A second constraint on the emergence and enactment of the informed patient identity has to do with skills and competencies in what we might call ‘information literacy’. These skills involve general awareness of where to find information, information retrieval, understanding the context of the information being provided, and interpretation and communication of that information in the context of health-care decision-making. This point becomes all the more pertinent when we come to look at Internet use. Although almost half of our participants had used the Internet for accessing health information, we found that the search strategies used were very unsystematic. In addition, we found, as did Eysenbach and Köhler (2002) in their qualitative study of health information searching on the Web, there was almost no awareness of who or what organisation was publishing the information being accessed. Indeed, for some, the information ‘media’ and ‘source’ were collapsed and the Internet was itself considered a source of health information and, for many, a good one at that.