Lane Medical Library

2009

• MLA
• MACY Medical Education
• WGEA

Medical Library Association (May 15-20, 2009)

 Don't go it alone: Librarians collaborating with healthcare practitioners to redesign a clinical portal optimized for use in clinical practice Authors: Lauren Maggio, Ryan Steinberg, Richard Zwies, Chris Stave, Keith Posley, Heidi Heilemann

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Objective:

In 2008, librarians at an academic medical center initiated the redesign of the library's online Clinical Portal, which was designed to provide healthcare professionals quick gateway to clinical information. This study seeks to determine if the librarians efforts to collaborate with a broad range of healthcare practitioners in redesigning this Clinical Portal will translate to an improved portal use.

Methods:

Although heavily used, the Clinical Portal, which had not been significantly updated since 2006, required upgrading to better support Evidence-Based Practice (EBP) and the needs of the Stanford University community. In preparation for redesign, librarians surveyed medical center affiliates to identify key information resources and understand portal usage.

 Point-of-care Nursing Portals: Injecting Library Resources into the Bedside Workflow Authors: Christopher Stave, Information Services Librarian; Richard Zwies, Web Development Specialist, Lane Medical Library, Stanford University Medical Center, Stanford, CA; Debra Updegraff, Clinical Nurse Specialist; Pediatric Intensive Care Unit, Lucille Packard Children's Hospital, Stanford, CA

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Objective:

To develop a sustainable and extensible model for integrating library resources into the nursing workflow at the point of care.

Methods:

In October 2006, a team consisting of a librarian and a pediatric clinical nurse specialist created a focused collection of e-resources customized to the needs of a pediatric intensive care unit's (PICU's) nurses. Because PICU nurses use networked "computers on wheels" (COWS), access to the portal could be made--literally--at the bedside. The nurse specialist worked with the PICU staff to select a set of locally and externally produced point-of-care tools. These tools consisted of calculators, trauma scales, and equipment guides. The librarian subsequently added various library-maintained resources, including e-journals, e-books, databases, coding tools, drug compatibility guides, image databases, and patient education materials. The portal was introduced to clinical managers and to day-shift nursing staff via a series of presentations and one-on-one orientations. In a successful effort to generate interest in portal development among other nursing units, the librarian and nurse specialist gave several presentations showcasing both the portal's high practical value and low production costs. Periodic assessments of the portal were made using web analysis tools. A two-year analysis of usage data is currently underway.

Results:

Overall usage of the PICU portal grew steadily from October 2006 to February 2009. The resources with the highest use tended to be drug related. Some library-sponsored resources (e.g., CINAHL) were significantly less popular. The PICU portal's success has led to an upsurge in requests for portal development from other nursing units.

Conclusion:

The PICU portal is consistently among the most heavily used clinical portals maintained by the library. Soliciting feedback from the nursing staff was a critical factor in selecting resources that nurses would actually use at the bedside. Based on current usage data, some of the library-maintained resources are rarely used, evidence of a poor fit within the quick reference environment of the portal. Nevertheless, the overall utility of the portal--perhaps combined with a natural competitiveness among nursing units--has generated a significant surge in demand for customized, unit-specific clearinghouses of clinical tools.

 Macy Medical Education

Defining the Information Literate Physician Authors: Lauren Maggio MS(LIS), MA, AHIP; Olya Gary; Kristin Fabbro; and Keith Posley MD, MS

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Statement of Problem:

Evidence-Based Practice (EBP) integrates best research evidence, clinical expertise and patient values to guide medical decision making. Information Literacy (IL)a persons capacity to recognize information needs and ability to locate, evaluate, and effectively use information is critical to EBP and to physicians capacity to sustain lifelong learning. Our literature review reveals that medical education does not have a definition of an Information Literate physician nor current IL clinical competencies.

Objectives of Program:

This project seeks to define the Information Literate physician by creating a set of IL Clinical Competencies that can act as a benchmark to guide future curricular development.

Description of Program:

A group of 15 physician-educators from a variety of specialties and levels of practice were surveyed to better understand faculty knowledge, attitudes, and skills in the domain of IL. Survey data helped guide round table discussions with physician educators to draft an IL definition and competencies. To set this data into the larger context of IL, we performed a systematic literature review and examined existing IL competencies from various disciplines. Through an amalgamation of faculty-driven data and reviewed literature, a working draft of the Stanford Information Literacy Clinical Competencies (SILCC) was created. Moving forward, SILCC will be employed as a framework for EBP curricula, self-assessment of EBP skills, and objective assessment of trainees to enable more effective incorporation of IL skills into the practice of EBP.

Findings To Date:

100% of Stanford faculty surveyed agreed that IL was important to support lifelong learning; despite this fact, a working definition of the Information Literate Physician and related competencies has not yet appeared in the biomedical literature. Perhaps related to this fact is that 93% of faculty felt that they did not have the knowledge and skills to teach others in this domain. To bolster physicians abilities to serve as IL role models and teacher the implementation of SILCC and further IL training is needed at all levels of medical education.

Key Lessons Learned:

Physicians need to be able to assess and articulate their strengths and weaknesses in the domain of IL. However, this type of recognition is difficult without formalized competencies or a clear definition of an Information Literate physician. Formulating IL competencies must take into account a variety of literature in conjunction with physician input. SILCC will provide physicians and medical students with the necessary IL framework to achieve these goals.

 Western Group on Educational Affairs (WGEA) (April 18-21, 2009)

The Road Not Traveled: Evidence-Based Practice and Information LiteracyAuthors: Lauren Maggio MS(LIS), MA, AHIP; Kristin Fabbro; and Keith Posley MD, MS

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