Caribbean Medical Caribbean Medical Schools: Library Schools: Library

Services & Literacy Services & Literacy EducationEducation

Caribbean Islands with Caribbean Islands with Medical Schools:Medical Schools:

AntiguaAntigua

ArubaAruba

BonaireBonaire

DominicaDominica

Cayman IslandsCayman Islands

CuracaoCuracao

Grand CaymanGrand Cayman

NevisNevis

SabaSaba

St. EustatiusSt. Eustatius

St. KittsSt. Kitts

St. LuciaSt. Lucia

St. MaartenSt. Maarten

St. VincentSt. Vincent

Why attend a Caribbean Why attend a Caribbean medical school?medical school?

Shortage of openings in the StatesShortage of openings in the States

Accept students with a lower GPA Accept students with a lower GPA and/or MCATand/or MCAT

Non-traditional studentsNon-traditional students

More flexible program starting datesMore flexible program starting dates

Generally less expensiveGenerally less expensive

AUC Student AUC Student Population, 2008Population, 2008::

519 students519 students

58 percent 58 percent malesmales

42 percent 42 percent femalesfemales

69 percent 69 percent AmericansAmericans

31 percent 31 percent were born were born outside of the outside of the United StatesUnited States

AUC AUC FacultyFaculty

25 full-time faculty members25 full-time faculty members

20 visiting faculty members20 visiting faculty members

12 faculty are from the United States12 faculty are from the United States

13 faculty are from outside of the 13 faculty are from outside of the United States (including: Canada, United States (including: Canada, New Zealand, Scotland, Ireland, New Zealand, Scotland, Ireland, Nigeria, Holland, India) Nigeria, Holland, India)

Academic ProgramAcademic Program

5 semesters of basic sciences at 5 semesters of basic sciences at AUC, with rolling enrollmentAUC, with rolling enrollment

20 months of clinical rotations in the 20 months of clinical rotations in the United States (24 hospitals in 10 United States (24 hospitals in 10 states), Ireland (1 site), or England (7 states), Ireland (1 site), or England (7 sites)sites)

Accredited by the ACCM Accredited by the ACCM (Accreditation Commission on (Accreditation Commission on Colleges of Medicine)Colleges of Medicine)

AUC LibraryAUC Library Services Services::433 sq. meters (4,660 sq. feet) quiet study area433 sq. meters (4,660 sq. feet) quiet study area

Open 7 days a week from 8 am to 11 pmOpen 7 days a week from 8 am to 11 pm

5,800 Books, DVDs, & videos5,800 Books, DVDs, & videos

Reserve textbook collectionReserve textbook collection

Access to UpToDateAccess to UpToDate

Research assistance for faculty, students, & Research assistance for faculty, students, & communitycommunity

Approximately 85 journalsApproximately 85 journals

ILL serviceILL service

6 computers w/ internet access & DVD players6 computers w/ internet access & DVD players

Wireless internet access throughout libraryWireless internet access throughout library

Collection & Study RoomCollection & Study Room

Study RoomStudy Room

Library Computer AreaLibrary Computer Area

Computer LabComputer Lab

Literacy EducationLiteracy EducationClassroom instruction is Classroom instruction is offered in the following:offered in the following:

Critiquing general & medical Critiquing general & medical websiteswebsites– Reliability of WikipediaReliability of Wikipedia– Google search tipsGoogle search tips

Formulating the clinical questionFormulating the clinical question

Medical database search techniquesMedical database search techniques

HTTP://WWW.LIB.BERKELEY.EDU/TEACHINGLIB/GUIDES/INTERNET/HTTP://WWW.LIB.BERKELEY.EDU/TEACHINGLIB/GUIDES/INTERNET/EVALUATION_CHECKLIST_2008_SPRING.PDFEVALUATION_CHECKLIST_2008_SPRING.PDF

Evaluating Internet Evaluating Internet WebsitesWebsites::

And remember…And remember…

Medical DatabasesMedical Databases

STAT!RefSTAT!Ref

PubMedPubMed

OVIDOVID

UpToDateUpToDate

MDConsultMDConsult

EBSCOEBSCO

ProquestProquest

MircomedexMircomedex

Web of Web of KnowledgeKnowledge

To help formulate clinical questions, To help formulate clinical questions, a framework called PICO has been a framework called PICO has been

developeddeveloped

PICO stands for:PICO stands for:

– P – Patient, Population, or ProblemP – Patient, Population, or Problem– I – Intervention or IndicatorI – Intervention or Indicator– C – Comparison or ControlC – Comparison or Control– O – Outcome O – Outcome

Example of a Clinical Case:Example of a Clinical Case:

Your patient is a 6 month old child, Your patient is a 6 month old child, newly diagnosed with sickle cell newly diagnosed with sickle cell disease. He is currently taking disease. He is currently taking penicillin daily as a prophylaxis against penicillin daily as a prophylaxis against pneumococcal infections. You suggest pneumococcal infections. You suggest that this might be a long term therapy that this might be a long term therapy for the child. His parents are worried for the child. His parents are worried about possible adverse side effects of about possible adverse side effects of long term use of penicillin, including long term use of penicillin, including developing a resistance to the drug.developing a resistance to the drug.

Search terms to consider:Search terms to consider:

P P sickle cell disease, childsickle cell disease, child

II prophylactic penicillinprophylactic penicillin

CCdoesn’t apply to this questiondoesn’t apply to this question

OOprevention of infectionsprevention of infections

PICO Worksheet and Search Strategy

Name___________________

1. Define your question using PICO by identifying: Problem, Intervention, ComparisonGroup, and Outcomes.

Your question should be used to help establish your search strategy.Patient/Problem________________________________Intervention___________________________________Comparison___________________________________Outcome______________________________________

Write out your question:_________________________________________________________________________________________________________________________________

2. Type of question/problem: Circle one: Therapy/Prevention Diagnosis Etiology Prognosis

3. Type of study (Publication Type) to include in the search: Check all that apply:( )Meta-Analysis ( ) Systematic Review ( ) Randomized Controlled Trial( ) Cohort Study ( ) Case Control Study ( ) Case series or Case Report( ) Editorials, Letters, Opinions ( ) Animal Research ( ) In Vitro/Lab Research

4. List main topics and alternate terms from your PICO question that can be used for your search

List your inclusion criteria –gender, age, year of publication, language.

List irrelevant terms that you may want to exclude in your search.

P PATIENT OR PROBLEM

In a 6 mo female with GERD.

IINVESTIGATION(A CAUSE, A PROGNOSTICFACTOR, A TREATMENT,ETC.)

Will a PPI - lansoprazole

C COMPARISON(IF NECESSARY)

Compared to a H2 blocker - pepcid

OOutcomes1. Consider outcomes notonly relevant to clinicians,but to patients, payers,and healthcareadministrators2. An outcome must bemeasurable3. Don’t forget to includeAEs (Adverse Events) fortherapies.

Decreased GERD symptoms (irritabilityepisodes of emesis) and/or Incidence of Nissen fundoplication

PICO WorksheetThe 4 Elements of a Well-Built Clinical Questions

Use the PICO elements to formulate an answerable clinical question. (E.g. In a 6 month old female with GERD, is using a PPI more effective in reduction of symptoms and incidence of Nissen fundoplications than using an H2 blocker? )

UpToDate is an evidence-based clinical information UpToDate is an evidence-based clinical information databasedatabaseApproximately 3,000 clinicians serve as authorsApproximately 3,000 clinicians serve as authorsExtensive peer review to ensure information is Extensive peer review to ensure information is accurateaccurateReview of over 375 journals, and other resourcesReview of over 375 journals, and other resourcesAvailable anywhere on campus, no password requiredAvailable anywhere on campus, no password required

www.uptodate.com/onlinewww.uptodate.com/online

PubMedPubMed

PubMed provides access to bibliographic information

that includes MEDLINE, OLDMEDLINE and other

medical information

www.ncbi.nlm.nih.gov/pubmed

PubMed/MedlinePubMed/Medlinevia PICO:via PICO:

http://http://pubmedhh.nlm.nih.gov/pubmedhh.nlm.nih.gov/

nlm/picostudy/pico2.htmlnlm/picostudy/pico2.html