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Evidence-based Information Seeking Skills of Young Clinicians

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Rowena Cullen …

Rowena Cullen
School of Information Management, Victoria University of Wellington
www.vuw.ac.nz
(P38, 1/10/09, Skellerup Room, 11.28)

Published in: Health & Medicine, Education

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  • 1. Evidence based information seeking skills of young clinicians Rowena Cullen, Megan Clark, Rachel Esson
  • 2. Longitudinal study 1995-2009
    • Focus – to improve skills of medical students ability to search and appraise literature for clinical decision-making
    • Identify impact on life-long learning in challenging new health environment
    • Ongoing cohorts received various levels of training, assessed now as young clinicians
    • Intention to assess teaching intervention, changes in style, increase in EBM in terms of learning outcomes
  • 3. Research objectives
    • 1. What are the information seeking behaviours of these young clinicians in relation to queries that arise during their clinical practice?
    • 2. How much do they retain of the basic, and any additional training undergone during their clinical years?
    • 3. Has the training they received had an impact on their current ability to search, retrieve and evaluate information relevant to their clinical practice?
  • 4. Key points in literature
    • Increased need for information literacy skills in online environment, proliferation of resources etc.
    • Ongoing evidence of lack of skill in search strategy, evaluation of items retrieved, applying knowledge
    • Debate about when intervention most effective – in early pre-clinical years, or when making clinical decisions
    • Negative attitude in early years, difficulty in creating ‘real-life’ situations
  • 5. Participants 4 th year students 1995-2003, now Registrars and House surgeons
    • Cohort 1 - control group (no training) 1995-1996
    • Cohort 2 – 1 hour tutorial during orientation
    • Cohort 3 - received self-paced, assessed HI module as well
    • Cohort 4 – additional advanced Medline training, EBM, CATs
    • Cohort 5 - HI and EBM part of assessed coursework
  • 6. Method
    • 34 participants recruited - at least some from each of the cohorts outlined above
    • Interviewed in medical library with full resources available, including: OVID Medline as well as PubMed
      • Structured interviews
      • Self-evaluation of search skills
      • Evaluation by experts of search based on given scenario
  • 7. Findings
    • Most claim to remember (even those with no training remember vaguely!)
    • What do they remember?
      • the training took place
      • terms used (e.g. ‘Boolean’, ‘explode’ etc.) and some content
      • the interface they were trained on
    • But not how to apply these
  • 8. Current strategies include
    • Use of Google (most often), UptoDate, Bpac (espec GPs), Colleagues, Medical databases
    • No apparent impact of EBM training
    • Medline use most reported, but not reflected in strategy searching primary literature, and search skills poor, espec EBM retrieval
    • Librarians rarely consulted
  • 9. How they evaluated the information they retrieved
  • 10. How they evaluated their search skills
    • Self-assessment against 7 search and appraisal skills (0,1,2; possible total 14)
    • Skills reported by participants varied considerably
    • Rated selves best at
      • Ability to search and find RCTs and systematic reviews (av = 1.9)
      • Ability to use ‘explode’ and ‘focus’ lowest ( av= .68)
  • 11. How experts searchers rated them
  • 12. Reflections on their searching
    • Confident (overconfident?) of their ability to search and apply information
    • Inadequate use of Medline
    • No correlation between more advanced EBM training and current skills
  • 13. Critical appraisal skills
    • Appraisal
    • Can understand the principles
    • Poor searching means poor data set
    • Implications for patient care
    • Application
    • In theory can apply the principles as taught
    • Implications for patient before them are less clear
  • 14. Influences on information seeking behaviour
    • Personality
    • Confidence
    • Variety of sources
    • Quality of sources
    • Speed
    • Role models
    • Facilitators and barriers
    • Range of resources available
    • Subject dependent
    • Course work/training dependent
    • Work place location
  • 15. Lessons learned
    • Searching skills require constant practice to remain effective
    • Without constant assessment as part of core medical skill students will not spend time learning to become proficient
    • Without an expectation by professional bodies that this skill is important it will not be valued by young clinicians