Stephanie M. Swanberg

Improvement in attitudes toward influenza vaccination in medical students following an integrated curricular intervention.

INTRODUCTION Vaccination of health care workers (HCW) reduces transmission of influenza among patients, yet uptake of vaccination remains low. If vaccination education is integrated into the early medical school curriculum, will student attitudes toward the vaccine change? The objectives of the study were to: (1) Determine influenza vaccination rates among entering medical students; (2) Assess the attitudes toward influenza vaccination; (3) Evaluate the effects of a multifaceted educational intervention on attitudes to vaccination. METHODS Entering medical students were surveyed before and after an intervention at the beginning of the influenza season. This intervention provided by an inter-professional team, included education about influenza, importance of vaccination for HCWs, followed by vaccination administration practice, and ended with students vaccinating consenting classmates. RESULTS The pre-intervention surveys and intervention were completed by 124 of 125 (99%) students. Pre-intervention survey revealed 60 (48%) of students had been previously vaccinated. Of the vaccinated students 91% had been recommended vaccination by their healthcare provider compared to 43% of non-vaccinated students. More positive attitudes were noted in the vaccinated students compared to non-vaccinated students: importance of vaccination (p<0.01); HCWs should be vaccinated (p<0.01); recommendation of vaccine to family and friends (p<0.01). 97 (78%) students completed post-intervention surveys. Significant improvement in these attitudes was noted post-intervention compared to pre-intervention: importance of vaccination 93% versus 71% (p<0.01); HCWs should be vaccinated 95% versus 83% (p<0.01); recommendation to family and friends 93% versus 73% (p<0.01); comfort with vaccine counseling 92% versus 41%; comfort with vaccine administration 84% versus 22% (p<0.01). CONCLUSION Educating medical students and promoting the importance of vaccination early in a medical students career using such an intervention is relatively simple and easily integrated into the curriculum. This intervention was successful in vaccinating all students, and demonstrated a marked positive shift in attitudes toward influenza vaccination.

Instructional methods used by health sciences librarians to teach evidence-based practice (EBP): a systematic review

BACKGROUND Librarians often teach evidence-based practice (EBP) within health sciences curricula. It is not known what teaching methods are most effective. METHODS A systematic review of the literature was conducted searching CINAHL, EMBASE, ERIC, LISTA, PubMed, Scopus, and others. Searches were completed through December 2014. No limits were applied. Hand searching of Medical Library Association annual meeting abstracts from 2009-2014 was also completed. Studies must be about EBP instruction by a librarian within undergraduate or graduate health sciences curricula and include skills assessment. Studies with no assessment, letters and comments, and veterinary education studies were excluded. Data extraction and critical appraisal were performed to determine the risk of bias of each study. RESULTS Twenty-seven studies were included for analysis. Studies occurred in the United States (20), Canada (3), the United Kingdom (1), and Italy (1), with 22 in medicine and 5 in allied health. Teaching methods included lecture (20), small group or one-on-one instruction (16), computer lab practice (15), and online learning (6). Assessments were quizzes or tests, pretests and posttests, peer-review, search strategy evaluations, clinical scenario assignments, or a hybrid. Due to large variability across studies, meta-analysis was not conducted. DISCUSSION Findings were weakly significant for positive change in search performance for most studies. Only one study compared teaching methods, and no one teaching method proved more effective. Future studies could conduct multisite interventions using randomized or quasi-randomized controlled trial study design and standardized assessment tools to measure outcomes.

Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students

BackgroundHuman papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is also well established that HPV viruses are responsible for a variety of cancers. Little is known about the prevailing knowledge and attitudes toward the HPV vaccine in our future healthcare providers, a majority of whom were among the first in the target age group to receive the vaccine; the same vaccine that they will in turn be expected to recommend to their patients. The aims of this pilot study were to examine the HPV vaccination rate among medical students and determine their knowledge about HPV and attitudes toward vaccination.MethodsTo aid in the development of an HPV educational intervention, a needs assessment survey was administered to discover medical students’ knowledge and attitudes toward the HPV vaccine. All medical students at a Midwestern US medical school were invited to complete the survey.ResultsTwo hundred fourteen of 390 medical students completed the survey with 44% having been previously vaccinated. Although 82% of all respondents believed they would recommend the vaccine to family and friends, only 40% felt knowledgeable about the vaccine and 40% felt comfortable counseling patients. More positive attitudes and better knowledge scores were found in fully vaccinated students compared to non-vaccinated students. Provider recommendation was strongly associated with HPV vaccination status.ConclusionsThis study revealed the unique perspectives of U.S. millennial medical students as the first group of future healthcare providers to have personally encountered the HPV vaccine. Overall, students’ knowledge as well as their comfort level in counseling patients was lacking. This assessment has guided the development of targeted educational interventions to address knowledge gaps and prepare students to appropriately discuss the vaccine with patients and parents and help protect young people from life threatening cancers.

Partnership for Diversity: A Multidisciplinary Approach to Nurturing Cultural Competence at an Emerging Medical School.

Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.

Community Engagement at an Emerging Academic Medical Library: A Three-Pronged Outreach Model

Abstract The Oakland University William Beaumont School of Medicine’s (OUWB) service-oriented mission and vision is reflected in all aspects of the school including its culture, curriculum, research, community engagement, and the OUWB Medical Library. Though starting informally, the OUWB Medical Library’s outreach program has matured and now sustains a wide array of activities each year. This outreach program has blossomed into a three-pronged model that is inclusive of activities and endeavors engaging the institution and local community: integrate, partner, and create. Among its successes and challenges, the library’s ongoing outreach efforts have showcased the value of libraries in promoting community health and meaningfully contributing to the institutional mission.

Utilizing journal club to facilitate critical thinking in pre-clinical medical students

Learning and practicing evidence-based medicine (EBM) is vital for all healthcare professionals throughout their careers and requires expert medical knowledge, effective communication skills to uncover patient values, as well as critical thinking skills in appraisal of the scientific literature.1 Integrating EBM training and critical thinking skills into undergraduate medical education programs is required and fully supported by accrediting bodies, such as the Liaison Committee on Medical Education (LCME) and professional organizations.2,3 Specifically, in their 2014 report, Core Entrustable Professional Activities (EPAs) for Entering Residency, the Association of American Medical Colleges (AAMC) named retrieving and applying evidence as a fundamental skill for graduating medical students.3 Core EPAs for entering residency is an initiative to define a “...common core set of behaviors that could/should be expected of all [medical school] graduates”.3 One way to incorporate these fundamental skills into undergraduate medical education is through the use of journal clubs. Journal clubs are already a well-documented instructional method used in residency programs and for continuing medical education.4,5 In that journal clubs focus on critically evaluating current literature and applying it to patient care, they provide the perfect environment for teaching EBM and have been shown to positively impact EBM knowledge and skills.6,7 Effectiveness of these journal clubs has depended on several characteristics including a clear purpose, incentives, and a trained journal club leader.8 Despite extensive use at higher medical education levels, use of journal clubs has been minimally reported in the undergraduate pre-clinical medical education literature. Most studies have implemented journal clubs during medical students’ clinical years.9,10 The purpose of this article is to describe the successes and challenges of, as well as lessons learned in implementing, structured journal club activities in the pre-clinical years in an effort to introduce critical thinking and application skills.

An Integrated, Case-Based Approach to Teaching Medical Students How to Locate the Best Available Evidence for Clinical Care

Introduction A major step of the evidence-based medicine (EBM) process is to locate the most current evidence in support of clinical care. This requires identifying and searching appropriate evidence-based resources. Medical library faculty at the Oakland University William Beaumont School of Medicine teach these skills as part of a dedicated EBM course at the end of the second year of the medical school curriculum. Methods A 3-hour “Locating the Best Available Evidence” session is divided into two major components: an optional 50-minute didactic lecture followed by a mandatory 2-hour interactive lab. Students formulate a PICO (patient, intervention, comparison, outcome) question from a case, develop search strategies, and gather evidence. Formative feedback is provided to the students to help them prepare for a final case presentation. Results Session effectiveness is assessed using course evaluations and the case presentation grade. Course evaluations indicate that students find this session structure to be especially helpful in learning the breadth of available EBM resources, preparing for their course case presentations, and acquiring skills for clinical clerkships. Quality of the case presentations also indicates students have acquired the necessary skills to be successful in practicing EBM skills in clerkship rotations and residency. Discussion Whether institutions have a dedicated EBM course or integrate EBM skills into the medical school curriculum, this session could easily be adapted and implemented. It could also be tailored for graduate or continuing medical education environments in any specialty.

Continuing education for medical students: a library model

PURPOSE The research assessed a three-year continuing medical education-style program for medical students in a Midwestern academic medical library. METHODS A mixed methods approach of a survey and two focus groups comparing attendees versus non-attendees assessed the program. RESULTS Eleven students participated in the focus groups. Attendance was driven by topic interest and lunch. Barriers included lack of interest, scheduling, location, and convenience. CONCLUSIONS Although attendance was a challenge, students valued opportunities to learn new skills. This study show cases a reproducible method to engage students outside the curriculum.