Finding the time to read clinically relevant research is a challenge for health professionals. Electronic Knowledge Resources (EKRs) can facilitate this process. Many knowledge providers 'push' e-mail alerts to doctors in the form of brief synopses of clinical research. These synopses are integrated into searchable databases to be retrieved or pulled as needed. When health professionals use EKRs, our method (Information Assessment Method) will systematically and concomitantly assess the relevance, cognitive impact and use of information they receive or retrieve. In addition, we wish to discover how email alerts (push) affect information retrieval (pull) in clinical practice.

With funding from the Canadian Institutes of Health Research (CIHR), we are now conducting a field research study to answer four related questions:

(1) What is the usability and validity of our method in the push and pull context?

(2) To what extent do doctors retrieve information they have previously assessed as an email alert?

(3) Given the same information, does the type of impact perceived by the user differ in the context of email alert (push) vs. information search (pull)?

(4) When doctors pull information they have previously assessed on email, is it because they were searching for that particular information?

In this study (see schema), 40 family doctors will use their handheld computer to search a commercial database, in particular for answers to their clinical questions. Doctors will indicate if each information item is relevant, used, and has a positive, neutral or negative cognitive impact, choosing among statements like "I learned something new" or "I disagree with this information." Our assessment method may be useful to compare and evaluate the impact of clinical information, and for capturing user feedback to maintain database quality. Our research will also explore the relationship between information that is pushed to clinicians on e-mail and then pulled at some later time.