The step of qualitative content analysis.

BackgroundWith the growing volume of medical information, proficiency in utilizing clinical decision support systems (CDSSs) is increasingly important for physicians. Further, research has primarily focused on CDSSs’ accuracy for specific symptoms, diseases, and treatments, but the extent to which CDSSs contribute to the clinical reasoning process and evaluation of their output remains unclear. While Google is not a traditional CDSS, previous studies have evaluated its role as a diagnostic support tool, demonstrating its ability to assist physicians in retrieving relevant medical information and influencing diagnostic decision-making.ObjectiveThis study aimed to assess whether using Google search can enhance diagnostic accuracy and confidence among medical students, and to evaluate how the interpretation of search results influences their diagnostic confidence.MethodsForty-eight fifth-year medical students in clinical clerkship at Chiba University Hospital were presented with ten clinical scenarios in text format. Initially, they provided the most likely diagnosis without assistance and recorded their confidence levels. Subsequently, they used Google search to revisit their diagnoses and confidence levels, using a 7-point Likert Scale. Focus group interviews were conducted to discuss changes in confidence, and the interviews were analyzed qualitatively using content analysis. A mixed-methods analysis compared the average number of correct diagnoses and confidence levels before and after using Google search.ResultsIn total, 470 responses from 48 fifth-year medical students were evaluated after excluding 10 inappropriate responses. Correct diagnoses increased from an average of 63.6% without assistance to 76.2% using Google search (P P ConclusionsThis study underscores the value of using Google search in medical education to enhance diagnostic skills and confidence. The improvement in accuracy and confidence among students demonstrates the supportive role of Google search in clinical reasoning and education. This highlights the need for educators to teach discernment in information analysis to ensure optimal use of CDSS in medical training. Proper integration of these tools is crucial for developing future physicians capable of effectively navigating vast amounts of medical data.背景 随着医疗信息体量的持续增长，医师熟练运用临床决策支持系统（clinical decision support systems, CDSSs）的重要性日益凸显。既往研究多聚焦于临床决策支持系统在特定症状、疾病与治疗方案中的准确性，但此类系统在临床推理过程中的助力程度，以及对其输出结果的评估维度仍有待明确。尽管Google并非传统意义上的临床决策支持系统，但已有研究将其作为诊断辅助工具进行评估，证实其可协助医师检索相关医学信息，并对诊断决策产生影响。 目的 本研究旨在评估使用Google搜索能否提升医学生的诊断准确率与诊断信心，并探究搜索结果的解读方式对其诊断信心的影响。 方法 本研究招募了千叶大学医院临床实习的48名五年级医学生，为其提供10个文本格式的临床场景。受试者首先在无辅助条件下给出最可能的诊断，并记录其信心水平；随后，他们借助Google搜索重新审视自身的诊断及信心水平，采用7点李克特量表（7-point Likert Scale）进行评分。随后开展焦点小组访谈，就信心变化展开讨论，并采用内容分析法对访谈资料进行质性分析。本研究采用混合研究分析法，对比了使用Google搜索前后，受试者正确诊断的平均数量与信心水平。 结果 剔除10份不合格应答后，本研究共纳入48名五年级医学生的470份有效应答。无辅助情况下的平均正确诊断率为63.6%，使用Google搜索后提升至76.2%（P < 0.05）。 结论 本研究证实，将Google搜索应用于医学教育可有效提升医学生的诊断技能与诊断信心。学生诊断准确率与信心的提升，表明Google搜索在临床推理与医学教育中具备辅助价值。这一结果提示教育工作者需开展信息分析辨别能力的相关教学，以确保在医学培训中最优地运用临床决策支持系统。合理整合此类工具，对于培养能够高效应对海量医疗数据的未来医师至关重要。