Evaluation of evidence-based medicine search skills in the clinical years

The librarians of the Health Sciences Library worked with the director of the Primary Care Clerkship to reinforce the principles of Evidence-Based Medicine (EBM) searching, taught during the first two years of medical school, through an intensive workshop. The purpose of the program was to ensure that students apply EBM principles in a timely and effective manner in clinical situations. Working in teams led by a resident and librarian, students researched real cases and then evaluated the effectiveness of their approach to the problems. This paper outlines the rationale for the team approach, reviews the administration of a computer-based workshop, and discusses the evaluation process. Evaluation focused on both the current workshop and its implications for the informatics program presented to students during years one and two.     

How much effort is needed to keep up with the literature relevant for primary care?

OBJECTIVES: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions). The authors estimated the volume of medical literature potentially relevant to primary care published in a month and the time required for physicians trained in medical epidemiology to evaluate it for updating a clinical knowledge base. METHODS: We included journals listed in five primary care journal review services (ACP Journal Club, DynaMed, Evidence-Based Practice, Journal Watch, and QuickScan Reviews). Finding little overlap, we added the 2001 "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." We counted articles (including letters, editorials, and other commentaries) published in March 2002, using bibliographic software where possible and hand counting when necessary. For journals not published in March 2002, we reviewed the nearest issue. Five primary care physicians independently evaluated fifty randomly selected articles and timed the process. RESULTS: The combined list contained 341 currently active journals with 8,265 articles. Adjusting for publication frequency, we estimate 7,287 articles are published monthly in this set of journals. Physicians trained in epidemiology would take an estimated 627.5 hours per month to evaluate these articles. CONCLUSIONS: To provide practicing clinicians with the best current evidence, more comprehensive and systematic literature surveillance efforts are needed.     

The decline in CUNY applications: Who and how come

In the fall of 1976 applications for admission to the City University of New York (CUNY) had dropped sharply. In total number they were down by almost 13,000 from 1974, a drop of approximately 18%. Several hypotheses have been posited for the sharp decline in student applicants to the City University. Analysis of data drawn from the computer printouts of the City University's allocations indicates that the end of open admissions, for example, does not, in and of itself, explain the application drop. Similarly, the change in allocation formulas at CUNY seems not to explain the enrollment decline adequately. Finally, the imposition of tuition, or the perception about tuition, appears by no means the single most important factor in the enrollment drop. This paper attempts to determine the characteristics of the students not applying and to examine the reasons contributing to the sharp enrollment decline.     

Planar asymmetry tips the phonological playground and environment raises the bar

Reading readiness varies as a function of family and environmental variables. This study of 11-year-old children (N = 39) was designed to determine if there was an additional or interactive contribution of brain structure. Evidence is presented that both environmental and biological variables predict phonological development. Temporal lobe (planar) asymmetry, hand preference, family history of reading disability, and SES explained over half of the variance in phonological and verbal performance. The results demonstrate a linear association between cerebral organization and phonological skill within socioeconomic groups. These data provide concrete evidence to support the commonly held assumption that both environmental and biological factors are independent determinants of a child's ability to process linguistic information.