Developing an Innovative, Integrated Curriculum to Teach Information Literacy and Management Skills to First Year Medical Students Linda J. Collins, MSLS, AHIP User Services Librarian; School of Medicine Specialist Health Sciences Library University of North Carolina at Chapel Hill

Setting: University of North Carolina at Chapel Hill

UNC-Chapel Hill Health Sciences Library Primary library for the UNC-CH schools of Dentistry, Medicine, Nursing, Pharmacy, Public Health and UNC Hospitals “The library provides access to information and knowledge and educates users to manage information and knowledge” –Educational programs:138 (2003-4) –Participants in educational programs: 3,778

UNC-Chapel Hill School of Medicine Public medical school with top rankings in research, primary care and selected specialty areas (e.g. geriatrics, oncology) –Strong mission of service to the state of North Carolina –Admissions process stresses ethnic and cultural diversity (minorities: 28.4%) First year class – 160 students (20 non-NC)

Background: School of Medicine 1 st year curriculum Traditional basic science courses –Biochemistry, cell biology, immunology, pathology, anatomy, physiology, neurobiology, etc. Two clinically-related offerings –“Introduction to Clinical Medicine” –“Medicine and Society” Introduction to clinical case thinking –“Breast Cancer Case” Problem-based clinical cases –HIV, hypercholesterolemia, diabetes, etc.

Evolution of the Pre-Clinical Informatics class Library staff had played a minor role in previous 1 st year introductory computing course –“Managing the Medical Computing Environment” Course name and structure changed in 2002 –“Pre-Clinical Informatics” Incorporated new learning technologies in 2003 Online options in response to student feedback SofTV: create multi-media e-learning modules Introduced pre- and post-testing in 2004

Pre-Clinical Informatics class Required for all first-year medical students Focus: building information literacy skills Assignments based on clinical cases incorporated in the basic science curriculum Conventional lectures supplemented by online multi-media courseware Clinician guest lecturers in first and last sessions –Working physicians reinforce the importance of these skills - help with credibility of the effort

Collaborative work Course director: Eve Juliano, head, Educational Technology Group, Office of Information Systems –ETG designs and develops web applications –Also produce video and other digital media; coordinate and deliver videoconferencing for the SOM –Other ETG staff critical to course development; some teaching activities Health Sciences librarian is a full partner in the effort –Co-developer and course designer –Teach 6 of the 8 class sessions

General course objectives Objective I –Students will develop skills to effectively locate, search and retrieve biomedical information Objective II –Students will develop skills to effectively search the MEDLINE database using the PubMed system

General course objectives Objective III –Students will be able to both critically evaluate and properly cite their information sources Objective IV –Students will be able to use appropriate technology to effectively communicate and share ideas online

Course planning process: 2003 Change to course design and content required multiple planning meetings –Weekly from February to August Multiple meetings with basic science faculty members needed to coordinate teaching efforts Developing scripts and PowerPoint files for videotaped portions of online modules required lots of thought and revision

Course planning process: 2004 Built heavily on existing content from 2003 Pre-existing relationships with faculty greatly aided the process Linked EBM session to the pivotal clinical case for 1 st year students: Breast Cancer Case –Also coordinated EndNote session with this case –Required students to do more independent literature searching for the case Added HIPAA session

PCI schedule: part I

PCI schedule: part II

PCI schedule: part III

Sample from resources page

Sample online module page

Sample assignment

Pre-Test sample questions 1. Which of the following would be the best resource to use when looking for reliable, concise information on the interaction between coumadin and phenytoin? –A. PubMed B. Cochrane C. Harrison's D. Lexi-Comp E. Google F. I do not know the answer to this question 5. What Medical Subject Heading (MeSH term) is used for searching PubMed for information on beta blockers?

Challenges Gaining the support of key School of Medicine faculty members Scheduling PCI sessions to closely coordinate with basic science classes –Making assignments truly relevant Competing with time needed for very challenging 1 st year classes Overcome the prevailing student mentality that “we already know how to do this”

Successes Documented improvements in students’ PubMed knowledge and searching skills Established a strong presence in the 1 st year medical school curriculum Increased faculty and administrator awareness of the need to incorporate regular reinforcement of EBM principles and information literacy skills

Lessons learned Students at this stage often reluctant to acknowledge they need help with building information literacy skills Highly relevant, point-of-need instruction has the best chance of “sticking” Collaborative partnerships are crucial to the success of this kind of endeavor

What’s next? Everything changes! UNC SOM decided to switch to a block approach for Fall 2005 –Block 1 (“Molecules to Cells”) will incorporate portions of PCI curriculum –Need to be a strong presence in ongoing clinical cases Lessons learned will provide groundwork and guidance for adapting to new scenarios

For further information MLA DocKit: Informatics in Health Sciences Curricula, revised editionMLA DocKit: Informatics in Health Sciences Curricula, revised edition Barnett, S. H., S. Kaiser, et al. (2000). "An integrated program for evidence-based medicine in medical school." Mt Sinai J Med 67(2): Berner, E. S., J. J. McGowan, et al. (2002). "A model for assessing information retrieval and application skills of medical students." Acad Med 77(6):

For further information Brettle, A. (2003). "Information skills training: a systematic review of the literature." Health Info Libr J 20 Suppl 1: 3-9. Burrows, S. C. and V. Tylman (1999). "Evaluating medical student searches of MEDLINE for evidence-based information: process and application of results." Bull Med Libr Assoc 87(4): Garg, A. and K. M. Turtle (2003). "Effectiveness of training health professionals in literature search skills using electronic health databases--a critical appraisal." Health Info Libr J 20(1):