In an era of easy access to information, university students who will soon enter health professions need to develop their information competencies. The Research Readiness Self-Assessment (RRSA) is based on the Information Literacy Competency Standards for Higher Education, and it measures proficiency in obtaining health information, evaluating the quality of health information, and understanding plagiarism.
This study aimed to measure the proficiency of college-age health information consumers in finding and evaluating electronic health information; to assess their ability to discriminate between peer-reviewed scholarly resources and opinion pieces or sales pitches; and to examine the extent to which they are aware of their level of health information competency.
An interactive 56-item online assessment, the Research Readiness Self-Assessment (RRSA), was used to measure the health information competencies of university students. We invited 400 students to take part in the study, and 308 participated, giving a response rate of 77%. The RRSA included multiple-choice questions and problem-based exercises. Declarative and procedural knowledge were assessed in three domains: finding health information, evaluating health information, and understanding plagiarism. Actual performance was contrasted with self-reported skill level. Upon answering all questions, students received a results page that summarized their numerical results and displayed individually tailored feedback composed by an experienced librarian.
Even though most students (89%) understood that a one-keyword search is likely to return too many documents, few students were able to narrow a search by using multiple search categories simultaneously or by employing Boolean operators. In addition, nearly half of the respondents had trouble discriminating between primary and secondary sources of information as well as between references to journal articles and other published documents. When presented with questionable websites on nonexistent nutritional supplements, only 50% of respondents were able to correctly identify the website with the most trustworthy features. Less than a quarter of study participants reached the correct conclusion that none of the websites made a good case for taking the nutritional supplements. Up to 45% of students were unsure if they needed to provide references for ideas expressed in paraphrased sentences or sentences whose structure they modified. Most respondents (84%) believed that their research skills were good, very good, or excellent. Students’ self-perceptions of skill tended to increase with increasing level of education. Self-reported skills were weakly correlated with actual skill level, operationalized as the overall RRSA score (Cronbach alpha = .78 for 56 RRSA items).
While the majority of students think that their research skills are good or excellent, many of them are unable to conduct advanced information searches, judge the trustworthiness of health-related websites and articles, and differentiate between various information sources. Students’ self-reports may not be an accurate predictor of their actual health information competencies.
As society moves toward evidence-based medicine [
Recent reports suggest that over 55% of Americans with Internet access seek health information online [
Internet users may tend to underestimate the effort and competence required for obtaining trustworthy health information. A decade ago, communication researchers who compared print and television media described this paradox:
[Individuals] have learned that print materials, so highly prized in school and elsewhere, are indeed more difficult to process, whereas TV can be processed for pleasure without much effort. However, this argument pertains only to the minimum effort needed for the satisfactory processing of materials; it says nothing about the amount of additional effort one
Although the Internet provides access to a vast number of documents on health-related topics, it is hard to build evidence-based knowledge about a health issue if one cannot determine the credibility of websites and the trustworthiness of the online documents. The
Higher education institutions in the United States provide access to an unprecedented quantity of digital information via library archives, licensed online databases, and the public-access Internet. To differentiate between publicly accessible Web documents and password-protected scholarly databases, which can be accessed by paid members via the Web, we refer to the former as the “the public-access Internet.”
Our study explores three basic questions: How proficient are university students at finding and evaluating health-related information? How well do they understand the difference between peer-reviewed scholarly resources and opinion pieces or sales pitches? How aware are they of their own level of health information competencies? The main goal of this project was to identify approaches to building Information Age competencies of young health consumers, specifically a cohort of 18- to 23-year-old students enrolled in higher education programs.
In accordance with the Healthy People 2010 health communication objective [
Thus, abundance of health information does not always translate into informed choices. Hibbard and Peters [
Online health care is having a growing cultural impact, affecting the practitioner-patient relationship and opening up the possibility of new roles for social workers and educators in the provision of health services [
Schneider and Shiffrin [
We also draw upon Anderson’s ACT theory [
Our research originated from the collaboration of a psychologist, a health educator, and a librarian who set out to understand and improve health information competencies of the Information Age generation. The collaboration enhances our research in several ways. The psychologist contributes expertise in the area of psychometrics and test design, whereas the health educator contributes knowledge of health consumers’ behavior and intervention designs. The librarian contributes expertise in training and enhancing patrons’ health information–seeking skills [
A sample of 400 college-age students was selected because this cohort is the first Information Age generation that has been exposed, for up to one-half of their lives, to the Internet. Students enrolled in three courses in the College of Health Sciences at a Midwestern university were invited to participate in the study. The first class was a high-enrollment introductory course on the determinants of health. Although only undergraduate students (n = 354) participated in this course, they represented all levels of undergraduates—freshman (59%), sophomores (22%), juniors (9%), and seniors (10%). The second class was an advanced course in health administration in which both undergraduate (n = 19) and graduate students (n = 3) were enrolled. The third class was a mid-level health education course (n = 25) for undergraduate students. All students enrolled in the advanced health administration course and the mid-level health education course were majoring in health professions. About one third of the introductory course students with declared majors were majoring in a health-related discipline, and 31% of students had not made up their minds about a major field of study.
Introductory course students completed the assessment for extra credit, while others did it to learn more about their own skills. The instructors emphasized that the purpose of the assessment was to help students become competent consumers of health-related information.
Ivanitskaya and Casey developed the Research Readiness Self-Assessment (RRSA) to measure basic research skills based on the Information Literacy Competency Standards for Higher Education developed by the Association of College and Research Libraries [
The RRSA contains the following items: (1) multiple choice or true/false questions that measure declarative knowledge; (2) interactive, problem-based exercises that measure procedural knowledge; (3) demographic questions; and (4) a question that asks for a self-report about the level of the respondent’s research skills [
Declarative knowledge, defined as knowledge of facts or verbal knowledge, is a precursor to higher-order learning, which is needed, for example, to complete a sequence of steps to critically analyze a website or to employ elegant information search strategies [
A journal article abstract is…
an annotated list of references used in the article a summary of the article’s content a summary of other research on this topic a note or paragraph about the authors of the article a glossary of abstract concepts included in the researcher’s model
Compared to declarative knowledge, procedural knowledge is related to skills and problem solving. Essential for reproduction of learned behaviors, procedural knowledge is defined as knowledge of the process used to complete a task (e.g., how an information search process can be sequenced, organized, or controlled) [
You are interested in gathering information about work stress but are not interested in its medical side effects. Set up a document search in a separate window using the following keywords:
In addition, students evaluate the quality of research publications, make judgments about website trustworthiness, and detect plagiarism. For example, the following item is used to measure evaluation of the trustworthiness of websites:
You are looking for information on various nutritional supplements. You found three websites. Click on the links below to examine each site and to evaluate its content. Which of these websites is the most trustworthy? a) cognitogenic aids [a hyperlink]; b) dormitogenic aids [a hyperlink]; c) vescorogenic (gustatogenic) aids [a hyperlink].
To pilot test an earlier version of the RRSA instrument and to gather initial evidence about its validity and reliability, we administered a 60-item assessment to undergraduates (n = 100) and doctoral students (n = 45), as well as professional librarians (n = 5) and health professionals (n = 3). The feedback from librarians and health professionals offered preliminary evidence in support of the instrument’s face validity and content validity. Specifically, the librarians confirmed that the items included in the RRSA assessment conformed to the Information Literacy Competency Standards and addressed knowledge and skills important to health information consumers. The wording of several items, both stems and response options, was revised based on librarians’ recommendations. In addition, the librarians completed the assessment themselves. Their scores were then compared to the scores of students at two academic levels, undergraduate and doctoral. The results indicated that individuals with greater training and experience in managing digital health information performed better than individuals with less experience. Undergraduate students’ overall scores were the lowest (about 66% correct responses), followed by doctoral students’ scores (73%) and librarians’ scores (95%). These results offer preliminary evidence of the assessment’s criterion-related validity. The pilot test indicated an acceptable internal consistency value (Cronbach alpha > .70), although it could be improved (approach .80) if four items were removed. Therefore, four RRSA items that reduced the overall internal consistency were deleted.
The revised assessment contains 56 items, including 16 multiple-choice questions and 40 true/false questions grouped under 7 stems (Multimedia Appendix 1). For example, knowledge of information sources is measured by a stem that states, “Which of these citations are to journal articles?” The participants then check all that apply from the list of 6 true/false items (3 references to journal articles, 1 book reference, and 1 book chapter reference). Items are scored as +1 if the answer is a correct positive or a correct negative and +0 if the answer is a false positive or a false negative. Further description of the development of the stimulus materials used in website evaluation appears in the Results section, under Proficiency in Evaluating Health Information.
The RRSA assessment was designed to be useable by more than one institution. Its content can be adapted to the needs of various educational programs. Specifically, instructions to participants, the text of individual questions, detailed feedback, links to additional resources, and disclaimers (e.g., about participants’ rights and how the information they provide will be used) can be revised, without help from programmers, using the password-protected online control panel. This has been done by three US universities and one Canadian university that adopted the RRSA for use in their academic programs. For example, all four institutions revised search questions to enable their students to search for documents in their own university’s library catalog. The original RRSA designers provide coaching and training in order to ensure that the changes made to the RRSA do not have a negative impact on its reliability and validity. Ongoing validation studies provide a quality control mechanism and allow the testing of new or revised questions suggested by the partner institutions. The administration of the RRSA to partner institutions is supported through grants, partner donations, and volunteer efforts by the RRSA design team members.
We asked the study participants to share information about their age, gender, and education. Self-reported level of research skills was measured with a single item, “How do you rate your research skills?” with six response options ranging from 1 (nonexistent) to 6 (excellent).
The RRSA instrument was administered online. Each student was issued a unique pass to access RRSA questions. The students had the option of submitting an incomplete survey and then returning to it at a later time to finish the remaining questions. This feature promoted better information processing and relieved the students from the need to rush and finish the entire assessment on their first attempt. The average estimated RRSA completion time was 26 minutes. Upon answering all questions, the students received an individualized results page that summarized their performance in different areas by providing a score, a maximum possible score, and percent attained. In addition to the numerical RRSA results, the Web page displayed individually tailored feedback composed by an experienced librarian. The Web page was programmed to compare, within each performance category, each individual student’s performance to the performance of a norm group. In accordance with the student’s competency level, the feedback provided suggestions for skill improvement and an explanation of factors that may have contributed to low, average, or high performance in each area. Finally, students who completed the RRSA were given the option to request additional materials for remedial learning, such as an explanation of the difference between scholarly and nonscholarly resources. The links to these additional materials were delivered to students via email.
Descriptive statistics were used to examine respondents’ performance in four areas—searching for health-related information, understanding plagiarism, evaluating health information, and self-reported skill level. To examine the relationship between self-reported skill level and actual performance, we computed composite scores. A composite overall score, which is indicative of the health information competency level, was created by adding points for 56 items, which were either true/false or multiple choice. Composite score calculations were preceded by an internal consistency reliability analysis that determined the appropriateness of combining responses from multiple items. We used a Spearman correlation to assess the relationship between the actual skill level (overall score) and self-reported skill level. A multiple regression analysis was used to examine the relationship between actual performance and perceived skill while holding the amount of education (number of credit hours earned) constant.
Our research questions were the following: How proficient are university students at searching for and evaluating health-related information? How well do they understand the difference between peer-reviewed scholarly resources and opinion pieces or sales pitches? How aware are they of their own level of health information competencies? The results for each question are presented below, preceded by a sample description.
The participation rate was 77%. Nonrespondents (n = 92) differed from respondents (n = 308) in terms of their academic level (
Table 1 summarizes performance in searching for health information. The data indicate that most students recognize common health journal titles and can perform a basic search in a library catalog, for example, by entering an exact book title into the title search. Few students, however, can perform an advanced search for a book when they know the book’s author (with a very common last name), general topic, and publication date. We call this search advanced because imprecise book specifications make it hard to find the book without performing a search that takes into account all or nearly all of the available information.
The data also show that two thirds of study participants are unable to understand or apply Boolean operators, such as
One of the most important markers of a competent health information consumer—critical judgment of information—is assessed in two ways: (1) the first set of questions calls for a review of three full-text articles from journals, and (2) the second set of questions calls for a comparison of three health-related websites.
The three journal articles are on the topic of job satisfaction, a topic relevant to any profession, and come from a full-text library research database. They include a rigorous empirical study, a case study, and an opinion article. Only the empirical study has a bibliography and an explicit statement about the author’s affiliation. The opinion article, clearly the least authoritative source, makes no mention of the author’s affiliation. As shown in
The three Web pages about nutritional supplements are realistic looking interactive screens that appear to be live websites. The content of these mock websites, developed specifically for the RRSA, includes graphics, hyperlinks, and text about nonexistent classes of nutritional supplements—cognitogenics, dormitogenics, and gustatogenics. Each website is dedicated to one class of supplement and explains its purpose (e.g., cognitogenics help people with learning disabilities), prevalence (e.g., “gustatogenic aids have been available in Germany and Canada for over five years”), and safety. Even though the descriptions of nutritional supplements were fictitious, all three websites accurately stated that the US Food and Drug Administration did not evaluate the safety or benefits of these nutritional supplements.
Searching and evaluating health information: performance on select measures (n = 308)
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Knowledge of a scholarly source, |
293 | 95 |
Demonstration of a skill in locating a book in a university library catalogue based on its exact title (16) | 286 | 93 |
Understanding that a one-keyword generic search may return too many documents—an overwhelmingly large number of resources on a variety of topics (4) | 275 | 89 |
Use of a proper research strategy—thinking about a broad topic to identify a sub-area of interest (2) | 268 | 87 |
Ability to detect a journal citation that is incomplete—lacks a year of publication (17) | 241 | 78 |
Understanding of a term “article abstract”—a summary of the article’s content (8) | 234 | 76 |
Knowledge that a journal is a source of scholarly (analytical) information on a narrowly specialized topic (6) | 214 | 70 |
Understanding of a term “bibliography”—a list of references or citations (9) | 213 | 69 |
Identification of a primary source of health information: medical record (14) | 195 | 63 |
Identification of references to journal articles from a list of references that includes both book references and article references (11) | 187 | 61 |
Knowledge of a peer-reviewed journal article as an authoritative source of specialized health information (12) | 185 | 60 |
Identification of a primary source of health information: hospital annual report (14) | 173 | 56 |
Demonstration of a skill in locating a book in a university library catalogue based on a non-unique authors’ name and a general topic (15) | 111 | 36 |
Knowledge of Boolean operators ( |
105 | 34 |
Demonstration of a skill in setting up and performing a search with Boolean operators ( |
98 | 32 |
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Evaluation of journal articles: Identification of an article published prior to year 2000 (22) | 248 | 80 |
Evaluation of journal articles: Identification of an article based on opinion rather than well-supported evidence (19) | 242 | 79 |
Evaluation of journal articles: Identification of an article based on a review of existing research (20) | 166 | 54 |
Evaluation of journal articles: Identification of an article written by an author whose affiliation is unknown (21) | 148 | 48 |
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Evidence-based decision-making: Disagree that “all three websites make a good case for taking nutritional supplements” (25) | 187 | 61 |
Evaluation of health-related websites: Identification of the most trustworthy website (23) | 154 | 50 |
Evaluation of health-related websites: Ability to identify the purpose of a website—to sell services (24) | 42* | 46 |
Evidence-based decision-making: Agree that “none of the websites makes a good case for taking nutritional supplements” (25) | 67 | 22 |
*This question was added later, and, therefore, it had a smaller number of respondents (n = 92).
Note: RRSA question numbers are shown in parentheses; see Multimedia Appendix 1 for exact question wording.
To facilitate comparison of the three websites, we built in standard features that provided clues about high or low credibility. The standard features are URLs (two websites were .org and one was .com), links to the authors’ biographies, dates of publication, references, disclaimers, and links to organizations with which the authors are affiliated. These features act as contextual clues that maximize or minimize the trustworthiness of the websites. A review of such features is part of many website evaluation recommendations (for example, in their 1999 publication, Kotecki and Chamness [
These standard features, rather than the text content, are intended to differentiate the websites in terms of their credibility. Because all respondents are equally uninformed about the nutritional supplements described in the text, they must attend to other features when making quality-related judgments. This purposeful design was motivated by the desire to avoid the confounding influence of pre-existing knowledge about the subject matter described in the document that is being judged. A good measure of one’s ability to critically evaluate Web pages is being able to disentangle the judgment of a website’s features from the judgment of its content. Study participants may have had preconceived notions about the quality of nutritional supplements depending on their purpose (e.g., cognitogenics are for sleeping disorders and gustatogenics are for appetite suppression). To avoid a possible interaction between the untrustworthy features of a website and the believable description of the nutritional supplement, we asked a group of students (n = 52) to judge the trustworthiness of the supplements’ descriptions presented as Microsoft Word documents rather than as websites. Although the level of trustworthiness was about the same for all nutritional supplement descriptions, the least trusted nutritional supplements were placed on the website with the highest number of untrustworthy features.
When five subject matter experts independently reviewed the three websites and rated their trustworthiness using the Kotecki and Chamness [
Less than half of respondents determined the purpose of the least trustworthy website, which was to sell products and services. The visitors to this .com website are charged for reprints of the content, offered discounted products, and provided with multiple prompts (e.g., a running line) to book a consulting appointment with a private nutritionist who has few relevant qualifications. Customer testimonials posted on this site describe fantastic outcomes achieved within an unrealistically short time frame.
Less than a quarter of study participants reached the correct conclusion that none of the websites made a good case for taking the nutritional supplements, whereas 39% of respondents thought that all three websites made a good case for taking the supplements.
Health care professionals are expected to share health information with others, for example, by summarizing information from a variety of sources and distributing it to patients and clients. Higher education programs prepare students to apply standard rules for acknowledging contributions by others and referencing idea sources. Because this skill set is expected to become an integral part of their professional ethics, we built the RRSA to include measures of students’ knowledge of plagiarism, their ability to recognize it, and their awareness of its penalties. Our results indicate that the vast majority of students (92%) know that their university may impose a severe penalty for plagiarism, up to and including expulsion.
Understanding plagiarism: when references are needed (n = 308)
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Common knowledge* | 294 | 96 |
Hospital board member’s point of view | 264 | 86 |
My classmate’s ideas | 232 | 75 |
Unpublished works | 223 | 73 |
Spoken word | 209 | 68 |
My dad’s political opinions | 156 | 51 |
*Common knowledge can be reproduced without proper reference.
Note: Items are scored as +1 if the answer is a correct positive or a correct negative and +0 if the answer is a false positive or a false negative.
Defining plagiarism (n = 308)
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Submitting a free research paper that was downloaded off the Internet.* | 290 | 95 |
Reproducing a sentence that you found quoted in a book without referring to the original source.* | 276 | 90 |
Enclosing the word-for-word sentence in quotation marks, accompanied by a citation. | 271 | 88 |
Copying from the source verbatim without any quotation marks but adding a citation.* | 215 | 70 |
Putting someone’s idea in my own words without citing a specific source.* | 201 | 65 |
Using similar sentence structure to express another person’s ideas without referring to the original source.* | 169 | 55 |
*These items are examples of plagiarism..
Note: Items are scored as +1 if the answer is a correct positive or a correct negative and +0 if the answer is a false positive or a false negative.
To measure procedural knowledge of plagiarism, we ask respondents to compare a sentence from a
When asked “How do you rate your research skills overall?” most respondents (84%) believed that their skills were good, very good, or excellent. To compare self-reported and actual skill levels, we computed an overall health information competency score for each participant. An acceptable level of internal consistency reliability (Cronbach alpha = .78) for 56 right/wrong items indicates that it is appropriate to calculate the overall score as the sum of points of these 56 items. The overall scores ranged from 20 to 54 with a mean of 37 (SD = 6.35) and did not significantly depart from a normal distribution.
Actual performance was examined by self-reported skill level. The group differences were mostly in the expected direction (see
Means for health information competency overall score by self-reported skill level
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Nonexistent | 0 | - | 0 |
Poor | 3 | 36.33 | 4.04 |
Fair | 47 | 34.89 | 5.52 |
Good | 162 | 36.89 | 6.29 |
Very good | 83 | 37.64 | 6.89 |
Excellent | 13 | 36.77 | 6.10 |
Total | 308 | 36.78 | 6.35 |
Health information competencies may vary as a function of education; therefore, we regressed undergraduates’ overall scores on the amount of credit hours earned toward the bachelor’s degree (Step 1) and self-reported skill level (Step 2). The level of education was operationalized as the number of credit hours earned (0-9, 10-24, 25-40, 41-70, and more than 71). The analysis was conducted for 302 undergraduate students (six graduate students were removed from this analysis). Age could not be used as a control variable because most students (95%) fell into the same category of 18 to 23 years of age. The variables entered on Steps 1 and 2 account for 8% of variance in the overall score (
The present study represents a systematic effort to measure health information competencies using a standardized and reliable measurement tool, the Research Readiness Self-Assessment (RRSA). The data were obtained from a diverse sample of 308 respondents (77% response rate). Nonrespondents (n = 92) differed from respondents (n = 308) in terms of their academic level: freshmen were slightly more likely not to participate in the RRSA than higher-level students. The most likely explanation for nonparticipation is a lack of interest in extra credit rather than the computer-assisted administration of the RRSA. It is possible, of course, that students with particularly poor computer skills found the online administration a barrier. However, a semester after we collected the data reported in this paper, there was a 100% participation rate by 180 undergraduates in two introductory courses where the instructors required RRSA completion. The two course instructors reported no student complaints about not being able to follow emailed instructions on how to complete the assessment.
The data indicate that many students lack important competencies that may limit their ability to make informed health choices. We observed deficiencies in the areas of conducting advanced searches, discriminating among different types of information sources, referencing other people’s ideas, and evaluating information from Web pages and journal articles. Our data suggest that undergraduate students are inaccurate judges of their own competencies and hold a very positive view of their ability to do research. This finding may reveal an important barrier to building health information competencies of college-age students.
We found that there is a large competency gap between the average and the best information consumer. An average undergraduate in our sample is able to solve only 68% of problems that are solved by the best performing study participant (an average score of 37 versus a maximum score of 54). Health information competencies are applied to transform health-related information into knowledge that is consistent with the most current medical practice. High competence variability is a proxy indicator of students’ varying ability to make evidence-based decisions. In the past, limited access to information may have prevented health information consumers from acquiring knowledge and making informed choices. The new generation of health information consumers has, for the most part, easy access to information; yet it may not be able to take full advantage of this convenient access.
Our study shows that individuals with limited health information competencies may fail to locate the best available information due to employing poor search strategies. Searches that do not take into account all of the important criteria often produce low-relevancy documents or documents from commercial websites that promote products or services. These sites often present one-sided evidence, which can be detrimental to making a good decision about one’s health. Overall, many students are rather unsophisticated information consumers who rely on basic searchers and the easiest ways of retrieving information.
We found that many individuals know little about information sources—primary versus secondary, articles versus books, commercial versus noncommercial websites, and opinion pieces versus empirical studies. Information consumers who do not understand these distinctions are likely to engage in information processing that is shallow and superficial. They may, for example, follow a search path that produces the highest number of documents, rather than a path that produces documents of the highest quality. When the number of documents criterion is applied, Google and Yahoo significantly outperform all scholarly databases available through libraries. For instance, a Google search for the keyword
Once the plethora of documents is obtained, they need to be critically evaluated. Although health consumers are warned to critically examine websites to determine the document’s purpose, author’s affiliation, date of publication, and other features [
Indeed, there is no substitute for good judgment when it comes to navigating information. Because this good judgment is a product of both critical thinking and extensive knowledge of the subject matter being researched, we believe that higher education programs are uniquely positioned to develop health information competencies. However, initial work on developing Information Age competencies needs to be done at the K-12 level when children are beginning to be exposed to various sources of information, including the Internet.
In this study, we reviewed three broad categories of information competencies—obtaining information, evaluating information, and using information. Using information includes such behaviors as reaching evidence-based conclusions and sharing information with others, a behavior guided by one’s understanding of plagiarism. One study of plagiarism revealed that cyberplagiarism, or inappropriate use of phrases and ideas published on the Internet, is prevalent even among scholars [
Perhaps the most interesting finding is the fact that participants are so unaware of their own skill deficiencies. It is possible that students make global judgments about their research skills based primarily on their ability to access information. That is, one’s ability to access information may be confused with one’s ability to generate knowledge from the information accessed. But obtaining information is merely the first step of knowledge acquisition. All of our study participants can access the Internet, as demonstrated by completing the RRSA online, but not all may be able to make good use of the information they access. Extending the argument by Solomon and Leigh [
The findings of our study have several implications for individuals who practice health promotion for health information consumers. Health educators, librarians, and other professionals who play an active part in promoting health information literacy need to assist health information consumers in becoming more aware of their skill limitations. These professionals should develop their own proficiency in managing modern media and be able to find, evaluate, interpret, and present health-related information to other information consumers. Research on health information competencies of practicing health professionals remains limited, and we do not yet have a complete picture of their preparedness for evidence-based practice. But in one survey study of 1097 registered nurses, it was found that many respondents “had no exposure to the research process in their educational programs, do not appreciate the importance of research to practice, and have great difficulty understanding research articles” [
The RRSA instrument offers an operational definition of information literacy, which remains an ill-defined concept. Upon examination of 97 Medline articles on the topic of information literacy for health care professionals, Saranto and Hovenga [
Among the limitations of the present study is the narrowly focused sample, which limits our ability to generalize the study’s findings to the broader population of health information consumers. The students from a Midwestern university may not be completely representative of the entire population of US Information Age students, due to, for example, the relatively homogeneous ethnic composition and possible overrepresentation of individuals raised in rural communities. In our future studies, we intend to broaden the pool of RRSA participants by including multiple educational institutions as well as urban and rural communities located in different geographic regions.
In contrast with many health information literacy studies, this research presents the results obtained via direct measure of skills and knowledge rather than via self-reports by health information consumers. While the reliability of the RRSA assessment reaches acceptable levels, it is necessary to further assess its unidimensionality, content validity, and criterion-related validity. A comprehensive validation study of the RRSA instrument is currently under way.
Today, health consumers are actively seeking information and using it to make health decisions. The ease of accessing information may influence their perceptions of their ability to make informed health decisions. Our study shows that to become savvy information consumers, young people may need assistance in understanding the various health media, building awareness of their own skill sets, and improving their ability to make evidence-based decisions. Individuals with less education and exposure to information-related activities are expected to have even lower health information competencies than our study participants [
The assessment tool used in the present study is a self-administered instrument that provides a reliable account of health information competencies related to managing electronic health information. Data acquired through this research can be used to suggest curriculum improvements and estimates of the higher end level of skill held by health information consumers. It can also be used to educate health information consumers about their levels of skill necessary for managing health information from electronic sources. RRSA findings suggest that health information competencies of undergraduate students, many of whom will soon enter a variety of health professions, are limited. Health literacy educators can utilize RRSA findings to design educational interventions that impact information consumers’ skills and prepare them for the challenges of living and working in the Information Age.
The authors would like to thank Aamna Qamar for her assistance in preparing the final copy of this manuscript and Wesley A. Leonard for providing programming support for our research project. This research was completed with support from Central Michigan University’s School of Graduate Studies, University Libraries, and The Herbert H. and Grace A. Dow College of Health Professions.
None declared.
RRSA questions.
Video of the online-administered RRSA instrument.
Powerpoint slides about the RRSA study.
Research Readiness Self-Assessment