P roactive Participation of Medical Librarians in EBM : Finding &Teaching How to Find Evidence
description
Transcript of P roactive Participation of Medical Librarians in EBM : Finding &Teaching How to Find Evidence
Proactive Participation of Medical Librarians in EBM : Finding &Teaching How to Find Evidence
Jarmila PotomkováMedical Librarian
Dana ŠubováE-Librarian
Vladimír MihálProfessor of Pediatrics & Vice-Dean for Clinical Education
Vladimír JanoutProfessor of Epidemiology
Palacky University Faculty of MedicineOlomouc, Czech Republic
Contact: [email protected]
PALACKÝ UNIVERSITY IN OLOMOUC
founded 15731573 (Jesuit College)
restored 19461946 7 faculties Medicine, Science, LawPhilosophy, Theology,Physical Culture,
Education
FACULTY OF MEDICINE
1,9001,900 students students 280 graduates/year 250 teachers
PROGRAMMES: Master‘s Bachelor‘s Postgraduate
Integrated Access to Information Resources: Funding INSTITUTIONAL LEVEL
Medical Library Budget 60% : 40% = Faculty of Medicine : University Hospital
NATIONAL LEVEL National Consortia (Blackwell, Elsevier, Proquest, Springer, Web of Knowledge, Wiley)
2004-2008 Duty to maintain journal collections & pay annual consortial fee (supported by
Central Library budget) Resources
– Subscription to 83 print journals opens online access to >1200 titles
Multi-institutional project „Information Resources for Biomedical Research in Czech R.“
2004-2008 3 universities + National Library of Medicine Prague Resources
– MEDLINE, EMBASE,SPORTDiscuss, COCHRANE LIBRARY, MICROMEDEX, LWW HIGH IMPACT COLLECTION
INTERNATIONAL LEVEL EU-supported projects
INNO-MED
INTERREG IIICNorth –East –South - West
EU-funded programme that helps Europe’s regions form partnerships to work together on common projects.by sharing knowledge and experience, these partnerships enable the regions involved to develop new solutionsto economic, social and environmental challenges.
Sub-project INNO-MEDDevelopment of an Innovative Evidence-Based Medical Information System for the
Improvement of Effectiveness and Quality of Medical Care
Lead Participant: University of Patras (GREECE)
Participants: Centro Multimediale di Terni Spa (ITALY)
University Hospital Olomouc (CZECH R.) CZ Team: 3 IT specialists, 3 clinicians, 1epidemiologist, 1administrator. 1 economist, 1 medical librarian
Module: Users requirements for Clinical Knowlčdge Retrieval & Analysis Resources: Current Opinion Series online (23 clinical specialties)
Summary: The need for this project is validated from the assumption that health care is largely information and
communication dependent, while ICT solutions can provide easily accessible and cost effective ways of meeting this increasing dependency
. The proposed system will provide a wide range of users (medical doctors, health care professionals, health policy makers, patients and citizens) with the opportunity to access, process and produce evidence-based medical information.
Sub-project web site: www.innomed-project.net
Integration of Information ResourcesOvid LinkSolver
Value-added library service Trained staff
Activate access to eelectronic journals Increase usage rate of resources
Databases Journals
Extend resources to the point of need Training end-users to master searching multiple
databases to get „the best evidence“.
Ovid Administrative ToolsLinkSolver
Activation
Ovid LinkSolver Options
Ovid LinkSolver Options
Ovid Multifile Searching for Best Evidence
„Go beyond MEDLINE“ philosophy EMBASE may return around 40% unique records
Multifile searching via Ovid allows to search multiple databases as if they were one database.
Having entered one search statement, Ovid carries that query across all databases of the multifile, retrieving results from each.
Deduplication functionality helps remove duplicate records before viewing, saving, or printing records.
Application of limits filters out Publication types (eg. reviews) Fulltext articles
Multifile SearchList of Resources for Palacky University
Information Retrieval Case Study
Clinical Question for Today
Does folic acid help prevent birth defects, in particular neural tube defects?
Search strategy Identification of search terms Use of Boolean operators Application of limits
Working with Search ResultsDeduplication, Application of Limits
Multifile Search ResultsDistribution across Databases
Teaching How to Find Best EvidenceChanges in Palacky University Medical Curricula
Medical Curriculum CourseBIOMEDICAL INFORMATION RETRIEVAL Mandatory course for 1st year international medical students Duration: 2 semesters Taught by medical librarians Organized in eight 90 min blocks Introduced 2004/2005
Outline:1. Fundamentals of evidence based medicine.2. Biomedical literature resources and hierarchy of evidence. 3. MEDLINE - the most important biomedical database. PubMed online training. 4. MEDLINE - sample searches. Search strategy tips, Boolean operators, application of limits
working with search results.5. From MEDLINE to the Cochrane Library - a reliable way to locate best evidence for healthcare. 6. Basics of medical literature critical appraisal. 7. Bibliometric Tools for Evaluating Medical Literature Quality. 8. Consolidation workshop (information retrieval, quality evaluation & analysis of selected
publication types). Feedback: highly appreciated, 2-year-experience
Teaching How to Find Best EvidenceChanges in Palacky University Medical Curricula
Medical Curriculum SubjectINTERNET RESOURCES FOR MEDICINE AND HEALTHCARE Elective course for 3rd-5th year medical students Duration: 1 semester Taught by medical librarians Organized in six 90 min blocks Introduced 2004/2005
Outline:1.Access to core biomedical information resources, 2. Clinical scenarios, formulation of searcheable questions, search strategy development.3. PubMed search features, use of MeSH and methodology filters.4. Working with search results: publication types, hierarchy of evidence, systematic vs.
narrative reviews.5. Moving beyond MEDLINE: Cochrane Library - a reliable way to locate best evidence for healthcare. 6. Tools for evaluating Medical Literature Quality.
Feedback: demand largely exceeds capacity of computer lab and teaching staff workload.
Teaching How to Find Best EvidenceChanges in Medical CurriculaNew Medical Curriculum SubjectEVIDENCE-BASED MEDICINE Mandatory course for 6th year medical students Duration: 1 week Taught by epidemiologists, clinician-teachers, medical librarians Organized in ten half-day blocks Introduced 2005/2006 as a substitute for traditional onsite practice in regional epidemiology and
prophylaxis centers. Total number of trainees: 119
Outline:1. EBM essentials – pros/cons. 2. Medical literature as a resource of best evidence.3. Diagnostic tests I – introduction.4. Diagnostic tests II – practical training.5. Therapy and other interventions.6. Therapy – practical training.7. Therapy and harm.8. Prognosis.9. Errors in epidemiologic research.10. From evidence to action: pediatric evidence-based case reports..
Feedback: very promising & challenging.
Student Evaluation Survey Teaching Staff Competencies
Parameter 1 : Teaching staff Competencies6-score-scale:
1 - excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
0
5
10
15
20
25
30
35
40
45
50
Vysoká 1 2 3 4 Nízká 5 Nevím
n=
119
Number of respondents: 119
27.7%
39.4%
26.8%
Student Evaluation Survey Professional Level of Practical Training
Parameter 2 : Professional level of practical training6-score-scale:
1-excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
0
5
10
15
20
25
30
35
40
45
50
Vysoká 1 2 3 4 Nízká 5 Nevím
n=
11
9
Number of respondents: 119
36.9%33.6%
15.9%11.7%
Student Evaluation Survey Overall Level of Subject
Parameter 3 :Overall Level of the Subject6-score-scale:
1-excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
0
10
20
30
40
50
60
Vysoká 1 2 3 4 Nízká 5 Nevím
n=
119
Number of respondents: 119
34.4%
44.5%
16.8%
Student Evaluation SurveyMotivation towards EBM
Parameter 4 :Increase in Motivation towards EBM6-score-scale:
1-remarkable, 2-high, 3-average, 4-slight, 5-low, 6-can´t say
0
10
20
30
40
50
60
Velmi zvýšil 1 2 3 4 Ztratil 5 Nevím
n=
119
Number of respondents: 119
8.4%
36.1%42.8%
Evaluating Training Programs
Kirkpatrick, D. L. Evaluating Training Programs.2nd Ed. San Francisco : Berret Koehler Publishers.1998.
Perspectives for Palacky University
New EU-supported project„INTRODUCTION OF EBM PRINCIPLES INTO UNDERGRADUATE MEDICAL
CURRICULA“
Just approved Period: July 2006 - June 2008
Lead Participant: Palacky University, Faculty of Medicine, Olomouc
Participant: Ostrava University,Faculty of Health Allied Professions,
Team: 8 clinician-teachers, 2 epidemiologists, 1 IT specialist, , 1 administrator, 2 medical librarians
Main Objectives: Re-engineering of curricula Training-of-trainers (critical appraisal skills) Enhanced access to EBM information resources
Conclusions
It is crucial to have a multidisciplinary team of professionals, enthusiastic teachers, information resources, funding, and institutional support for EBM curricula.
Students must learn a framework + see the practical aspects of EBM in a clinical setting.
EBM should be promoted as tool for better
patient care.
Acknowledgements
American International Health Alliance (Washington D.C.) for training in EBM
Prof. V. Mihal and prof. V. Janout of Palacky University for many years of collaboration and friendship.
THANK YOU VERY MUCH FOR YOUR INVITATION
AND ATTENTION !