1. Caribbean Medical Schools: Library Services & Literacy Education

3. Caribbean Islands with Medical Schools: AntiguaArubaBonaireDominica Cayman Islands Curacao Grand Cayman NevisSaba St. Eustatius St. Kitts St. Lucia St. Maarten St. Vincent

4. Why attend a Caribbean medical school? Shortage of openings in the States Accept students with a lower GPA and/or MCAT Non-traditional students More flexible program starting dates Generally less expensive

6. AUC Student Population, 2008 : 519 students 58 percent males 42 percent females 69 percent Americans 31 percent were born outside of the United States

7. AUC Faculty AUC Faculty 25 full-time faculty members 20 visiting faculty members 12 faculty are from the United States 13 faculty are from outside of the United States (including: Canada, New Zealand, Scotland, Ireland, Nigeria, Holland, India)

8. Academic Program 5 semesters of basic sciences at AUC, with rolling enrollment 20 months of clinical rotations in the United States (24 hospitals in 10 states), Ireland (1 site), or England (7 sites) Accredited by the ACCM (Accreditation Commission on Colleges of Medicine)

9. AUC Library Services: 433 sq. meters (4,660 sq. feet) quiet study area Open 7 days a week from 8 am to 11 pm 5,800 Books, DVDs, & videos Reserve textbook collection Access to UpToDate Research assistance for faculty, students, & community Approximately 85 journals ILL service 6 computers w/ internet access & DVD players Wireless internet access throughout library

10. Collection & Study Room

11. Study Room

12. Library Computer Area

13. Computer Lab

14. Literacy Education Classroom instruction is offered in the following: Critiquing general & medical websites –Reliability of Wikipedia –Google search tips Formulating the clinical question Medical database search techniques

15. HTTP://WWW.LIB.BERKELEY.EDU/TEACHINGLIB/GUIDES/INTERNET/EVALUATION_CHECKLI ST_2008_SPRING.PDF HTTP://WWW.LIB.BERKELEY.EDU/TEACHINGLIB/GUIDES/INTERNET/EVALUATION_CHECKLI ST_2008_SPRING.PDF Evaluating Internet Websites:

16. And remember…

17. Medical Databases STAT!RefPubMedOVIDUpToDateMDConsultEBSCOProquestMircomedex Web of Knowledge

18. To help formulate clinical questions, a framework called PICO has been developed PICO stands for: –P – Patient, Population, or Problem –I – Intervention or Indicator –C – Comparison or Control –O – Outcome

19. Example of a Clinical Case: Your patient is a 6 month old child, newly diagnosed with sickle cell disease. He is currently taking penicillin daily as a prophylaxis against pneumococcal infections. You suggest that this might be a long term therapy for the child. His parents are worried about possible adverse side effects of long term use of penicillin, including developing a resistance to the drug.

20. Search terms to consider: P sickle cell disease, child sickle cell disease, childI prophylactic penicillin prophylactic penicillinC doesn’t apply to this question O prevention of infections

21. PICO Worksheet and Search Strategy Name___________________ 1. Define your question using PICO by identifying: Problem, Intervention, Comparison Group, and Outcomes. Your question should be used to help establish your search strategy. Patient/Problem________________________________ Intervention___________________________________ Comparison___________________________________ Outcome______________________________________ Write out your question:_______________________________________________________ __________________________________________________________________________ 2. Type of question/problem: Circle one: Therapy/Prevention Diagnosis Etiology Prognosis 3. Type of study (Publication Type) to include in the search: Check all that apply: ( ) Meta-Analysis ( ) Systematic Review ( ) Randomized Controlled Trial ( ) Cohort Study ( ) Case Control Study ( ) Case series or Case Report ( ) Editorials, Letters, Opinions ( ) Animal Research ( ) In Vitro/Lab Research 4. List main topics and alternate terms from your PICO question that can be used for your search List your inclusion criteria –gender, age, year of publication, language. List irrelevant terms that you may want to exclude in your search.

22. P PATIENT OR PROBLEM In a 6 mo female with GERD. I INVESTIGATION (A CAUSE, A PROGNOSTIC FACTOR, A TREATMENT, ETC.) Will a PPI - lansoprazole C COMPARISON (IF NECESSARY) Compared to a H2 blocker - pepcid O Outcomes 1. Consider outcomes not only relevant to clinicians, but to patients, payers, and healthcare administrators 2. An outcome must be measurable 3. Don’t forget to include AEs (Adverse Events) for therapies. Decreased GERD symptoms (irritability episodes of emesis) and/or Incidence of Nissen fundoplication PICO Worksheet The 4 Elements of a Well-Built Clinical Questions Use the PICO elements to formulate an answerable clinical question. (E.g. In a 6 month old female with GERD, is using a PPI more effective in reduction of symptoms and incidence of Nissen fundoplications than using an H2 blocker? )

23. UpToDate is an evidence-based clinical information database Approximately 3,000 clinicians serve as authors Extensive peer review to ensure information is accurate Review of over 375 journals, and other resources Available anywhere on campus, no password required www.uptodate.com/online

24. PubMed PubMed provides access to bibliographic information that includes MEDLINE, OLDMEDLINE and other medical information www.ncbi.nlm.nih.gov/pubmed

25. PubMed/Medline via PICO: http://pubmedhh.nlm.nih.gov/nlm/ picostudy/pico2.html http://pubmedhh.nlm.nih.gov/nlm/ picostudy/pico2.html