Using the Literature to Make Decisions

Objectives The student will identify information based questions from a clinical scenario. The student will classify these questions according to the source from which

they may best be answered (i.e. primary sources & secondary sources). The student will construct an answerable question to evaluate a treatment

decision. The student will construct a search strategy in PubMed for locating supporting

evidence. The student will appraise the effectiveness of this search and adjust search

criteria and/or the clinical question when needed to advocate for a treatment option.

The student will analyze and summarize the data found in each resource, identifying supporting and contradictory information.

The student will appraise the strength of the informational resource in making a treatment decision.

The student will recommend a course of treatment based on this literature review

Corresponding ACRL Information Literacy Standards

The information literate student determines the nature and extend of information needed. (I)

The information literate student accesses needed information effectively and efficiently. (II)

The information literate student evaluates information and its sources critically and incorporates selected information into his or her knowledge base. (III)

Phase 1

Class divided into 5 groups, given scenario, asked to submit 10 information based questions

Information sources for each question identified

Entire class reviews list of questions, selects one treatment-related question for further study

Deliverable: List of questions

Librarian Intervention

Librarian introduces PubMed, explores specialized tools, guides group through a query including evaluating results and revising strategy

Handouts PubMed Research Log Results Red Flags

Phase 2 Groups collaborate to do a literature search based on question

generated in phase 1 A ranked list of articles will be generated from the search based

on: Study methodology Impact factor of journal (Core Clinical?) Article impact (citations) Accessibility of article Major subject headings Abstract review Clinical relevance

3 articles will be chosen, submitted for entire class to read Deliverable: Submission of articles

Phase 3

Each group leads class discussion on 3 articles addressing: Study design Population Concordance with clinical scenario

Deliverable: class discussion

Phase 4

Each member of group individually formulates an answer to the treatment based question, supported by literature and discussion.

Deliverable: 1-2 page summary and treatment recommendation.

Example of treatment based question:

In a _(population)_ with _(condition)_ does _(intervention)_accomplish _(expected outcome)_?

Assessment

Phase 1 = 25% Questions clearly written? Questions relate to different aspects of scenario? Target population identified? Condition defined? Intervention defined? Outcome defined?

Assessment

Phase 2 = 25% Logical search criteria Uses MeSH subject headings when appropriate Appropriate limits applied Search results sorted by contribution to answer

Assessment

Phase 3 = 25% Study design and population well defined Effective summary of research results Confidence in study results Assessment of relevance to clincal scenario

Assessment

Phase 4 = 25% Well defined clinical question Findings of literature summarized Well developed treatment plan based on literature

Additional Optional Activities

Using the classroom response system (clickers) the class will be shown a series of questions and asked to identify whether they are answerable questions.

“I need information about sexually transmitted diseases among prostitutes.”

“Should people eat more soy products?”“Is acupuncture effective?”

Additional Optional Activities Use StudyMate (Blackboard plug-in) to create flash

cards to reinforce elements of the clinical question, elements of a good search, responses to insufficient or unsuccessful queries.

Too many results Broaden search with OR

Results off topic Use limits to choose language preference

Results all in “foreign” languages

Narrow search with AND

Not enough results Search subject field

Conclusion

Second assignment: Using an assigned controversial case (i.e. hormone replacement therapy) students will review the literature, create an annotated bibliography in favor of or against a treatment option. In class the two sides will debate the issue using the literature, all students will then make an individual choice.