A total of 362 students joined the survey, 329 of them belonging to medical school and 33 to communication theory school. Female respondents were 217 (59.9%) and male respondents were 145 (40.1%). The mean age of medical students was 20.6 ± 2.1 years while the mean age of communication students was 27.3 ± 4.3 years (Table 1) [see Additional file 1, page 1]. Only 26 of medical students (7.9%; Female: 8.9%; Male: 11.6%) were aware of the existence of DMVEC website, mostly due to general surfing of the web, while 10 communication students (30.3%; Female: 34.6%; Male: 14.3%) were aware of it (Table 1) [see Additional file 1, page 1].
Regarding first evaluation, the initial overall mean score of eHEALS for medical students was 3.6 (SD 0.7). Of the 329 participants, 159 (48.3%) had scores higher than the mean score of eHEALS. Participants felt moderately confident in how to find helpful health resources on the Internet (82.4% agree or strongly agree; n = 271; mean score of 3.9, SD 0.8) and how to use the Internet to answer health questions (74.5% agree or strongly agree; n = 245; mean score of 3.8, SD 0.9). On the other hand, they felt quite less sure concerning what health resources are available on the Internet, where to find helpful health resources, how to use the health information and in the ability in discerning and evaluating low quality to high quality health resources. The most critical item regarded their perceived confidence in using information from the Internet to make health decisions (only 36.2% agree or strongly agree; n = 119; mean score of 2.9, SD 1.1). In terms of elements that characterize the quality of sources, participants accorded with the importance of authoritative sources (80.6% agree or strongly agree; n = 265; mean score of 4.1, SD 1.0), subject matter (89.0% agree or strongly agree; n = 293; mean score of 4.3, SD 0.8) and language used (81.4% agree or strongly agree; n = 268; mean score of 4.1, SD 0.8). Participant’s opinion was almost split about the significance of date of last update, graphic elements, transparency of sources and bibliography and sponsor/advertisement (Table 2) [see Additional file 1, page 1–2].
eHEALS scores of communication students were quite lower. The initial overall mean score of eHEALS was 3.2 (SD 0.8). The item with higher score regarded their perceived ability in distinguishing low quality from high quality health resources (60.6% agree or strongly agree; n = 20; mean score of 3.5, SD 1.0), while they felt less confident in how and where to find or use health information on the Internet. The items with lower scores were the ones concerning the perceived abilities in evaluating health information on the internet (39.4% agree or strongly agree; n = 13; mean score of 2.9, SD 1.1) and the self-confidence in the use of the information obtained (33.3% agree or strongly agree; n = 11; mean score of 2.8, SD 1.1). In terms of elements that characterize the quality of sources, students appeared conscious about the importance of authoritative sources and subject matter (mean scores of 4.3 ± 1.1 and 4.4 ± 1.0 respectively), while the presence of sponsor/advertisement was underestimated (mean score of 2.8 ± 1.4) (Table 2) [see Additional file 1, page 1–2].
After in-depth analysis of the “aware internet surfing” section, 93.4% of students (n = 338) felt more confident in recognizing and critically evaluating the quality of eHealth information. Mean scores of each item improved after the acknowledgement. Statistical significant differences in rate responses were found both in items of IT-eHEALS and in items related to elements that influence quality of sources (Table 3) [see Additional file 1, page 2–3].
The overall mean score of IT-eHEALS for medical students increased to 4.3 (SD 0.6; p < 0.001), while for communication students increased to 4.1 (SD 0.8; p < 0.001). Medical students positively agreed or strongly agreed to each item of the IT-eHEALS, with higher scores than the mean score for 175 of them (53.2%). The items with lower scores were the ones regarding the perceived abilities in evaluating health information on the internet (79.6% agree or strongly agree; n = 262; mean score of 4.1, SD 0.1; p < 0.001) and the self-confidence in their use (72.0% agree or strongly agree; n = 237; mean score of 3.9, SD 1.2; p < 0.001). Of the 329 participants, even 265 (80.6%) strongly agreed concerning the importance of authoritative sources and 261 (79.3%) strongly agreed with the significance of subject matter (mean scores of 4.7, SD 0.6; p < 0.001). In addition, the mean score related to transparency of sources, an aspect not well considered before, increased to 4.7 (95.4% agree or strongly agree; n = 314; p < 0.001). Participant’s opinion improved in the consideration of date of last update, language used and presence of sponsor/advertisement too (p < 0.001). The item with the worst score remained the one concerning graphic elements (63.2% agree or strongly agree; n = 208; mean score of 3.8, SD 1.1) (Table 4) [see Additional file 1, page 4].
Also for communication students, the items with lower scores were the ones regarding their skills in evaluating health information on the internet (78.8% agree or strongly agree; n = 26; mean score of 3.9, SD 0.9; p < 0.001) and the self-confidence in their use (69.7% agree or strongly agree; n = 23; mean score of 3.6, SD 1.4; p = 0.002). The item with highest score concerned how to find and to use health information (mean score of 4.3; SD 0.9; p < 0.001). Scores of items related to sources elements were all high, with a maximum mean score concerning the importance of authoritative sources and subject matter of 4.8 ± 0.6 and 4.8 ± 0.5 respectively. Participant’s opinion about the presence of sponsor/advertisement remained the lowest (63.6% agree or strongly agree; n = 21; mean score of 3.8, SD 1.3; p < 0.001) (Table 4) [see Additional file 1, page 4].