Is literature search training for medical students and residents effective? a literature review

Effect of a workplace-based learning program on clerkship students' behaviors and attitudes toward evidence-based medicine practice

In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program's effect on the students' attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students' clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the 'within six months' group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.

Implementation and evaluation of a self-directed learning activity for first-year medical students

Background: It is critical that medical students develop self-directed, life-long learning skills to navigate medical school successfully and to become competent healthcare professionals. Moreover, the Liaison Committee on Medical Education (LCME), the USA medical school accrediting body, requires activities designed to help students develop self-directed learning (SDL) skills in the preclinical years.Objective: We evaluated the feasibility and effectiveness of a self-directed learning activity in a 6-week first-year medical student course.Design: The course director assigned infectious disease case studies to teams of first-year medical students who individually assessed their knowledge gaps of the case, identified scholarly sources to fill their knowledge gaps, shared the information with their teammates, and reflected on their ability to guide their own learning. Students were asked to rate workload, team effort, acquisition of new clinical knowledge, and life-long learning skills. Students were also asked to reflect on how this assignment affected their perception of their SDL skills. Descriptive statistics were used to analyze responses to the Likert scale questions. Thematic analysis was applied to the comments.Results: Survey response rate was 80% (131/163). Students strongly or moderately agreed that 1) they spent an appropriate amount of time on the project (94%), 2) the workload was evenly distributed among their teammates (95%), 3) their teammates made significant and timely contributions to the project (97%), 4) the project contributed to learning new clinical knowledge (92%), and 5) the project contributed to the acquisition of life-long learning skills (85%). The analysis team identified four themes from student reflections on their perception of their self-directed learning skills: self-learning skills, collaboration, application, and meta-cognition,Conclusions: Study results demonstrated that we successfully implemented a case-based SDL activity in a first-year medical school course and that students perceived the activity as a valuable learning experience.

What every researcher should know about searching - clarified concepts, search advice, and an agenda to improve finding in academia

We researchers have taken searching for information for granted for far too long. The COVID-19 pandemic shows us the boundaries of academic searching capabilities, both in terms of our know-how and of the systems we have. With hundreds of studies published daily on COVID-19, for example, we struggle to find, stay up-to-date, and synthesize information-all hampering evidence-informed decision making. This COVID-19 information crisis is indicative of the broader problem of information overloaded academic research. To improve our finding capabilities, we urgently need to improve how we search and the systems we use. We respond to Klopfenstein and Dampier (Res Syn Meth. 2020) who commented on our 2020 paper and proposed a way of improving PubMed's and Google Scholar's search functionalities. Our response puts their commentary in a larger frame and suggests how we can improve academic searching altogether. We urge that researchers need to understand that search skills require dedicated education and training. Better and more efficient searching requires an initial understanding of the different goals that define the way searching needs to be conducted. We explain the main types of searching that we academics routinely engage in; distinguishing lookup, exploratory, and systematic searching. These three types must be conducted using different search methods (heuristics) and using search systems with specific capabilities. To improve academic searching, we introduce the "Search Triangle" model emphasizing the importance of matching goals, heuristics, and systems. Further, we suggest an urgently needed agenda toward search literacy as the norm in academic research and fit-for-purpose search systems.

Educational interventions to improve literature searching skills in the health sciences: a scoping review

OBJECTIVE

The authors reviewed educational interventions for improving literature searching skills in the health sciences.

METHODS

We performed a scoping review of experimental and quasi-experimental studies published in English and German, irrespective of publication year. Targeted outcomes were objectively measurable literature searching skills (e.g., quality of search strategy, study retrieval, precision). The search methods consisted of searching databases (CINAHL, Embase, MEDLINE, PsycINFO, Web of Science), tracking citations, free web searching, and contacting experts. Two reviewers performed screening and data extraction. To evaluate the completeness of reporting, the Template for Intervention Description and Replication (TIDieR) was applied.

RESULTS

We included 6 controlled trials and 8 pre-post trials from the 8,484 references that we screened. Study participants were students in various health professions and physicians. The educational formats of the interventions varied. Outcomes clustered into 2 categories: (1) developing search strategies (e.g., identifying search concepts, selecting databases, applying Boolean operators) and (2) database searching skills (e.g., searching PubMed, MEDLINE, or CINAHL). In addition to baseline and post-intervention measurement, 5 studies reported follow-up. Almost all studies adequately described their intervention procedures and delivery but did not provide access to the educational material. The expertise of the intervention facilitators was described in only 3 studies.

CONCLUSIONS

The results showed a wide range of study populations, interventions, and outcomes. Studies often lacked information about educational material and facilitators' expertise. Further research should focus on intervention effectiveness using controlled study designs and long-term follow-up. To ensure transparency, replication, and comparability, studies should rigorously describe their intervention.

The educational role of clinical informationist on improving clinical education among medical students: Based on Kirkpatrick model

INTRODUCTION

Due to time constraints and a significant increase in medical information, one of the ways to keep physicians and medical teams up to date is to use evidence-based medicine. The current research focused on the effects of the educational role of clinical informationist (CI) on improving clinical education among medical students based on the Kirkpatrick (KP) model.

METHODS

The method was semiexperimental research in two group designed with pretest and posttest. The research population included thirty medical students for each group that was selected by the convenience time-based sequential sampling method. The study data were collected using a researcher-made two questionnaires and a checklist. Data were analyzed by the descriptive statistics and inferential statistics using SPSS version 20 software.

RESULTS

Based on the first level of the KP model, the total mean of medical students' satisfaction in the experimental group was 4.06 from 5. Based on the second, third, and fourth levels of the model, the independent t-test showed that before the intervention, the mean scores of attitude, knowledge, information-seeking skills and behaviors, and also clinical skills were not significantly different in both the intervention and control groups (P > 0.05). After the intervention, the results of covariance test showed that attitude, knowledge, information-seeking skills and behaviors, and also clinical skills of the intervention group are significantly better than that of the control group (P < 0.001).

CONCLUSION

Training and the presence of the CIs in the clinical round had resulted in the improved satisfaction, attitude, knowledge, and information-seeking skills while also improving information-seeking behaviors and clinical skills of medical students.

Evidence-Based Medicine in the Clinical Learning Environment of Pediatric Hospital Medicine

The article begins with an overview of evidence-based medicine (EBM), including its history and core principles. Next, the article discusses how the current clinical learning environment has shaped EBM, including the accessibility and portability of technology; the access to electronic search engines and libraries; and the movement toward applying the best evidence through order sets, clinical guidelines, and pathways to work toward standardizing care. The article ends with a focus on how educators can influence a trainee's knowledge, skills, attitudes, and behaviors regarding EBM.

Underutilization of Research Journals by Undergraduate Students of Medical Colleges in Islamabad: A Cross-sectional Study

OBJECTIVE

To analyze the factors behind the underutilization of research articles as an adjuvant source of knowledge by medical students.

MATERIALS & METHODS

We conducted a cross-sectional study of students from medical colleges in Islamabad from June 2017 to August 2017. The students were verbally informed about the study, and those who gave their consent were included. The data was collected through a self-constructed questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.68. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21 (IBM, Armonk, NY, US).

RESULTS

A total of 382 students participated in the study. The use of research articles for the preparation of problem-based learning (PBL), small group discussions, or assessments was very low. Students did, however, consult journals if emphasized by the faculty. A majority of the students did appreciate the importance of medical journals to explore detailed information about disease states and health issues encountered by self or family members. The use of research articles by students for preparing for exams was very low.

CONCLUSION

The students' underutilization of journals may be attributable to an over-familiarity with books, a lack of faculty prompting, and a lack of knowledge on how to access such journals. These factors should be addressed while designing the medical curriculum to enhance journal perusal among medical students.

Assessment of knowledge and skills in information literacy instruction for rehabilitation sciences students: a scoping review

OBJECTIVE

This scoping review investigates how knowledge and skills are assessed in the information literacy (IL) instruction for students in physical therapy, occupational therapy, or speech-language pathology, regardless of whether the instruction was given by a librarian. The objectives were to discover what assessment measures were used, determine whether these assessment methods were tested for reliability and validity, and provide librarians with guidance on assessment methods to use in their instruction in evidence-based practice contexts.

METHODS

A scoping review methodology was used. A systematic search strategy was run in Ovid MEDLINE and adapted for CINAHL; EMBASE; Education Resources Information Center (ERIC) (EBSCO); Library and Information Science Abstracts (LISA); Library, Information Science & Technology Abstracts (LISTA); and Proquest Theses and Dissertations from 1990 to January 16, 2017. Forty articles were included for data extraction.

RESULTS

Three major themes emerged: types of measures used, type and context of librarian involvement, and skills and outcomes described. Thirty-four measures of attitude and thirty-seven measures of performance were identified. Course products were the most commonly used type of performance measure. Librarians were involved in almost half the studies, most frequently as instructor, but also as author or assessor. Information literacy skills such as question formulation and database searching were described in studies that did not involve a librarian.

CONCLUSION

Librarians involved in instructional assessment can use rubrics such as the Valid Assessment of Learning in Undergraduate Education (VALUE) when grading assignments to improve the measurement of knowledge and skills in course-integrated IL instruction. The Adapted Fresno Test could be modified to better suit the real-life application of IL knowledge and skills.

Information literacy skills retention over the first professional year of pharmacy school

The authors aimed to determine if first-professional-year pharmacy students retain library literature search skills throughout the school year. Students (n = 61 consented) were given an identical seven-item quiz on basic library search skills prior to library instruction in the fall semester and at the end of the spring semester. There was no significant difference between median scores on the two quizzes, nor were any significant differences noted in subgroup analyses. Search competency may be retained to a higher degree if library instruction is moved later in the pharmacy curriculum when literature search skills are used more often.

Reflections on the value and impact of library and information services

Purpose

– The purpose of this paper is to critically review methods of impact assessment and economic analyses.

Design/methodology/approach

– Reviews the literature on impact assessment, and examines some case studies of impact assessment in health libraries. Relates satisfaction and dissatisfaction assessment to impact assessment. Identifies recent impact assessment approaches in public and academic libraries, and explores different uses of terminology for impact and outcome. Reviews literature on economic analysis of value, including cost analyses, cost-effectiveness analysis and return on investment (ROI) studies.

Findings

– Terms for library assessment (outcome, output, impact, value and benefit) vary among different sectors. Impact evaluation should examine initial assumptions of value carefully, and examine possible gaps in the line of argument linking inputs of library services to presumed impacts (positive and negative). More attention to sampling and response rates is required, to avoid problems such as the “warm glow” effect. Qualitative and quantitative evidence should be carefully integrated to tell the impact story. Economic impact can be estimated, but methodology depends on the service aims and sector.

Originality/value

– Demonstrates that some of the requirements for traditional impact assessment also affect economic analyses and ROI studies.

Performance of a core of transversal skills: self-perceptions of undergraduate medical students

BACKGROUND

There is an increasingly growing trend towards integrating scientific research training into undergraduate medical education. Communication, research and organisational/learning skills are core competences acquired by scientific research activity. The aim of this study was to assess the perceived performance of a core of transversal skills, related with scientific research, by Portuguese medical students.

METHODS

A cross-sectional study was conducted in 611 Portuguese students attending the first, fourth and sixth years of the medical course, during the same academic year. A validated questionnaire was applied for this purpose.

RESULTS

Medical students felt confident regarding the majority of the analyzed transversal skills, particularly regarding team work capacity (72.7% perceived their own capacity as good). On the other hand, the perceived ability to manage information technology, time and to search literature was classified only as sufficient by many of them. The progression over the medical course and participation in research activities were associated with an increasing odds of a good perceived performance of skills such as writing skills (research activity: OR = 2.00; 95% CI: 1.34-2.97) and English proficiency (research activity: OR = 1.59; 95% CI: 1.06-2.38/final year medical students: OR = 3.63; 95% CI: 2.42-5.45).

CONCLUSIONS

In this line, the early exposure to research activities along undergraduate medical education is an added value for students and the implementation of an integrated research program on medical curriculum should be considered.

How are medical students trained to locate biomedical information to practice evidence-based medicine? A review of the 2007-2012 literature

OBJECTIVES

This study describes how information retrieval skills are taught in evidence-based medicine (EBM) at the undergraduate medical education (UGME) level.

METHODS

The authors systematically searched MEDLINE, Scopus, Educational Resource Information Center, Web of Science, and Evidence-Based Medicine Reviews for English-language articles published between 2007 and 2012 describing information retrieval training to support EBM. Data on learning environment, frequency of training, learner characteristics, resources and information skills taught, teaching modalities, and instructor roles were compiled and analyzed.

RESULTS

Twelve studies were identified for analysis. Studies were set in the United States (9), Australia (1), the Czech Republic (1), and Iran (1). Most trainings (7) featured multiple sessions with trainings offered to preclinical students (5) and clinical students (6). A single study described a longitudinal training experience. A variety of information resources were introduced, including PubMed, DynaMed, UpToDate, and AccessMedicine. The majority of the interventions (10) were classified as interactive teaching sessions in classroom settings. Librarians played major and collaborative roles with physicians in teaching and designing training. Unfortunately, few studies provided details of information skills activities or evaluations, making them difficult to evaluate and replicate.

CONCLUSIONS

This study reviewed the literature and characterized how EBM search skills are taught in UGME. Details are provided on learning environment, frequency of training, level of learners, resources and skills trained, and instructor roles.

IMPLICATIONS

The results suggest a number of steps that librarians can take to improve information skills training including using a longitudinal approach, integrating consumer health resources, and developing robust assessments.

Student peer assessment in evidence-based medicine (EBM) searching skills training: an experiment

BACKGROUND

Student peer assessment (SPA) has been used intermittently in medical education for more than four decades, particularly in connection with skills training. SPA generally has not been rigorously tested, so medical educators have limited evidence about SPA effectiveness.

METHODS

EXPERIMENTAL DESIGN

Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups, and then these assigned groups were randomized further into intervention and control groups. All students received evidence-based medicine (EBM) training. Only the intervention group members received SPA training, practice with assessment rubrics, and then application of anonymous SPA to assignments submitted by other members of the intervention group.

RESULTS

Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group, 45.7 and 43.5, respectively (P = 0.06).

CONCLUSIONS

SPA training and the application of these skills by the intervention group resulted in higher scores on formative tests compared to those in the control group, a difference approaching statistical significance. The extra effort expended by librarians, other personnel, and medical students must be factored into the decision to use SPA in any specific educational context.

IMPLICATIONS

SPA has not been rigorously tested, particularly in medical education. Future, similarly rigorous studies could further validate use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula.

Twelve tips for teachers to encourage student engagement in academic medicine

BACKGROUND

Recruitment of trainees into clinical academic medicine remains an area of concern across the globe, with clinical academics making up a dwindling proportion of the medical workforce. To date, few approaches have emphasised early medical student research involvement as a solution to the decline of the clinician-scientist.

AIM AND METHOD

We identify 12 tips that all medical teachers can adopt to foster medical student participation in research and encourage student engagement with academic aspects of medicine throughout their time as an undergraduate. These recommendations are based on a comprehensive review of the international literature and our personal experience of research-focussed interventions and activities as medical students.

CONCLUSION

Through these 12 tips, we provide a practical framework for enhancing medical student exposure to research at medical school. This has the potential to inspire and maintain student interest in the varied role of the clinical academic and could contribute to reversing the downward trend that has occurred in this field over recent times.