Speech Language Pathology 4543 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263

Knowledge is the Enemy of Disease Sir Muir Gray Existing Knowledge Can Prevent Waste & Errors Poor Patient Experience Adoption of low value interventions Failure to adopt high value interventions

Sandra Martin Provides…. Instruction Research Assistance Small Group Consulting Database Searches Collection Development (Selection of print and online books, audiovisuals, journals and databases) Assistance with any health-related information need Office Hours: Tuesday 10 am to 4 pm – Tahlequah

Bookmark this Page: http://library. nsuok

From the NSU Libraries Home Page

From the Health Professions Page, Click on Speech Language Pathology

Remote Access Enter NT-NSU user id and password to access the library’s electronic resources Contact your instructor if you have problems with your user id or password Contact Darren Tobey at tobey@nsuok.edu to report technical problems Contact Sandra Martin at marti004@nsuok.edu for search assistance

Technical Issues Check your browser Check your Internet Carrier Use Chrome or Firefox Check your Internet Carrier Satellite Systems are frequently erratic or go down entirely during inclement weather Wireless Hotspot You need at least 3G The library link from within Blackboard is sometimes slow. Please access the Library Resources for SLP page directly from your browser

Interlibrary Loan/Document Delivery Services Delivery of journal articles, books, and other items not owned by the library Delivery of books, audiovisuals, and journal articles in the library’s print collection Journal articles delivered electronically if possible ILL Requests Click on Interlibrary Loan link from SLP Web Page Complete and submit the online registration form Complete the online request form Provide complete information about the journal article or book that you need. Indicate your status as a health professions student and include your contact information If you have questions or need assistance, contact: ill@nsuok.edu or 918-444-3278

Learning Objectives To provide a mechanism for students to access the most current speech language pathology and health care information To familiarize students with specific information resources and services to support the speech language pathology curriculum To familiarize SLP students with evidence-based health care and lifelong learning skills

Overview of Online Resources Research and Clinical Databases e-Journals e-Books Consumer Health Evidence-Based Summaries

Journal Article Databases CINAHL Complete, ClinicalKey, and MEDLINE, are most frequently used resources to find journal articles on SLP topics Search these resources when you need articles on subjects, e.g., aphasia, stuttering, stroke, etc. Databases in this section provide links to full text journal articles and other resources You must start at the library’s SLP web page to access our subscribed full text

Databases - CINAHL Complete CINAHL stands for Cumulative Index to Nursing and Allied Health Literature Core research tool that contains full text of 1,400 journals and citations in more than 5,300 journals Check the box next to “suggest subject terms” and search CINAHL headings for best results, e.g., search “fluency disorders” for “stuttering” Full text of ASHA journals included View the brief tutorial to get started

Databases - CINAHL Complete

Clinical Key “All in one” database with full text access to 1,000 books and 500 journals in every medical and surgical specialty 12 Content Types including MEDLINE, images & videos Access to information at all levels from topic overview to evidence-based data in one search Smart search engine matches first few letters of search word/words to relevant clinical content No complicated search strategies or Boolean connectors Easier than Google – but with reliable, evidence-based results

ClinicalKey “Autosuggest” displays search term choices

MEDLINE Covers 1946-present U. S. National Library of Medicine’s premier database. Contains over 20 million citations to journal articles in medicine, nursing, allied health, and basic sciences as they relate to health care Covers 1946-present Ovid and Clinical Key include “user friendly” interface. Natural language processing of keywords eliminate complicated searches Use Ovid or Clinical Key MEDLINE for links to full text in our subscribed journals

Databases – Science Direct Scientific database produced by Elsevier Provides journal articles from over 2,500 journals and chapters from almost 20,000 books in all life sciences disciplines Contains full text of life sciences journals not found in other databases Choose “Advanced Search” to narrow your search results to full text in selected time periods

Databases – Education Full Text Full text of over 350 journals Includes coverage of special education and educational tests Includes full text back to 1996

Additional Research Databases Health and Psychosocial Instruments – assists researchers in identifying tests, questionnaires, rating scales in health and psychosocial sciences. Does not include full text of the instruments National Library of Medicine – provides access to hundreds of databases covering a wide range of biomedical information resources Native Health Databases – contains citations and abstracts of documents pertaining to the health care of North American indigenous peoples

ASHA Journals Click on the individual ASHA journal titles from the SLP web page Open the year, volume, and issue you need Click on the PDF full text icon to display the article

Tracking Down the Full Text If your database search does not provide a link to full text of a relevant article, play the brief video from the Library Resources for SLP web page:

e-Books R2 Digital Library – Nursing and allied health books from Doody’s Core Titles in the Health Sciences ClinicalKey – full text of over 1,000 books in all medical specialties Books@Ovid - full text of nursing and health sciences books published by Lippincott Williams & Wilkins, American Nurses Association, Joanna Briggs Institute, Jones-Bartlett, and Springer Publishing Access Medicine - text of leading medical and health sciences books from McGraw-Hill ClinicalKey, UpToDate, and Access Medicine contain full text monographs for the health care professional and the patient of all FDA approved drugs

Consumer Health Resources Current, authoritative, peer-reviewed, and evidence-based resources written specifically for the layperson MEDLINEPlus – the National Institutes of Health’s web site for patients and families ClinicalKey and UpToDate - include patient education handouts with basic and detailed versions Access Medicine – contains patient education materials for adults and children and includes handouts for drugs and medicines

Databases – MEDLINEPlus National Institute’s of Health’s web site for patients and families Produced by the National Library of Medicine Contains current, reliable, well-written information summaries and videos about diseases, conditions, and wellness issues Widely used in major hospitals and medical centers

Getting Started: Match Resource to Information Need What is the question? How will information be used?

Information Retrieval to conduct Research Comprehensive in scope and time All levels of resources Current and Retrospective Background and Foreground Information

Background vs. Foreground Questions Asking questions about your proposed topic helps to clarify your knowledge gap Clarifying type of question helps to determine which sources are most likely to have the answers you need

Background Questions Generally ask who, what, why, where or how about a single concept

Research Project Examples Is speech and language therapy more effective than no treatment in improving functional communication in patients with aphasia following stroke? Evaluate the effectiveness of constraint induced aphasia therapy for patients following stroke.

Background Questions What are the signs & symptoms, causes, incidence & prevalence of aphasia? What percentage of stroke survivors experience aphasia? What percentage of strokes are ischemic? What is the clinical presentation of ischemic stroke?

Answers to Background Questions Resources ClinicalKey CINAHL Complete

Foreground Questions Usually compare two or more concepts – theories, drugs, treatments, tests, harms or benefits of two approaches

Foreground (Clinical) Question In adult patients with chronic aphasia following stroke, [patient] does constraint induced aphasia therapy [intervention] versus no therapy [comparison intervention] stimulate language recovery [outcome]? PICO Model: Patient, Intervention, Comparison Intervention, Outcome

Answers to Foreground Questions Require precise information about complex issues Sources should provide current, original clinical research data Start with evidence maps (ASHA), evidence-based summaries and systematic reviews Supplement with searches of ClinicalKey, CINAHL Complete, etc.

New Tools Target High-Quality Studies Increase ease of accessing and understanding clinical information Preprocessed - practical resources that facilitate ready access to high-quality research Preappraised – tools that have undergone a filtering process to include only those studies that are regularly updated and of higher quality

Point-of-Care Resources Evidence based textbooks Provide rapid access to concise information to clinicians at the point of care Not a database of articles from books, journals, or guidelines Original, current, summaries written by experts Formal systems used to grade strength of recommendations and quality of evidence

Information Retrieval for Evidence Based Health Care Using research findings versus conducting research Retrieving and evaluating information that has direct application to specific patient care problems Selecting resources that are current, valid and available at point-of-care Developing search strategies that are feasible within time constraints of clinical practice

Summaries UpToDate Evidence based summaries of over 10,000 topics in over 22 specialties 8,500 Treatment Recommendations GRADE System used to score recommendations and strength of evidence Practice changing updates; Updated continuously Drug database; Patient education materials The Gold Standard of summaries

Simple UTD Search Provides Quick Answers

Reviews current research and practice

Summaries FirstConsult Search online in Clinical Key App available through NSU subscription to Clinical Key for iPhone or iPad only Create a personal account in Clinical Key Download the app from the Apple app store Login with your CK username and password Concise summaries; sections on differential diagnosis; quality of evidence graded Not updated as rapidly as UTD

ClinicalKey “stroke” search terms

CK First Consult Summary

ASHA Evidence Map - Aphasia

Systematic Review Analyzes data from several primary studies to answer a specific clinical question Provides search strategies and resources used to locate studies Uses explicit methods to identify, select, and critically appraise relevant research and to collect and analyze data from the studies Statistical methods (meta-analysis) may or may not be used to analyze and summarize results Benefits: Limits bias and increases confidence in conclusions

Syntheses Cochrane Database of Systematic Reviews (DSR) Part of the Cochrane Library (1996) Over 3,000 reviews & protocols (reviews in the making) The Gold Standard of systematic reviews Full Text Available in Ovid

ASHA - Aphasia

Not all topics fit the 6S Model High levels of evidence may not exist for all questions

If no synthesized research is available, find individual studies Clinical Key (Includes MEDLINE) Ovid MEDLINE (tools for “precise” search strategies) CINAHL Complete – targets nursing & allied health topics Science Direct – targets scientific and technical topics

Take Home Points Focused clinical question (PICO) reveals your search terms and best type of studies Start your search at top of 6S hierarchy and work down (UpToDate, First Consult, ASHA) Be aware of the filters: levels of evidence, graded recommendations, speed of updating Look at more than one resource in the hierarchy. Findings may differ

Life-Long Learning Selecting and searching online databases is challenging Information is ever changing Contact Sandra (email preferred)

If you need Help, contact Sandra

Speech Language Pathology 4543 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263