In a 20-bed surgical intensive care unit in a large, tertiary-care teaching hospital, informationists shadowed clinicians for 2 48-hour periods to record questions, noting when they were asked and whether they were answered. Thirty-eight percent of 112 recorded questions remained unanswered.
That's a lot of unanswered questions and may reflect a lack of time, lack of searching skills or the fact that for many questions there is no external evidence available.
As to the resources used, the findings reflect a great deal of variation:
Participants were satisfied two-thirds of the time when they looked up an answer from a resource (23 of 37 observed instances). PubMed (n=10 or 26%), Google (n=10 or 26%), UpToDate (n=7 or 18%), Wikipedia (n=4 or 10%), and other evidence-based sources (n=2 or 5%) were the most frequently queried online sources. They also accessed known journal articles, practice guidelines, handbooks, pocket guides, and handwritten notes (n=6 or 15%) to answer questions.
This is all over the map and clearly not the rigorous approach advocated by traditional EBM teaching. And at Hopkins no less.