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PURPOSE: The authors studied the effectiveness of a train-the-trainer collaboration model between librarians and medical faculty to instruct librarians and health professionals in teaching evidence-based medicine (EBM) principles. METHODS: A telephone survey was administered to graduates of an EBM course who agreed to participate in the study. They were asked if and how they taught EBM on returning to their institutions, if they felt competent to critically appraise an article, if their skill in searching PubMed improved, and if they collaborated with others in teaching EBM. RESULTS: Most respondents were librarians. The class was successful in that most taught EBM on return to their home institutions. Most initiated collaboration with health professionals. The goals of improving PubMed searching and achieving statistical competency had less success. CONCLUSION: This model is effective in preparing librarians to teach EBM. Modeling and encouraging collaboration between librarians and health professionals were successful techniques. Librarians would like more instruction in statistical concepts and less in searching PubMed. conclusions cannot be made for health professionals because of the low response rate from this group. As evidence-based health care continues to extend to other disciplines, librarians can position themselves to participate fully in the EBM educational process. [ABSTRACT FROM AUTHOR]

PURPOSE: This evaluation study sought to assess the impact of an evidence-based medicine (EBM) course on students' self-perception of EBM skills, determine their use of EBM skills, and measure their performance in applying EBM skills in a simulated case scenario. METHODS: Pre- and post-surveys and skills tests were developed to measure students' attitudes toward and proficiency in EBM skills. Third-year students completed the voluntary survey and skills test at the beginning and completion of a twelve-week clerkship in internal medicine (IM) co-taught by medical and library faculty. Data were analyzed using the Mann-Whitney U test for a two-tailed test. RESULTS: A statistically significant increase was found in the students' self-assessment of skills. Students reported using the journal literature significantly more frequently during the clerkship than before, although textbooks remained their number one resource. A majority of students reported frequent use of EBM skills during the clerkship. Statistically significant improvement in student performance was also found on the posttest, although the level of improvement was more modest than that found on the post-surveys. CONCLUSION: The introduction of EBM skills to students during a clinical clerkship provides students an opportunity to practice EBM skills and reinforces the use of evidence in making patient-care decisions. [ABSTRACT FROM AUTHOR]

Purpose: This research sought to determine use of online biomedical journals and databases and to assess current user characteristics associated with the use of online resources in an academic health sciences center.Setting: The Library of the Health Sciences-Peoria is a regional site of the University of Illinois at Chicago (UIC) Library with 350 print journals, more than 4,000 online journals, and multiple online databases.Methodology: A survey was designed to assess online journal use, print journal use, database use, computer literacy levels, and other library user characteristics. A survey was sent through campus mail to all (471) UIC Peoria faculty, residents, and students.Results: Forty-one percent (188) of the surveys were returned. Ninety-eight percent of the students, faculty, and residents reported having convenient access to a computer connected to the Internet. While 53% of the users indicated they searched MEDLINE at least once a week, other databases showed much lower usage. Overall, 71% of respondents indicated a preference for online over print journals when possible.Conclusions: Users prefer online resources to print, and many choose to access these online resources remotely. Convenience and full-text availability appear to play roles in selecting online resources. The findings of this study suggest that databases without links to full text and online journal collections without links from bibliographic databases will have lower use. These findings have implications for collection development, promotion of library resources, and end-user training. [ABSTRACT FROM AUTHOR]

Donald A.B. Lindberg M.D. arrived as Director, U.S. National Library of Medicine (NLM) in late 1984 with the intention of implementing a physician-friendly interface to MEDLINE, a prime example of his interest in making NLM information services more directly useful in medical care. By early 1986, NLM's Grateful Med, an inexpensive PC search interface to MEDLINE useful for health professionals, had joined the group of end-user systems for searching MEDLINE that emerged in the 1980s. This chapter recounts Grateful Med's rapid iterative development and the subsequent campaign to bring it to attention of health professionals. It emphasizes Lindberg's role, the challenges faced by those introducing and using the interface in a pre-Internet world, and some longer-term effects of the effort to expand health professionals' use of MEDLINE during the decade from 1986 to 1996., (© 2022 – The authors. Published by IOS Press.)

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.

Objectives: In 2008, the Association of Academic Health Sciences Libraries established an Education Research Task Force (ERTF) to plan research addressing research priorities outlined in key Association of American Medical Colleges reports. ERTF members conducted a literature review to describe the state of collaborative research at the intersection of medical education and health sciences librarianship. Analysis of initial results revealed instruction in evidence-based medicine (EBM) was a shared interest and is thus the focus of this review., Methods: Searches on EBM teaching programs were conducted, and results were posted to a shared online citation management service. Individual articles were assessed and assigned metadata describing subject matter, scope, and format., Results: Article analysis identified key themes. Most papers were descriptive narratives of curricular development. Evaluation studies were also prominent and often based on student satisfaction or self-reported competency. A smaller number of controlled studies provide evidence of impacts of librarian involvement in EBM instruction., Conclusions: Scholarship of EBM instruction is of common interest between medical educators and health sciences librarians. Coauthorship between the groups and distribution of literature points to a productive collaboration. An emerging literature of controlled studies measuring the impact of cross-disciplinary efforts signals continued progress in the arena of EBM instruction.

Background: Medical Informatics (MI) is increasingly a critical aspect of medical education and patient care., Aims: This study assessed the status of MI training, perception of needs and barriers for the implementation of MI curricula and utilization of information technology (IT) in patient care and medical education., Method: The MI questionnaire was a part of the 2006 Clerkship Directors in Internal Medicine survey of 110 institutional members. Descriptive statistics were calculated using Statistical Package for the Social Sciences (SPSS), version 12 and all p-values are two-tailed., Results: Eighty-three (75%) members responded. Out of this, 52, 32.5 and 12% report that students receive MI training for patient care activities during pre-clinical years, third-year internal medicine clerkship or intersession, respectively. House staff critiques (46.4%), patient billing (44.1%), radiographic imaging (40.8%), accessing clinical data (37.3%), and student evaluations (36.1%) were areas in which 35% of respondents use IT 'all the time.' Fifty-one percent of respondents rate the adequacy of training in MI as average. Cost, time and lack of trained faculty were primary barriers for the implementation., Conclusions: Significant variations exist in timing of MI curricula. IT is utilized more frequently for non-patient activities. Studies are needed to examine the needs, processes and outcomes of MI curricula.

Background: Evidence-based medicine (EBM) is an essential tool for students across the medical education continuum. Incorporation of EBM skills into core competencies by national educational organizations denotes their vital role., Aim: The main purpose is to describe the transformation of an EBM curriculum in an Internal Medicine clerkship and the educational principles that influenced changes over ten years., Methods: The EBM curriculum over ten years was reviewed. This retrospective review was divided into four phases, based on the educational interventions used. Associated outcomes of the curriculum, student skills, and satisfaction with the course and faculty involvement were assessed., Results: A majority of the 493 students felt they received adequate and appropriate exposure to EBM. The curriculum evolved from a teacher-centered approach using computer-based case scenarios to a learner-centered, and patient centric approach. Student skills in EBM improved, as was evidenced by the pre- and post-tests and the evaluations of critically appraised topic assignments., Conclusions: EBM is an essential tool to develop life-long learners. A learner-centered, patient centric approach is well received by students. Long-term studies are needed to assess the impact of these teaching interventions on patient outcomes.

Human spinal biomechanics are profoundly complex and not well understood, especially in terms of the dynamic spine function. Translation of biomechanics to disease is difficult, particularly since cause must be separated from effect. Primary dynamics predisposing to the onset of chronic spinal disorders, e.g., adolescent idiopathic scoliosis (AIS) or ankylosing spondylitis (AS), must clearly be differentiated from secondary alterations. This commentary addresses primary biomechanics that may predispose to these idiopathic diseases. A novel hypothesis is proposed, based upon inferences regarding their contrasting muscular dynamics. The hypothesis postulates opposing inherent muscle tonicity in AIS versus AS. Converse degrees of spinal stability may predispose to the respective curvature deformities of AIS and the enthesopathy lesions of AS. One condition is suspected to counter-oppose the other, within a polymorphic spectrum of spinal stability.

A collaborative Evidence-Based Medicine (EBM) course, co-taught by medical and library faculty, targets the needs of health care and information professionals involved in teaching and practicing EBM by introducing concepts, methods and tools of the EBM process. The one-week course engages working teams of health care and information professionals in case-based activities to encourage participation in the learning process and the "Train the Trainer" approach of the course. The interdisciplinary partnership, both of teachers and learners, has led to a successful and effective educational program that accentuates the strengths and contributions of each group. Further research will determine whether this collaborative experience leads to ongoing partnerships between these professional groups in the clinical setting.

Purpose: The research sought to determine the impact of online journals on the use of print journals and interlibrary loan (ILL)., Setting: The Library of the Health Sciences-Peoria is a regional site of the University of Illinois at Chicago (UIC) Library with a print journal collection of approximately 400 titles. Since 1999, UIC site licenses have given students and faculty affiliated with UIC-Peoria access to more than 4,000 online full-text journal titles through the Internet., Methodology: The Library of the Health Sciences-Peoria has conducted a journal-use study over an extended period of time. The information collected from this study was used to assess the impact of 104 online journals, added to the collection in January 1999, on the use of print journals., Results: Results of the statistical analysis showed print journal usage decreased significantly since the introduction of online journals (F(1,147) = 12.10, P < 0.001). This decrease occurred regardless of whether a journal was available only in print or both online and in print. Interlibrary loan requests have also significantly decreased since the introduction of online journals (F(2,30) = 4.46, P < 0.02)., Conclusions: The decrease in use of the print collection suggests that many patrons prefer to access journals online. The negative impact the online journals have had on the use of the journal titles available only in print suggests users may be compromising quality for convenience when selecting journal articles. Possible implications for collection development are discussed.

This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.

Librarians' participation in evidence-based medicine (EBM) is rooted in past practices, most notably in clinical medical librarianship. EBM extends the librarians' role beyond identification of the literature to involvement in practicing and teaching quality filtering and critical appraisal of the literature. These activities require librarians to acquire new knowledge and develop new skills. A professional development program for librarians at the Library of the Health Sciences (LHS) at the University of Illinois at Chicago (UIC) is described. The program's goals are to increase librarians' skills and support the EBM curricular initiative at the UIC College of Medicine (COM). The unique program has been a collaborative effort of the LHS and the COM. The locally developed classes provide librarians with instruction in clinical study designs, statistical concepts, and critical appraisal of the literature. Other interventions such as an EBM round table are also described. The programs' success is measured by librarians' growing involvement in EBM medical curricula, journal clubs, and morning reports. Additionally, librarians gained competence in new skills and professional satisfaction from working collegially with COM students, residents, and faculty.

To explore the information needs of rural health professionals, a retrospective study was undertaken of 1,224 document delivery requests made during the course of three outreach projects in west and central Illinois. The 547 unique journals from which the articles were requested were analyzed for frequency of request, subject content, and inclusion on core lists. These rural health professionals were found to request current information on a wide range of topics in clinical medicine, nursing, health administration, allied health, social sciences, and basic sciences. While 10% of the titles filled 37% of the requests, 58% of the titles were requested once and filled 26% of the requests. A high correlation with Abridged Index Medicus and Brandon/Hill list titles was found, but titles from either of these lists could fill no more than 30% of the total requests. Besides demonstrating the complex information needs of rural health professionals and depicting the difficulty of building a collection to support them, the study exemplifies a method for need-based journal collection development and begins to identify titles commonly requested in a rural health setting.

BIOETHICSLINE uselogs were analyzed during months when second-year medical students were engaged in ethics coursework that included curriculum-integrated bibliographic instruction. Uselog data showed that peak activity occurred while students were preparing a required paper. Further uselog analysis indicated that students applied database features such as controlled vocabulary, the "explode" command, and a combination of multiple search concepts. In addition, the study examined journal use and interlibrary loan activity for a correlation with online search activity. Higher bioethics journal use and interlibrary loan statistics coincided with peak BIOETHICSLINE activity periods. Citation analysis of student bibliographies reflected the interdisciplinary nature of BIOETHICSLINE and the need for ethics, legal, and clinical information sources in a bioethics collection. This study suggests that the integration of bibliographic instruction and the coordination of collection development with students' curricular needs lead to increased and more competent use of information resources.

A follow-up outreach project was undertaken to extend and reinforce the work of a National Library of Medicine-funded outreach project conducted in west central Illinois in 1991. The participants included five of the eight original sites as well as additional populations. An evolving partnership with the state's Center for Rural Health expanded the project's geographic area statewide. Evaluation showed benefits of varied training formats, reexposure to end-user searching, and the importance of "readiness." Follow-up training and longer trials for practice searching resulted in greater volume of search and document delivery activity. Varied training formats proved successful in reaching specific groups. Loansome Doc activity throughout the eighteen-month project suggested sustained use of Grateful Med beyond the two-month trial periods. The introduction of Grateful Med/Loansome Doc to unaffiliated health professionals is an important component in equalizing information access. Future information service initiatives are suggested to meet the challenge of building a rural information infrastructure and support system for health professionals.

An analysis of documents provided to eight rural Illinois hospital sites during a GRATEFUL MED outreach project involving end-user searching revealed significant patterns that have implications for collection development and information services in small, underserved hospitals. Document requests were analyzed by user groups making the requests, subject matter, inclusion on the Brandon/Hill lists and in Abridged Index Medicus, and publication date. Of the 359 documents requested, 86% came from health professional groups other than physicians and nurses. Eighty-five percent of all requests came from two sites that had active project-trained intermediaries, with most requests forwarded by the intermediaries. Subject analysis revealed a strong need for administrative and allied health information in addition to clinical information. Fewer than half of the titles on the recommended lists were requested during the project. Most documents requested had been published in the past five years. Introduction of end-user searching is not the complete answer to improved information access at small hospitals; the authors conclude that basic collections and library personnel are still needed locally to respond effectively to health professionals' information needs.

The Library of the Health Sciences-Peoria (LHS-Peoria), located at a regional site of the University of Illinois College of Medicine, conducted an eighteen-month GRATEFUL MED outreach project funded by the National Library of Medicine. The project was designed to enhance information services for health professionals at eight underserved rural hospitals in west central Illinois. One hundred rural health professionals, mainly nonphysicians, received GRATEFUL MED training at these hospitals; LHS delivered more than 350 documents to the trainees. In this paper, investigators describe the project and its goals and discuss results and their evaluation, from both individual and institutional perspectives. Outcome is examined in the context of future outreach plans, both at LHS and elsewhere.

A study of the effectiveness of a collaborative course in teaching library and critical appraisal skills was conducted at the University of Illinois College of Medicine. A critical appraisal and library skills course was taught at the Peoria site during the third-year medical clerkship. The performance of Peoria students on a twenty-item multiple choice posttest was compared to that of third-year students in Rockford, who received no library or critical appraisal instruction during their medicine clerkship. The two groups were similar in self-perceived library skills, critical appraisal skills, and other demographic values. Peoria students scored significantly higher on library, critical appraisal, and total posttest questions. An improving trend during the year was not observed at either site, implying that students were not acquiring these skills in day-to-day clerkship activities. Results suggest that this multidisciplinary course is effective in teaching library and critical appraisal skills.

The formulation of clinical decisions based on evidence requires the ability to locate information and evaluate it critically. A ten-week critical appraisal course for third-year medical students, taught cooperatively by library and Department of Medicine faculty, integrates education in the selection, evaluation, and application of information to patient care. The course is distinctive in that information management skills are taught by a multidisciplinary team in a problem-based format as part of the compulsory medical curriculum. Medical faculty provided instruction in reading and evaluating research methodology, as well as statistical analyses in published reports, using clinical scenarios and related journal articles at weekly sessions. Library faculty provided instruction in locating pertinent research on a sample clinical problem using standard printed and computerized indexes and local library resources, and presented criteria for selecting the most useful and significant works from those retrieved. Library faculty also met individually with students to provide instruction in online literature searching. Based on formal evaluation and informal feedback, the course was well received; it effectively presents the literature search as an integral part of critical appraisal of the medical literature and of the clinical decision-making process.