A validated search assessment tool: assessing practice-based learning and improvement in a residency program

Objective:

The objective of this study was to validate an assessment instrument for MEDLINE search strategies at an academic medical center.

Method:

Two approaches were used to investigate if the search assessment tool could capture performance differences in search strategy construction. First, data from an evaluation of MEDLINE searches from a pediatric resident''s longitudinal assessment were investigated. Second, a cross-section of search strategies from residents in one incoming class was compared with strategies of residents graduating a year later. MEDLINE search strategies formulated by faculty who had been identified as having search expertise were used as a gold standard comparison. Participants were presented with a clinical scenario and asked to identify the search question and conduct a MEDLINE search. Two librarians rated the blinded search strategies.

Results:

Search strategy scores were significantly higher for residents who received training than the comparison group with no training. There was no significant difference in search strategy scores between senior residents who received training and faculty experts.

Conclusion:

The results provide evidence for the validity of the instrument to evaluate MEDLINE search strategies. This assessment tool can measure improvements in information-seeking skills and provide data to fulfill Accreditation Council for Graduate Medical Education competencies.

Highlights

• The University of Michigan MEDLINE Search Assessment tool can be used to assess search skills in residency education.
• Five elements were identified as critical elements in the development of an effective MEDLINE search strategy: inclusion of all search concepts, appropriate use of Medical Subject Headings, appropriate use of search limits, successful combination of all concepts, and search efficiency.

Implications

• This validated assessment tool can serve as an effective means to measure improvements in residents'' information-seeking skills and provide data to fulfill Accreditation Council for Graduate Medical Education competencies.

     

A survey study of evidence-based medicine training in US and Canadian medical schools

Purpose:

The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators'' and librarians'' participation in EBM training, and (3) barriers to EBM training.

Methods:

A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom''s taxonomy.

Results:

One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom''s categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches.

Conclusions:

Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment.

Implications:

Findings can provide a starting point for discussion to develop a standardized competency framework.     

Librarian instruction-delivery modality preferences for professional continuing education

Objectives:

Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians'' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes.

Methods:

Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors.

Results:

The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost.

Conclusions:

All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians'' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

Highlights

• Despite the many technological advances in the education arena, librarians prefer face-to-face instruction (direct interaction with instructors and other participants, hands-on experience, focused learning). This creates a dilemma as increased budgetary constraints are a barrier to attending face-to-face professional continuing education (CE) classes.
• Librarians in all age groups preferred the traditional classroom style of face-to-face instruction to web-based methods.

Implications

• Instructors and course designers face a challenge in incorporating the perceived advantages of face-to-face instruction into the more affordable modalities of online instruction.
• As cost becomes more of a factor for attending professional CE classes, web-based asynchronous and synchronous modalities offer important, less expensive, alternatives.

     

Time to rethink the role of the library in educating doctors: driving information literacy in the clinical environment

Question:

Can information literacy (IL) be embedded into the curriculum and clinical environment to facilitate patient care and lifelong learning?

Setting:

The Australian School of Advanced Medicine (ASAM) provides competence-based programs incorporating patient-centred care and lifelong learning. ASAM librarians use outcomes-based educational theory to embed and assess IL into ASAM''s educational and clinical environments.

Methods:

A competence-based IL program was developed where learning outcomes were linked to current patients and assessed with checklists. Weekly case presentations included clinicians'' literature search strategies, results, and conclusions. Librarians provided support to clinicians'' literature searches and assessed their presentations using a checklist.

Main Results:

Outcome data showed clinicians'' searching skills improved over time; however, advanced MEDLINE searching remained challenging for some. Recommendations are provided.

Conclusion:

IL learning that takes place in context using measurable outcomes is more meaningful, is enduring, and likely contributes to patient care. Competence-based assessment drives learning in this environment.     

Mapping the literature of health education: 2006–2008

Objectives:

The study updates Schloman''s 1997 study, “Mapping the Literature of Health Education.” The authors identify an updated list of core health education journals and determine the coverage of these journals by electronic indexes.

Methods:

Citations from four source journals for the years 2006 to 2008 were analyzed using the established methodology of the “Mapping the Literature of Allied Health Project.” The cited journals were divided into three zones of productivity by using Bradford''s Law of Scattering.

Results:

There were 19,907 citations in 602 source articles. Journal articles were the most commonly cited format type. Of the 1,896 journal titles cited, 20 (1.1%) made up the core journals. Together, the fields of medicine, health education, and psychology accounted for 85.0% of the journals in the core. Self-citation was found to be a common practice in the source journals. Scopus had the broadest journal coverage of the indexes examined.

Conclusions:

The results of this study provide a new picture of the health education literature: The volume has grown significantly, cites older materials, and relies less on sexual health journals and more on psychology journals.

Highlights

• Three of the four health education journals in this study showed a statistically significant increase in the number of journal articles published since 1993.
• The majority of core journals in the field are from medicine (35.0%), health education (30.0%), and psychology (20.0%), with the largest change in core journal make-up being an increase in psychology journals.
• Scopus provided the most thorough coverage of the cited journals, followed by MEDLINE, Social Sciences Citation Index, and CINAHL Plus with Full Text.

Implications

• Reference librarians should instruct users on more sophisticated ways to manage the growing volume of the health education literature.
• Collection development librarians may need to purchase and retain older materials to support health education research.
• Librarians should purchase and direct patrons to a variety of databases to completely cover the literature of medicine, health education, and psychology.

     

Development of the research lifecycle model for library services

Question:

Can the niche services of individual librarians across multiple libraries be developed into a suite of standard services available to all scientists that support the entire research lifecycle?

Setting:

Services at a large, research-intensive state university campus are described.

Method:

Initial data were collected via concept mapping by librarians. Additional data were collected at conferences and meetings through interactive poster presentations.

Main Results:

Services of interest to scientists for each of the stages in the research lifecycle were developed by the team to reflect the wide range of strengths of team members in aggregate.

Conclusion:

Input from researchers was the most effective tool for developing the model. A flexible research lifecycle model can be developed to match the needs of different service groups and the skills of different librarians.     

The librarian as research informationist: a case study

Question:

How can an embedded research informationist add value to the scientific output of research teams?

Setting:

The University of California–Los Angeles (UCLA) Louise M. Darling Biomedical Library is an academic health sciences library serving the clinical, educational, and research needs of the UCLA community.

Methods:

A grant from the National Library of Medicine funded a librarian to join a UCLA research team as an informationist. The informationist meets regularly with the research team and provides guidance related to data management, preservation, and other information-related issues.

Main Results:

Early results suggest that the informationist''s involvement has influenced the team''s data gathering, storage, and curation methods. The UCLA Library has also changed the librarian''s title to research informationist to reflect the new activities that she performs.

Conclusion:

The research informationist role provides an opportunity for librarians to become effective members of research teams and improve research output.     

Exploring e-readers to support clinical medical education: two case studies

Question:

Can e-readers loaded with medical textbooks and other relevant material benefit medical students, residents, and preceptors in clinical settings?

Settings:

The settings are North Carolina community clinics served by Duke University Medical Center and St. Joseph''s Hospital in Bryan, Texas, and Scott and White Memorial Hospital in Temple, Texas.

Methods:

Duke University: Twenty second-year medical students and fourteen family medicine clerkship preceptors used Kindle e-readers in clinics during eight months of rotations. Students and preceptors provided feedback through an anonymous online survey. Texas A&M University: Nine fourth-year medical students in an elective compared medical textbooks in print, online, and on a Kindle. Six residents at a local hospital completed an anonymous online survey after a three-week loan of a Kindle loaded with medical textbooks.

Results:

The e-reader''s major advantages in clinical settings are portability and searchability. The selected e-reader''s limitations include connection speed, navigation, and display. User preferences varied, but online resources were preferred. Participants suggested additional uses for Kindles in medical education.

Conclusions:

The selected e-reader''s limitations may be resolved with further development of the device. Investigation of other e-readers is needed. Criteria for evaluating e-readers in clinical settings should include portability, searchability, speed, navigation, and display. Research comparing e-readers and mobile devices in clinical education is also warranted.     

Case study: the Health SmartLibrary experiences in web personalization and customization at the Galter Health Sciences Library,Northwestern University

Question:

How can the user''s access to health information, especially full-text articles, be improved? The solution is building and evaluating the Health SmartLibrary (HSL).

Setting:

The setting is the Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University.

Method:

The HSL was built on web-based personalization and customization tools: My E-Resources, Stay Current, Quick Search, and File Cabinet. Personalization and customization data were tracked to show user activity with these value-added, online services.

Main Results:

Registration data indicated that users were receptive to personalized resource selection and that the automated application of specialty-based, personalized HSLs was more frequently adopted than manual customization by users. Those who did customize customized My E-Resources and Stay Current more often than Quick Search and File Cabinet. Most of those who customized did so only once.

Conclusion:

Users did not always take advantage of the services designed to aid their library research experiences. When personalization is available at registration, users readily accepted it. Customization tools were used less frequently; however, more research is needed to determine why this was the case.     

Development of a clinical information tool for the electronic medical record: a case study

Question:

What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center?

Setting:

The development took place at the University of Pittsburgh Health Sciences Library System.

Method:

The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized “on the fly” into meaningful categories using clustering technology and are directly accessible from the results page.

Results:

After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center''s electronic health record.

Conclusion:

The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness.     

Starting the data conversation: informing data services at an academic health sciences library

Objective

The research obtained information to plan data-related products and services.

Methods

Biomedical researchers in an academic medical center were selected using purposive sampling and interviewed using open-ended questions based on a literature review. Interviews were conducted until saturation was achieved.

Results

Interview responses informed library planners about researchers’ key data issues.

Conclusions

This approach proved valuable for planning data management products and services and raising library visibility among clients in the research data realm.     

Use and perceptions of information among family physicians: sources considered accessible,relevant, and reliable

Objectives:

The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs.

Methods:

A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008.

Results:

Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access).

Conclusions:

When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.

Highlights

• Medical textbooks were the most popular information source for family physicians'' (FPs'') clinical decision-making purposes, and medical journals were the most popular information source for the purpose of updating FPs'' general medical knowledge.
• FPs considered medical textbooks to be the most reliable (trustworthy) source, colleagues the most physically accessible, and continuing medical education the most relevant and intellectually accessible.
• The lowest ranked information sources across all four attributes were personal digital assistants, mental health professionals, pharmaceutical sales representatives, and other decision aids.

Implications

• The most popular information sources for clinical decision-making purposes among FPs were sources characterized as reliable and generally physically accessible.
• This study suggests the need for further research into interventions that target information access barriers in FPs'' practice settings and the promotion of reliable evidence for FPs'' clinical decision-making purposes.

     

Evaluation of best practices in the design of online evidence-based practice instructional modules

Objectives:

The research determined to what extent best practices are being followed by freely available online modules aimed at teaching critical thinking and evidence-based practices (EBPs) in health sciences fields.

Methods:

In phase I, an evaluation rubric was created after reviewing the literature. Individual rubric questions were assigned point values and grouped into sections, and the sections weighted. Phase II involved searching Internet platforms to locate online EBP modules, which were screened to determine if they met predetermined criteria for inclusion. Phase III comprised a first evaluation, in which two authors assessed each module, followed by a second evaluation of the top-scoring modules by five representatives from different health sciences units.

Results:

The rubric''s 28 questions were categorized into 4 sections: content, design, interactivity, and usability. After retrieving 170 online modules and closely screening 91, 42 were in the first evaluation and 8 modules were in the second evaluation. Modules in the first evaluation earned, on average, 59% of available points; modules in the second earned an average of 68%. Both evaluations had a moderate level of inter-rater reliability.

Conclusions:

The rubric was effective and reliable in evaluating the modules. Most modules followed best practices for content and usability but not for design and interactivity.

Implications:

By systematically collecting and evaluating instructional modules, the authors found many potentially useful elements for module creation. Also, by reviewing the limitations of the evaluated modules, the authors were able to anticipate and plan ways to overcome potential issues in module design.     

Expanding roles in a library-based bioinformatics service program: a case study

Question:

How can a library-based bioinformatics support program be implemented and expanded to continuously support the growing and changing needs of the research community?

Setting:

A program at a health sciences library serving a large academic medical center with a strong research focus is described.

Methods:

The bioinformatics service program was established at the Norris Medical Library in 2005. As part of program development, the library assessed users'' bioinformatics needs, acquired additional funds, established and expanded service offerings, and explored additional roles in promoting on-campus collaboration.

Results:

Personnel and software have increased along with the number of registered software users and use of the provided services.

Conclusion:

With strategic efforts and persistent advocacy within the broader university environment, library-based bioinformatics service programs can become a key part of an institution''s comprehensive solution to researchers'' ever-increasing bioinformatics needs.     

Metropolis revisited: the evolving role of librarians in informatics education for the health professions

Objective:

The authors'' goal was to assess changes in the role of librarians in informatics education from 2004 to 2013. This is a follow-up to “Metropolis Redux: The Unique Importance of Library Skills in Informatics,” a 2004 survey of informatics programs.

Methods:

An electronic survey was conducted in January 2013 and sent to librarians via the MEDLIB-L email discussion list, the library section of the American Association of Colleges of Pharmacy, the Medical Informatics Section of the Medical Library Association, the Information Technology Interest Group of the Association of College and Research Libraries/New England Region, and various library directors across the country.

Results:

Librarians from fifty-five institutions responded to the survey. Of these respondents, thirty-four included librarians in nonlibrary aspects of informatics training. Fifteen institutions have librarians participating in leadership positions in their informatics programs. Compared to the earlier survey, the role of librarians has evolved.

Conclusions:

Librarians possess skills that enable them to participate in informatics programs beyond a narrow library focus. Librarians currently perform significant leadership roles in informatics education. There are opportunities for librarian interdisciplinary collaboration in informatics programs.

Implications:

Informatics is much more than the study of technology. The information skills that librarians bring to the table enrich and broaden the study of informatics in addition to adding value to the library profession itself.     

Aligning library instruction with the needs of basic sciences graduate students: a case study

Question:

How can an existing library instruction program be reconfigured to reach basic sciences graduate students and other patrons missed by curriculum-based instruction?

Setting:

The setting is an academic health sciences library that serves both the university and its affiliated teaching hospital.

Methods:

The existing program was redesigned to incorporate a series of seven workshops that encompassed the range of information literacy skills that graduate students in the basic sciences need. In developing the new model, the teaching librarians made changes in pedagogy, technology, marketing, and assessment strategies.

Results:

Total attendance at the sessions increased substantially in the first 2 years of the new model, increasing from an average of 20 per semester to an average of 124. Survey results provided insight about what patrons wanted to learn and how best to teach it.

Conclusion:

Modifying the program''s content and structure resulted in a program that appealed to the target audience.