A Clinical Librarian Embedded in Medical Education: Patient-Centered Encounters for Preclinical Medical Students

Adding patient encounters and simulation to the preclinical years of medical school is becoming increasingly popular. This article describes the creation of active learning opportunities by a clinical librarian that are aimed at training preclinical students through the use of simulated patient scenarios. Scenarios for second-year students walk them through the evidence-based resources needed in clinical years and beyond through a standardized patient encounter. Scenarios for first-year students involve role-play of cases where the patient and physician bring contrasting ideas to the outpatient interaction. All scenarios are carried out under the guidance of a clinician and librarian.     

Impact of librarians in first-year medical and dental student problem-based learning (PBL) groups: a controlled study

BACKGROUND: Librarians at the University of Alberta have been involved with teaching undergraduate medical and dental education for several years. After 1 year of increased librarian involvement at the problem-based learning (PBL), small-group level, informal feedback from faculty and students suggested that librarians' participation in PBL groups was beneficial. There was, however, no real evidence to support this claim or justify the high demand on librarians' time. OBJECTIVES: The study aimed to determine whether having a librarian present in the small-group, problem-based learning modules for first-year medical and dental students results in an improved understanding of evidence-based medicine concepts, the nature of medical literature, and information access skills. METHODS: One hundred and sixty-four first-year medical and dental students participated in the study. There were a total of 18 PBL groups, each with approximately nine students and one faculty tutor. Six librarians participated and were assigned randomly to the six intervention groups. Students were given pre- and post-tests at the outset and upon completion of the 6-week course. RESULTS: Post-test scores showed that there was a small positive librarian impact, but final exam scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not. CONCLUSIONS: Impact was not sufficient to warrant continued participation of librarians in PBL. In future instruction, librarians at the John W. Scott Health Sciences Library will continue to teach at the larger group level.     

Using the ADDIE Model in Designing Library Instruction

Librarians are increasingly placed in the role of instructor and are required to design and deliver effective instruction. This article highlights ADDIE, an instructional design model that librarians at Weill Cornell Medical College used to redesign an evidence-based medicine course taken by first-year medical students. The ADDIE model incorporates the five phases of analysis, design, development, implementation, and evaluation. It was found that the application of ADDIE can result in instruction that focuses on learning outcomes relevant to students, meets students' needs, and facilitates active learning.     

Teaching First-year Medical Students Where to Go First: Connecting Information Needs to e-resources

The purpose of this project was to introduce first-year medical students to electronic resources that are best suited for different types of background questions. Specific questions from a case study were presented, and the students generalized them into a “type” of question. They then identified the best e-resources for that type of question. This is their first introduction to the lifelong learning competency in the Indiana University School of Medicine competency-based curriculum.     

Wiki Technology Enhanced Group Project to Promote Active Learning in a Neuroscience Course for First-Year Medical Students: An Exploratory Study

A wiki group project was integrated into a neuroscience course for first-year medical students. The project was developed as a self-directed, collaborative learning task to help medical students review course content and make clinically important connections. The goals of the project were to enhance students’ understanding of key concepts in neuroscience, promote active learning, and reinforce their information literacy skills. The objective of the exploratory study was to provide a formative evaluation of the wiki group project and to examine how wiki technology was utilized to enhance active and collaborative learning of first-year medical students in the course and to reinforce information literacy skills.     

Student peer assessment in evidence-based medicine (EBM) searching skills training: an experiment

Background:

Student peer assessment (SPA) has been used intermittently in medical education for more than four decades, particularly in connection with skills training. SPA generally has not been rigorously tested, so medical educators have limited evidence about SPA effectiveness.

Methods:

Experimental design: Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups, and then these assigned groups were randomized further into intervention and control groups. All students received evidence-based medicine (EBM) training. Only the intervention group members received SPA training, practice with assessment rubrics, and then application of anonymous SPA to assignments submitted by other members of the intervention group.

Results:

Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group, 45.7 and 43.5, respectively (P = 0.06).

Conclusions:

SPA training and the application of these skills by the intervention group resulted in higher scores on formative tests compared to those in the control group, a difference approaching statistical significance. The extra effort expended by librarians, other personnel, and medical students must be factored into the decision to use SPA in any specific educational context.

Implications:

SPA has not been rigorously tested, particularly in medical education. Future, similarly rigorous studies could further validate use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula.     

Mobile devices in medicine: a survey of how medical students,residents, and faculty use smartphones and other mobile devices to find information

Objectives:

The research investigated the extent to which students, residents, and faculty members in Canadian medical faculties use mobile devices, such as smartphones (e.g., iPhone, Android, Blackberry) and tablet computers (e.g., iPad), to answer clinical questions and find medical information. The results of this study will inform how health libraries can effectively support mobile technology and collections.

Methods:

An electronic survey was distributed by medical librarians at four Canadian universities to medical students, residents, and faculty members via departmental email discussion lists, personal contacts, and relevant websites. It investigated the types of information sought, facilitators to mobile device use in medical information seeking, barriers to access, support needs, familiarity with institutionally licensed resources, and most frequently used resources.

Results:

The survey of 1,210 respondents indicated widespread use of smartphones and tablets in clinical settings in 4 Canadian universities. Third- and fourth-year undergraduate students (i.e., those in their clinical clerkships) and medical residents, compared to other graduate students and faculty, used their mobile devices more often, used them for a broader range of activities, and purchased more resources for their devices.

Conclusions:

Technological and intellectual barriers do not seem to prevent medical trainees and faculty from regularly using mobile devices for their medical information searches; however, barriers to access and lack of awareness might keep them from using reliable, library-licensed resources.

Implications:

Libraries should focus on providing access to a smaller number of highly used mobile resources instead of a huge collection until library-licensed mobile resources have streamlined authentication processes.     

No more tours: how library tours of the past become today's celebrations

In 1999, Northwestern University's Galter Health Sciences Library redesigned the library orientation program for first-year medical students. Surveys indicated tours were ineffective and students retained little of the information presented. Furthermore, the tour was not related to the student's curriculum and did not reinforce their learning objectives. As a replacement, the library staff developed a self-directed two-hour library open house. Stations throughout the library showcased the library staff, services, and resources, focusing on the first-year student curriculum. A follow-up survey found this redesign more useful and relevant to the students' course work, indicating libraries should be creating more interactive tours for students allowing them to learn actively.     

Medical student, resident, and faculty use of a computerized literature searching system

The experiences of medical students, residents, and faculty with a computerized literature searching system were evaluated. Third-year medical students, internal medicine and family practice residents, and full-time and voluntary faculty at one medical school had the opportunity to use a full-text and bibliographic medical literature retrieval system free of charge for an eleven-month period. Subjects conducted nearly nine thousand literature searches over a period of 942 system hours. Questionnaire data showed that participants could learn to use and would use an electronic information system, felt capable of using the system, utilized the system for a variety of purposes and in a number of different ways, and viewed the system as a valuable tool in searching the medical literature. The results are discussed in the context of the educational needs of the four user-groups and medical education planning by institutions.     

PDA power at the bedside

George Washington University's Himmelfarb Health Sciences Library was investigating adding PDA resources to the collection when a medical education grant was received. Funds were used for a pilot project to compare PDA use by third-year medical students (MSIII), fourth-year medical students (MSIV), second-year physician assistant (PAII) students, and residents in the clinical setting. The PDA Committee evaluated various titles by the following criteria: both Palm and PocketPC operating systems compatibility, ease of use, depth of information, product cost, and a wide target audience. Griffith's 5 Minute Clinical Consult by Skyscape was selected. Library registration was required to receive the software and PDA downloading instructions. A short, Web-based questionnaire was developed to evaluate the product's use in the clinical setting. A low response rate of 74 questionnaires (23% of participants) was received and analyzed in March 2004. As additional funding becomes available, PDA software will be seriously considered as additions to the collection.     

Stacks,Serials, Search Engines,and Students' Success: First-Year Undergraduate Students' Library Use,Academic Achievement,and Retention

Like other units within colleges and universities, academic libraries are subject to increasing internal and external pressures to demonstrate their contributions to institutional goals related to students' success. The purpose of this study was to investigate the relationships between first-year undergraduate students' use of the academic library, academic achievement, and retention. Results of ordinary least squares regressions predicting first-year students' cumulative grade point averages (GPA) and logistic regressions predicting students' first-year to second-year retention suggest that students who used academic library services and resources at least once during the academic year had higher GPA and retention on average than their peers who did not use library services. The results of two separate regressions predicting students' GPA by 10 different types of library use suggest that four library use areas were consistently and positively associated with students' GPA: database logins, book loans, electronic journal logins, and library workstation logins. The results of two separate logistic regression analyses suggest that logging into databases and using library workstations were actions consistently and positively associated with students' retention. Additional results predicted by students' use of services at least one time and by one-unit increases in the frequency of library area uses are discussed.     

“First years' information literacy backpacks: What's already packed or not packed?”

This survey-based research explores whether first-year college students who have had previous interactions with library instruction, services, and resources at the high school level are better prepared to undertake information literacy challenges and are better equipped to adapt to the rigors of academic research. In this collaborative project, academic librarians across six colleges in New Jersey surveyed first-year students regarding their research preparation and their experiences in high school and in their first year of college. Additionally, the team surveyed a group of vetted, certified high school librarians in New Jersey regarding their resources and instructional practices and followed members of their senior class to college Based on student survey responses relating to their high school experiences, the team was able to identify, study, and compare three groups of first-year students: novice researchers, non-novice researchers, and a subset of non-novices from the high schools with vetted librarians. These were labeled alumni non-novices. The team found that students with prior high school research experiences (non-novices), especially those followed from schools identified as having certified librarians (alumni non-novices), felt more prepared for academic research and performed at a higher level relating to their understanding and use of research tools and strategies. The results point to equity concerns and suggest that students require differentiated attention at the college level.     

Integration of information literacy into a revised medical school curriculum

The Keck School of Medicine of the University of Southern California's newly revised Year I-II curriculum integrates information literacy components based on the AAMC's medical informatics objectives throughout the two-year continuum. Students are required to participate in various components taught by librarians from the Norris Medical Library including (1) an information skills workshop, (2) a yearlong literature search project, and (3) an evidence-based medicine resources workshop. Critical appraisal of literature also is included in the curriculum to ensure that the students are familiar with the various research study designs. Librarians also provide resources to assist students in researching learning issues related to cases presented in the curriculum. To encourage the faculty mentors to serve as good models of information users, librarians offer brief training sessions on information resources to faculty.     

Building Positive Learning Experiences through Pedagogical Research Guide Design

Abstract

Library research guides are traditionally designed in a pathfinder-style format by resource type. However, would a pedagogical-style guide, which moves students through the research process, better support the student learning experience? This study sought to answer the question: Which guide design best supports the student information literacy learning experience outside of a classroom setting? This article reports results of a usability study (n?=?22) of first-year to graduate students who interacted with either a pedagogical or pathfinder-style research guide through a simulated research assignment. Results indicate that, although there is no statistically significant performance difference between guide type, students using the pedagogical guide reported a more positive experience than those using the pathfinder guide. As a result, this led them to spend more time on, interact more with, and consult more resources on the research guide. Librarians who wish to enhance the usability of research guides may get greater student engagement by designing their guides pedagogically.     

Seizing the opportunity: Collaborative creation of academic integrity and information literacy LMS modules for undergraduate Chemistry

With the recent mass shift to an online environment in the university context and increases in course sizes, the need for online learning management system (LMS) content from departments, libraries, and writing services is at an all-time high. In particular, integrated course content is needed that addresses academic integrity and information literacy skills holistically.To ensure that a large number of first-year students would become aware of the resources and services available to them for research, writing, and academic integrity, a partnership between librarians, faculty, and writing support services has produced a series of scaffolded online learning opportunities for first-year undergraduate Chemistry students in their course LMS. The topics collaboratively identified to support students include: academic honesty and integrity, scientific writing, peer review, finding sources, reading academic chemistry articles, and citing using the American Chemical Society citation style.This column will describe and analyze the program development and implementation, make connections to resource development and promotion, and conclude with the limitations and next steps for growth. The developed materials have evolved over the years, and it is hoped that by sharing our experiences, others can see opportunities for online course content development through academic library partnerships.     

Changes in learning-resource use across physicians' learning episodes

INTRODUCTION: This study explores the numbers of learning resources physicians use at each stage in self-directed learning episodes addressing general problems. MATERIALS AND METHODS: A survey of a statewide random sample of doctors estimated the number of resources used at each stage in solving various general problems. RESULTS: The 50% response rate for faculty allowed generalization of findings to the population of these physicians; the rate for nonfaculty physicians was too low to allow generalization. Faculty findings showed (1) broader resource use in learning about diseases than diagnosis or therapeutics (2) comparable numbers of resources used in deciding whether to take on the learning problem and learning the required skills and knowledge, (3) greater numbers of resources selected to evaluate the problem and to learn the required skills and knowledge than to gain experience with the newly learned skills and knowledge, and (4) support for assertions that doctors value learning resources that are accessible, applicable, familiar, and time effective. DISCUSSION: The findings were interpreted in light of theory describing physicians' self-directed learning episodes, and implications are presented for physicians-in-training, physicians, and medical librarians.     

Problem-based medical education: effect on library use.

Problem-based learning (PBL) is being adopted by U.S. medical schools. Information-seeking skills are central to the PBL curriculum, which emphasizes self-directed learning and the acquisition of problem-solving and lifelong learning skills. The purpose of this study is to begin exploring the relationship between the PBL curriculum and student information and library use. Medical students in PBL and conventional medical school curricula were compared on library and information-seeking competencies, behaviors, and perceptions. A survey was sent to second-year students in four medical schools, two schools with two curricular tracks (one PBL and one conventional), one PBL school, and one conventional school. The results showed certain significant differences (P less than 0.05) between PBL and conventional curriculum students, suggesting that PBL students were the more frequent library users, used information resources that supported the independent learning process, acquired information-seeking skills at an earlier stage in their medical education, and reported greater ease in using these skills.     

Problem-Based Learning for Engineering Students: An Evidence-Based Comparative Study

This paper describes two studies, one a pilot and the second, an enhanced study, that compare problem-based learning and lecture-based learning in library instruction for first-year engineering students. Two distinct assessment strategies were used to provide empirical evidence that supports the use of problem-based learning as an effective teaching method. Based on the results of the enhanced study, the authors conclude that problem-based learning leads to better outcomes for the learning styles of engineering students.     

Library instruction and Wikipedia: investigating students' perceived information literacy,lifelong learning,and social responsibility through Wikipedia editing

Objectives:This article presents a multiyear pilot study delineating practical challenges, solutions, and lessons learned from Wikipedia editing experiences with first-year medical students at the John A. Burns School of Medicine at the University of Hawai‘i at Mānoa. The purpose of our project was to determine the feasibility and effectiveness of Wikipedia editing to improve information literacy and lifelong learning skills and to investigate aspects of social responsibility in first-year medical students.Methods:Lessons were provided through a combination of in-person and online instruction via the WikiEdu learning management system (LMS). Students next selected a health-related Wikipedia article to edit. After the editing experience, structural completeness data were collected from the WikiEdu LMS. Feedback was collected via an anonymous retrospective pre-post survey to assess the students'' attitudes toward their perceived information literacy skills and the social responsibility of improving Wikipedia articles. Nonparametric tests were conducted to compare pre versus post outcomes.Results:Fifty-seven (79%) participants in the 2018 cohort and forty-nine (64%) participants in the 2019 cohort completed the retrospective pre-post survey. In both cohorts, respondents showed statistically significant increases (p<.05) in self-rating of all ten domains of information literacy and social responsibility after completing the program.Conclusions:This study showed that medical students are competent editors of Wikipedia and that their contributions improve both the quality of the articles and their own perceived information literacy. Additionally, editing medicine-related articles provides an opportunity to build students'' social responsibility by improving content on an open platform that reaches millions each day.