From a Mercy College student

1. Information Resources and Information Expectations: Meeting Market Demand for Research Ready Healthcare Professionals From a Mercy College student From a nurse at Mercy One Hello!I am a member of the shared governance team on 7North.  We are currently working to revamp our VPO (virtual patient observation) program in order to improve patient safety and falls.  I was wondering if you would be able to find me some evidence based research on other hospitals that have successfully used VPO in their facilities.  Thank you so much for your assistance! • I have been at this for hours and am a bit crazed.  I tried clinical key and every site listed in the text book.  Nothing mentions anything on funding types, validity, the literature they reviewed, other options, how the research used peer review, etc.  The article I started to use just doesn't cover all of the bullet points that are required. 

2. A quick tour around cognitive shortcuts and media trends • Two problematic concepts: authority and quality • How do students learn evidence-based practice right now? • What resources do we already have?

3. This is the only time I’m even going to mention this idea. Promise. But it’s not our students’ fault that they may start out crazed and confused.

4. A perfect storm of sophisticated “bad guys” and our innate cognitive shortcuts work against critical thinking—in class or out. • Stanford study, 2016 • Most high school students accept photographs as presented, without verifying them. • Most college students didn't suspect potential bias in a tweet from an activist group. • Most Stanfordstudents couldn't identify the difference between a mainstream and fringe source.

5. What is authority? • Authority as related to title • Authority as related to expertise • Can we always tells the difference? • Authority as related to deeper disciplinary knowledge and standing • The idea of peer review ensuring that a research article is authoritative • Predatory journals • Bad research • “Think tanks”

6. How do we determine the quality of a source? • Not all journals are legit. They never were, but the proliferation of new titles makes this difficult to discern. • Research articles and blogs and magazine articles and ads look more and more alike: old visual clues are not useful. • Increasingly, unsophisticated information consumers are being confronted with sophisticated content providers’ ersatz information. • Retractions by mainstream news and researchers are seen as evidence of their biases, not as evidence of transparency of process by an increasingly skeptical cohort of students.

7. People have a variety of cognitive shortcuts, or tendencies, that make this level of scrutiny that much more challenging. Confirmation bias: The tendency to search for, interpret, favor, and recall information in a way that confirms one's preexisting beliefs or hypotheses.

8. Heuristics and cognitive shortcuts working against critical thinking about information sources • Filter bubble • Isolation that can occur when websites make use of algorithms to selectively assume the information a user would want to see, and then give information to the user according to this assumption. • Echo chamber: • Information, ideas, or beliefs are amplified or reinforced by communication and repetition inside a defined system. • Dunning-Kruger effect • A lack of metacognitive ability resulting in those who are ignorant or unskilled in a given domain tending to believe they are much more competent than they are. • Satisficing • A decision heuristic in which one settle for a good enough option, not necessarily the very best option.

9. Social media’s features have affected our use of traditional media in several ways. Speed v. accuracy The idea that free access to media is the norm, not the exception The 24-hour news cycle: continued articles about the same thing, or nothing The “comments section” Personalized news and sponsored content Formatting clues common for a hundred years are now either absent or “vanilla-ed out” when seen on screen

10. What scholars know about research. How did we learn it? Was it explicitly taught? Implicitly gleaned?

11. There are four primary reasons health care professionals utilize evidence: scholarly activities, clinical research, quality improvement, and safety initiatives. • During Practice Council today I was assigned to find an interesting article in regards falls for out next meeting. I was wondering if you could send me some evidence based articles on High fall risk patients specifically the risk for injury patients who qualify for the ABCS (Age, Bones, Coagulation or Surgery). I really didn’t think I’d ever be doing research as a nurse and remember nothing from my one research class. Help me Jennie!  • I am looking for some literature (journal articles) focused on the Joint Commission’s Universal Protocol – Performing a time-out prior to a patient procedure. This time-out used to be on paper here and we moved it into our electronic record when we implemented Cerner.  My question really is: In the world of electronic documentation, should the documentation of our time-out procedures stay on paper?

13. IOWA Model of Evidence-Based Practice to Promote Quality Care • The steps of the Iowa Model also fall into the five "A’s” • ASK • Recognize the existence of problems (trigger) • Form a team • ACQUIRE • Assemble relevant research and related literature • APPRAISE • Critique and synthesize research • APPLY • Determine the sufficiency of the research • Determine if change is appropriate to adopt into practice • Institute change if appropriate • ASSESS • Monitor and analyze the structure, process, and outcome data • Disseminate results throughout the unit or organization

14. An option is to curate all information for the students and either not require or outright forbid the use of source types. For example: “use Heathy People 2020.’ Full disclosure: I’m not in favor of this option. • This kicks the can down the road--the student may never have another opportunity to practice these skills or use these tools. • It overstates the quality or accuracy of certain sources while giving a bad rap to sources which are often and legitimately used in health sciences disciplines and professions. • 60 percent of medical research reports are not published in journals, but as conference papers and posters, in dissertations, or in standalone research reports. • Students learn by trial, error, failures, and second tries. They will get this wrong sometimes. Can we help them gradually gain mastery of these tools in the classroom?

15. And now, a word from our sponsor….

16. Starter recommendations • Use the library research guides and video tutorials as assignment starters/resources • Ask Jennie for new research guides and tutorials • Incorporate the library into an assignment • A good start: please don’t delete the library information widget in D2L • Give extra points for interaction with the librarian • Discuss with students the “gray literature” you use in your field • Discuss the information cycle: how research trials become research reports which become practice and practice guidelines--and practice informs research, how gray lit and research articles lead to systematic reviews. Mind blowing! We’ll add to these

17. Brainstorm possible assignments tactics and strategies…. • Look at the same information reported in different kinds of sources: a study, a news item about the study, a blog post about the study. Which should be used and/or cited, when and why? • Explore gray literature in your field as part of an assignment: clinical trial information, conference papers, practice guidelines. • Read about the same topic with the class in several sources: a reference work, a research article, a systematic review. How do they differ? How could they be used in EBP? • Offer a moderated discussion board about evaluating resources: with librarian assisting. • Require students to use library tools like Credo Reference to give students some foreground information which may help them make good choices amongst evidence sources. • What else?

18. What learning activities would help these researchers “take it all the way?” • I am emailing because I am having a lot of difficulties finding a qualitative research article for my PICO question. I am going to attach two articles that I think may be considered qualitative, and would like your help in determining if they actually are. I question the first because it has a section saying "literature review“ and we’re not supposed to use those. And I question the second because it does not cite an in depth study. Qualitative studies are in depth. If these are not qualitative articles, I would love any tips you could provide on how to find a qualitative article. 

19. Crowdsourced ideas/questions