1. Librarian Led Technology Sessions Participation in EBM Conference
Integrating Live Point-of-Care Searches into an Evidence-Based Medicine Curriculum
Rebecca A. Birr, MSLIS, AHIP, Maricopa Integrated Health System, Phoenix, AZ; Kathy A. Zeblisky, MLS, AHIP, Katherine McDonnell, MD, Phoenix Children’s Hospital, Phoenix, AZ
Objectives
Integrating evidence-based medicine (EBM) into daily practice is an essential skill residents must attain. This poster examines librarian involvement with revising the EBM curriculum at a joint pediatric residency program. The existing EBM pediatric curriculum included monthly, resident-led, large group sessions with didactics on key EBM topics and application via patient/problem, intervention, comparison, outcome (PICO) question analysis. The joint program has 119 residents.
Librarian Roles
Curriculum Changes
Curriculum Committee
Librarian Led Technology Sessions
Participation in EBM Conference
A multidisciplinary resident-driven QI task force included librarian
Librarian attended monthly task force meetings
Offered input into roles librarians could play
Literature search conducted to benchmark how other residency programs tackled EBM
Optional technology sessions were offered to residents at the beginning of the academic year
Librarians helped residents download and activate web-based applications onto their mobile devices
Residents received guidance on how to use resources to answer point of care questions
Provided support to residents leading conference
Attended monthly EBM Conference
Highlighted resource relevant to PICO question
Provided feedback to live searching discussion
Before
After
Unstructured
Structured: EBM topic must be approved, librarian assistance encouraged, inclusion of PICO question analysis, article appraisal
Monthly
Monthly, supplemented with technology workshops led by librarians
Resident-led conference
Resident-led conference but inclusion of librarians, pharmacy and others as appropriate
Large group session
Large groups and small break-out groups based on program year
Didactic, PowerPoint presentation
Didactic, live searching or demos, interactive journal club format, use of personal mobile devices for searching
No discussion of library resources
Librarians highlight appropriate resources for question at hand and present at least one teaching pearl
Almost exclusive use of UpToDate or Google
Use of other resources as identified in survey
Focus on statistical analysis, boring
Less boring with interactive discussions
No hard skills learned; just listen to lecture
Learn skills to perform point-of-care searching to answer clinical question
Methods
The annual program review and conference evaluations revealed a gap between the intended outcome of the EBM curriculum and the residents' perceived abilities to integrate this knowledge into meaningful literature searches. All residents were surveyed at the beginning of the academic year to identify the barriers they face answering real-time clinical questions and the web-based resources they most commonly use. The Curriculum Committee, a resident-driven quality improvement task force, addressed this issue by revising the format of our EBM conferences to include small group, technology-driven, point-of-care clinical searches framed by the existing curriculum. One of the librarians sat on the Curriculum Committee during this process improvement. A second survey (n=45) was conducted toward the end of the academic year to assess the impact of curriculum changes and on residents' perceived abilities to integrate this knowledge into meaningful literature searches. The response rate to the second survey was 38%.
Post-Intervention Survey Results
Residents were asked to respond to the following statements using the scale provided.
Residents reported using an expanded variety of library resources compared to before curriculum revisions
Strongly Disagree
Disagree
Agree
Strongly Agree
Attending the mobile technology session changed how I use point of care resources on my mobile device
0.0%
19.0%
57.1%
I find the librarian-led didactic portion of the EBM Conference helpful
6.5%
63.0%
23.9%
My knowledge of library resources increased since librarians became part of the EBM Conference
13.0%
54.3%
28.3%
I feel that I can integrate the knowledge learned during EBM Conferences into meaningful searches
67.4%
19.6%
The new EBM Conference format (started in July 2013) has helped me feel more comfortable using electronic resources
10.9%
58.7%
Prior to Academic Year
After Curriculum Intervention
Needs Assessment
What are the biggest barriers to answering a clinical question?
What do you perceive as the biggest barrier to accessing EBM?
Conclusion
Results of the second survey analyzing the residents' feedback on the curriculum changes indicated positive improvements. Overall, residents saw librarian involvement as a positive experience.
As a result of the curriculum modifications, the residents reported:
They were able to complete more meaningful searches
Their knowledge and comfort level increased on the resources available
Resources used changed and expanded from just UpToDate and Google
Lack of time
Accessibility of online resources on computers
Not sure how to search for the answer
Accessibility of online resources through wireless devices
Not sure how to formulate the question
Access to current medical journals
Lack of available resources
Personal knowledge about when/how to search
I though PICO was a condiment
All of the above