate research and learning for health and medical information. Eight out of 10 Internet users look online for health information, making it the third most popular Web activity next to checking email and using search engines [1
]. The pervasiveness of the Internet and the continued evolution of devices that employ Web-based technologies makes obtaining, processing, and understanding health information a critical competency area for medical professionals in training. Among medical professionals around the world, mobile information and communication technologies (eg, smartphones, iPads, and notebook computers) enable frequent Web 2.0 searches for health information [2
]. Recent studies have highlighted limitations in measuring and evaluating the interchangeable and interrelated skills necessary for information gathering in the highly social Web 2.0 environment [6
]. The ability to conduct an effective Internet search to locate health information is particularly important for health and medical professional students who represent an especially “plugged in” subgroup of the future public health workforce. Approximately 76% of college students use the Internet frequently for research or homework, while 86% report spending at least some time on social networking sites each week [9
]. Given the wealth of health and medical information that exists on the Internet, implementing evidence-based health and medical Internet searches becomes far more complex than simply entering a medical condition or health term into an Internet search engine (eg, Google or Bing) and clicking on the most prominent search result within the selected Web browser.
Obtaining health information using the Internet involves a variety of competencies that health information seekers generally lack [10
], such as: (1) conducting both basic and advanced information searches; (2) applying Boolean operators to limit Internet search results; (3) differentiating between scholarly documents, authoritative sources, periodicals, and primary versus secondary sources of health information; and (4) comprehending ambiguous eHealth terminology.
Increasingly, health and medical professionals must use at least basic eHealth literacy skills to perform their job-related responsibilities [4
]. “eHealth literacy” refers to the ability of individuals to seek, understand, and evaluate health information from electronic resources and apply such knowledge to addressing or solving a health problem [12
]. The construct reflects the composite of both analytic and context-specific skills that require cognitive-behavioral capabilities to work with technology, critically think about issues of media and science, and navigate through online decision-making resources. The literature has established the need to begin unraveling the basis for cognitive Internet search tasks among medical professionals, especially tasks that may be repeated over long periods of time [4
]. Medical professionals are aware of the need to make evidence-based decisions using eHealth resources [4
]; yet, they rarely make evaluative judgments regarding the sources of health and/or medical information they are consuming and habitually visit websites that are perceived to represent high levels of information quality, where cognitive authority is presumed to be high [13
College students who are professionally trained in the health and medical professions should be taught the knowledge and skills necessary to conduct advanced eHealth information searches on the Internet. These search tasks are complemented by critical appraisals of both the information content and source [14
]. The medical education community has recognized the important responsibility of fostering the use of eHealth technologies among future health professionals who will continue to work in the Internet age [15
]. Although college students do not encounter the environmental, physical, and resource-related barriers associated with surfing the Internet [8
], this population still reports an inability to find desired materials in the digital age [16
]. Recent investigations have examined eHealth literacy among college students [14
]. Stellefson and colleagues [14
] conducted a systematic literature review of studies assessing eHealth literacy among college students and found that college students generally lack eHealth literacy skills. Few studies have examined the unique patterns and underlying reasons for college students’ health information search behaviors on the Internet [18
], which has led to an incomplete understanding of these tasks. The limited current understanding of eHealth literacy is especially disconcerting when considering the importance of Internet search capabilities among young people studying to become future health and medical professionals.
Hanik and Stellefson [17
] attempted to fill the gap in this literature by investigating perceived and actual eHealth literacy among undergraduate health education students studying to become allied health professionals. Participants were asked to complete the Research Readiness Self-Assessment-Health (RRSA-h) [19
] online assessment, which measures knowledge/skill sets necessary for performing eHealth searches on specific health and medical topics. The multi-part eHealth search task was operationally defined as: (1) making a determination into possible sources of quality health information; (2) conducting an actual health information search on the Internet; (3) evaluating the quality of the health information retrieved; and (4) answering questions following the analysis of health information that was located and evaluated. A total of 77 undergraduate students (88% female) completed this online assessment and earned subpar actual eHealth literacy test scores (mean overall ability score = 42.6%) [17
] as compared to results from a previous study in a similar population [19
]. However, it was noted that more advanced students (eg, juniors and seniors) had higher overall eHealth literacy than their younger counterparts did. Although the more senior level students exhibited higher levels of eHealth literacy, it could not be determined whether specific eHealth search attributes were qualitatively different among students possessing high versus low eHealth literacy. It was determined, however, that actual eHealth literacy was markedly inferior to ratings of perceived eHealth literacy [17
In light of these preliminary research findings, it is important to better understand how personal eHealth search practices are perceived among health and medical professional students. These insights may provide a context for determining the types of characteristics that predict and explain eHealth literacy achievement within this population. The purpose of the current research study was to systematically identify health professional college student perspectives of eHealth search practices. The current study addressed three research questions in hopes of achieving this research aim:
1. How many clusters of health professional college students exist, given information about perceptions of personal eHealth search practices?
2. Which college students belong to the eHealth search clusters that emerge?
3. Which specific perceptions of personal eHealth search practices provide the basis for differentiating the clusters that emerge?