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Jessica Cole, MLIS, AHIPNorthern Arizona University
At Phoenix Biomedical Campus
Library InstructionPhysician Assistant (PA) Program
About the PA ProgramO NAU’s PA program is 24 continuous months.
O Phase I of the curriculum is didactic, with students on campus for the first year.
O Phase II consists of several clinical rotations, with students mostly off- campus.
O Library instruction is integrated into the Evidence-Based Medicine curriculum over multiple sessions throughout the first year and facilitates active learning based on clinical cases.
EBP in PA Curriculum
Evidence-based practice (EBP) instruction is required by PA
program accreditors.
“The curriculum establishes a strong foundation in health information technology and evidence-based medicine and emphasizes the importance of remaining current with the changing nature of clinical practice.”
http://www.arc-pa.org/acc_standards/
PA Curriculum: Library Instruction Needs
NAU PA Graduate Competencies /Outcomes:• Transfer clinical information needs into
answerable clinical questions.• Identify the best available evidence to
answer clinical questions.• Critically evaluate the available clinical
evidence for its validity and usefulness.• Apply the findings of the appraisals to the
specific clinical scenarios/questions.• Demonstrate skills necessary for life-long
learning.
Fall 2012 Lib Inst (PHA 520) Fall 2012 PHA 520 Evidence-Based Practice Graduation Competencies Spring 2013 Lib Inst (PHA 560) Spring 2013 PHA 560Library Session Outcomes Related Course Objectives 5 Basic Steps of EBP Outcomes Library Session Objectives CAT Requirements
Formulate a focused clinical question
Define evidence-based medicine
1) Ask a focused clinical question
Transfer clinical information needs into answerable clinical questions
Where can I find general information to better understand a condition or intervention?
Case presentation/ clinical question
Retrieve abstracts and citations with basic keyword searches in PubMed.
Describe the process of critical appraisal
2) Search the literature for evidence
Identify the best available evidence to answer clinical questions
Which database can I search for complex questions? (foreground questions, i.e. PICO)
Background information, including relevant practice guidelines
Limit search results to specific article types that correspond with levels of evidence.
Formulate a clear clinical question from a practical clinical problem
3) Critically appraise the evidence
Critically evaluate the available clinical evidence for its validity and usefulness Where can I find answers fast?
Search strategy used to retrieve evidence
Manage information sources retrieved from PubMed for future access
Perform an electronic search of the potentially relevant literature
4) Integrate evidence with clinical expertise & patient values to apply in practice
Apply the findings of the appraisals to the specific clinical scenarios/questions
Which library resources are considered “evidence-based?”
Study selection methodology
Build a multi-line PubMed search with Boolean operators using the Advanced Search Builder Select studies to review 5) Evaluate performance
Demonstrate skills necessary for life-long learning
How do I find systematic reviews?
Summary of study/studies with highest level of evidence
Determine whether full text is available through the library
Critically evaluate review scientific evidence
How do I find practice guidelines?
Discussion and conclusions - clinical bottom line
Translate keyword concepts into medical subject headings using the MeSH Database and understand the difference between a keyword vs. a MeSH search
Differentiate between scientific evidence and popular knowledge
Where can I find materials to support my critical appraisal process?
AMA-formatted references
Summarize findings from the articles reviewed
How can RefWorks help me manage references and format papers?
Apply the knowledge gained to for the eventual purpose of improving clinical practice and specific patient outcomes
Curriculum-Integrated Library Instruction
PA Library SessionsYear 1 (Didactic Phase)Fall Semester
O Librarian partners with PHA 520 Foundations faculty to teach:
O Basic PubMedO Advanced
PubMed (Search PICO questions)
O In-class group activities Individual assignments
O Final exam questions at end of semester
Spring SemesterO PHA 560: Clinical
Decision Making O Instruction supports
student development of Critically Appraised Topics (CATs)
O Groups work on multiple CATs throughout semester to address clinical questions
O Faculty, student peers & librarian evaluate group CATs
Classroom: Learning Studios
Display presenter’s monitor or one connected device per table. Great for displaying case-based group work to whole class! https://www.youtube.com/watch?v=pOggHOaYFJ4
Active LearningClinical Case Example
The public has lost confidence in vaccines over time. The mother of an infant less than two months old asks about vaccines being linked to autism. This possibility makes her very nervous, and she wants to
know if there is proof that vaccines can cause autism. Can you ease her
mind?
Case: The public has lost confidence in vaccines over time. The mother of an infant less than two months old asks about vaccines being linked to autism. This possibility makes her very nervous, and she wants to know if there is proof that vaccines can cause autism. Can you ease her mind?
PICO Question to search: In infants, does MMR vaccination increase the prevalence of autism?Group Activity
Online Library Resources for PAsYears 1 & 2
Online content is also available for students:• Search Tutorials• Resource Guides
(Sources for background vs. foreground questions, etc.)
• Evidence-Based Practice Modules
Online
content
Online content
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