Thursday, May 26, 2016

Dr Alfred Roy Awarded For Teaching Excellence by Figure 1

The Chair and Professor of Pathology at UMHS, Alfred Roy, MD, MBBS, has been awarded the Figure One 2016 Healthcare Educators Award. This award is given in recognition of outstanding teaching excellence and commitment to going above and beyond for their students.  
Congratulations Dr Roy!
Since completing basic medicine and residency in Pathology in 1993, Dr Roy has held numerous key positions in medical education and Pathology with such institutions as the University of the West Indies, Melaka University, Manipal University, St. Matthew's University, and the American University of Antigua, before joining the University of Medicine and Health Sciences in May of 2013.
Figure 1 is a growing internet phenomenon which connects the global medical community in the ongoing quest for the patient diagnosis!
"Where do doctors turn when even they don’t know what’s wrong with you? Colleagues? Books? The internet?"
Launched in 2013, the Figure 1 app was born from the idea that sharing images of what confounds doctors with other doctors across the world can help point them in the direction of the right answer.
Figure 1 is like an Instagram for doctors connecting one million healthcare professionals to view, discuss, and share medical cases. This crowd-sourcing for a diagnosis is effectively a win-win situation with everyone learning and benefiting; including professors, medical students, and patients!

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Thursday, May 05, 2016

Resources Tour of the UMHS Anne Ross Library

Anne Ross Library

Join me on a tour of the Anne Ross Library where I will be showcasing the information resources provided by the university for the benefit of the UMHS student body and faculty. I hope you will find time to further explore and utilize these valuable databases, as you probably realize you can’t memorize it all! Once you are practicing medicine, the key to success will be your ability to search out the best and most current medical information when and where you need it.
The foundation of evidence-based practice is being able to find, access and evaluate the medical evidence!
The Anne Ross Library Home page is your jumping off point to all of the library's resources so we will start the tour there http://lib.umhs-sk.net. The online Anne Ross Library Catalogue is the first link in the left-hand side bar. Browse the library’s collection of books, videos, ebooks, etc. and place holds on the items you need that are checked out, or click the link provided in the record to go to the ebook itself. The LibraryWorld catalogue provides a mobile interface link or downloadable App for easy access to searching the library’s holdings. The mobile login for the catalogue is USER: AnneRoss Library (notice NO space between ‘Anne’ and ‘Ross’), and the PSW: (blank) – no password is required. Search for ‘ebook’ or ‘electronic resource’ along with your search term, to easily locate in the catalogue records available downloadable ebooks.

Anne Ross Library Home

The next link is to MyUMHS which is the UMHS Egnyte file server drive or online ‘M’ drive for remote access to all your course materials. If you can’t recall the login sent to you via email, contact the Library.

Clicking on the links in the second grouping of the left sidebar and you can access the various EBSCO databases. Do you remember this login? In particular on this list of databases, take time to explore EBSCO’s DynaMed database,a topical, point-of-care clinical database. It will be invaluable to you in ICM and beyond. When you don’t have time to search the journal literature for the latest treatment options, DynaMed gathers this information for you and updates the database daily. To access DynaMed on your mobile device go into DynaMed and click on the ‘Mobile’ tab along the top of the screen for the latest step-by-step instructions.

NOTE: Currently we are trialing the new DynaMed Plus database as well. This updated DynaMed platform has expanded and been enhanced in many ways. In fact, this produce has been adopted by the ACP (American College of Physicians) as their official clinical decision support tool. Make sure you explore it too!

NOTE 2: UMHS is also currently trialing the GIDEON (Global Infectious Disease and Epidemiology Network) database from EBSCO which is a must for your Microbiology and Epidemiology classes with its extensive microbiology and data on global infectious diseases, and current disease outbreaks.

Next check out the EBSCO journal databases such as Academic Search Premier and Medline Complete. These databases provide you with access to around 6000 journals, approximately 2000 of which are medical journals with full text! This resource will be very useful to you for researching a medical topic and discovering the latest articles published on that topic. The advantage to these EBSCO journal databases over PubMed (or Google & Google Scholar for that matter) is the instant and comprehensive access to the full text for many of the articles. In fact full text is provided for 34% of the citations found in PubMed!

You also have the option of performing your literature search in PubMed itself (using the special link you see on the Library Home page) and being provided the LinkOut notification (the UMHS logo will display in the top right corner whenever we have available the full text of an article retrieved by your PubMed search). In order for the LinkOut icon to appear you must also be signed into your personal MyNCBI account, which you can set up for yourself for free.

The EBSCO Academic and Clinical ebook collections (containing over 150,000 ebooks, 2000 of which are clinical ebooks) are also accessible using your UMHS EBSCO login. However, you will also need to set up for yourself your own personal MyEBSCO account. This personal second login will allow you to save your database searches, collect articles in folders, as well as download the ebooks. In addition an EBSCO ebook App is available for your mobile devices allowing you to search, check out, and download ebooks to your mobile reading device, tablet or phone.

AccessMedicine at UMHS

Returning to the Library Home page next please locate the link for Access Medicine. This valuable resource provides you with full text access to over 85 medical reference textbooks (including Harrison’s’!), procedural and instructional videos, clinical cases, practice questions, a drug database, the Diagnosaurus diagnostic tool, etc. Course materials and small group project assignments from your professors may also be available to you via this platform. Your personal logins are set up and emailed to you soon after your coming to UMHS. If you have trouble accessing your personal space in this database, please contact the library. Med4 and EBS5 students MUST verify their personal logins before the end of their last St. Kitts semester in order to be able to access their course materials in Maine and during the Clinical Core Rotations!

AccessMedicine also provides an App for your mobile. Set up instructions for your device is on the Anne Ross Library Blog. The App is designed as a diagnostic tool and contains four key diagnostic resources from McGraw Hill, but not the whole AccessMedicine database, or the Custom Curriculum.

VERY IMPORTANT: In Maine all the course materials for your ICM 2 course will be assigned through learning modules in AccessMedicine. Also, when you go out on your Clinical Core Rotationsa whole curriculum of more than 150 learning modules will be assigned to you for your completion during that time. So it is very important that you are completely up to speed with using AccessMedicine, understanding how to access your modules, and how to submit them on completion. Look under the ‘Custom Curriculum’ tab for your assigned learning modules.

The practice questions in USMLE-Easy will help you test your knowledge with USMLE-style questions while preparing for the USMLE Step 1, 2, and 3. In order to take full advantage of the test bank you must login via the UMHS institutional interface with your personal login that was created for you (an email was previously sent regarding your logins). If you have trouble accessing please contact the Library.

Next I would like to draw your attention to the various internet resource 'Kits', in particular the Medical Kit , and each of the semester specific 'kits', such as the Med5 Kit . I hope you will find some of these recommended websites useful. Please send me feedback and site suggestions so I can continue to improve the 'Kits'.

Finally, the four column section along the bottom is a gathering of links to in-house resources that you will probably need to access frequently, such as our social media sites, ExamSoft exam portal, etc.

Remember to regularly check this blog, the Anne Ross Library Blog, and The UMHS Endeavour Blog for interesting news posts and access to a wealth of information pertaining to medical resources and educational programs.

In this bottom section you will also find links to your Webmail and to the CAMS Student Portal, etc. CAMS is where you will find your courses, your attendance record, and some of your grades. Most of your grades are found in your ExamSoft account, but at least your final course grade, will be posted for your confidential viewing in CAMS. Your CAMS login is provided for you by the IT department.

Keep up to date on UMHS Research happenings on the UMHS Research Wiki and be aware of upcoming medical conferences, calls for papers, etc. on the Research Committee’s Pinterest Board.

Notice the link to the UMHS Exam Portal right there are well. This is the link to our computer based testing program ExamSoft. This program is what all of you are using for exam taking and where most of your professors release your scores on quizzes and exams.

Now you can follow the Library on Twitter and Pinterest! As you go forward in your career, stay up-to-date on new resource developments by checking the Library Blog, the Library Twitter feed, and the Library Pinterest boards. Further descriptions of the library's resources, links to them, and instructions on how to navigate them, are available via the Library Blog and the Library website, particularly in the section 'Navigation Guides' on the 'Medical Kit'.

I hope you all found this library resource tour valuable. Let me know if you need further help accessing and searching any of these resources. Each resource also has HELP links – so have fun and play around with trying different searches and different resources!

Remember to stay informed by reading the blogs and subscribing to our Twitter feed and Pinterest boards.

Please don’t hesitate to drop by the library or phone, email or Skype us, Linda, Doya, Jezelle, Raeeza, or Ann , for further assistance with accessing any information resources.

Your suggestions are always welcome. Have a great semester!

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Monday, October 27, 2014

AccessMedicine at UMHS

UPDATE Monday October 27, 2014: UMHS is pleased to announce that it is now in the process of purchasing a subscription to AccessMedicine! This is great news for our Faculty and Students, both in Basic Sciences and Clinical Sciences! Watch for more announcements as UMHS rolls out its Custom Curriculum using this platform.

 The Anne Ross Library is pleased to announce that for the next 2 months UMHS will be trialing the premier product from McGraw Hill Medical supporting medical education, Access Medicine, along with the new companion product Clinical Access.

What is AccessMedicine? AccessMedicine is a comprehensive online medical resource that provides medical students and residents with a complete spectrum of knowledge needed to excel in basic science studies and clinical clerkships. Instant access to videos, self-assessment, and leading medical textbooks facilitates decision-making at the point-of-care; enables faculty to create, track, and report their students’ progress through a curriculum tool; and allows physicians to brush up on their medical knowledge.

Medical Reference Texts: More than 85 medical reference texts such as Harrison’s Principles of Internal Medicine and CURRENT Medical Diagnosis & Treatment are available in their latest editions. Find the full list of texts on AccessMedicine at: accessmedicine.mhmedical.com/textbooks

Extensive multimedia library: A unique collection of more than 250 examination and procedural videos, patient safety modules, audio files, and animations that feature complicated concepts presented in terms students can understand. For a complete listing of videos and animations go to: accessmedicine.mhmedical.com/multimedia

Differential Diagnosis Tool: Connect to more than 1,000 diagnoses through Diagnosaurus®, a tool that saves you time by allowing you to browse by symptom, disease, or organ system at the point of care.

Other Quick Reference Tools:
  • Practice Guidelines are annually updated guidelines from Current Practice Guidelines in Primary Care that assist in disease screening, prevention, and management by providing succinct digest versions of longer original guidelines.
  • Diagnostic Tests, from Pocket Guide to Diagnostic Tests, is a quick reference guide to the selection and interpretation of commonly used diagnostic tests, including laboratory procedures in the clinical setting.
  • Quick Medical Dx & Rx is a collection of concise evidence-based outlines of conditions and disorders most often encountered in medical practice – perfect for high-yield review or for quick reference in the clinical setting.
Self-Assessment: Extensive Q&A to assist students and residents in exam preparation.

Patient Education: Comprehensive, reliable healthcare information for adults, pediatrics, medicines, and acute settings available in multiple languages and for over 7000 topics

Integrated Drug Database: Look up dosing, indications, and adverse reactions quickly from more than 1,000 generic and brand-name drugs, with customizable, printable patient handouts presented in English and Spanish.

Images: Tens of thousands of photos and illustrations to aid in visual diagnosis are available to save and download for educational purposes.

Clerkship Corner: An invaluable resource that presents clerks with the complete scope of information they need to be familiar with to successfully become residents. Clerkship Corner provides a suggested reading list for students to master required topics. Content is organized by core topics in internal medicine.

Cases: A selection of cases from across the popular Case Files series and Pathophysiology of Disease helps medical students better understand and evaluate real world experiences by offering questions to frame the case and the approach to the patient.

Custom Curriculum: This powerful online tool helps ease the workflow for program directors by customizing and managing resident training from one convenient site.To access this portion of the site you will need to create a personal login to a MyAccess account. Watch a short video explaining how to do this.

Watch your email for information on how to login and begin to enjoy this excellent resource!
[This information has been gleaned from the Access Medicine website]



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Wednesday, April 30, 2014

NBME U Learning Portal Launched


UMHS students please take note of the recent announcement by the NBME of the launch of NBME U, an online collection of lessons to aid your learning the range of topics in the basic sciences in preparation for the NBME shelf exams and USMLE Step 1 assessment.

Visit the NBME U learning portal to enroll  https://nbmeu.desire2learn.com 


Please check out too the great hard copy USMLE review and practice question resources on Reserve at the Anne Ross Library Desk.
Updated practice materials for the Step 1 examination have also been posted to the USMLE website. They include:

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Thursday, April 17, 2014

The MedEd Revolution: AMA Steps Up Focus on Information Literacy


Medical education, in it's current modern form (since the Flexner Report of 1910) seems ripe for change if the response rate to a recent AMA program initiative is any indication.  The American Medical Association recently developed a proposal outlining a number of  key trans-formative changes they would like to see in the way physicians are educated. The response from US medical schools was in their words "overwhelming". 
"The reason the AMA emphasizes “accelerating” change is that incremental changes aren’t enough to ensure that future doctors get the training they need in a world in which rapid business, population and technological changes have made being a doctor a much more dynamic profession. These have to be systemic changes, as bold and far-reaching in our time as they were in the wake of the Flexner report."
Click to read the full report (posted March 18, 2013): Medical schools signal readiness for revolution 

In my role as Library Director at UMHS, a top tear Caribbean medical school, I habitually stress to our faculty and students the importance of that fundamental element for success as an 'evidence-based' medical practitioner, the ability to find the current best evidence. To determine the best diagnosis and course of treatment for the best clinical outcomes, medical students must learn how to locate the best, most up-to-date, credible medical evidence to support their case. This requires a fairly sophisticated level of skill in information searching, along with knowledge of the credible medical literature, the databases that contain it, as well as an understanding of the structure and functioning of the online environment.

I commend the AMA for recognizing the fact that mature information seeking behavior needs to be acquired by medical students, and for stepping up the focus on the importance of acquiring the concepts involved. Now the onus is on medical schools to include throughout their curriculum, embedded or otherwise, adequate instruction and ongoing reinforcement of information searching skills.  

" The proposals reflect a changing health care delivery system transformed by technology so that the skill of finding and applying information is as important — or more so — than memorizing it."  
You may be thinking, "Isn't Generation Y completely computer savvy already?" In fact the answer is no, for the most part they aren't. I can say this confidently because of another report finding, also recently released, called the JISC Digital Information Seeker Report. This report demonstrates what my gut has told me all along, that the crucial factor in student's information seeking behavior is convenience! What does this lead to? The report's initial results indicate that
"...as users progress through the educational stages, the digital literacies they employ do not necessarily become more sophisticated."  "...findings indicate the students use smart phones and laptop computers to access Wikipedia, Google, teachers or professors, friends and peers to get information for their academic studies."
Click to read the full report (posted March 20, 2013): JISC Digital Information Seeker Report 

Google is great for KISS ('keep it simple searching') and 'needle-in-a-haystack' type searches, however when it comes to a medical diagnosis the best, most accurate information is required! An interesting  BMJ research article by Hangwi Tang and Jennifer Hwee Kwoon Ng, called "Googling for a diagnosis - use of Google as a diagnostic aid: internet based study.",  found that Google yielded a correct diagnosis 58% of the time (based on one year's worth of diagnostic case records published in the New England Journal of Medicine). Not an accuracy rate that would inspire patient confidence!

If the anticipated MedEd revolution unfolds as the AMA is indicating, it is my hope that medical schools will recognize the expertise already in their midst and turn to their 'Information Professionals" ~ the medical librarians! I will rest my case with the age-old words of wisdom penned by Samuel Johnson...
“Knowledge is of two kinds. We know a subject ourselves, or we know where we can find the information.”

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Monday, February 24, 2014

Joint NRMP/ECFMG Report Released: Charting the Outcomes of International Medical Graduates in the Medical Residency MATCH 2013

Charting Outcomes in the Match International Medical Graduates: Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2013 Main Residency Match is a collaborative publication of the National Resident Matching Program® (NRMP®) and the Educational Commission for Foreign Medical Graduates (ECFMG®).
"Some general observations apply to all of the specialties in this report. IMG applicants who are successful in matching to their preferred specialty are more likely to:
  • rank more programs within their preferred specialty
  • have higher USMLE scores
  • have fewer attempts at ECFMG certification examinations
  • be U.S. citizens
  • speak English as a native language
  • have obtained ECFMG certification closer to the Match year (2013)
  • have graduated from medical school closer to the Match year (2013)"
"Despite the fairly strong relationship between USMLE Step scores and match success, the distributions of scores show that program directors consider other qualifications, and high USMLE scores are not a guarantee of success."
Citation: National Resident Matching Program and Educational Commission for Foreign Medical Graduates. Charting Outcomes in the Match for International Medical Graduates, 2014. National Resident Matching Program and Educational Commission for Foreign Medical Graduates. 2014.

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Monday, June 17, 2013

History of Medicine: Book Review

Jacalyn Duffin, a Canadian physician-historian-educator, "blows the dust off the shelves of medical history" with this survey of the history of Western medicine. "History of Medicine: A Scandalously Short Introduction", written from a decidedly Canadian perspective, is a medical history textbook that is well researched, logically organized, and chock-full of interesting and intriguing content and illustrations.[Anne Ross Library Call No. R 31 .D783 1999]

One of the authors goals in writing this book was to spark the interest and imagination of the next generation of medical students and their educators. I found this textbook easy to digest in terms of assimilating the information presented of the people, places and events that shaped the history of Western medicine, but I discovered the real value of this treatise is in the wisdom that can be acquired by stepping away from the here and now and gaining that broader historical perspective. An understanding of where medicine has come from can only help young enthusiastic medical students to dispel their inherent generational tunnel vision, to find deeper meaning in today's medical practice, and to envision the future of medicine.

 I highly recommend that all medical students set aside time to read this "cultural history...of medical events". As the book is organized along the lines of a traditional medical school curriculum complete with learning objectives, students could read the chapters for each course as they embark on each new semester.
[ Published by the University of Toronto Press, ISBN 0-8020-7912-1, 1999. reprint 2004.]

 For a more complete review of this title, I refer you to the annotation by Audrey Shafer,
 New York University School of Medicine.

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Wednesday, May 29, 2013

UMHS Rolls out ExamSoft for Computer Based Testing

As Block One day for the new May 2013 Semester fast approaches, UMHS is about to pass another milestone in it's continuing development as a premier institution of higher learning in medicine.
Having recently contracted with ExamSoft to provide UMHS with computer based testing capabilites, we are very excited to begin rolling out our use of the software this semester in the Accelerated Review Program (ARP), Med One, and Extended Basic Sciences One (EBS1) courses. Within the next year the plan is to have all our courses utilizing this electronic format, including with additional iPAD capabilites as ExamSoft rolls out its SoftTest-M App.


The advantages that come with the software are numerous, and were the motivating factors in the decision to move forward with this implementation at UMHS. Ultimately we anticipate student learning and performance to improve as well. Some advantages are:
  1. Enhanced feedback and reporting capabiiltes for students and faculty.
  2. Easy access to statistics and historical exam records.
  3. Question bank development capability.
  4. Enhanced curriculum management and review.
  5. Classification and tagging of questions.
  6. Audio, video and enhanced images in questions.
  7. Better preparation for students to sit the USMLE Step exams, as mimics the experience.  
  8. Increased exam security.
  9. Allows for continual question quality improvement.
  10. As exams are taken offline, dependance on internet access is reduced.
 To learn more about ExamSoft and SoftTest-M , I encourage you to read the excellent article recently published  in "Information Week" , by David Carr.

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Thursday, April 11, 2013

Caribbean Medical Education: Experience of a UMHS Graduate


We are pleased to announce that UMHS graduate, Dr. Larry McMann will hold a special presentation on Friday, April 12th from 3:00 – 4:00 PM, in the Auditorium.

The title of the presentation is “Offshore Medical Education”. Dr. McMann will walk you through his journey which includes clinical rotations and securing a residency spot.

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Tuesday, November 13, 2012

Dr. John Hall Stresses Importance of Physiology in Medical Education

Dr. John Hall, author of the Guyton and Hall Textbook of Medical Physiology, was interviewed at the EB 2012 Conference held in San Diego, California in April.
"Dr. Hall discusses how he became involved with "Guyton and Hall Textbook of Medical Physiology," [published by Elsevier] now in its 12th edition. He also chats about some hot trends in the field, including the greater demand for digital media and how students are hungry for digestible online information. Finally, Dr. Hall shares some advice to medical students and reveals his 3 'defining moments.' "


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Thursday, October 11, 2012

Time to Reassess your Study Habits? Nine Points to Consider.


      Are you beating yourself up after Block One? Saying, “should ‘a, could ‘a, would ‘a done better …BUTif only _________(fill in the blank)”. What is your excuse?
Maybe it is time to reassess your study habits?

1. Time: “But I don’t have enough time!” Take the test and see where your time really goes? How much time do you spend on your cell phone, texting, and checking your email? How motivated are you to study? “Deep motive correlated with time on assignments. Students who were less certain they wanted to work as a doctor undertook less study activity and spent less time with patients.” Yet, more time studying is not better if your problem is inefficient study habits! (Wilkinson, 2007) Which leads to the next issue …

2. Focusing: "But there is so much going on, I have trouble blocking out the distractions?" Use ear plugs, try the study carrels in the library, close out Facebook, turn off you cell phone, do what it takes! To quote KevinMD from his blog article “9 Essential Tips for new Medical Students” ~ “When you study, focus on studying.”

3. Location: Research shows that studying a certain piece of information repeatedly is good, but that studying it repeatedly in different surroundings is even better (Sasanow, 2010). So review that lecture power point in the LRC , then read it over again while studying in the library, then of course learn it during the lecture, then review it again at home. The research shows that if you learn something in multiple settings it will stick with you better as your mind is not connecting that piece of information with only one particular location or environment (Carey, 2010).

4. Multitasking: “But I went to all the lectures!” That is very good because research has shown those who attend live lectures score 3% higher than those who rely on even recorded lectures. (Wenger, 2012) BUT what were you doing during the lectures? Research shows that only 5% of people can multitask effectively (Weimer, 2012). Do you honestly believe you are in that 5%? Note the following quotes: “…students who did not text (during the lecture) scored significantly higher (on a post-lecture quiz) (Ellis, 2010).” “Students who tried to listen to the lecture while using … distractive windows (on their laptops ~ such as games, pictures, email, instant messaging, and web surfing) had significantly lower scores … (Kraushaar, 2010).” “The level of laptop use negatively correlated with how much attention students paid to lectures, the clarity of the lectures and how well they understood the lecture material (Fried, 2008).” “Their multitasking was significantly related to lower GPA … (Barak. 2012).”

5. Practice Review: “But I read the textbook!” But you didn’t really get it did you? While you were reading did you periodically stop and think about what you just learned? How did it relate to what you already know? Write down the key points and concepts you managed to extract from what you just read and then try to explain them, teach them, to yourself. Then go back and re-read the section again, refine your notes then meditate some more on the points. “…high-achievers spent significantly more hours/week on self-study (…and) scored higher on 3 factors which measured aspects of deliberate practice – planning, study style and motivation.” (Moulaert, 2004) The Moulaert study also showed that high achieving students owned more books and read more articles! So make good use of our library resources and our online medical literature databases.

6. Concept mapping: “But I memorized all the facts!” So after you have done your reading, got your notes, got your points, try ‘concept mapping’. In other words draw a diagram of what you just learned. Generally speaking, most educators are big on this as they believe “…having students draw detailed diagrams documenting what they are learning …forces students to make connections among facts.” However according to recent research you need to take this a step further…

7. Practice questions: “I am sure I got that now, I will remember that!” Now you need to test yourself so you are sure you own the material! Research reports that students who stop at point #5 can harbor “the illusion that they know the material better than they do” (Belluck, 2011). It also shows a further significant benefit to learning through testing, and the use of practice questions, even when students get the questions wrong. Note this reader’s comments: “During medical school we were also encouraged to "do questions" to prepare for both our institutional exams, as well as for the national licensing exams. In fact, there are large on-line 'question banks' and 'question books' that are available for purchase and everyone knows you need to do those to pass. The conventional wisdom is that if you do all the questions from the past 5 years of books, you'll pass the exam. I don't know why it works, but it does. These are NOT questions that you will see again on the exam so it's not a case of just memorizing the right answer.“ “While students have many different ways to study, which includes reading the text book, students can perform well on examinations using high yield review books and practice exam questions as resources. Students who used practice clinical vignette-type questions on average scored 5 points higher than the class average.” (Wenger, 2012) Have you started using Exam Master yet, or the many review books available to you in the library?

8. Test Taking Strategies: Learn key test-taking strategies and the anatomy of multiple choice exams, by attending the study skills lecture to be given by Sue Simon, in the UMHS Auditorium on Wednesday, October 24, 2012 at 12:30 pm . Also take note of these “Tips for Success: Mastering Multiple-Choice Tests”.

9. Manage Stress: “But I am feeling so tired!” Research demonstrates that “stress symptoms, such as fatigue, sleeping problems, anxiety, irritability and depression, were common (during undergraduate medical training).” Some other common symptoms of stress to watch out for are abdominal pain, nervousness, headache, dizziness, and pain in the neck, shoulders, or lower back. (Niemi, 2006) Learning to manage your stress early on will prevent more serious problems later, such as possible burnout. “Burnout is a psychological syndrome of emotional exhaustion, depersonalization, and impaired personal accomplishment induced by repeated workplace stressors. Current research suggests that physician burnout may have its origins in medical school.” (Mazurkiewicz, 2012) Don’t hold back from availing yourself of our campus counseling service for any extra support you may need to help get your stress level under control!

I hope you have been able to take something away from your read of these 9 points ~ and ‘all the best’ for an improved block 2 and your continued success at UMHS-St. Kitts! To quote Dean Camacho’s motto, Never give up, never give up!”

Ann Celestine
Library Director

References:

Barak, L. (2012). Multitasking in the university classroom. International Journal for the Scholarship of Teaching and Learning, 6 (2) http://academics.georgiasouthern.edu/ijsotl/v6n2.html.

Belluck, Pam. (2011). To really learn, quit studying and take a test. The New York Times- Science, January 20, 2011. http://www.nytimes.com/2011/01/21/science/21memory.html

Carey, B. (2010). Forget what you know about good study habits. The New York Times – Health – Mind Column, September 6, 2010. http://www.nytimes.com/2010/09/07/health/views/07mind.html?pagewanted=all

Ellis, Y., Daniels, W. and Jauregui, A. (2010). The effect of multitasking on the grade performance of business students. Research in Higher Education Journal, 8 http://www.aabri.com/manuscripts/10498.pdf

Fried, C. B. (2008). In-class laptop use and its effects on student learning. Computers and Education, 50 (3), 906-914.

Karpicke, J.D., Blunt, J.R. (2011). Retrieval practice produces more learning than elaborative studying with concept mapping. Science, 11 February 2011: 331 (6018), 772-775.Published online 20 January 2011 [DOI:10.1126/science.1199327].

Kraushaar, J. M. and Novak, D. C. (2010). Examining the affects of student multitasking with laptops during lecture. Journal of Information Systems Education, 21 (2), 241-251.

Niemi, P.,Vainiomäki, P. (2006). Medical students' distress--quality, continuity and gender differences during a six-year medical programme. Medical Teacher, 28(2), 136-141.

Mazurkiewicz, R., Korenstein, D., Fallar, R., & Ripp, J. (2012). The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. Psychology, Health & Medicine, 17(2), 188-195.

Moulaert, V., Verwijnen, M. M., Rikers, R., & Scherpbier, A. A. (2004). The effects of deliberate practice in undergraduate medical education. Medical Education, 38(10), 1044-1052. doi:10.1111/j.1365-2929.2004.01954.x

Pugsley, L. (2009). Study effectively. Education for Primary Care, 20(3), 195-197.

Sasanow, A. (2010). Varying study locations could improve content retention, psychologists say. The Tufts Daily, October 7, 2010. http://www.tuftsdaily.com/features/varying-study-locations-could-improve-content-retention-psychologists-say-1.2358170

Weimer, M. (2012). Students think they can multitask. Here’s proof they can’t. The Teaching Professor Blog, Faculty Focus, September 20, 2012, http://www.facultyfocus.com/articles/teaching-professor-blog/multitasking-confronting-students-with-the-facts/

Wenger, S.L., Hobbs, G.R., [et al]. (2012). Medical students study habits: Practice questions help exam scores. Journal of the International Association of Medical Science Educators, No. 4, n.d. Retrieved from the association’s website. http://www.iamse.org/artman/publish/printer_500.shtml .

Wilkinson, T. J., Wells, J., & Bushnell, J. A. (2007). Medical student characteristics associated with time in study: Is spending more time always a good thing?. Medical Teacher, 29(2/3), 106-110. doi:10.1080/01421590601175317

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Wednesday, May 23, 2012

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

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Thursday, April 19, 2012

AAMC reports 20% of Medical Students are Mistreated

One of this months top stories from the AMA MedEd Update News was about the mistreatment of medical students and the move to more accurately gather information on the prevelance of this problem in order to raise awarness and to better address the issue.
"...the Association of American Medical Colleges (AAMC) has made significant changes to its annual questionnaire of graduating medical students to improve collection of data on medical student mistreatment."
In the current 2012 survey, questions regarding mistreatment will be more visible.
"Current data from previous questionnaires show that approximately one in five medical students report that they have experienced mistreatment. Data from the 2012 questionnaire, which is currently in the field, will be available for release by the fall."

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Friday, March 23, 2012

Residency Programs Facing Accreditation Changes

"Financing Graduate Medical Education — Mounting Pressure for Reform",
by John K. Iglehart, NEJM: Perspective, March 21, 2012.
“A significant step forward is the announcement by the ACGME [Accreditation Council for Graduate Medical Education] describing major changes in how the nation's residency programs will be accredited in the future, putting in place an outcomes-based evaluation system by which new physicians will be measured for their competency in performing the essential tasks necessary for clinical practice in the 21st century.” ~ Dr. Darrell Kirch, chief executive officer of the AAMC.

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Friday, September 17, 2010

Can Burnout be Blamed for Unprofessionalism Among Medical Students?

JAMA this week released the findings of a study which looked at the toll burnout is taking among medical students.
The article is titled the "Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students".
Hypothesis: "...professional conduct, attitudes regarding appropriate relations with industry, and attitudes regarding physicians' responsibility to society are influenced more by medical students' degree of professional distress than personal distress."
Conclusion: "Burnout was associated with self-reported unprofessional conduct and less altruistic professional values among medical students at 7 US schools."
To read more click on the title to take you to JAMA's website.
JAMA. 2010;304(11):1173-1180. doi:10.1001/jama.2010.1318

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Thursday, September 09, 2010

Academic Medicine Publishes it's 10 Year "Snapshot" of Medical Education

Providing an excellent overview of the progress in medical education over the last ten years, Academic Medicine has just published this report as a freely accessible supplement to their September issue.
"This supplement provides details about curriculum management, the support for the educational program, and the many approaches to pedagogy and assessment that medical schools are employing."
"These reports provide important benchmarks and reveal a range of ideas for faculty and students to consider as they evaluate their own program. The reports provide similar opportunities for new schools that seek to build new and innovative programs."
Academic Medicine. 85(9):S1-S648, September 2010.

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Thursday, June 24, 2010

Rating the Social Mission of Medical Schools

While "the basic purpose of medical schools is to educate physicians to care for the national population. Fulfilling this goal requires an adequate number of primary care physicians, adequate distribution of physicians to underserved areas, and a sufficient number of minority physicians in the workforce."
In a new study released in the Annals of Internal Medicine, the researchers took a fresh look at the ranking of American medical schools according to these three criteria, labelling this new metric the 'social mission score'.
They summarized their conclusions in this way: "Medical schools vary substantially in their contribution to the social mission of medical education. School rankings based on the social mission score differ from those that use research funding and subjective assessments of school reputation. These findings suggest that initiatives at the medical school level could increase the proportion of physicians who practice primary care, work in underserved areas, and are underrepresented minorities."
"A diverse, equitably distributed physician workforce with a strong primary care base is essential to achieve quality health care that is accessible and affordable, regardless of the nature of any future health care reform."
The full text article is accessible through your EBSCO login or click on the title.
Online access includes a Facebook discussion as well as PowerPoint slides for teaching.

(2010). The Social Mission of Medical Education: Ranking the Schools. Annals of Internal Medicine, 152(12), 804-811. Retrieved from Academic Search Premier database.

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Tuesday, June 08, 2010

MedEdPORTAL is blossoming into a Suite of Portals!

The Association of American Medical Colleges (AAMC) has embarked on a plan to significantly expand the scope of the MedEdPORTAL, by establishing a new and exciting initiative called the Continuum of Learning Initiative (CLI). The CLI aims to unite multiple databases into a single medical education portal "to enhance competence along the health education continuum"; made possible by new content management technologies.

"The CLI will link medical education curricula, training innovations, administrative tools, teaching tools, and assessment resources across the entire physician-education continuum (from pre-med to the practicing physician)."
The portals will be launched in phases over the next five years, with each portal serving to expand the knowledge base of "academic medicine through a seamless and interactive system, providing a multi-faceted learning experience." Click to read more about these exciting new developments.

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Monday, March 22, 2010

Inaugural Issue Published of New Medical Education Journal

The Canadian Medical Education Journal (CMEJ) is pleased to announce the publication of its inaugural issue.
The CMEJ "is an online, open-access peer-reviewed journal exploring new developments and perspectives in the field of medical education from premedical to postgraduate and continuing medical education. We intend to publish research that focuses on the quantitative and qualitative aspects of prominent issues in the education, training and maintenance of health care professionals. Furthermore, the journal provides a forum for discussion specific to the challenges faced by medical education practitioners in Canada and internationally. Research in areas related to medical education including psychology, psychometrics, sociology, anthropology, linguistics, economics and other sciences is welcome. The target audience includes medical and medical education researchers and scholars, practitioners and professionals, universities and their students."

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Tuesday, February 23, 2010

Barbados Tightens up the Practice of Medicine

Yesterday's report in the Brigetown Barbados newpaper, the Daily Nation brought attention to plans for change being proposed by that islands' Ministry of Health. The Government is planning to tighten up the practice of medicine in two respects:
Minister of Health Donville Inniss stated it would soon become mandatory for doctors to continue their medical education to stay on the register and continue practicing medicine.
"Medicine is a very dynamic field and one has to continue to read, research and analyse matters in order to keep abreast..."
In conjunction, "We are going to establish, for the first time, a specialist register which will indicate who qualifies to be registered as a specialist in the medical profession," Inniss stated. Click on the title for the full news report.

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