EBM and Clinical Support Librarians@UCHC

A blog for medical students, faculty and librarians about their use of evidence based medicine, clinical literature, Web 2.0, sources and search strategies

Category Archives: Medicine 2.0

News, A Look Back: Happy New Year and Picks for Best Posts

First:  Best wishes for a Happy and Healthy New Year 2011 to everyone! 

Since I have been writing this blog (which began in July 2007), I have yet to assemble a list of  “favorite posts” from the backlist.  The first week of a brand New Year seems like a good time to offer up this collection.

Here’s a list of top picks from the EBM & Clinical Support Librarians@UCHC blog (in no particular order):

  • Digital Natives (Jun 12 2008) compares the learning environment of today’s graduate students with those from my generation (i.e., circa 1970’s).
  • A continuing series called Show Me The EvidencePart 1 is linked here. Part 2 – go here.  And Part 3 (which has received the most hits over time) link is here.

That’s a compilation to start out the New Year, folks – and thanks for reading this blog.

 


 

News, Clinical Resources, iPhone Apps: FirstConsult

Here’s some good news!  On Nov 6 2010, Elsevier Health, producer of the MD Consult/FirstConsult database, announced their free FirstConsult app for iPhone, iPod Touch or iPad .

UCHC Library is an institutional subscriber to the MD Consult database, which enables any registered library user to access the First Consult database via their mobile device.  If you haven’t used FirstConsult before, it is a clinical point-of-care resource designed for busy clinicians who need fast answers in a “wherever, whenever” wireless environment.  Below is a screenshot of  First Consult apps page from iTunes:

Source: http://www.mdconsult.com/php/227775087-4/homepage – All rights reserved – Copyright 2010

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Here are instructions on how to make it work on your iPhone/iPad:

1.       If you have not previously set up an account with MD Consult, first you’ll need to create one (which is free and quick).  Go to http://library.uchc.edu, then click on Databases, then scroll down to the MD Consult link.

The “Create Account” button is in the upper right-hand corner. (Without this step, your free FirstConsult app will only work for 60 days).  See the screenshot below:

Image Source: http://www.mdconsult.com/php/227775087-4/homepage – All rights reserved – Copyright 2010

2.      Next, using your mobile device, log into your MD Consult account.  Then go to the iPhone App Store.  Download the FirstConsult app into your device.  Medical topics download occurs automatically; you should budget 30 minutes for the initial data downloading.

If you have any questions or problems with getting this to work, please call UCHC Library Computer Education Center staff at 860-679-3772.

News, Libraries, Librarianship: Medlib’s Round Carnival Edition 2.5!

This is the June 2010 edition of Medlib’s Round Carnival.

This collection of links have been submitted by a (worldwide) group of dedicated bloggers… veteran medical librarians along with a new health science librarian, physicians and scientists contributing to the mix!

The broad  topic of this Carnival is about service. Librarians talk a lot among themselves about providing quality information services and library collections for their core users.   We are great believers in training our library visitors to recognize quality information sources, showing them what to search,  how to search and how to appraise those sources effectively; we also spend considerable time, effort and money to create digital or physical library collections that meet the information needs of our users.  Doing these things well is (actually) more difficult than it appears…  not as difficult as climbing the summit of Mount Everest but definitely made more challenging in an era of rapidly rising costs, disappearing personnel and shrinking budgets.

So without further ado, here is the Medlib’s Round Blog Carnival 2.5.

Jacqueline, blogger at Laika‘s MedLibLog recently wrote:  “It is so important that you know the pros and cons of databases and that you think before you even start searching“. Read her evidence-based discussion here:  “PubMed versus Google Scholar for Retrieving Evidence” (Jun 6 2010).

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Medical Library Association holds an annual conference, which this year was held May 21-26 in Washington, DCKrafty Librarian blogger Michelle Kraft was a conference speaker and official blogger at MLA.  She wrote MLA ’10 Week in Review, an excellent summary and set of links to presentations and other conference activities on her blog – especially valuable to those of us who weren’t able to attend the meeting.

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As a library student, you don’t get many chances to really dig your teeth into searching databases, unless you’re working on a thesis or have a really extraordinary work opportunity. Basic reference as a student usually involves basic searches for patrons, maybe some instruction, more than a little help given to new or remedial library users. This is why my experience with a systematic search team will be so memorable as a learning experience as I begin to launch my career as a health librarian. “

So wrote recent MLS graduate, Daniel Hooker, who blogs about Health Libraries, Medicine and the Web in a recent post about performing his First Systematic Search using the OvidSP search platform.  Check out the vintage librarian cartoon – what a laugh!

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Psychiatrist Walter van den Broek, who blogs at Dr. Shock, wrote an interesting post for the Carnival entitled “What’s Wrong with the Disclosure of Conflicts of Interest?” (Jun 6 2010).

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Relying on donations, librarian-volunteers collect and ship medical textbooks to American military personnel stationed in war zones throughout the world.  Their service mission is described on the blog Operation Medical Libraries:

” The mission of Operation Medical Libraries is to collect and distribute current medical textbooks and journals to war-torn countries through a partnership with American medical schools, hospitals, and physicians and the United States military… and

to foster the creation of permanent medical libraries and support the expansion of existing collections in conflict regions where health care education and the practice of medicine are suffering “.

Text Source: http://operationmedicallibraries.blogspot.com/ – All rights reserved – Copyright 2010

This post on the OML blog is about books sent to Afghanistan in 2009 and the photo below shows a happy library user in that facility:

Photo source: http://operationmedicallibraries.blogspot.com/2009/05/oml-library-in-bagram-af-provides.html – All rights reserved – copyright 2010

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Patients or family members are a common sight in the medical library, seeking current, credible medical information, or advice on where to find those patient education materials.  Technologist-librarian PF Anderson contributes two items to this Carnival on those topics:

Video Source: http://www.youtube.com – All rights reserved – Copyright 2010

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  • BitesizeBio, a blog written by and for lab biologists, offers practical advice on giving, receiving, qualifying and implementing advice in the Apr 26 2010 post, “The Art of Giving of Advice“.

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And that’s Medlib’s Round Blog Carnival Edition 2.5, folks!  Hope you enjoyed reading it. To all those who sent in submissions, I am grateful and send you heartfelt thanks!

The next edition of MedLib’s Round (July 2010) will be hosted at Laika‘s MedLibLog.

If you have material to submit for that edition, please use this form.  To subscribe to an RSS feed for Medlib’s Round, click here here.

News, Medicine, Librarians, Blogosphere: Participate in Medlib’s Blog Carnival – June 2010

Image/Photo Credit: http://blogcarnival.com/ – All rights reserved – Copyright 2010

Big News!

EBM and Clinical Support Librarians@UCHC has been invited to host Medlib’s Round Blog Carnival for the month of  June 2010. How does this work?  Here is an excerpt from the Blog Carnival FAQ page:

Welcome to the Blog Carnival page! We love the idea of blog carnivals where someone takes the time to find really good blog posts on a given topic, and then puts all those posts together in a blog post called a “carnival”… Carnivals are an edited (and usually annotated) collection of links that lets them serve as “magazines” within the blogosphere…

Since blog carnivals include lots of posts on specific topics, they also serve as a place to connect with those who are expert (or at least highly opinionated!) and those who are interested in that field. Blog Carnival simplifies carnivals for two kinds of people:  People who read and contribute to blog carnivals, and  people who organize and publish blog carnivals.

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What is the subject for Medlib’s Round Blog Carnival?

As a reference and public services librarian, over the years I have assembled a group of classic questions or library patrons in my mind that could be summarized as:  Questions (or People) I’ll Always Remember at the Health Science Library“.

This intent of this collaboration is learn more about the unique experiences of others librarians worldwide, or from those who work with health science librarians to teach, train and find medical information.  

Who should submit to the Medlib’s Round?

Bloggers from around the world

Medical/reference  librarians, folks who blog about clinical reasoning, evidence-based medicine, teaching and learning medicine (or practicing medicine).  I would appreciate hearing from physician- or scientist-bloggers who collaborate with health science librarians, medical students and others as they use digital library collections.

What should I write about?

Funny, sad, poignant, teachable moments (or people) encountered in your health science library.

  • Librarians: Please share some positive “memorable” encounters that took place in a public service/reference desk setting, over your career.
  • Clinicians, researchers,  pharmacists, graduate students, nurses: If your clinical or educational work as a scientist or care-provider has been positively enhanced by working with a librarian or librarian-instructors in health science library settings, please share your stories with us.

Is there a deadline to submit an entry?

Yes – please write your article, post it to your blog and send it to BlogCarnival.com no later than Tuesday, June 8th.

OK – I have an article to share.  Now what do I do?

First, go this link at BlogCarnival.com and paste the URL of your blog post using their online form.  You’ll need to also type in your name and email address.  (See screenshot below).  BlogCarnival will manage it from there.

Image/Photo Credit: http://blogcarnival.com/ – All rights reserved – Copyright 2010

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Questions – I have Questions. Who do I ask? Send an email message to ebmblog@gmail.com.  Thanks in advance!

Teaching & Learning in Medicine, Research Methodology, Biostatistics: Show Me the Evidence (Part 2)

May is the time of year when I get to sit in the back of a classroom with my mouth shut, listening (as opposed to standing in the front of a classroom, yakking about searching).

This post, Part 2 of “Show Me the Evidence“, is not about how to search a database better or when to find a systematic literature review… or anything about a library or its collections.

The “evidence” in this case isn’t a tangible product, nor can it be measured in ounces or liters.  This evidence is formed during years spent in a classroom and framed by clinical experience, listening to a patient describe their symptoms or the way a tumor feels under one’s hand or scalpel.  This evidence dwells in a scientists’ mind, whether they practice medicine or perform experiments, collecting images and allowing a peripheral brain to develop.  This knowledge has been informed by a hundred nights on call, scrutinizing CT scans, dissecting mice, examining EKG strips, observing the gait and balance of a child, listening to the characteristic sounds of COPD through a stethoscope. It could be the red flag raised by how a patient’s liver appears in a CT scan, or a questionable lab value.

This evidence-base has been formed by workdays lasting 18 hours, hunkered down in a pathology lab or an operating room.  It allows a collection of “clinical suspicions” to coalesce.  It improves diagnostic accuracy and surgical intuition.  It dwells in the life of the mind, it could be called intellectual rigor.

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A newer graduate program offered at UConn Health Center is the Masters in Clinical and Translational Research (MCTR) program.  There are over 50 faculty who teach individual components for this course, and it is a varied group: senior researchers, epidemiologists, a couple of psychiatrists, a pharmacologist, two biostatisticians, a health law attorney, an IT specialist, hospital administrators.

As the only librarian in the group, my main contribution is to spend three hours teaching the students about the range of information available to them through the UConn libraries and how to best choose, search and evaluate the sources that complement their clinical areas.  Following are key areas of course content:

  • Clinical Research Fundamentals.  Trial Design, Execution, Management. The role of the Principal Investigator.
  • Selecting the Type of Study: Observational Prospective Studies.  Experimental Intervention Studies.  Non-Randomized Intervention Studies.  Case-control and Non-Randomization Study Design.
  • Measurement of Exposure; Principles for Inferring Causation.  Group Interventions, Intention to Treat Analysis.
  • Application of Pharmacokinetic Principles in Design or Execution of Phase I or Phase II Studies.
  • Patient Recruitment, Retention and Management.
  • Elements of Informed Consent; Drafting the Form.  HIPAA Rules.
  • Ethical Treatment of Human Subjects.  The Common Rule. Federal Regulations. Scientific Misconduct.
  • Survey Design: Questionnaires, Sampling, Response Rates, Recruitment.  Cross-sectional versus longitudinal surveys.
  • Working with the Institutional Review Board (IRB).
  • Studies in Genetics.
  • Computerized Data Management: Storage and Retrieval Needs, Data Elements, Data Entry; System Security, Backup and Storage. Data Archiving.

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Each student in the program presents a capstone research project at year-end; the assignment is to design a clinical study of their choice from beginning to end with special care taken to select the “correct” potential patient subjects and to choose the “best” study design. The individual who writes the proposal serves as the PI (principal investigator).  There were six students in the class this year. Four are physicians, the others are in physical therapy or dentistry.

Their presentations were awe-inspiring. They have such a sure technical grasp of  methodologies (that remain dense to me) and confidence in planning the micro- and macro-aspects of their clinical research project. Certainly I hope they will succeed in securing funding for these proposals.

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So I sit in the back of the room, and am reminded annually of just how much I’ll never understand about gene expression profiles, how vectors are designed or how chromosome 10 got lost.  It is a humbling experience.

Didn’t Ben Franklin say: “It is better to keep one’s mouth closed and to be thought a fool, than to open it and remove all doubt“?  That’s excellent advice.

But the students also showed that they have become better searchers and THAT evidence is awesome, too! 🙂

Teaching & Learning in Medicine, Research Methodology, Biostatistics: Show Me the Evidence (Part 1)

Question everything… especially what you read.

A 2009 quote from Dr. P,  PBL facilitator

.One of the many tasks for first-year graduate students in clinical or research areas is building a healthy skepticism about what one reads in the medical literature.

Ideally, as they progress through four years of medical education, students find that they must change their approach to searching as well as exploring what new resources will answer their questions of increasing complexity.  What answered their learning issues in their first year often doesn’t carry over to their third-year clerkship, when they are faced with finding solutions to the care of actual living patients.

This evolution (both practical and intellectual) asks that they grow a set of appraisal techniques for examining, embracing or rejecting what they find in the ever-increasing assortment of health science, pharmacology or social science databases available to them. (Note that I’m not referring to what can be found by simply plugging a few words into a search engine.)

And very likely, they jettison the use of a few previously well-used resources  as their clinical questions and experience become more complex.

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.Separate what is of statistical importance from what is clinically significant.

Another 2009 quote from Dr. P

As a facilitator for PBL, many first-year students have stated in class that they rely most on the library’s subscription to the Access Medicine* collection – including Harrisons’ Online – as a “first place” to go to do research.

It is what the librarians consider as a sort of a “package product”.  This subscription resource has developed in major ways over the years which UCHC Library has been providing it for our users.

As examples: there are now 60 core medical textbooks on the site, lists of DDx criteria, audio cases, calculators and clinical videos, podcasts, study guides for USMLE.  The library added subscriptions to Access Surgery and Access Emergency Medicine when they became available from the company.

Residents especially appreciate having 24×7 access to these resources.

And truly, we librarians were thrilled back in 1999 when the subscription to a digital version of Harrisons’ Principals of Internal Medicine was rolled out.  LOL.  (Link here to an academic paper from 1999 reviewing the resource.)  Back then, the medical and dental students were excited about this 16th digital edition too, although most of them elected to purchase their own hardbound copy of the textbook.  These memories seem a little quaint from eleven years on.

In 2010, here’s a screenshot of the newly-redesigned Access Medicine front page:

Photo/Text source: http://www.accessmedicine.com/features.aspx – All rights reserved – Copyright 2010
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What are other examples of what librarians consider garden-variety “packaged databases” that are frequently mentioned by first year students as essential to their research?

MD-Consult*, Up to Date* and for locating primary studies (or for “just shopping around” as one student said), PubMed.

As librarians (and instructors) a major teaching role for us is to encourage their exploration… and also to model the effective use of these information resources.  Feedback from students or faculty on the nature of their experiences as they  “consume” these products is very important.

And (dare I mention!) the librarians are there in the classrooms to also reinforce that using sources such as Google or Google Scholar to do credible clinical research represent truly two of the least satisfactory choices but also the ones most easily or readily available.   (Sigh.)

There are many free information sites in the world… the librarians don’t use or teach (or endorse) many of them. Why? Not because we are close-minded, too traditional, or old and cranky. This is a conversation thread that will be continued in Part 2 of this post.

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Seeing a dozen patients with XYZ syndrome will significantly increase their practical assessment skills.  So will participating in the care of a patient that even the seasoned clinicians and experts haven’t yet figured out a diagnosis for. A common short-hand for diagnostic skills is Horses versus Zebras.

Learning to comb the literature for clinically-sound research studies – and weighing what has been found for validity or predictive value – are skills not easily learned.  Is four years sufficient time for practice in this pick-and-choose process?

Many students in their third and fourth year of study come back to meet with the reference librarians for a “refresher course” on how to search more efficiently, as they begin their required fourth year individual research project (called their “selective“).

I consider these reference training sessions with students as excellent indicators that they are growing quite sophisticated about what they consider to be “good” evidence.  Getting choosy is a wonderful thing.

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* Please note: Resources mentioned are subscriptions and limited to UCHC students, staff and faculty only.  If off-site, use the Library’s proxy access to connect to them.

Academic Medicine, Teaching & Learning in Medicine: Announcing a New Series called Learning Medicine

It’s looking more like spring each morning in the Northeast, after a nasty late winter. There are daffodils poking out of the ground. The days are growing longer. This morning I saw a green bagel in the cafeteria because tomorrow is St. Patrick’s Day*.

This makes it a good time to try something new on the blog. Today marks the first post in a series which I have titled Learning Medicine: Ten Questions.

The series is intended as an open dialog between current and former medical students, educators, clinical researchers, PBL facilitators, librarians (and anyone else I can rope into answering 10+ questions!). The content or questions in the interview may vary, depending on the background and professional experience of the interviewee.

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Today, please welcome esteemed veteran blogger and physician Graham Walker!

A Background Question – Who Are You?

Graham Walker describes himself in this way:

I’m a second-year Emergency Medicine resident at St. Luke’s-Roosevelt Hospital System in New York City. I was originally a medical school blogger (at the now-defunct Over  My Med Body! ) blog. Recently I’ve returned to blogging as a contributor to The Central Line, the official blog of the American College of Emergency Physicians.

My interests include: surviving residency, technology and web design, simulation medicine, informatics, health policy and caffeine highs.  I’m originally from Kansas, went to undergrad at Northwestern in Chicago, studying social policy/health policy, then went to Stanford for med school with a concentration in Community Health.

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Making the transition from undergraduate/or pre-med to graduate medical student

Can you name 4 or 5 key things that (in retrospect) you wished you had known before you began your first day of medical school?

Oh boy. Hopefully I can still remember anything about being a premed!  Here goes:

1) Know how you study, and develop good study skills in undergrad. Medical school is tough — they say it is like trying to drink water out of a firehose — so make sure that you’ve got a system in place to organize information in your head and commit it to memory.

For some people that’s flashcards, for others it’s study groups; for me, I *still* find I have to write things down in a notebook to get them to stick.

2) Know how you relax, and don’t give up doing that. For some people, that’s going to the gym. For others, that’s playing the guitar. Or doing a hobby. Or keeping in touch with your family. Medical school (and residency even more-so) requires copious coping mechanisms so have yours ready.

3) Get by with a little help from your friends. Don’t be a gunner in medical school. You’re in — You get to be a doctor — Yay!  Med school will be much easier if you work together with your classmates rather than view them as competition — *especially* once clinics start.

4) It is normal to feel overwhelmed. Accept it and embrace it, and it won’t be so stressful. There are parts of it that you’re going to hate, that are not going to be intuitive. But it will get better!

5) Try to get yourself all figured out. Know yourself by the time medical school starts, because while you’re in the thick of things, it’s easier to have as many of your own internal issues worked out before trying to ascend Mt. Medical School. “

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Being a Person AND a Medical Student

Please tell us about some moments in medical school or clerkship that:

Made You Angry: I remember two instances that made me upset: one was the way some OB-Gyn residents were talking disrespectfully about a terminal cancer patient. (I actually kind of understand their perspective as a resident now, but still don’t agree with it.)

The other was a grossly abnormal physical finding in a patient that I found that a group of residents chose to ignore, because I was a medical student. As the medical student, you are — more than anyone — your patient’s advocate. Know when to speak up.”

Made you wish you had Studied More: “ The Boards. But you always wish you could memorize more. Do your best, and move on “.

Brought Tears to your Eyes:  “ I remember it like it was yesterday. It was on my medicine rotation, one of the first patients that I really felt was “mine.” My residents let me “be in charge” as much as I could, and I fought for him to get a much-needed foot amputation. I was off or post-call one day, and I remember coming back the next morning and finding out he had died.

I wrote up the experience: Wonderful, Just Wonderful, Dr. Walker at: http://www.grahamazon.com/over/2006/02/wonderful-just-wonderful-dr-walker/ “.

Made you Roll on the Floor Laughing:  “ Slap-happy post-call. I’m known for being a little hyper and a bit of a morning person, which usually drives people crazy. Also any shift in the Emergency Department “.

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Learning Medicine, Becoming a Doctor. Empathy, gravitas, demeanor, honesty

Part A:  How does one learn to “act like a physician”?   (It’s not really in a textbook.)

I certainly steal bits and pieces from different mentors and heroes of mine. A phrase from this attending, a style from that one. Tips and tricks along the way.

There’s no one way to “act like a physician,” and often it changes for the situation and the patient. I’m a different type of doctor when I’m seeing an infant compared to when I’m evaluating a trauma patient or interviewing a 95 year-old. Being able to adapt and change: maybe that’s the ticket. ”

One area the third-year medical students are concerned with is effective communications with patients and their families when managing someone with a terminal illness, in palliative care or especially when attending unexpected deaths due to accidents, homicide, military, etc.

Part B:  How does a physician learn to “deliver bad news” to a patient or their family members?

Get at or below the patient or loved one’s level. Empathize. Speak in private. Speak their language, if you can. (Learn as many languages as you can.) Make eye contact. Be direct, calm, and compassionate. Tell them however they’re feeling or reacting is normal and okay: everyone reacts differently.

Be present in the moment.  This is one of the hardest things for me to do now, and I have to remind myself of it, especially in a busy emergency department. Don’t worry about what’s happening to the rest of the team, or the other patients, or the rest of the department. Just be there, if only for a few minutes.   Apply the Golden Rule “.

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Congratulations – You are now a resident!  Choosing a specialty.

Match Day is Thursday, March 18, 2010. Can you describe the process that allowed you to select a medical specialty (Emergency Medicine) and why?

Man, it’s hard to remember, because my view of the specialty has changed so much as a resident. I remember really connecting with the type of attendings and residents who went into Emergency Medicine.  My type of people, I guess.

They say it’s much easier to rule out specialties than rule any in, and that’s very true. I was the type of medical student who enjoyed most of my clerkships, but in the end, I chose the one that I thought I’d enjoy, be challenged by, and excel at. ”

What advice would you give fourth-year students as they learn their Match and prepare for residency?

Get excited, relax, and get scared. Residency is not anything like a harder version of medical school, like I imagined it to be.  Enjoy your last few free months. Travel. Get married. Spend time with the people who are important to you.

Do. NOT. Study. And most of all: learn Spanish “.

Do you ever get enough sleep?

Yes, I do. My program is pretty resident-friendly in that regard, and I think it makes us all better, happier, more efficient, and more compassionate doctors. It’s hard to go the extra mile (which is what you realize you have to do as a resident) when you’re exhausted and cranky. ”

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Since this blog is written to inform readers about health science literature, trends in medical or scholarly communications, effective search strategies and sources, the next question focuses on your experience in learning to effectively use health science literature, sources for evidence-based practice or anything digital.

Have your information needs and/or searching behavior(s) changed between medical school and residency?  Are mobile computing resources and technologies important to you?

Definitely.  In medical school it’s all about learning about the basics, and the basics of how you treat X.

In residency, it’s much more about management, when to use what, finesse, and pattern recognition. I think it’s different for every specialty, too.

Regarding searching for clinical evidence, which sources, journals or databases have you found most-useful in answering clinical or patient care questions over time?

Great question. If I’m going to anything, it’s usually either UpToDate or E-Medicine or straight to actual papers, via Pubmed.

I really like JAMA’s Rational Clinical Examination series, as well as BestBets, The TRIP Database, Cochrane Reviews, and often just… Google.  I also keep a private little blog of things I’ve learned and journal articles I want to hold onto for future reference.”

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What aspect of medicine/science digital communication and/or particular use of the Web for medicine or patient care interests you the most? (This is a completely open-ended question.)

I love Podcasts, Videos, Image Banks and clinically-useful blogs. It’s a whole other style of learning that helps you learn more when you’re tired of reading journal articles, review articles, or textbooks. ”

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Bonus Question: What question would you like to ask the readers? – or – What do you want medical students who read the EBM and Clinical Support Librarians@UCHC blog to learn from our interview?

I’d love to know how the students think medicine is going to change in their lifetime.

What do they think of the blurring of private/public life through [social media sites such as] Facebook?  Should we as doctors hide our private lives — that is, is it inappropriate for a patient to see a doctor, say, smoking or drinking on a site like Facebook?

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And that’s the first interview for Learning Medicine: Ten Questions series.  Special thanks again to Graham Walker for sharing his time, expertise, advice and experiences.

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Happy St. Patrick’s Day!

Cardiac Physiology, History of Medicine, Digital Collections: Timelines and History for ECG

The first year medical and dental students are studying cardiac electrophysiology this month.  The Dubin book* (6th edition) is currently a hot item in the library reserve section.

Answering a reference question for a cardiologist this week on the topic of Medicine, Arts and Humanities, I came across a unique site, a timeline called “A Brief History of ECG“.  Nice.

Then I found the home page of The Heart Rhythm Society (HRS) which links to a section explaining “Electricity and the Heart“.

On the HRS page, there is timeline arranged by decade, which has the stated purpose of: ” …trac[ing] the evolution of the fields of cardiac pacing, cardiac electro-physiology and implantable cardioversion-defibrillation through a tour of historic devices and other material significant to the fields. ”

Below is a screenshot of their Timeline 1970’s:

Image Credit: The Heart Rhythm Society Timeline – All rights reserved – Copyright 2010

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Here are a few additional ECG teaching-and-learning sites:

  • Looking for a site you could easily spend hours in practicing ECG strip-interpretations? Try ECG-Maven, created by four physicians from Harvard University School of Medicine, has dozens of cases and quizzes.

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Finally, I’d like to mention finding a real treasure trove of a site: Exploring and Collecting History Online (ECHO), a digital history/directory site created by librarians at George Mason University, who describe their page in this way:

ECHO is a portal to over 5,000 websites concerning the history of science, technology, and industry… it is also a first step into the field of digital history.  Since 2001 it has been a laboratory for experimentation in this new field, and it fosters communication and dialog among historians, scientists, engineers, doctors, and technologists “.

Text credit: George Mason University – ECHO – All rights reserved – Copyright 2010

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* Editors Note:  The author, Dale Dubin, MD, has a website which is meant to serve a a companion to the book.

News, Medical & Technology Blogs: A Great Crop of “Best Medical Blogs”

MedGadget.com annually stages a “Best Medical Blog” award.  Their selections are always interesting to review for new – and well-established – writers.  This is the sixth year which the competition has been held.

This years’ nominees for the 2009 “Best Medical Blog” –  in seven different categories – represent many new bloggers, as well as some classic, veteran writers.  Each writer on the list represents a refreshing point of view in their own particular specialty, be it as a technologist, physician, research scientist, nurse, patient or librarian.

If you like, you can visit the site to review and vote for your choice(s) for the 2009 Medical Weblogs awards.  The online voting began Jan 27 and polls will remain open until Feb 14 2010.

Someday, maybe this blog will make it onto the list  8)

Clinical Reasoning, Mobile Computing, Point of Care Tools: Medical Knowledge in Your Pocket

This month, the second-year medical students at UCHC are in the process of selecting and purchasing their mobile computing devices (PDAs or SmartPhones) in preparation for the beginning of their clinical clerkship year when they’ll be using them to keep a log of patient encounters, check for drug interactions, calculate laboratory test results, look up point-of-care medical/reference facts or other essential activities like checking email and sharing files.

I’ve noticed that quite a few of the first-year medical students are already using PDAs, Blackberries and iPhones, thus getting ahead of the learning curve.  Several are already using EpocratesRX, a basic mobile drug reference resource available at no cost from Epocrates.com.

Other free downloads popular with medical students are Diagnosaurus 2.0, a differential diagnosis tool from McGraw-Hill, and Archimedes, a medical calculator, provided by Skyscape.

A desirable feature when evaluating potential new library subscription products is the availability of a mobile computing version.  Examples of highly-useful clinical resources which come with a mobile version are DynaMed, Essential Evidence Plus, Lexi-Comp, Micromedex, MD-Consult/First Consult, and two integrative-complementary-alternative medicines resources, Natural Medicines and Natural Standard.

These last two resources are especially important when clinicians need to determine potentially hazardous drug interactions between “over-the-counter” homeopathic or dietary supplements and allopathic prescription medicines.

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It is a rapidly changing world of devices, products, access, cost (and choices).  To review more of what is available in hand-helds for medical applications, visit a few pages* written for UCHC students by library staff :

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Wikipedia.org has a page about Open Source Healthcare Software.

Recently I came across a free clinical calculator site which anyone can use: MD+Calc.  Thanks to Graham Walker for putting this site up. Below is a screenshot of the topic page “Endocrine/Metabolic“:

Image/Source credit: http://www.mdcalc.com/ – All rights reserved – Copyright 2010
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Finally, here is a brief list of other free clinically-oriented sites**:

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* Note: Access to the clinical subscription databases described here is limited to UCHC students, staff and faculty.

** These links are provided for educational use only – not for clinical decision-making in the care of actual patients.