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Evidence-based Information Seeking Skills of Young Clinicians
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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)

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    Evidence-based Information Seeking Skills of Young Clinicians Evidence-based Information Seeking Skills of Young Clinicians Presentation Transcript

    • Evidence based information seeking skills of young clinicians Rowena Cullen, Megan Clark, Rachel Esson
    • 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
    • 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?
    • 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
    • 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
    • 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
    • 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
    • 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
    • How they evaluated the information they retrieved
    • 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)
    • How experts searchers rated them
    • 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
    • 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
    • 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
    • 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