Transcript Document

Proactive Participation of Medical
Librarians in EBM : Finding &Teaching
How to Find Evidence
Jarmila Potomková
Medical Librarian
Dana Šubová
E-Librarian
Vladimír Mihál
Professor of Pediatrics & Vice-Dean for Clinical Education
Vladimír Janout
Professor of Epidemiology
Palacky University Faculty of Medicine
Olomouc, Czech Republic
Contact: [email protected]
PALACKÝ UNIVERSITY IN OLOMOUC
founded 1573
(Jesuit College)
restored 1946
7 faculties
Medicine, Science, Law
Philosophy, Theology,
Physical Culture, Education
FACULTY OF MEDICINE
1,900 students
280 graduates/year
250 teachers
PROGRAMMES:
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
Master‘s
Bachelor‘s
Postgraduate
Integrated Access to Information
Resources: Funding
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INSTITUTIONAL LEVEL
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Medical Library Budget
 60% : 40% = Faculty of Medicine : University Hospital
NATIONAL LEVEL
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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
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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
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INTERNATIONAL LEVEL
 EU-supported projects
 INNO-MED
INTERREG IIIC
North –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 solutions
to economic, social and environmental challenges.
Sub-project INNO-MED
Development of an Innovative Evidence-Based Medical Information System for the
Improvement of Effectiveness and Quality of Medical Care
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Lead Participant:
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Participants:
University of Patras (GREECE)
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)
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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.
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Sub-project web site: www.innomed-project.net
Integration of Information Resources
Ovid 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 Tools
LinkSolver
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 Search
List 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 Results
Deduplication, Application of Limits
Multifile Search Results
Distribution across Databases
Teaching How to Find Best Evidence
Changes in Palacky University Medical Curricula
Medical Curriculum Course
BIOMEDICAL 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 Evidence
Changes in Palacky University Medical Curricula
Medical Curriculum Subject
INTERNET 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 Evidence
Changes in Medical Curricula
New Medical Curriculum Subject
EVIDENCE-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 Competencies
6-score-scale:
1 - excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
39.4%
50
45
40
n=119
35
27.7%
26.8%
30
25
20
15
10
5
0
Vysoká 1
2
3
Number of respondents: 119
4
Nízká 5
Nevím
Student Evaluation Survey
Professional Level of Practical Training
Parameter 2 : Professional level of practical training
6-score-scale:
1-excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
50
n=119
45
40
36.9%
33.6%
35
30
25
20
15.9%
11.7%
15
10
5
0
Vysoká 1
2
3
Number of respondents: 119
4
Nízká 5
Nevím
Student Evaluation Survey
Overall Level of Subject
Parameter 3 :Overall Level of the Subject
6-score-scale:
1-excellent, 2-high, 3-average, 4-acceptable, 5-low, 6-can´t say
60
44.5%
50
n=119
40
34.4%
30
16.8%
20
10
0
Vysoká 1
2
3
Number of respondents: 119
4
Nízká 5
Nevím
Student Evaluation Survey
Motivation towards EBM
Parameter 4 :Increase in Motivation towards EBM
6-score-scale:
1-remarkable, 2-high, 3-average, 4-slight, 5-low, 6-can´t say
60
42.8%
50
36.1%
n=119
40
30
20
10
8.4%
0
Velmi zvýšil 1
2
3
Number of respondents: 119
4
Ztratil 5
Nevím
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“
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Just approved
Period: July 2006 - June 2008
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Lead Participant:
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Participant:
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Team:
Palacky University, Faculty of Medicine, Olomouc
Ostrava University,Faculty of Health Allied Professions,
8 clinician-teachers, 2 epidemiologists, 1 IT specialist, ,
1 administrator, 2 medical librarians
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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 !