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P roactive 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

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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 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: potomkov@.tunw.upol.cz

palack university in olomouc
PALACKÝ UNIVERSITY IN OLOMOUC

founded 1573

(Jesuit College)

restored 1946

7 faculties

Medicine, Science, Law

Philosophy, Theology,

Physical Culture, Education

faculty of medicine
FACULTY OF MEDICINE

1,900 students

280 graduates/year

250 teachers

PROGRAMMES:

  • Master‘s
  • Bachelor‘s
  • Postgraduate
integrated access to information resources funding
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 iiic north east south west
INTERREG IIICNorth –East –South - West

EU-funded programmethat 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
Sub-project INNO-MED

Development 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 resources ovid linksolver
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 multifile searching for best evidence
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
information retrieval case study
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
teaching how to find best evidence changes in palacky university medical curricula
Teaching How to Find Best EvidenceChanges 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 curricula1
Teaching How to Find Best EvidenceChanges 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
Teaching How to Find Best EvidenceChanges 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
Student Evaluation SurveyTeaching Staff Competencies

39.4%

27.7%

26.8%

Number of respondents: 119

student evaluation survey professional level of practical training
Student Evaluation SurveyProfessional Level of Practical Training

36.9%

33.6%

15.9%

11.7%

Number of respondents: 119

student evaluation survey overall level of subject
Student Evaluation SurveyOverall Level of Subject

44.5%

34.4%

16.8%

Number of respondents: 119

student evaluation survey motivation towards ebm
Student Evaluation SurveyMotivation towards EBM

42.8%

36.1%

8.4%

Number of respondents: 119

evaluating training programs
Evaluating Training Programs
  • Kirkpatrick, D. L.Evaluating Training Programs.2nd Ed. San Francisco: BerretKoehler Publishers.1998.
perspectives for palacky university
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:

8clinician-teachers, 2 epidemiologists, 1 IT specialist, ,

1 administrator,2medical librarians

  • Main Objectives:
    • Re-engineering of curricula
    • Training-of-trainers (critical appraisal skills)
    • Enhanced access to EBM information resources
conclusions
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
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.