Bringing evidence to practice: a team approach to teaching skills required for an informationist role in evidence-based clinical and public health practice

Objective: The objectives were (1) to develop an academic, graduate-level course designed for information professionals seeking to bring evidence to clinical medicine and public health practice and to address, in the course approach, the “real-world” time constraints of these domains and (2) to further specify and realize identified elements of the “informationist” concept.Setting: The course took place at the Division of Health Sciences Informatics, School of Medicine, Johns Hopkins University.Participants: A multidisciplinary faculty, selected for their expertise in the course core competencies, and three students, two post-graduate National Library of Medicine (NLM) informationist fellows and one NLM second-year associate, participated in the research.Intervention: A 1.5-credit, graduate-level course, “Informationist Seminar: Bringing the Evidence to Practice,” was offered in October to December 2006. In this team-taught course, a series of lectures by course faculty and panel discussions involving outside experts were combined with in-class discussion, homework exercises, and a major project that involved choosing and answering, in both oral and written form, a real-world question based on a case scenario in clinical or public health practice.Conclusion: This course represents an approach that could be replicated in other academic health centers with similar pools of expertise. Ongoing journal clubs that reiterate the question-and-answer process with new questions derived from clinical and public health practice and incorporate peer review and faculty mentoring would reinforce the skills acquired in the seminar.

Highlights

• Interdisciplinary faculty designed and offered a graduate-level course to teach the skills required by an informationist in clinical and public health practice, further elaborating a model for preparing informationists.

Implications

• This scalable approach to teaching skills for the transfer of evidence into practice could be replicated in academic health centers with similar pools of expertise; such replication could contribute data toward validating this training approach.
• Greater clarity on an appropriate, or “good enough,” standard of evidence for supporting point-of-action decision making is needed.
• Based on the assumption that practicing skills increases confidence and the likelihood that skills will be applied, this course included mentored practice of oral and written evidence presentation skills. Further research could determine whether a course that includes such mentored practice increases the likelihood that students will apply their newly acquired skills.

     

Walk-In Triage Systems in University Counseling Centers

To meet the complex mental health needs of students, some university counseling centers (UCCs) have implemented walk-in triage intake systems, which have not yet been empirically investigated. This study compared client and clinician differences (N = 5564) between a traditional scheduled intake system (Year 1) and a walk-in triage system (Year 2) at a large, southeastern UCC. Results showed a significant increase in clients’ attendance rates and clinicians’ caseloads, a significant decrease in no-show rates, and no change in students’ symptom severity at intake between Years 1 and 2. Clinicians’ number of scheduled appointments were unchanged, indicating that clinicians were already at maximum capacity for appointments in Year 1. Results are discussed in terms of the benefits and challenges that walk-in triage systems present to students, universities, and UCCs.     

The Limerick Reading Initiative: a reading intervention targeted at struggling readers in primary school

In this study we examined the effectiveness of a reading intervention targeting a group of 24 struggling readers in ten primary schools in Ireland. The intervention consisted of two components; component one consisted of 15‐20 minutes delivery of the Toe‐by‐Toe programme (a well established systematic synthetic phonics programme) and the second component consisted of 15‐20 minutes guided oral reading using levelled texts. Using standardised measures of word reading, reading fluency, reading comprehension, word attack skills and spelling, we found that after five months of the intervention, the majority of the pupils made significant improvements in reading and reading fluency. The reading comprehension improvements were more varied with almost a quarter of participants showing remarkable progress, while the remainder recorded considerably less impressive gains. These results are very encouraging for classroom practitioners and demonstrate that research validated approaches can help at‐risk readers close the gap with their typically developing peers.     

A PUPIL WITH EMOTIONAL AND BEHAVIOURAL DIFFICULTIES PERSPECTIVE: DOES JOHN FEEL THAT HIS BEHAVIOUR IS AFFECTING HIS LEARNING?

This paper has been written from the perspective of John, a year 9 pupil with emotional and behavioural difficulties. The intention of the research was to gain a clearer understanding of the factors affecting John's behaviour, and consequently, his learning. The research indicates that it is primarily the breakdown of the teacher‐pupil relationship that affects John's behaviour. Other factors include his need to communicate with peers and his poor concentration span. The research demonstrates the importance of gaining pupil perception and acting on this information when differentiating in the learning environment to include pupils with emotional and behavioural difficulties.     

Suggestions for staff development in teaching critical thinking

Trends towards the devolution of responsibility for decision‐making to the school level are evident in education systems throughout the world. Underpinning policies of devolution are assumptions that school communities will work collaboratively to make decisions appropriate to the local context. However, collaborative processes do not occur automatically. In this paper, a case study of one school committee is presented to outline the processes used and to highlight the difficulties experienced in working collaboratively to develop a school behaviour management policy.     

Concealment of Child Sexual Abuse in Sports

Researchers and theorists offer a strong base of research in physical activity for high risk groups, particularly sedentary children, adults, and the elderly. Little research examines the lifelong healthy movement behaviors of former competitive athletes. This paper raises some important questions relevant to this population, in particular the disturbing, yet limited research pointing to a serious failure of former competitive athletes to necessarily live longer, healthier, and more physically active lives. The scarce research that seems to highlight this neglected problem is outlined and hypotheses that may contribute to this phenomenon are offered and categorized in the following three sections: atypical physical behaviors found in the sporting realm, utilitarian uses of physical activity, and the long-term consequences of athletic identity. Suggestions are offered to direct future research and to implement practical intervention strategies and educational programs.