VU Library: Evidence-based practice tutorial


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This presentation was designed for use in Library tutorials with Nursing & Paramedic Science students. The workshop introduces students to the basic concepts of evidence-based practice; asking answerable clinical questions using PICO; levels of evidence and how to search Library databases to find appropriate evidence.

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  • Get students to reduce their topic to one sentence if necessaryIdentify main concepts in research topicE.g., how do the polyphenols in chocolate prevent cardiovascular disease?Students need to write down alternative words for these conceptse.g., flavonoid, cocoa, CVD, heart disease
  • Use whiteboard to illustrate boolean conceptse.g., how do the polyphenols in chocolate preventcardiovascular disease?Eg. polyphenol? AND chocolate AND “cardiovascular disease”Illustrate how the AND operator narrows down the search.
  • Use whiteboard to illustrate boolean conceptse.g., how do the polyphenols in chocolate preventcardiovascular disease?Eg. polyphenol? AND chocolate AND “cardiovascular disease”Illustrate how the AND operator narrows down the search.
  • VU Library: Evidence-based practice tutorial

    1. 1. EVIDENCE-BASED HEALTH CARE: SEARCHING THE LITERATURE Ishbel Leggat Faculty Librarian Health, Engineering & Science Victoria University LibraryWWW.VU.EDU.AU 1
    2. 2. Evidence-based practice:Session outline• Evidence-based practice • 5 steps • Step 1: Asking clinical questions • Step 2: Finding evidence • Levels of evidence• Which databases to use• Search process • Peer-reviewed articles• Hands-on search session• How to find full text articles 2
    3. 3. Evidence-based practice:Definitions"Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research" (Sackett et al 1996, p. 71)."Even though this definition [by Sackett et al] was originally given with respect to evidence-based medicine, it is often extended beyond the medical profession and used to define evidence-based practice as well" (Hoffmann, Bennett & Del Mar 2010, p. 2). 3
    4. 4. Evidence-based practice:5 steps 1 Ask question 5 2 Evaluate Search 3 4 Critically Implement appraise Adapted from: Purnell 2011 4
    5. 5. Evidence-based practice:Step 1 - Asking questionsPICO can be used to formulate a focused clinical research question. P I C O 5
    6. 6. Evidence-based practice:Step 1 - Asking questionsPICO can be used to formulate a focused clinical research question. P I C O Population Intervention Comparison Outcome Patient OR Problem Exposure Who are the What do we do What do we What patients? to them? compare the happens? What is the What are they intervention What is the problem? exposed to? with? outcome? Adapted from: Purnell 2011 6
    7. 7. Evidence-based practice:Step 1 - Asking questionsWhen you have formulated a focused clinical question, it can also be useful to determine what type of question it is. Diagnosis Prognosis Aetiology Effects Experiences How can we find What happens Why does a How can we How does it feel out whether or to a person with person get a prevent or treat to have a not a person has a specific specific a specific specific a specific condition or condition or condition, illness condition, illness condition or illness? illness? or problem? or problem? illness? Adapted from: Purnell 2011This will help you to decide what type of clinical studies to search for. 7
    8. 8. Evidence-based practice:Step 1 - Asking questionsPractice formulating a clinical question using PICO... 8
    9. 9. Evidence-based practice:Step 1 - Asking questions 9
    10. 10. Evidence-based practice:Step 1 - Asking questionsNow try writing a clinical question... 10
    11. 11. Evidence-based practice:Step 1 - Asking questions 11
    12. 12. Evidence-based practice:Step 1 - Asking questions 12
    13. 13. Evidence-based practice:Step 1 - Asking questions 13
    14. 14. Evidence-based practice:Step 2 – Finding evidence• Levels of evidence" Why you shouldnt just Google it Google is good for finding some information but evidence-based practice requires that you find and use the best available evidence from systematic research. Google will find you lots of information but it doesnt find everything and it wont help you filter the good from the bad. When looking for answers to clinical questions, you should start with resources containing pre-appraised evidence. The information you find in these have already undergone a filtering and critical appraisal process. The 6s Model … may help you choose the right information resources … " (Purnell 2011) 14
    15. 15. Evidence-based practice:Step 2 – Finding evidence• Levels of evidence - the 6s ModelAs explained by DiCenso et al … you should begin your search at the highest possible level in thismodel. The type of question you have is also important to consider when choosing informationresources… (Purnell 2011) 15
    16. 16. Evidence-based practice:Which databases to use?Depends on your topic – be prepared to use severaldatabases... • Biomed & health Medline; PubMed; Informit Health Collection (Australian info); Cinahl; Cochrane Library (EBM); PsychINFO (mental health) • Multidisciplinary science ScienceDirect; Web of Knowledge; Wiley Online Library; SpringerLink • General full-text Academic Search Premier 16
    17. 17. Evidence-based practice:Search processPeer-reviewed articles•Some databases have options to search only for peer-reviewed articles• Most databases don’t – that’s why you need to be aware of what peerreviewed articles look likeCharacteristics of peer-reviewed articles Formal language, technical vocabulary Charts, tables, statistical data (science literature) References to other scholarly literature Read and critiqued by anonymous reviewers who are scholars in the field Have a formal appearance (usually b&w, no pictures) 17
    18. 18. Evidence-based practice:Search process• Before you start searchingHave a clear idea of what you are looking for and write it downe.g. administration of epinephrine by paramedics during cardiac arrest• Identify the key words in your topice.g. epinephrine, paramedics, cardiac arrest• Write down alternative words for the key words alreadyidentifiede.g. adrenaline, allied health personnel, heart attack 18
    19. 19. Evidence-based practice:Search process• Construct your searchStart out with a simple searche.g. paramedics AND epinephrineLink key words with the search operator AND to narrow down yoursearchAdd more key words if you get too many resultse.g. paramedics AND epinephrine AND “cardiac arrest”Use double quotes to match phrasese.g. “cardiac arrest” 19
    20. 20. Evidence-based practice:Search process• Test drive your search in a database... • Start out with a simple search • Review your search results to determine what to do next...Add more key words to narrow down your searchUse different key words if your results aren’t relevantUse thesauri or subject lists (such as MeSH – Medical Subject Headings)to find alternative key wordsIncorporate alternative key words into your search if you are not gettingenough resultse.g. paramedics AND (epinephrine OR adrenaline)Make use of database features to limit your search more effectivelye.g. limit to scholarly or peer reviewed articles; set specific date range... 20
    21. 21. Evidence-based practice:Finding full text articles• Many databases have the full text or links to free full text• If full text is not available, look out for button inlibrary databasesThis will run a search in the library catalogue for the required journaltitle – check ALL options... 21
    22. 22. Evidence-based practice:ReferencesDiCenso, A, Bayley, L, & Haynes, RB 2009, Accessing preappraised evidence: fine-tuning the 5Smodel into a 6S model, ACP Journal Club, vol. 151, no. 3, p. 1, viewed 4 August 2011, retrievedfrom CINAHL with Full Text.Hoffmann, T, Bennett, S & Del Mar, C 2010, Evidence-based practice across the health professions,Elsevier Australia, Chatswood, NSW.Purnell, M 2011, Evidence based practice: LibGuides at Northern Territory Department of Health,Northern Territory Department of Health, viewed 4 August 2011,< >.Sackett, D, Rosenberg, W, Gray, J, Haynes, R, & Richardson, W 1996, Evidence based medicine:what it is and what it isnt, BMJ, vol. 312, no. 7023, pp. 71-2, viewed 3 August 2011,<>.University of Minnesota Libraries n.d., Evidence based practice, University of Minnesota,Minneapolis, MN, viewed 4 August 2011, < >. 22
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