Enjoy UpToDate (UTD) at UMHS
UpToDate (UTD) for Evidence-based Clinical Decision Support is now provided to UMHS students and faculty! Check out the access link on the Anne Ross Library Home page and further information on the UMHS LMS - Library Services section.
"When you care for patients, the stakes are high and every decision counts.You need the best evidence and clinical guidance at your fingertips to answer even the most complex questions with confidence.
Healthcare professionals turn to UpToDate as the one trusted reference for answers even when the evidence isn’t clear. When you face a challenging clinical question or need to confirm your approach, you can turn to UpToDate for trusted answers based on the latest evidence and best practice.
Registration provides the following benefits:
Easy remote access to UpToDate(outside of the UMHS network)
Convenient continuing education credits (CME/CE/CPD)earned researching clinical questions using UpToDate onsite, remotely, and on mobile.
CME Real-time reflection: Look for the blue checkmark in the top navigation of the topic review to complete your CME reflection in real-time.
Electronically submit UpToDate CME credits for MOC points for these boards:
American boards of Internal Medicine, Anesthesiology, Ophthalmology, Otolaryngology (head and neck surgery), Pathology,Pediatrics, and Surgery."
Labels: Anne Ross Library, clinical decision support, CME, evidence-based medicine, evidence-based practice, mobile medicine, new library resources, UMHS, UpToDate, UTD
The first in a new video series from the
Health Council of Canada will answer this question for you and help you to understand
Clinical Practice Guidelines (CPG's); how they are used, how they are disseminated and implemented, and what impact they can have. This video series was developed by the professionals who design, disseminate, and use CPG's in Canada.
"CPGs are evidence-based recommendations that help health care professionals make better clinical decisions. When designed and used properly, CPGs can play an important role in the Canadian health care system."
Understanding Clinical Practice Guidelines: A Video Series Primer
Video 1: What are CPGs?
Video 2: Challenges for CPGs.
Video 3: Integration of CPGs at the system level.
Video 4: Opportunities and future considerations for CPGs. Labels: clinical decision making, clinical medicine, clinical practice guidelines, CPG's, evidence-based medicine, evidence-based practice, Health Council of Canada, medical diagnosis
Facing the Challenge of Teaching Evidence-Based Medicine to Medical Students
I would encourage you all to read this article!
George P., Reis S., Nothnagle M., (2012). Using a Learning Coach to Teach Residents Evidence-based Medicine.
Family Medicine, 44(5), 351-355. http://www.stfm.org/fmhub/fm2012/May/Paul351.pdf
This study demonstrates how important the acquisition of
‘information mastery skills’ are to physician success in practicing evidence-based medicine! It shows what one university medical school did to try to improve these skills in their students, targeting their second year family medicine residents. [Alpert Medical School, Brown University, Family Medicine Residency Program and the Department of Family Medicine, Memorial Hospital of Rhode Island]
The article quotes the current ACGME accreditation competency:
“The ACGME requires that residents demonstrate competency in information mastery or the ability to 'locate, appraise, and assimilate evidence from scientific studies'.“
Reiterated in the
ACGMEs Next Accreditation System (NAS) ‘General Milestones’
*:
(adopting July 2013)
Level 2: (residents) “Formulates a searchable question from a clinical question (e.g., using PICO format).”
Level 3: (residents) “Applies a set of critical appraisal criteria to different types of research, including synopses of original research findings, systemic reviews and meta-analyses, and clinical-practice guidelines.” “Critically evaluates information from others.”
Level 4: (graduating resident) “Demonstrates a clinical practice that incorporates principles and basic practices of evidence-based practice and information mastery.”
Overall, I agree with the approaches taken by the developers of the course, the
one-on-one coaching model coupled with being a
structured component of the curriculum, and would encourage the adoption of a similar type of program at UMHS. Post intervention assessment of the resident’s EBM knowledge showed a notable increase of
31.8% , along with improved attitudes toward EBM and its increased use in the clinical setting. However there is still room for improvement as the average score on the posttest was still only 58%!
A few areas I suggest warrant further consideration or emphasis when undertaking such a program :
- stressing the quality and value of subscription clinical point-of-care databases, full-text journal databases, and other library resources.
- the integral involvement of the medical librarians in the program (course development, delivery, and evaluation).
- incorporating the ‘6S’ model ** for accessing pre-appraised evidence and providing directional steps to the search process.
- augmenting the course with training in current methods for staying up-to-date while navigating the flood of medical information, such as RSS alerting.
- recognizing that information resources are dynamic and will continue to challenge the information searcher’s flexibility and adaptability. Thus, it is important that the program emphasize teaching the concepts of information searching rather than focusing on the idiosyncrasies of any individual resource, or promoting dependency on any one database.
- working toward seamless integration of relevant evidence-based clinical information into the individual patient’s electronic medical record (a CDSS or Computerized Decision Support System).
Evidence-based practice isn’t just about finding
an answer to your clinical question, it is finding the
current best answer based on the peer-reviewed medical evidence, for the care of your particular patient.
I invite your comments ….
Ann Celestine,
Library Director
http://lib.umhs-sk.net/
*Nasca, T. J., Brigham, T., Philibert, I., & Flynn, T. C. (2012).
The Next GME Accreditation System — Rationale and Benefits. New England Journal Of Medicine, 366(11), 1051-1056. doi:10.1056/NEJMsr1200117.
**DiCenso, A., Bayley, L., & Haynes, R. (2009).
Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence Based Nursing, 12(4), 99-101. doi:10.1136/ebn.12.4.99-b
Labels: evidence-based medicine, evidence-based practice, information literacy, medical education, medical information search, medical student competencies, medical students
Did you know that
DynaMed has recorded
nine "Practice-Changing Updates" already this morning? Yesterday, DynaMed posted
21 updates!
Never before has the saying
"If you stand still you will be left behind" been more true than in the world of 21st century medicine.
How can you keep pace and truely provide current, best, evidence-based practice? One method is to take advantage of DynaMed's
"Recent Updates" page (notice the second link on left in the top navigation bar), which provides a view of the most recent articles added to DynaMed summaries.
◦DynaMed is updated daily through a 7-step evidence-based method for systematic literature surveillance so clinicians can find the best available evidence at the point of care. DynaMed topics provide synthesized summaries integrating new evidence with existing evidence to directly answer most clinical questions in a single source.
Check out DynaMed's new interface while you are there.If you need more help accessing DynaMed come and see us in the Library for your EBSCO login and/or your mobile access code.
Labels: DynaMed, evidence-based medicine, evidence-based practice, staying current
Have you been looking to join a journal club? Do you want to do more for your journal club but are restrained by time? I invite you to consider what the
Cochrane Journal Club offers to members:
"The Cochrane Journal Club is a free, monthly publication that introduces a recent Cochrane review, together with relevant background information, a podcast explaining the key points of the review, discussion questions to help you to explore the review methods and findings in more detail, and downloadable PowerPoint slides containing key figures and tables. You can even contact the review authors with your questions."
The
latest issue #21 discusses
"Selenium for preventing cancer". Labels: cancer prevention, Cochrane Collaboration, Cochrane Journal Club, Cochrane Systematic Reviews, evidence-based medicine, evidence-based practice, journal clubs, selenium, systematic reviews
A recent study evaluated the information literacy skills of first-year dental students and looked to identify any significant associations between search engine use and database preferences.
Conclusion: The study confirmed that
information literacy was lacking and that
"preference for the use of Google was significantly associated with students who were unable to find evidence-based citations." "Few issues in higher education are as fundamental as the ability to search for, evaluate, and synthesize information. The need to develop information literacy, the process of finding, retrieving, organizing, and evaluating the ever-expanding collection of online information, has precipitated the need for training in skill-based competencies in higher education, as well as medical and dental education."
Recommendation: Integrate evidence-based learning modules early in the curriculum to help students filter and establish the quality of online information.
Click post title for full text of the research article:
"Why not just Google it? An assessment of information literacy skills in a biomedical science curriculum." (April 25, 2011), Kingsley K [et al], BMC Medical Education 2011, 11:17doi:10.1186/1472-6920-11-17.
Labels: EBP, evidence-based practice, information literacy, medical curriculum, nursing curriculum, search skills
Translational medicine just got a shot in the arm with
DynaMed teaming up with
McMaster University (Health Information Research Unit), along with a body of physicians from around the world, to identify and synthesize practice-changing evidence by monitoring high-quality research across medical disciplines. To faciltiate the rapid application of research,
DynaMed synthesizes the new evidence, summarizes it into a digestable format, and rates the relevance for decision support.
"The sheer volume of the new information being published makes it impossible for a practicing physician to read every article or to identify which articles contain research that needs to be put into practice. Having a mechanism to synthesize the new medical evidence into a useable format and rate the relevance is becoming more and more essential. The agreement between McMaster University and DynaMed provides physicians with the information they need to know—the best available evidence—when and where they need it most—at the point of care."
Need help accessing DynaMed? Come and see us in the Library for your EBSCO login and/or your mobile access code.
Labels: decision support, DynaMed, evidence-based practice, knowledge transfer, McMaster University, translational medicine
"The enemy of disease is knowledge!"
~ Sir Muir Gray, Chief Knowledge Officer, NHS.
In a short video interview, Sir Muir Gray likens knowledge to water by stating that just as
'clean, clear water' is crucial to good health, so today's 'water' is
'clean, clear knowledge'. He maintains that this
'knowledge' is even more important than any drug or technological healthcare innovation.
As a spokesperson for the
Map of Medicine, the tool that is tranforming healthcare in the UK and beyond, Sir Gray explains that we are currently in the
'3rd health care revolution'. The three key ingredients in this revolution he states are:
1) knowledge
2) the internet
3) patients
This
Web 3.0 meets the
'6S model' of evidence-based medical practice; is transcending the old
'care plan/ medical record' to facilitate a new, more satisfactory level of interdisciplinary cooperation and patient-physician collaboration for improved health outcomes!
Click on the post title to access the video clip of this interview. Labels: 6S model, evidence-based practice, interdisciplinary healthcare, knowledge transfer, patient education, patient-physician communication, Web 3.0
What is Evidence-Based Practice (EBP)?
Evidence-based practice is "the integration of best research evidence
with clinical experience
and patient values and circumstances."
EBP is like a three legged tripod. Just as a tripod needs all three legs to stand, EBP needs all three components to really succeed!
Thank you
Janet Wale from
CCNet for sharing this in the Cochrane Collaboration
'Consumer Digest' Vol.556(1), Feb 14, 2010.
From: Straus S, Richardson SR, Glasziou P, Haynes BR. Evidence-Based Medicine. How to practice and teach EBM. 3rd ed. Elsevier Churchill Livingstone. 2005.
Labels: Cochrane Collaboration, consumer health, evidence-based medicine, evidence-based practice
PubMed Clinical Q&A is a collection of summaries of health information, systemic reviews and answers to clinical questions. A great searchable resource for those
PBL sessions!"Each summary contains several questions that compare treatments, for example:
"How do statins compare in reducing 'bad cholesterol' (LDL-c)?"A brief answer which highlights recent findings is available, along with a link back to the source of the evidence where more details can be found."
...just one of the many excellent full text
medical ebooks available on the
NCBI Bookshelf [find permanent link in the right sidebar].Labels: clinical queries, ebooks, evidence-based practice, medical information search, NCBI Bookshelf, problem-based learning, PubMed
