Examining the readiness of best evidence in medical education guides for integration into educational practice: A meta-synthesis.

BACKGROUND: To support evidence-informed education, health professions education (HPE) stakeholders encourage the creation and use of knowledge syntheses or reviews. However, it is unclear if these knowledge syntheses are ready for translation into educational practice. Without understanding the readiness, defined by three criteria-quality, accessibility and relevance-we risk translating weak evidence into practice and/or providing information that is not useful to educators. METHODS: A librarian searched Web of Science for knowledge syntheses, specifically Best Evidence in Medical Education (BEME) Guides. This meta-synthesis focuses on BEME Guides because of their explicit goal to inform educational practice and policy. Two authors extracted data from all Guides, guided by the 25-item STructured apprOach to the Reporting In healthcare education of Evidence Synthesis (STORIES). RESULTS: Forty-two Guides published in Medical Teacher between 1999 and 2017 were analyzed. No Guide met all STORIES criteria, but all included structured summaries and most described their literature search (n = 39) and study inclusion/exclusion (n = 40) procedures. Eleven Guides reported the presence of theory and/or educational principles, and eight consulted with external subject matter experts. Accessibility to each Guide's full-text and supplemental materials was variable. DISCUSSION: For a subset of HPE knowledge syntheses, BEME Guides, this meta-synthesis identifies factors that support readiness and indicates potential areas of improvement, such as consistent access to Guides and inclusion of external subject matter experts on the review team. This analysis is useful for understanding the current readiness of HPE knowledge syntheses and informing future reviews to evolve so they can catalyze translation of evidence into educational practice.

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.

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).

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.

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.

Impact and user satisfaction of a clinical information portal embedded in an electronic health record.

In 2008, a clinical information tool was developed and embedded in the electronic health record system of an academic medical center. In 2009, the initial information tool, Clinical-e, was superseded by a portal called Clinical Focus, with a single search box enabling a federated search of selected online information resources. To measure the usefulness and impact of Clinical Focus, a survey was used to gather feedback about users' experience with this clinical resource. The survey determined what type of clinicians were using this tool and assessed user satisfaction and perceived impact on patient care decision making. Initial survey results suggest the majority of respondents found Clinical Focus easy to navigate, the content easy to read, and the retrieved information relevant and complete. The majority would recommend Clinical Focus to their colleagues. Results indicate that this tool is a promising area for future development.

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.

Development of a clinical information tool for the electronic medical record: a case study.

QUESTION: What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center? SETTING: The development took place at the University of Pittsburgh Health Sciences Library System. METHOD: The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized "on the fly" into meaningful categories using clustering technology and are directly accessible from the results page. RESULTS: After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center's electronic health record. CONCLUSION: The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness.

Information-seeking behavior and use of information resources by clinical research coordinators.

PURPOSE: The study sought to understand the literature searching experiences and skills of clinical research coordinators at a large academic medical center. SETTING/PARTICIPANTS/RESOURCES: The Health Sciences Library System, University of Pittsburgh, conducted a survey of clinical research coordinators at the University of Pittsburgh and the University of Pittsburgh Medical Center to solicit their perceived use and knowledge of the library's electronic resources. BRIEF DESCRIPTION: The University of Pittsburgh Institutional Review Board (IRB) is a "high volume IRB" that monitors human subject research at both the University of Pittsburgh and the University of Pittsburgh Medical Center. More than 3,500 human research studies and clinical trials are active at any given time. Many studies entail more than minimal risk to human subjects, with the majority evaluating or including a drug or medical device. Clinical research coordinators are involved in most of these studies or trials. Their roles and responsibilities focus on managing many aspects of the study or clinical trial. As a first step in understanding the literature searching experiences and skills of these research coordinators, baseline data were gathered from this group in November 2004. RESULTS/OUTCOME: The data from this survey indicate that clinical research coordinators are a population who would benefit from training by academic medical center librarians in how to use electronic library resources and services. EVALUATION METHOD: A Web-based survey solicited participants' information (gender, education, job title) and role in the IRB process (job responsibilities, number studies they manage). The majority of the survey questions focused on the use of specific electronic library resources, the type of information wanted, and the types of problems encountered.