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1.
Objectives
There is little research on pediatric hospitalists'' use of evidence-based resources. The aim of this study was to determine the electronic resources that pediatric hospitalists prefer.Methods
Using a web-based survey, the authors determined hospitalists'' preferred electronic resources, as well as their attitudes toward lifelong learning, practice, and experience characteristics.Results
One hundred sixteen hospitalists completed the survey. The most preferred resource for general information, patient handouts, and treatment was UpToDate. Online search engines were ranked second for general information and patient handouts.Conclusions
Pediatric hospitalists tend to utilize less rigorous electronic resources such as UpToDate and Google. These results can set a platform for discussing the quality of resources that pediatric hospitalists use. 相似文献2.
Jonathan D. Eldredge Laura J. Hall Karen R. McElfresh Teddy D. Warner Tiffany L. Stromberg Jaren Trost Devin A. Jelinek 《Journal of the Medical Library Association》2016,104(1):33-41
Objective
The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.Methods
In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants'' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen''s d statistic to compare pre- and post-study effects sizes.Results
Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen''s d increase of +1.50 compared to AccessMedicine users'' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen''s d.Conclusion
Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.Keywords and Medical Subject Headings (MeSH) Clinical Decision Support Systems, Computer-Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide, Information-Seeking Behavior, Medically Underserved Area, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Public Health Nurses, Randomized Controlled Trial as Topic, Service Learning, Vulnerable PopulationsHealth care practitioners regularly seek to incorporate valid information into their evidence-based decisions. Electronic information resources now provide easy access to current health information and summarized forms of evidence to support clinical decision making.Access effects on health care
Health care providers who are affiliated with well-funded institutions benefit from access to a variety of high-quality information resources to support their evidence-based practices. Practitioners who are not affiliated with academic health sciences centers rarely have access to these same resources due to prohibitively high licensing costs. Ely et al. report that not having access to easy-to-use, high-quality, current information can negatively affect sound clinical decision making. [1].Patients in Isaac et al.''s study who were admitted to hospitals that had access to an electronic evidence-based resource experienced reduced length of stay and lower risk-adjusted mortality rates for prespecified conditions [2]. That study was validated on a broader scale by a multicenter investigation on the utilization of information resources by practitioners [3].Primary health care practitioners who are not affiliated with academic health sciences centers, particularly those who practice in rural or remote areas, often articulate the need for increased access to health information resources. The authors'' literature search and review of 114 of the most relevant research articles about the information needs and information-seeking behavior of health care practitioners suggested that these professionals most value speed and accuracy. For example, they likely would prefer to use point-of-care (PoC) resources for quickly and accurately answering their clinical questions.Desirability of point of care
PoC resources quickly guide physicians through the diagnosis, treatment, and management of commonly encountered clinical conditions. PoC resources can present compilations of highly authoritative, often evidence-based, information. Physicians can answer more questions and revise clinical decisions more often using these PoC resources [4]. Meanwhile, many health care practitioners still rely on textbooks familiar to them from their professional training programs, despite their potentially dated contents [5–14].Limited access in rural New Mexico
A randomized controlled trial involving public health practitioners across the rural state of New Mexico reported many barriers in accessing valued information resources [15, 16]. In another study, researchers in New Mexico set out to determine and analyze information needs of health care practitioners who were not affiliated with an academic center. Fifty-one interviews of rural physicians, nurses, physician assistants, and nurse practitioners showed both a need and desire for access to information resources [17].Goals and hypothesis
This study sought to determine which rural health care providers found more useful in answering everyday clinical questions: electronic PoC DynaMed, which is more clinically oriented, or electronic PoC AccessMedicine, which consists primarily of a health sciences textbook collection. We hypothesized that free access to the explicitly clinical format of the PoC resource DynaMed would result in more extensive use than a baseline of zero over a six-month period than the electronic PoC textbook collection AccessMedicine. We felt this would be due to greater utility of DynaMed in clinical practice. We also predicted that clinicians using the clinically oriented PoC would express higher levels of satisfaction than those using the textbook-based PoC and that clinicians using these PoC resources would prefer using them over other information resources. 相似文献3.
Objectives:
This study describes how information retrieval skills are taught in evidence-based medicine (EBM) at the undergraduate medical education (UGME) level.Methods:
The authors systematically searched MEDLINE, Scopus, Educational Resource Information Center, Web of Science, and Evidence-Based Medicine Reviews for English-language articles published between 2007 and 2012 describing information retrieval training to support EBM. Data on learning environment, frequency of training, learner characteristics, resources and information skills taught, teaching modalities, and instructor roles were compiled and analyzed.Results:
Twelve studies were identified for analysis. Studies were set in the United States (9), Australia (1), the Czech Republic (1), and Iran (1). Most trainings (7) featured multiple sessions with trainings offered to preclinical students (5) and clinical students (6). A single study described a longitudinal training experience. A variety of information resources were introduced, including PubMed, DynaMed, UpToDate, and AccessMedicine. The majority of the interventions (10) were classified as interactive teaching sessions in classroom settings. Librarians played major and collaborative roles with physicians in teaching and designing training. Unfortunately, few studies provided details of information skills activities or evaluations, making them difficult to evaluate and replicate.Conclusions:
This study reviewed the literature and characterized how EBM search skills are taught in UGME. Details are provided on learning environment, frequency of training, level of learners, resources and skills trained, and instructor roles.Implications:
The results suggest a number of steps that librarians can take to improve information skills training including using a longitudinal approach, integrating consumer health resources, and developing robust assessments. 相似文献4.
Joshua E. Richardson Daina R. Bouquin Lyubov L. Tmanova Drew Wright 《Journal of the Medical Library Association》2015,103(4):198-202
Purpose
The study evaluated medical students'' familiarity with information literacy and informatics during the health sciences library orientation.Methods
A survey was fielded at the start of the 2013 school year.Results
Seventy-two of 77 students (94%) completed the survey. Over one-half (57%) expected to use library research materials and services. About half (43%) expected to use library physical space. Students preferred accessing biomedical research on laptops and learning via online-asynchronous modes.Conclusions
The library identified areas for service development and outreach to medical students and academic departments. 相似文献5.
6.
Estelle Hu 《Journal of the Medical Library Association》2016,104(2):150-153
Question
What to do when a major database ceases publication?Setting
An urban, academic health sciences library with four campuses serves a university health sciences system, a college of medicine, and five other health sciences colleges.Methods
Usage statistics of each e-book title in the resource were carefully analyzed. Purchase decisions were made based on the assessment of usage.Results
Sustainable resources were acquired from other vendors, with perpetual access for library users.Conclusion
This systematic process of finding alternative resources is an example of librarians'' persistence in acquiring perpetual electronic resources when a major resource is cancelled. 相似文献7.
Ryan S. Rafferty 《Journal of the Medical Library Association》2013,101(3):213-217
Objectives:
The research sought to determine if first-year medical students consulted and cited resources specifically highlighted during library instructional sessions.Methods:
Students attended a library resources instructional session. Resources that pertained to the students'' assignment were demonstrated and discussed. The students created a report including citations from relevant literature. The citations were analyzed and categorized as: a resource discussed at the instructional session, a resource found on the course LibGuide, a library resource, course material, or some other resource. All citations were subcategorized as print or electronic.Results:
Three years (2008–2011) of data analyzing 2,983 citations showed that 49.55% of all citations were from resources discussed during library instructional sessions; 21.86% came from resources with links on the course LibGuide; 77.51% were from library resources; and 90.68% came from electronic resources.Conclusion:
Students cited resources specifically highlighted during library instructional sessions for their assignments. The percentage of all citations coming from resources highlighted during the instructional sessions or found on the course LibGuide indicates that library instruction had an impact on the students'' work.Highlights
- Review of the literature shows that instruction about library resources accompanied by clear guidelines on scholarly research methods and resources provided by course instructors have the biggest impact on the quality of cited materials in student bibliographies.
- Graduate medical students cited library resources more frequently than nonlibrary resources for their assigned coursework.
- Graduate medical students cited materials and resources specifically highlighted during library instructional sessions for their assigned coursework.
Implications
- Instruction about library resources tailored to medical students'' assignments impacts the resources that the students consult and cite for their assignments.
- Using the information gathered from citation analysis to modify teaching plans can impact the effectiveness of library instructional sessions.
8.
Maria A. Blanco Carol F. Capello Josephine L. Dorsch Gerald Perry Mary L. Zanetti 《Journal of the Medical Library Association》2014,102(3):160-168
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. 相似文献9.
Xinyu Yu Yue Xie Xuequn Pan Susan Mayfield-Johnson Jessica Whipple Elena Azadbakht 《Journal of the Medical Library Association》2015,103(4):194-197
Objectives
This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course.Methods
Community assessments employing focus group interviews and an online survey were utilized to determine course need and content.Results
Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information.Conclusions
A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library''s profile. 相似文献10.
A. Tyler Nix Jeffrey T. Huber Robert M. Shapiro II Andrea Pfeifle 《Journal of the Medical Library Association》2016,104(2):131-137
Objective
This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship.Method
The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample''s responsibilities and skill sets.Results
Coordination of patient care and a bachelor''s degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams.Conclusion
Such overlap may provide an avenue for collaboration between navigators and health sciences librarians. 相似文献11.
Mary R. Simons Michael Kerin Morgan Andrew Stewart Davidson 《Journal of the Medical Library Association》2012,100(4):291-296
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. 相似文献12.
Laura L. Haines Jeanene Light Donna O'Malley Frances A. Delwiche 《Journal of the Medical Library Association》2010,98(1):73-81
Objectives:
This study examined the information-seeking behaviors of basic science researchers to inform the development of customized library services.Methods:
A qualitative study using semi-structured interviews was conducted on a sample of basic science researchers employed at a university medical school.Results:
The basic science researchers used a variety of information resources ranging from popular Internet search engines to highly technical databases. They generally relied on basic keyword searching, using the simplest interface of a database or search engine. They were highly collegial, interacting primarily with coworkers in their laboratories and colleagues employed at other institutions. They made little use of traditional library services and instead performed many traditional library functions internally.Conclusions:
Although the basic science researchers expressed a positive attitude toward the library, they did not view its resources or services as integral to their work. To maximize their use by researchers, library resources must be accessible via departmental websites. Use of library services may be increased by cultivating relationships with key departmental administrative personnel. Despite their self-sufficiency, subjects expressed a desire for centralized information about ongoing research on campus and shared resources, suggesting a role for the library in creating and managing an institutional repository.Highlights
- Basic science researchers rely on a small network of individuals in their institution and at other institutions to satisfy their information needs.
- Basic science researchers tend to ignore institutional boundaries when searching for information and do not necessarily view the library as the primary source of scholarly information.
- Basic science researchers use the interlibrary loan service regularly but otherwise rarely use traditional library services such as mediated literature searching and instruction.
Implications
- The library must establish a presence in researchers'' work environments, rather than expect them to seek out library resources and services.
- The increased emphasis by funding agencies on clinical translational science may impact the information needs of basic science researchers in the future.
- Libraries have an opportunity to capitalize on their positive reputation and basic scientists'' desire for more centralized information to create new information resources and services such as institutional repositories.
13.
14.
Barbara A Epstein Nancy H Tannery Charles B Wessel Frances Yarger John LaDue Anthony B Fiorillo 《Journal of the Medical Library Association》2010,98(3):223-227
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. 相似文献15.
Julie G. Kosteniuk Debra G. Morgan Carl K. D'Arcy 《Journal of the Medical Library Association》2013,101(1):32-37
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.
16.
Nunzia B. Giuse Sheila V. Kusnoor Taneya Y. Koonce Christopher R. Ryland Rachel R. Walden Helen M. Naylor Annette M. Williams Rebecca N. Jerome 《Journal of the Medical Library Association》2013,101(4):261-267
Objective:
This paper offers insight into the processes that have shaped the Eskind Biomedical Library''s (EBL''s) strategic direction and its alignment to the institution''s transformative vision.Setting:
The academic biomedical library has a notable track record for developing and pioneering roles for information professionals focused on a sophisticated level of information provision that draws from and fuels practice evolutions.Strategy:
The medical center''s overall transformative vision informs the creation of a fully aligned library strategic plan designed to effectively contribute to the execution of key organizational goals. Annual goals reflect organizational priorities and contain quantifiable and measurable deliverables. Two strategic themes, facilitating genetic literacy and preserving community history, are described in detail to illustrate the concept of goal setting.Conclusion:
The strategic planning model reflects EBL''s adaptation to the ever-changing needs of its organization. The paper provides a characterization of a workable model that can be replicated by other institutions. 相似文献17.
Cynthia M. Schmidt Roxanne Cox Alissa V. Fial Teresa L. Hartman Martha L. Magee 《Journal of the Medical Library Association》2016,104(2):138-142
Objective
The authors sought to determine whether unexpected gaps existed in Scopus''s author affiliation indexing of publications written by the University of Nebraska Medical Center or Nebraska Medicine (UNMC/NM) authors during 2014.Methods
First, we compared Scopus affiliation identifier search results to PubMed affiliation keyword search results. Then, we searched Scopus using affiliation keywords (UNMC, etc.) and compared the results to PubMed affiliation keyword and Scopus affiliation identifier searches.Results
We found that Scopus''s records for approximately 7% of UNMC/NM authors'' publications lacked appropriate UNMC/NM author affiliation identifiers, and many journals'' publishers were supplying incomplete author affiliation information to PubMed.Conclusions
Institutions relying on Scopus to track their impact should determine whether Scopus''s affiliation identifiers will, in fact, identify all articles published by their authors and investigators. 相似文献18.
Lana V. Ivanitskaya Kaitlyn A. Hanisko Julie A. Garrison Samantha J. Janson Danielle Vibbert 《Journal of the Medical Library Association》2012,100(4):277-283
Objective:
The research identified the skills, if any, that health preprofessional students wished to develop after receiving feedback on skill gaps as well as any strategies they intended to use to address these gaps.Methods:
A qualitative approach was used to elicit students'' reflections on building health information literacy skills. First, the students took the Research Readiness Self-Assessment instrument, which measured their health information literacy, and then they received individually tailored feedback about their scores and skill gaps. Second, students completed a post-assessment survey asking how they intended to close identified gaps in their skills on these. Three trained coders analyzed qualitative comments by 181 students and grouped them into themes relating to “what skills to improve” and “how to improve them.”Results:
Students intended to develop library skills (64% of respondents), Internet skills (63%), and information evaluation skills (63%). Most students reported that they would use library staff members'' assistance (55%), but even more respondents (82%) planned to learn the skills by practicing on their own. Getting help from librarians was a much more popular learning strategy than getting assistance from peers (20%) or professors (17%).Conclusions:
The study highlighted the importance of providing health preprofessional students with resources to improve skills on their own, remote access to library staff members, and instruction on the complexity of building health literacy skills, while also building relationships among students, librarians, and faculty.Highlights
- After receiving feedback on skill gaps, most preprofessional health students intend to develop their information literacy skills.
- Some students report that a trip to the library is a barrier to using library resources.
- Students see the need to build their information evaluation skills, knowledge of citations and plagiarism, and library skills, which they differentiate from Internet skills.
- Students are more likely to identify librarians as sources for assistance in finding information than faculty or peers after receiving individual feedback explaining the role of libraries and library staff members.
Implications
- Students'' health information competencies can be built through assessment and feedback that reveals skill gaps, highlights misconceptions, and offers ideas on how to improve.
- Access to professionally designed self-study resources is needed for students who intend to develop health information competencies on their own.
19.
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. 相似文献20.
Jonathan D. Eldredge David G. Bear Sharon J. Wayne Paul P. Perea 《Journal of the Medical Library Association》2013,101(4):244-251