Occupational Therapy 5903 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B –

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 2

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 By Appointment: NSU Muskogee 3

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Bookmark this Page: 5

From the NSU Libraries Home Page 6

From the Health Professions Page, Click on Occupational Therapy 7

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 in the Library at to report other technical problems 8

Technical Issues Check your browser  Internet Explorer does not work with our online resources  Use Firefox or Chrome 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 does not work well. Please access the Library Resources for OT page directly from your browser 9

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 OT 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 graduate student and include your contact information If you have questions or need assistance, contact:  Donna Graham – x3243 –

Learning Objectives To provide a mechanism for students to access the most current occupational therapy and health related information To familiarize students with specific information resources and services to support the occupational therapy curriculum To familiarize OT students with evidence-based health care and lifelong learning skills 11

Overview of Online Resources Research and Clinical Databases e-Journals e-Books Consumer Health Evidence-Based Summaries 12

Journal Article Databases Ovid MEDLINE, CINAHL Plus w/Full Text, and Mosby’s Nursing Consult are most frequently used resources to find journal articles on OT topics. Search this section when you need articles on subjects, e.g., stroke, hand splinting, pressure ulcer Databases in this section provide links to full text journal articles and other resources You must start at the library’s OT web page to access our subscribed full text 13

Databases – Ovid MEDLINE Premier biomedical database from the National Library of Medicine Provides journal articles in over 5,000 journals from 1946 to present in medicine, nursing, health care system, and allied health care practice, education, and research Hints:  Search the Daily Update, and In-Process segments simultaneously with desired range of years  Search keywords along with subject headings 14

Use MEDLINE to locate Articles that report results of primary (original) studies Conclusions supported by data and reproducible methodology Ovid MEDLINE contains full text of many OT and rehabilitation journals

Databases - CINAHL Plus w/Full Text CINAHL stands for Cumulative Index to Nursing and Allied Health Literature Core research tool that contains articles in 770 journals with full text of many of nursing and allied health journals Use “CINAHL Headings” to search topics for best results, e.g., search “pediatric occupational therapy” for occupational therapy with children Use CINAHL to locate overviews and articles in related allied health care fields 16

Databases – Mosby’s Nursing Consult All in one resource provides full text of e-Journals, e- Books, images, and other documents Unique features include full text from pre-searches of popular health topics (top picks), full text monographs of all FDA approved drugs, and peer-reviewed patient education materials Widely used in major hospitals and medical centers 17

Native American Health Care National Library of Medicine – provides free access to American Indian Health database Native Health Databases – contains citations and abstracts of documents pertaining to the health care of North American indigenous peoples 18

Tracking Down the Full Text If your database search does not provide a link to full text of a relevant article:  Print a list of the citations  Click on the Library e-Journals link on the Library’s OT web page  Enter the title of the journal in the search box  Click on the database that contains the year you need 19

OT Journals Click on the individual OT journal title from the OT web page Open the year, volume, and issue you need 20

Consumer Health Resources Current, authoritative, peer-reviewed, and evidence- based resources MEDLINEPlus – the National Institutes of Health’s web site for patients and families Joanna Briggs Database - provides full text consumer information sheets Mosby’s Nursing Consult - includes patient education handouts produced by Elsevier 21

Getting Started: Match Resource to Information Need What is the question? How will information be used? 22

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 23

Proposed Research Projects Evaluate the effectiveness of fatigue management programs for patients with multiple sclerosis Use of virtual reality therapies in rehabilitation of stroke patients 24

Background Questions Generally ask who, what, why, where or how about a single concept 25

Background Questions What are methods of reducing fatigue in patients with multiple sclerosis? What are newer approaches to rehabilitation therapy for stroke patients that are based on motor learning? 26

Answers to Background Questions Resources:  MEDLINE  CINAHL Plus w/Full Text  Mosby’s Nursing Consult  Books – print and online 29

Information Retrieval to conduct Research Comprehensive in scope and time  All levels of resources  Current and Retrospective  Background and Foreground Information 30

Foreground Questions Usually compare two or more concepts – theories, drugs, treatments, tests, harms or benefits of two approaches 31

Answers to Foreground Questions Require precise information about complex issues Sources should provide current, original clinical research data  Start with Evidence-based summaries 32

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

Critically Appraised (Evidence-Based) Summaries DynaMed First Consult Joanna Briggs Institute 34

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

“Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values” Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2. Patient Concerns Clinical Expertise Best research evidence EBM What is EBM?

EBM Process – 5 Steps 1. ASK: Convert need for information into answerable question 2. ACQUIRE: Find best evidence to answer the question 3. APPRAISE: Critically appraise evidence for validity, impact, and applicability 4. APPLY: Integrate evidence with clinical expertise and patient values 5. ASSESS: Evaluate own effectiveness

Information Retrieval to Answer Clinical Questions Requires New Skills Clinical question formulation Search and retrieval of best evidence Critical appraisal of study methods

Is All Evidence Created Equal? Small portion of medical literature is immediately useful to answer clinical questions Understanding “wedge or pyramid of evidence” is helpful in finding highest level of evidence High levels of evidence may not exist for all questions due to nature of medical problems and research limitations

As you move up the pyramid the amount of available literature decreases, but it increases in its relevance to the clinical setting. Source: Sackett, D.L., Richardson, W.S., Rosenberg, W.M.C., & Haynes, R.B. (1996). Evidence-Based Medicine: How to practice and teach EBM. London: Churchill-Livingstone.

Highest Level of Evidence - Critically Appraised Content Evidence Based Summaries First Consult, DynaMed, Joanna Briggs Institute Joanna Briggs, Mosby’s Nursing Consult, OT Seeker, PEDro, ACP Journal Club, DARE Joanna Briggs, Cochrane Database of Systematic Reviews MEDLINE, CINAHL Plus w/Full Text SOURCE: Haynes, R. B. (2001). Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evidence-Based Medicine, 6 (2), Retrieved from

Summaries FirstConsult Includes summaries of systematic reviews of primary research, high-quality research papers from MEDLINE and evidence-based practice guidelines Included studies are evaluated for clinical relevance and scientific validity Recommendations labeled with Levels of Evidence Detailed narrative format and lengthy overviews

DynaMed Summaries for more than 3,000 topics Monitors >500 medical journals and systematic review databases Updated daily Each article evaluated for clinical relevance and scientific validity Recommendations labeled with Levels of Evidence 44

Joanna Briggs Institute (JBI) an international, not-for-profit research organization at the University of Adelaide collaborates internationally with over 70 entities to promote synthesis and transfer of evidence contributes to improving health care outcomes by supporting evidence-based practice 45

JBI Database Evidence Summaries – literature reviews that summarize existing literature on common health care problems Evidence-Based Recommended Practices – procedures that recommend practice on clinical topics Best Practice Information Sheets – guidelines produced for practicing health care professionals Systematic Reviews – comprehensive reviews of international research literature Consumer Information Sheets – summaries designed for patients, clients, and care providers Updated weekly, access through Ovid 46

Life-Long Learning Selecting and searching online databases is challenging Information is ever changing Contact Sandra ( preferred) 48

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Occupational Therapy 5903 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B –