Battling the biomedical information explosion: a plan for implementing a quality filtered database.

In 1980 an article appeared in the Archives of Internal Medicine stating that two-thirds of the studies appearing in the best medical journals contain unwarranted conclusions. In order to deal with the ever increasing mass of biomedical information (termed a "journalistic blastoma" by one editor), IAIMS has extolled the use of quality filters, devices to sort through the literature and sift the good from the bad. The complexity of the task is staggering. Quality is obviously subjective, and its nature raises the question of whether our users can be taught the necessary skills to systematically evaluate the literature. This report is based on a research project that grew into an elective course for medical students at Texas Tech University School of Medicine on "Critical Appraisal of the Biomedical Literature."     

Quality assurance in health sciences literature searching: applying the ISO 9000 quality standard

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Embedded Clinical Librarianship: Bringing Medical Reference Services Bedside

This article was written by Patti Gibbons and Debra A. Werner. Patti is the Head of Collection Management at the University of Chicago Library’s Special Collections Research Center and holds a MLIS from the University of Illinois and a MA from the University of Washington. Debra is the Librarian for Science Instruction & Outreach and Biomedical Reference Librarian at the University of Chicago Library and the University of Chicago’s Pritzker School of Medicine’s Director of Library Research in Medical Education and she holds a MLIS from Dominican University. This article covers an experimental project at the University of Chicago where the library’s medical librarian teamed up with the hospital’s clinical team during patient rounds to provide real-time reference services. The project’s effectiveness was studied by a medical student who found that the embedded librarian’s services improved the clinical team’s evidence-based medical decision-making abilities without increasing the length of bedside rounds.     

A Survey of the Reference Sources for Holistic Medicine

Holistic medicine and therapeutic systems are increasingly popular health care alternatives. Reference librarians, when asked about subjects pertaining to the vast field of holistic health, have found the bibliographic resources to be obscure, confusing, and inconsistent. The first two sections of this article discuss the subject access that is provided by Library of Congress and National Library of Medicine subject headings. In the final section there is an annotated bibliography of the chief reference sources for the field. Reference librarians are encouraged to work through the difficulties of finding answers in this field and to treat such queries as typical consumer health care questions.     

IAIMS development at Harvard Medical School

The long-range goal of this IAIMS development project is to achieve an Integrated Academic Information Management System for the Harvard Medical School, the Francis A. Countway Library of Medicine, and Harvard's affiliated institutions and their respective libraries. An "opportunistic, incremental" approach to planning has been devised. The projects selected for the initial phase are to implement an increasingly powerful electronic communications network, to encourage the use of a variety of bibliographic and information access techniques, and to begin an ambitious program of faculty and student education in computer science and its applications to medical education, medical care, and research. In addition, we will explore means to promote better collaboration among the separate computer science units in the various schools and hospitals. We believe that our planning approach will have relevance to other educational institutions where lack of strong central organizational control prevents a "top-down" approach to planning.     

Foundations of Database Searching: Integrating Evidence-Based Medicine into the Medical Curriculum

Library integration into the medical school curriculum is a crucial aspect of meeting Liaison Committee on Medical Education (LCME) Accreditation Standards and the Association of American Medical Colleges (AAMC) Medical School Objectives Project (MSOP) guidelines. To accomplish this, academic health sciences libraries seek to develop evidence-based medicine (EBM) literature searching classes within the medical school curriculum. Establishing a basic understanding of the fundamental concepts behind health sciences database searching among medical students is a prerequisite for a more demanding evidence-based literature searching curriculum. The George T. Harrell Health Sciences Library, Penn State College of Medicine, sought to incorporate an evidence-based medicine literature searching structure by working within the existing problem-based learning system during the preclinical years. Students in the clinical years will participate in evidence-based assignments during their rotations. A fourth-year EBM elective will be created to reinforce and round out students' exposure to these concepts.     

A multidisciplinary approach to information and critical appraisal instruction

The formulation of clinical decisions based on evidence requires the ability to locate information and evaluate it critically. A ten-week critical appraisal course for third-year medical students, taught cooperatively by library and Department of Medicine faculty, integrates education in the selection, evaluation, and application of information to patient care. The course is distinctive in that information management skills are taught by a multidisciplinary team in a problem-based format as part of the compulsory medical curriculum. Medical faculty provided instruction in reading and evaluating research methodology, as well as statistical analyses in published reports, using clinical scenarios and related journal articles at weekly sessions. Library faculty provided instruction in locating pertinent research on a sample clinical problem using standard printed and computerized indexes and local library resources, and presented criteria for selecting the most useful and significant works from those retrieved. Library faculty also met individually with students to provide instruction in online literature searching. Based on formal evaluation and informal feedback, the course was well received; it effectively presents the literature search as an integral part of critical appraisal of the medical literature and of the clinical decision-making process.     

Evaluating medical student searches of MEDLINE for evidence-based information: process and application of results.

OBJECTIVE: To evaluate the adequacy of the MEDLINE instruction routinely given to all entering medical students at the University of Miami School of Medicine and the ability of students to search effectively for and retrieve evidence-based information for clinical decision making by the end of their third-year. METHODOLOGY: The authors developed and implemented a strategy for evaluating the search strategies and articles selected by third-year students, who participated in the Objective Structured Clinical Examination (OSCE) in June 1996, 1997, and 1998, and reviewed the literature on evidence-based medicine and evaluation of medical student searches. RESULTS: A mean of 5% of the students' search strategies and a mean of 26% of articles selected were ranked "excellent" or "good"; a mean of 26% of search strategies were ranked "fair" and a mean of 69% were ranked "poor"; and a mean of 22% of articles selected were ranked "fair" and a mean of 52% were ranked "poor" based on the strategy developed to evaluate student searches. CONCLUSIONS: Evaluating medical student searches for evidence-based information is an effective way of evaluating students' searching proficiency, and, in turn, the adequacy of the instruction they receive. Based on the results of the OSCE test, the school of medicine expanded the library's educational role and the library implemented major changes in the training program. Information on evidence-based medicine is now incorporated into the MEDLINE instruction. Library faculty evaluate the required searches performed by students for evidence-based information during their first and second years; 30% of students are identified for follow-up, individualized instruction based on the evaluation; and a new case-based curriculum has been proposed with a fourteen-week problem-based learning (PBL) block. These developments are timely in light of the evidence-based competencies recently published by the Association of American Medical Colleges.     

The role of the British Library for medical and health information*

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Veterinary medicine and the medical school library

The study of veterinary medicine is becoming increasingly important in the progress of human medicine, and as a consequence the literature of veterinary medicine is assuming increased importance in the libraries of schools of human medicine. In the past decade programs in comparative medicine have been initiated in many centers, reestablishing the linkage between veterinary and human medicine.Since 1966 the National Library of Medicine has assumed extra responsibilities in the collection and control of veterinary medical literature. increased indexing has thus far been the major result, with a resultant increase in the need to consult veterinary journals. Advances in the veterinary curriculum and continued veterinary education have also increased demand for veterinary publications. Such demand must be foreseen and met by medical school libraries if they are to fulfill their obligations to the scholarly medical community.     

Consumer Health Reference Interview: Ideas for Public Librarians

This two-stage study seeks to help public librarians become better prepared, and more confident and competent, when answering medical/health questions. At the first stage, eleven barriers that public librarians often encounter in the consumer health reference interview were identified through a comprehensive literature review, and at the second stage, input from professional consumer health librarians on how to overcome the barriers was gathered via a qualitative survey. Findings of the study provide concrete and practical strategies that will help public librarians more successfully conduct the reference interview to assist library users in their health information-seeking journey.     

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.     

Meta-analysis: a tool for medical and scientific discoveries.

Medicine has made increasing use of meta-analysis, largely as a quantitative procedure for combining results of clinical trials. Meta-analysis begins with a comprehensive review of the literature. The next step is a systematic analysis of the quality and content of each study. Finally, results are combined statistically and conclusions are drawn from this new overview of the data. This paper presents a brief historical perspective on the use of meta-analysis in medicine with emphasis on the medical library. The authors conclude that in the future, medical librarians will play a significant role in the application of this useful technique.     

Use of an Audience Response System in an Evidence-Based Mini-Curriculum

ABSTRACT

Since 2002, library faculty at the Indiana University School of Medicine have taught third-year medical students how to retrieve the best evidence from MEDLINE to address their clinical questions. In preparation for their Neurology, Medicine, and Psychiatry clerkships, students attended a review of evidence-based medicine principles and techniques for searching the literature. The session was team-taught by two faculty members, one from the Internal Medicine department and the other from the Library. The librarian reviewed important MEDLINE principles for constructing a good subject search and applying appropriate evidence-based filters. During the clerkships, students were asked to generate clinical questions arising from their patient encounters, searched MEDLINE for the best evidence, critiqued the results, and then applied them back to their patients' care. Library faculty provided individualized feedback on the student searches. A follow-up session two months later reinforced MEDLINE principles, used student searches as examples, and extended the discussion to other evidence-based, point-of-care resources. To add to the interactivity of the follow-up sessions, librarians used an audience response system to measure students' understanding of literature retrieval techniques and to gauge student preferences for information seeking on clinical topics. Overall, the sessions have been well-received by the students.     

PubMed免费MEDLINE检索功能和使用方法

针对网上医学文献检索中的实际问题，介绍了美国国家医学图书馆生物技术中心开发的PubMed网站更新的免费MEDLINE检索功能和使用方法。     

International programs of the National Library of Medicine

The National Library of Medicine (NLM) has a broad mission in biomedical information service. There are three major reasons for NLM, as a national institution, having an international program: first, the global nature of disease; second, the international scope of medical literature; and third, the universal goal of better communication. This paper reviews NLM's programs in relation to international medical information exchange: International MEDLARS Centers, collaboration with WHO and PAHO, NLM Special Foreign Currency Program, and development of the NLM collection.     

关于转化医学时代医学科技期刊发展的建议

医学发展逐渐进入转化医学时代,医学科技期刊编辑应积极探索期刊如何发展才能适应转化医学时代的要求.文章提出的高度关注转化医学研究领域的动态、加大转化医学稿件组稿力度、从转化医学的视角去改变期刊的选稿方向等发展建议或许有一定的借鉴意义.     

Teaching life-long learning skills in a fourth-year medical curriculum

For more than twenty years, the Ruth Lilly Medical Library has been a traditional part of the Indiana University School of Medicine curriculum. Recently, following changes to the curriculum, the Library's role has evolved to include responsibility for developing and teaching a Medical Informatics rotation as part of the senior year clerkships. Heavy emphasis is placed on acquiring life-long learning skills, especially on locating and critically appraising the best clinical evidence in the medical literature. In its first four months, the rotation has been quite favorably received by both students and faculty, but will continue changing to keep pace with future curriculum alterations and new technology.     

The Medical Library Assistance Act: an analysis of the NLM extramural programs, 1965-1970

The imbalance between medical library resources and information needs of the health professional led to a reexamination of the mandate for the National Library of Medicine. Legislation known as the Medical Library Assistance Act (MLAA) was passed in 1965 which enabled the NLM to (1) initiate programs to assist the nation's medical libraries and (2) develop a medical library network with the establishment of regional medical libraries to link the NLM with local institutions.The National Library of Medicine, through the MLAA, has made available $40.8 million to the medical library community under a competitive grant and contract mechanism for the period July 1965-June 1970. A total of 604 projects has been executed in resources, research and development, training, construction, regional medical libraries, publications, and special scientific projects. An assessment is given of each of these programs and their impact on both the National Library of Medicine and individual medical libraries. In the aggregate, these programs have significantly improved library and information services to the professional health user. The principal limitation has been inadequate funding to accomplish the level of originally stated objectives.