Nancy Hrinya Tannery

Evidence-based medicine training in undergraduate medical education: a review and critique of the literature published 2006-2011.

Purpose To characterize recent evidence-based medicine (EBM) educational interventions for medical students and suggest future directions for EBM education. Method The authors searched the MEDLINE, Scopus, Educational Resource Information Center, and Evidence-Based Medicine Reviews databases for English-language articles published between 2006 and 2011 that featured medical students and interventions addressing multiple EBM skills. They extracted data on learner and instructor characteristics, educational settings, teaching methods, and EBM skills covered. Results The 20 included articles described interventions delivered in 12 countries in classroom (75%), clinic (25%), and/or online (20%) environments. The majority (60%) focused on clinical students, whereas 30% targeted preclinical students and 10% included both. EBM skills addressed included recognizing a knowledge gap (20%), asking a clinical question (90%), searching for information (90%), appraising information (85%), applying information (65%), and evaluating practice change (5%). Physicians were most often identified as instructors (60%); co-teachers included librarians (20%), allied health professionals (10%), and faculty from other disciplines (10%). Many studies (60%) included interventions at multiple points during one year, but none were longitudinal across students’ tenures. Teaching methods varied. Intervention efficacy could not be determined. Conclusions Settings, learner levels and instructors, teaching methods, and covered skills differed across interventions. Authors writing about EBM interventions should include detailed descriptions and employ more rigorous research methods to allow others to draw conclusions about efficacy. When designing EBM interventions, educators should consider trends in medical education (e.g., online learning, interprofessional education) and in health care (e.g., patient-centered care, electronic health records).

The Online Bioinformatics Resources Collection at the University of Pittsburgh Health Sciences Library System—a one-stop gateway to online bioinformatics databases and software tools

To bridge the gap between the rising information needs of biological and medical researchers and the rapidly growing number of online bioinformatics resources, we have created the Online Bioinformatics Resources Collection (OBRC) at the Health Sciences Library System (HSLS) at the University of Pittsburgh. The OBRC, containing 1542 major online bioinformatics databases and software tools, was constructed using the HSLS content management system built on the Zope® Web application server. To enhance the output of search results, we further implemented the Vivísimo Clustering Engine®, which automatically organizes the search results into categories created dynamically based on the textual information of the retrieved records. As the largest online collection of its kind and the only one with advanced search results clustering, OBRC is aimed at becoming a one-stop guided information gateway to the major bioinformatics databases and software tools on the Web. OBRC is available at the University of Pittsburghs HSLS Web site ().

Reproducibility of literature search reporting in medical education reviews.

Purpose Medical education literature has been found to lack key components of scientific reporting, including adequate descriptions of literature searches, thus preventing medical educators from replicating and building on previous scholarship. The purpose of this study was to examine the reproducibility of search strategies as reported in medical education literature reviews. Method The authors searched for and identified literature reviews published in 2009 in Academic Medicine, Teaching and Learning in Medicine, and Medical Education. They searched for citations whose titles included the words “meta-analysis,” “systematic literature review,” “systematic review,” or “literature review,” or whose publication type MEDLINE listed as “meta-analysis” or “review.” The authors created a checklist to identify key characteristics of literature searches and of literature search reporting within the full text of the reviews. The authors deemed searches reproducible only if the review reported both a search date and Boolean operators. Results Of the 34 reviews meeting the inclusion criteria, 19 (56%) explicitly described a literature search and mentioned MEDLINE; however, only 14 (41%) also mentioned searches of nonmedical databases. Eighteen reviews (53%) listed search terms, but only 6 (18%) listed Medical Subject Headings, and only 2 (6%) mentioned Boolean operators. Fifteen (44%) noted the use of limits. None of the reviews included reproducible searches. Conclusions According to this analysis, literature search strategies in medical education reviews are highly variable and generally not reproducible. The authors provide recommendations to facilitate future high-quality, transparent, and reproducible literature searches.

50 years of publication in the field of medical education

Background: The advent of new medical education (ME) journals makes evident the growth of the field of ME. However, the nature and context of growth is undefined. Aim: To analyze the evolution of publication in ME. Methods: MEDLINE retrieval using medical subject headings was used to analyze patterns of ME publications from 1960–2010: changes in number of ME publications; number of journals publishing ME articles; co-topics occurring frequently in ME articles; differences among journals’ publication of co-topics. Results: Annual publication of ME articles increased from 279 in 1960 to 3760 in 2010. 81 531 articles were published in 4208 different journals. 104 journals published ME articles in 1960, 855 in 2010. Despite an increase in journals in all fields, ME journals now account for a larger proportion of all journals indexed in MEDLINE than in 1960. One-quarter of all ME articles were indexed as internship/residency; 16% as graduate ME; 15% as undergraduate ME; and 14% as continuing ME. The five journals that published the most ME articles distinguished themselves by publishing some topics with greater or less frequency. Conclusions: The increase in the number of ME publications and in the number of journals publishing ME articles suggests a supportive environment for a growing field; but variation in journals’ foci has implications for readers, editors and authors.

AM last page: how to perform an effective database search.

• Journal articles • Diverse disciplines • Journal articles, book chapters, dissertations, abstracts • Education literature • Journal articles, book chapters, Association of American Medical Colleges reports • Nursing and allied health literature • Journal articles, book chapters, dissertations, audiovisuals • Scientific, technical, medical and social sciences literature, citation searching • Journal articles, conference papers

Librarians in Evidence-Based Medicine Curricula: A Qualitative Study of Librarian Roles, Training, and Desires for Future Development

This study aims to describe librarians’ roles in evidence-based medicine (EBM) from the librarian perspective, identify how librarians are trained to teach, and highlight preferences for professional development. A multiinstitution qualitative study was conducted. Nine medical librarians identified by their faculty as integrated into EBM training were interviewed. Participants’ descriptions indicated that they were active in curriculum development, deployment (including teaching activities), and assessment to support EBM. Participants identified direct experience and workshop participation as primary methods of learning to teach. Participants desired continuing development as teachers and requested opportunities for in-person workshops, shadowing physicians, and online training.

Literature Searching in Medical Education: Online Tutorial Development from Idea to Creation

The medical education literature is growing, and the result is not only greater knowledge, but an increasing complexity in locating quality evidence-based information. In 2008, eight librarians partnered with the Association of American Medical Colleges to research, conceptualize, and build an online module to develop medical educators’ search skills. Developing an online instructional module is a time-consuming, multi-stage process requiring the expertise of content, technical, and design specialists working in concert. Many lessons were learned, including the power of collaborative tools; the benefits of including specialists, such as graphic designers; the benefit of thoroughly surveying existing resources; and the importance of choosing technology wisely.

The role of medical librarians in medical education review articles

Sir Isaac Newton famously wrote, in reference to building on the research of Descartes, “If I have seen further it is by standing on the shoulders of giants” [1]. Today, this familiar sentence, which appears in such conspicuous places as the Google Scholar search page, has been interpreted to mean that for scholars to further their research, they should seize the opportunity to build on the work of their predecessors. In the last decade, medical education has been recognized as a discipline of scientific inquiry [2]. With this recognition has come the call for increased publication of scientifically rigorous research in medical education because the results of research in medical education will ultimately impact patient care [3, 4]. Additional research, especially additional systematic reviews, should provide an opportunity for medical educators to “hoist themselves upon the shoulders of their colleagues” so that they too may be able to see just a bit farther [5]. However, a recent examination of medical education review articles concluded there was variability in the quality and reporting of search strategies, resulting in an inability to reproduce results [6]. That study made recommendations for conducting and reporting literature searches, including adding a librarian to research teams to design and run the search and to assist with retrieving literature and writing the manuscript. The role of the librarian as an expert in literature search and retrieval has been described in published articles for a number of years [7–10]. Sampson and McGowan reviewed the search strategies of sixty-five systematic reviews and found that most contained at least one error and the majority of these errors could affect recall, which might also affect the results of the reviews [11]. That study suggested the need to use an expert when developing a search strategy. Furthermore, the Institute of Medicine and the Agency of Healthcare Research and Quality have both recently published reports recommending that librarians be included as members of research teams [12] and that their expertise in literature searching be integrated into the research process [13]. Librarian contributions not only add to the quality of the literature search, but the resulting research as well. As a follow up to the study of search quality and reporting in medical education review articles noted above [6], the current study examined the role (if any) that was played by a librarian in medical education reviews.

Evaluation of a Self-Paced Learning Module to Teach Responsible Literature Searching for Research**

The unanticipated death of a healthy research study volunteer at a major university highlighted the importance of a comprehensive and exhaustive literature review in conducting responsible research [1]. When this unfortunate event was investigated, it became evident that many researchers who perform literature searches have little guidance about what constitutes an appropriate or sufficient search to support human subject research. The researcher in that study had completed a basic search of MEDLINE and recent texts but had not conducted an extensive search, thereby missing relevant published research [2, 3]. After many of its members conducted literature searches themselves, the committee assigned to investigate this event found it was divided on what constitutes a sufficient literature search to support human subject research [4]. The Medical Library Association (MLA) recommended development of standards for literature searching to help institutional review boards assess the quality and comprehensiveness of literature searches in studies under review, and the association developed a policy statement on the role of expert searching in the health sciences [5–7]. In an article published long before this unfortunate event, Cullen and Mason decried the lack of standards for health sciences literature searching: