Every month I answer a question from my readers and nursing colleagues. This month’s question is about evaluating the credibility of an online website and its associated content.
There are many online websites that look good — but how do you know if you can trust the information they are offering?
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Whether you are a student, a practicing nurse, a patient, a family member, or just curious about a medical condition or healthcare practice — you have to be able to trust the information you are reading.
I’ve pulled together information from a variety of sources (Thank you, University Librarians!), including guidelines I developed for my students, into this one post.
Information literacy is a skill that helps one critically evaluate the information found on the Internet. This is an essential research skill for students doing papers and research projects and for nurses who want to be evidence-based practitioners. Learning this skill is considered so important it is a required class in some universities; educators are starting to teach these skills to middle-school students (Duke, 2016). Read on to find five characteristics of a credible online website for nursing and healthcare information.
All Websites are Not Created Equal!
Have a question? Google it! That’s what I do too. The Internet, also known as the “world wide web” is, perhaps, the greatest innovation of our time. The amount and quality of information that can be accessed almost immediately, every second, 24 hours a day is amazing. I can’t imagine living without this rapid access, anymore — can you?
BUT, just because you find an answer to your question on the Internet (or think you have) doesn’t mean that the answer you found was trustworthy.
Why can’t you blindly trust the information on the Internet to answer your questions? Because anyone can put up a website — anyone (Virginia Tech, 2017)! And with pre-made website themes one could be up and running a professional-looking website within an hour. But, and I know your mother told you this, looks aren’t everything!
The information provided may be inaccurate or biased or purposefully misleading. If the website is pretty, looks “official,” and/or has a recognized health care symbol (e.g., medical caduceus, stethoscope, ECG tracing, nursing cap, Nightingale’s lamp, pictures of nurses, etc.), many people will believe the information is valid – without doing any further checking. Remember that anyone can download pictures and make things up!
You see there is no quality assurance for website development – you don’t get a set of rules you have to promise to follow when you start a website. No one is looking over your shoulder to ensure that the information you share is accurate.
So you can understand why you need to act as your own quality control agent!
It is extremely important that you assess the quality of the information on every website you visit – before you use that information.
So what can you do to feel confident about the information you are reading? Assess these characteristics before believing information from any online website – no matter how official it sounds or looks!
Evaluate the online website for:
Accuracy and Validity
Step 1: Evaluate the Authority of the Author of Web Content
The first thing you should do when evaluating any online website, but especially for medical or healthcare information, is to assess whether the author is qualified to be presenting the information. Before reading and using information from a website, make sure you have confidence in who provided the information!
The answer to qualified or not will depend on the purpose of the website — is it for professional informational purposes or is it a personal blog? The level of confidence one has in the information presented from a medical professional versus a layperson will differ greatly. Not that the layperson’s point of view may not be valuable for your practice – but it will most likely be used for a different reason (e.g., understanding or anticipating a patient’s or family’s needs) rather than using that personal opinion as high-quality evidence for clinical decisions (e.g., choosing one treatment over another).
Figure out who authored the document you are reading and whether they are an authority or expert in the subject area or are just someone giving their opinion on the topic.
Keep in mind that the author may be one individual or multiple authors, a company, healthcare institution or agency, academic institution, government or military agency, professional organization, non-profit organization, etc. Check the web address (URL) for the extensions .com, .edu, .gov, .mil, .org, .net (CCRI, n.d.).
Personal websites usually have the name of the person in the web address or follow the hosting company name – like wordpress.com/name, tumbler.com/name.
Country-specific websites have the abbreviation of the country at the end or the URL, such as: .uk (Great Britain) .de (Germany) or .au (Australia)
Things To Look For and Ask Yourself Regarding Authority
Is there an author name listed with the document? Check the bottom of the page and footer, if not obvious (Virginia Tech, 2017).
Can you find an About page or Bio page that lists credentials (e.g., degree, position, certifications, scholarly work by the author) or affiliations (e.g., university, hospital center, clinic, professional organization)? Does the author state a mission, vision, or philosophy for the website (Virginia Tech, 2017)?
Is the author an expert in the topic area, such as a scientist, academic faculty, clinical educator, physician, nurse, advanced practice nurse, or a generalist (e.g., blogger, vlogger, podcaster, journalist, technician, student, layperson)?
Can you verify the credentials/affiliations? Is the organization or institution well-known? Does it have a good reputation? What can you find out about it? (CCRI, n.d.; Cornell University Library, 2017; ISU, 2017; Virginia Tech, 2017).
Look for links or information that you can verify through a Google search, faculty or staff directory of the named institution, etc.
Has the author written anything else? If so, verify through your Library electronic search databases or bibliographic databases such as Web of Science or Scopus or even an Amazon book search.
Is contact information for the author located somewhere on the website? (Cornell University Library, 2017; Virginia Tech, 2017).
Step 2: Assess the Accuracy and Validity of the Information
Okay. You’ve determined that the author is credible for the topic you are researching. Now what? There is a lot of information online – how do you weed out that which is inaccurate or purposely misleading?
The next step is to evaluate the content for accuracy and for truth or validity. Another name for accuracy is precision or reliability. A valid research instrument measures what it is supposed to measure – therefore you can believe the results the instrument produces. A research tool can be reliable (its measures are consistent, reproducible), but it may not be valid (or identify the truth) if the tool doesn’t really measure what it is supposed to measure.
For example, let’s use a scale that measures consistently 10 pounds less than the person really weighs. It is reliable because it consistently shows a weight 10 pounds less than actual every time someone steps on the scale, but it is not valid because it is not measuring what it is supposed to measure — a true weight.
We want to know that the information we read on an online website is accurate and is true before you use this information in your own work or in your own life! We can assess these qualities by looking at how the author organizes and cites the information and by comparing the information to what you know already and how it meshes with information from other veritable sources. Citations can be checked to verify the veracity of the information provided.
Things To Look For and Ask Yourself Regarding Content Accuracy and Validity
Determine the purpose and intended audience of the document or online information to help you evaluate how and why the information is presented (Berkeley Library, 2017; CCRI, n.d.; Cornell University Library, 2017).
How well-written, well-researched, detailed, and organized is the information? (CCRI, n.d.; ISU, 2017).
Even if the information is meant for a general audience, quality still counts! A lot of grammar or spelling errors are a sign of poor editing and/or poor comprehension (and possibly misinterpreted facts) of the material.
Are facts, statistics, or research results reported? (CCRI, n.d.).
Does the author cite their sources (journal articles, books, book chapters, websites, etc.) and use in-text cites, footnotes, or a reference list? Are the bibliographic citations complete (i.e., is there enough information so you can find the source if you wanted to)?
Does the author cite only his/her work or are other sources cited?
Are the citations from reputable sources, such as professional journals, textbooks, books, or well-known publishers/publishing houses?university or government publishers (e.g., Oxford University Press, Institute of Medicine) (Berkeley Library, 2017; ISU, 2017).
Has the author represented the sources accurately in their paraphrases or quotes?
If the online website is offering medical information, is the website HONcode certified? The Health on the Net Foundation Code of Conduct (HONcode) is a voluntary certification “for medical and health Web sites [that] addresses one of Internet’s main healthcare issues: the reliability and credibility of [human health] information” (https://www.hon.ch/HONcode/Pro/).
The Health On the Net (HON) Foundation is an organization whose purpose is to “promote[s] and guide[s] the deployment of useful and reliable online health information, and its appropriate and efficient use. … to protect citizens from misleading health information” (https://www.hon.ch).
There is an application process and a fee after the first year. The reviewers at this organization review your website for ethical conduct and reliable information. The Nursing Education Expert website has been HONcode certified since 2014.
Step 3: Evaluate the Currency of the Content
Medical and nursing information changes daily with the publication of new research, societal mandates, practice experience, and thoughts about the future. If you are going to use information from an online website then you want probably want to make sure it represents current knowledge.
Things To Look For and Ask Yourself When Evaluating Content Currency
First determine if Currency is a quality that is essential to the purpose or goals of the online website and to your use of the material (University of Maryland, 2014).
Are there dates on the online website for when the website is updated? (Check the welcome message, header, or the footer.)
Is a date posted for when specific content is published? updated? modified? or revised?
Tip: A notation of “Last updated” with a date may represent any type of update to an online website or specific webpage from substantial addition, deletion, or modification of content to small editorial changes or formatting changes (ISU, 2017; Virginia Tech, 2017).
Check the dates of cited material or sources in the references or bibliography (Cornell University Library, 2017; ISU, 2017; Virginia Tech, 2017)
You would want up-to-date knowledge (i.e., references) for any area that changes rapidly with research and technological advances (e.g., transplant surgery, spinal treatment, heart disease).
An article about the Current Care of the Heart Surgery Patient published in 1985, 1995, or 2005 would not provide current information to care for heart surgery patients today.
While there are classic, seminal articles that one might cite for background or historical purposes, you would want to see mostly current references. And while there may be topic areas for which there are no recent published studies, this will be rare.
Again, this parameter will differ with the topic, but many would identify sources published within the last 5 years as current.
Are the links working? Broken links may indicate a site that is not well-maintained (Cornell University Library, 2017; ISU, 2017; University of Maryland, 2014; Virginia Tech, 2017). Do the links point to out-dated information?
Step 4: Assess the Relevance of the Content to Your Needs
So you’ve decided that the author of the online website you are interested in is credible and that the information provided is accurate and valid, and current. Now what? The basic question about relevance is whether the content is suitable for your research or information needs and purposes (Berkeley Library, 2017; CCRI, n.d.). Some website evaluation sources use the term, coverage, for this characteristic.
Things To Look For and Ask Yourself When Evaluating Relevance
How does this content meet your needs? Does the content provide new or cutting-edge knowledge, a unique perspective, study material, practical knowledge, skill enhancement, continuing education, a clear explanation of a muddy point?
What is the breadth and depth of the content — is the content presented as an overview or as an in-depth analysis? Is the topic narrow or is it a broad focus? Detailed and comprehensive or an outline of major points (Berkeley Library, 2017; ISU, 2017; Virginia Tech, 2017)?
Does the content mesh with other sources written about the content area? Is the content helpful and useful (Berkeley Library, 2017; CCRI, n.d.; ISU, 2017; Virginia Tech, 2017)? Is the information unique (Virginia Tech, 2017)?
Step 5: Evaluating Objectivity in an Online Website
The purpose of this criterion is to have you think about whether the information being provided is primarily objective (factual), subjective (personal opinion, one point-of-view, biased), or a combination (University of Maryland, 2014). To do this you need to understand the purpose of the information – what are the author’s goals for this content? You also need to understand who the content is targeted to because whether content is objective, subjective, or both is a function of for whom the content is intended.
Things To Look For and Ask Yourself Regarding Objectivity
Identify the purpose of the document or online information. Is it informational? educational? scholarly? scientific? public service? news? promotional? commercial? marketing? personal? entertainment? (University of Maryland, 2014; Virginia Tech, 2017).
Note any advertising on a website and be aware that the presence of advertising may influence the content you are reading (ISU, 2017; Virginia Tech, 2017).
But do realize that advertising and/or affiliate links can help website owners pay for expenses to host and produce the content, which can quickly add up.
Tip: Look for transparency from the author. The author should disclose the presence of affiliate links and let the reader know that the author may receive a commission from clicks or purchases at that site. There is no extra cost to the reader when they click on or purchase from an affiliate link.
Who is the author targeting with the information? scholars or the general public? scientists or researchers? academics? peers? students? laypeople? (Berkeley Library, 2017; ISU, 2017; Virginia Tech, 2017). Is the information presented in a style and level you would expect for the intended audience? (ISU, 2017).
Determine the level of objectivity acceptable in relation to the purpose and intended audience for the content.
For healthcare content intended to teach or educate, you’d want the information to contain facts, citations, and other proof of scholarly sources.
In some healthcare content, subjectivity would be acceptable if one is sharing personal experiences for mentoring or educational purposes.
You would expect a personal blog in the healthcare domain to be subjective. Personal blogs are meant to be someone’s digital space from where they can spout anything they want – referenced or not. These personal blogs can be very educational and enlightening, of course. For example, perhaps a person wants to help others understand a rare disease process by sharing their personal experiences with the condition and their opinions about the healthcare system. I would not expect any referenced material in this type of blog.
The level of confidence one has for information presented from a medical professional versus a layperson will differ greatly. Not that the layperson’s point of view may not be valuable for your practice – but it will most likely be used for a different reason (e.g., understanding or anticipating a patient’s or family’s needs) rather than providing high-quality evidence for clinical decision-making (e.g., choosing one procedure over another).
Can you identify bias? Is opinion being presented as fact? Are multiple sides of an argument presented? Identifying bias does not preclude you from using an online website, but you just want to be aware of the influence of any particular slant on the presentation of the content (Berkeley Library, 2017; Cornell University Library, 2017; ISU, 2017; Virginia Tech, 2017).
The steps outlined in this post, after the first two, are not as rigid or linear as they might seem. Though I think assessing author credibility needs to come first, followed by assessing the quality of the content. Once those important assessments are made I don’t think it makes much of a difference in which order you do the rest. You clearly will have ascertained an inkling or outright answers to the rest of the Step questions as you evaluate the actual content. To be honest, I rearranged the steps multiple times as I thought about the logic of these characteristics.
This is the rationale I used to sequence the steps: In my mind, evaluating author credibility has to come first, followed by evaluating accuracy and validity of the content. Making sure the content is current will lead you to make a determination of relevancy to your needs. At that point, if you are happy with the answers, you can be a bit more critical of the content and assess objectivity, if that matters for your purposes.
You found my website by searching on some keyword — most of you are searching for answers to questions you have about theory! I’m happy you are reading this post because that tells me that you are finding value in the information I’m sharing – and that’s my purpose!
My goal is to help you by providing high-quality, evidence-based information that will be valuable at multiple points in your nursing career.
So you may have found the website because of a school question, but I’m hoping you’ll stick around for other info, resources, and insights.
Thanks for being a part of this online community – I appreciate YOU! Let me know what questions I can answer for you, in the comments or email me at email@example.com!
References and Sources
I want to thank University librarians who were the major sources of the information in this post. In my research for this post, I found a very good checklist from the University of Maryland that you might want to check out.
Berkeley Library. (2017, March 9). Evaluating resources. University of California Berkeley. Retrieved from http://guides.lib.berkeley.edu/evaluating-resources
CCRI Library. (n.d.). How do I evaluate websites? Community College of Rhode Island. Retrieved from https://www.ccri.edu/library/help/evalsites.html
Cornell University Library. (2017, February 13). Evaluating web pages: Questions to consider. Retrieved from http://guides.library.cornell.edu/evaluating_Web_pages
Duke, N. K. (2016, August 15). Evaluating websites as information sources. Edutopia. Retrieved from https://www.edutopia.org/blog/evaluating-websites-as-information-sources-nell-k-duke
Iowa State University [ISU] Library Instruction Department Staff. (2017, March 20). Evaluating websites: Information literacy guide. Retrieved from http://instr.iastate.libguides.com/c.php?g=49315
University of Maryland Libraries. (2014, February). Evaluating websites: A checklist. Retrieved from http://www.lib.umd.edu/binaries/content/assets/public/usereducation/evaluating-web-sites-checklist-form.pdf
Virginia Tech University Libraries [Virginia Tech]. (2017). Evaluating webpages for research: Evaluating internet information. Virginia Tech. Retrieved from http://www.lib.vt.edu/instruct/evaluate/