Guide on the Side: Clinical Reasoning Tutorial Part 1 Single-Page View

Welcome!

Welcome to Clinical Reasoning! In this tutorial, we will talk about some important concepts to master in your first year as an optometry student.

You'll be in clinic this year and will be seeing patients. Additionally, you may need to look up information about optometric conditions for class and for Clinical Reasoning, you'll need to look up information on your assigned patient's disorder. So where are good places to look for this kind of information? And how can we know if a website is untrustworthy?

We will be working through a research guide that I've designed for this class. To begin, click the link on the left that says "Find information on your patient's condition."

Background Questions

When you visit with the patient you've been assigned in Clinical Reasoning, you're going to have many questions.

Some of those questions (the more basic, general ones) are called background questions. Let's say you've just spoken with a patient who has retinitis pigmentosa. Your background questions might include things like:

What is retinitis pigmentosa?
What are the symptoms of retinitis pigmentosa?
What are treatment options for this disease?
What are the incidence and prevalence rates associated with this disease?

We recommend a couple of places to find this information.

Sources for Background Questions

We have two tools that tell you everything you need to know about a disorder or disease, including epidemiology, etiology, treatment options, adverse effects ... and more

DynaMed
UpToDate

You can also search for your assigned patient's disorder in NECO Library's search box which includes:

eBooks
print books
full-text articles
content in Scopus, PubMed and Cochrane Library

Assessing a Website

But let's talk about Googling. Google has probably been your first stop when you need information about a disorder or disease. However, not all of the information in Google can be trusted.

We're going to do an exercise called the CRAAP test where you use certain criteria to grade a website.

Click the link on the left that says "Evaluate a website with the CRAAP test to begin."

Let's pick a commonly used one...

Click the link labeled #1 to see this website.

WebMD: Trustworthy or not?

It's WebMD! A very commonly used website for finding basic information on a health condition. But can we trust it?

The CRAAP acronym stands for four different words: currency, relevancy, authority and accuracy. All of these things can be used to judge a website.

Currency

Let's start with currency or when the information was created. If the information is too dated or doesn't include a date, we can't trust it.

So let's assess WebMD for currency.

The website seems decent in terms of its date, but we still have more questions to answer.

Is there a date on the page?

Yes No

Do the links work? Try clicking some and then using the back button to return to the page

Yes No

Was the page updated recently?

Yes No

Relevancy

Next is relevancy or how the information relates to your topic. We want to make sure that we're looking at information that is intended for doctors, not patients.

Is this information intended for doctors or patients/consumers?

Doctors Patients/consumers

Is the information at an appropriate level (i.e. not too elementary or advanced for your needs)?

Yes No

Authority

Let's move on the next letter of CRAAP: authority. Authority is the "who" behind the information. Who wrote this information? An organization or author? What are their credentials? Can we trust them?

Let's start answering questions about this site's authority.

Is there an author or authors associated with the page?

Yes No

If there isn't an author listed on the page, is there a known organization listed?

Yes No

Can you find a physical location for this organization? Check the contact or About Us page.

Yes No

Accuracy

Accuracy refers to the correctness of the information. Your ability to detect accuracy will change as you progress through your studies at NECO. As you start to learn more about optometric disorders, look carefully at the websites you view.

Does the information match up to what you've learned in class or clinic?

There are also a couple of other things we can look for, like typos.

Are there footnotes, bibliographies, or references so that you can verify the information? Are these reliable?

Yes No

Is the content free of grammatical and spelling errors?

Yes No

Is the information based on sound medical research? Can the information on the web page be verified by another source?

Yes No

Purpose

Purpose refers to the "why" of the website. Why was this information created? To educate? To sell something?

Is there advertising on the page?

Yes No

Is the author using data improperly to promote a position or a product?

Yes No

Is the information showing just one point of view?

Yes No

Summing Up

Summing up, WebMD didn't completely fail the CRAAP test but it certainly didn't pass.

Also, some questions on the CRAAP test are more important than others. The three most important things here are that WebMD is not designed for doctors and lacks important clinical information, the site contains advertisements and the information cannot be verified by citations or an author.

We now know that some websites cannot be trusted or used for our patient projects.

In the next tutorial, we'll talk about study designs and different types of evidence.

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