1. 1 One-Click Learning Linda Watson, Health Sciences Libraries Gwen Halaas, Department of Family Medicine and Community Health; Rural Physician Associate Program Cindy Gruwell, Bio-Medical Library Minnesota Rural Health Conference, Duluth July 18, 2006

2. One-Click Learning and Knowledge Management Linda Watson, MLS Director, Health Sciences Libraries University of Minnesota lwatson@umn.edu

3. 3 One-Click Learning The Technology The Learner Knowledge Management Teams of Experts (including librarians) Challenges

4. 4 Technology “In rural America, appropriate use of ICT [Information and Communications Technology] can bridge distances by providing more immediate access to clinical knowledge, specialized expertise, and services not readily available in sparsely populated areas.” p147 “Elements of an ICT infrastructure for health care include electronic health records, clinical decision-support tools, and telehealth capabilities, with a focus on such areas as knowledge management, error reduction, and information acquisition.” p87 “Elements of an ICT infrastructure for health care include electronic health records, clinical decision-support tools, and telehealth capabilities, with a focus on such areas as knowledge management, error reduction, and information acquisition.” p87 Quality Through Collaboration: The Future of Rural Health Care, Institute of Medicine (2005)

5. 5 Mission: collect, organize and disseminate the biomedical literature of the world in order to advance the medical and related sciences and to improve the health of the public. Information and Technology

6. 6 Knowledge Explosion

7. 7 Imagine…..2025 “…we are entering a world in which a worldwide Internet based system of knowledge provided in real time and mediated by expert systems exploring massive databases will be useful tools for healthcare and research.” Visions of the National Library of Medicine in 2025 9/29/2005 “Learning resources will be online, 24-7 and pulled forward on demand by the professional who needs it. An integrated model of learning will support all professionals and include an ascending series of complexities in language so individuals and their families can use the basic level while very sophisticated advanced specialists us the most complex layer… These resources will also be accessible over the network for use in K-12 education…[This] will prepare consumers to be active participants in decisions about their care and prepare people coming into health education programs for more effective approaches to learning.”

8. 8 Web 1.0  Web 2.0 Web 1.0  Web 2.0 Portal, like Yahoo  Search, like Google Publishing (personal websites)  Participation (blogs, comments) Stickiness, stay on the website  Syndication, RSS, Podcast, website follows you Britannica Online  Wikipedia Directories, Favorites  Tags - De.licio.us Source: What Is Web 2.0 - Tim O'Reilly, modifiedWhat Is Web 2.0 Web 2.0 in Medicine, V. Dimov, MD, May 18, 2006. Link to ClinicalCases.org ClinicalCases.org “social computing”

9. 9 Web 2.0 in Medicine, V. Dimov, MD, May 18, 2006. Link to ClinicalCases.org ClinicalCases.org

10. 10 Learner Trends Recognition of unique learning styles / preferences; personalization Generational differences digital natives and digital immigrants Diverse and non-traditional students Students in clinical rotations remote from campus Knowledge management and information literacy (not just computer literacy) Competency based learning (performance) Interdisciplinary / Multidisciplinary Life-long learning (different stages of expertise)

11. 11 Learner Lifecycle Novice Expert Class Course Teacher Test / Grades Curriculum Listening Discovery Trial and error Collaborating Instructions Asking Skimming Conversing Networking Coaching / Teaching Observing Comparing Reflecting Informal Learning (pull) Formal Learning (push) Adapted from Jay Cross: Workflow Institute

12. 12 Knowledge Management “Creating, identifying and capturing knowledge; distributing the right knowledge to the right people at the right time; and putting that information into action in ways that improve individual and community health.” Requires infrastructure comprised of the following building blocks: expertise technology tools and systems access and connectivity continuous learning and improvement University of Minnesota Academic Health Center Knowledge Management Technology Task Force Report, May 5, 2006

13. 13 Envisioning a Learning Environment Learning Environment Learning ObjectsLearning Activities Learning Places Learning Assessment Learning Methods Learning Participants Lectures, images, virtual patients, molecular models, books, journal articles, patient education, practice tests…. Classes, assignments, journal club, research experience, studying, presentations, practicing skills…. Lecture, pbl, lab, patient contact, simulation, vr, podcasts, collecting & analyzing data, conversations… Classroom, lecture hall, hospitals, clinics, community, library, home, coffee shop, hallways, transportation (commuting)…. Students, clinicians, scientists, librarians, patients & families, staff, each other…. Tests, portfolios, observation, feedback….

14. 14 Librarians on Development Teams Information organization, dissemination, and archiving expertise Content from licensed resources (online books, journals, images, databases) Local content (ie training modules on information management) Development/deployment of tools for information customization (Blogs, wikis, RSS feeds, podcasts) Training of faculty and students to maximize use of the knowledge repository “Never underestimate the importance of a librarian.”

15. 15 www.biomed.lib.umn.edu

16. 16 Library Examples Teach a variety of classes (both stand- alone and in the curriculum) in the AHC schools and the community Expertise – Morning Report, linking clinicians with information when they need it Basics of Database Searching; Tools to Organize Online Research; PDAs; Powerpoint; Blogs; Google Scholar; more….

17. 17 Library Examples Linking national information resources with local resources (My Health Minnesota Go Local) COMING: December 2006!

18. 18 Challenges Understanding individual user preferences and information-seeking behaviors (an anthropological approach) Filtering the right kind of information to the learner or decision-maker and presenting it in the most effective way Integrating “just-in-time” learning in the clinical environment; into the workflow How to provide knowledge access to ALL the hospitals and clinics where students train students and their mentors in community preceptorships Patients and families; the community Consider Librarians as Your Partners in this Process!

19. Thank You

20. One-Click Learning Gwen Wagstrom Halaas, M.D., M.B.A. Director, Rural Physician Associate Program, University of Minnesota halaa@umn.edu

21. 21 Rural Physician Associate Program Established in 1971 1127 student graduates, 892 in practice Of 575 graduates practicing in Minnesota 63% practice in a rural community 82% practice in family medicine 89% in primary care

22. 22 RPAP Online Curriculum Modules Self-assessment Discussion of module questions Interesting stories Quick links Photo album Assignments/ evaluations

23. 23 WebVISTA Course

24. 24 RPAP Online Modules Rural health and health care systems Evidence-based medicine Managing health care Community health assessment End of life care

25. 25 RPAP Modules

26. 26 Rural Overview

27. 27 Rural Health

28. 28 Discussion Questions

29. 29 Rural Health Systems

30. 30 Rural Health Systems

31. 31 Evidence Based Medicine

32. 32 Evidence Based Medicine

33. 33 Assignments

34. 34 Discussion Questions

35. 35 Managing Health Care

36. 36 Managing Health Care

37. 37 Community Health Assessment

38. 38 Community Health Assessment

39. 39 End of Life Care

40. 40 End of Life Care

41. 41 Self Quiz

42. 42 Successes Learning about topics Engaging with community health contacts Enjoyable and educational discussion

43. 43 Challenges Time – for students and RPAP faculty Making changes Engaging community faculty

44. Thank you

45. One Click Learning Library Resources at Point of Need Cindy Gruwell, M.L.S. Librarian and Coordinator of Instruction, Bio-Medical Library, University of Minnesota gruwell@umn.edu

46. 46 One Click Leaning Resources at a distance Student and preceptor support Access to information resources and tools

47. 47 Resources at a Distance RPAP student orientation – library presentation Print – “Guide to Advanced Resources for Evidence Based Practice” Web Based sites RPAP CourseLib Resource Page Resources for Preceptors

48. 48 One Click – RPAP Resource Page

49. 49 One Click – Resources for Clinicians

50. 50 One Click – Preceptor Resource Page

51. 51 Student and Preceptor Support Consultations In person By phone Email support Searches Search technique videos Detailed answers to specific questions

52. 52 Access to Information Resources and Tools Web based tutorial Customized resource pages Remote access to multiple databases

53. 53 Successes Enhanced Evidence Based Practice tutorial Online Presentation: RPAP – Evidence Based Practice Personalized course related web pages CourseLib: Rural Physician Associate Program (RPAP) Evidence Based Practice Resources Resources for Preceptors Resources for Clinicians Extensive consultations by email

54. 54 RPAP Evidence Based Practice Tutorial

55. 55 Challenges Communicating at a distance Providing consultations live via the Web Breeze Live Access Affiliated vs. Non-Affiliated Faculty

56. 56 Upcoming Office hours by instant messaging Revised Breeze Live sessions *New* interactive EBP tutorial

57. Thank you Questions?