Dancing Between the Purist and the Practical: Teaching Evidence- Based Medicine in the 3rd Year Family Medicine Clerkship

OBJECTIVE: To teach 3rd year medical students in a Family Medicine rotation the concepts and methods required to practice Evidence-Based Medicine and how to search for that evidence. The course was developed with an emphasis on finding resources and included an extensive epidemiological and statistical component. Using student evaluations, the evolution over five years will be explored. METHODS: The didactic and experimental curriculum was developed with a strict interpretation of search strategies and EBM philosophy and rationale. In 1999, the class contained a detailed component on epidemiology and statistical interpretation of the four clinical study categories (etiology, diagnosis, therapy and prognosis). Following each session, student evaluations were solicited and changes were made to the curriculum based on student feedback and follow-up faculty discussion. Today, a more treatment-centered ethics-based curriculum is taught. While Evidence-Based vocabulary and some statistics such as Absolute Risk and Number Needed to Treat and Harm are included, emphasis is now placed on teaching students to look for good evidence and to use these findings within an effective patient interaction. Collected student evaluations from across the five-year time span will be analyzed to demonstrate the evolutionary steps of the curriculum. RESULTS & CONCLUSIONS: “More time for searching!” This is always a top comment on student evaluations. Ways to make this happen are consistently being identified and put into practice. As class time is limited, what is taught and how it is taught has become very selective. One recently incorporated tool is the use of a pre-session WebCT-based orientation. Material is always being added within this format to free up class time for more interactive practice. Two other practical content areas that have recently been introduced into the course are a) talking with patients about relative risk and b) understanding bias in the medical literature. The very simple evaluation form remains a device with which to collect further student feedback. The course will continue to be updated as EBM methodologies and outlooks within the medical community change and grow

Feeling Around in the Dark: Defining the Library’s Role in a Campus-Wide Digitization Project

Objective: Describe the library\u27s leadership on a team with representatives from academic computing and the faculty to develop a database of medical images. The library will (1) add value to the project by offering expertise in methods of organization, indexing, cataloging and project management; (2) develop policies and procedures for participation; and (3) maintain visibility by promoting both the library and its staff. Method:Case study: The library has marketed the idea of an image database for the past four years. In early 2003, the project was funded and a campuswide task force was formed. The library took the lead in project management by holding weekly and monthly meetings, establishing milestones, setting deadlines, and drafting usage policies. The library played an important role by interviewing potential contributors and developing a database and record structure that meets the needs of users. The library also participates in the cataloging of images by designing workflow procedures that allow library staff to check all images for quality control and to assign MeSH terms. Task force members developed a training session on how to search the database and how to contribute images. Results: A campuswide database of over 150 digital assets (and growing) has been created. The weekly and monthly meetings helped to keep project assignments clear and document changes to roles and responsibilities. Setting deadlines and establishing milestones helped to keep the project on schedule and progressing forward. The database structure and record format first developed by the team is meeting the needs of participants, but the library anticipates making adjustments as the database becomes more popular. Having MeSH terms assigned to each digital asset has improved searching for database users. To date, seven faculty members have been trained and are contributing to the database. Conclusions: The library has a valuable role to play in campuswide digital initiatives. Collaborating with information services has allowed both departments to gain a greater appreciation of the skills and resources that each department has to offer and provided the library with greater visibility and new opportunities for outreach and education. Presented at the Medical Library Association Annual Meeting, Washington, DC, May 23, 2004

Challenges and Lessons Learned: Moving From Image Database to Institutional Repository

Purpose– The purpose of this paper is to chronicle the Lamar Soutter Library\u27s effort to build an educational image database, and how the project developed into an institutional repository. Design/methodology/approach– The paper is divided into three phases and highlights the organizational, political, technological and resource issues that are unique to a specialized library with a medium-sized staff, lacking the resources of a traditional university campus. The case concludes with a list of barriers and facilitators to success and a summary of lessons learned. Findings– The paper finds that a library with limited staff, funding, and systems development resources can initiate and support an institutional repository. Facilitators of success include clear lines of authority, a strong champion, and the appropriate technology for the project. Originality/value – This paper serves as an example to libraries that are in the beginning phases of developing an institutional repository by discussing the barriers to and facilitators of success

Capturing Students\u27 International Experiences: eScholarship@UMMS and International Medical Education

Type of engagement and location: eScholarship@UMMS (http://escholarship.umassmed.edu/intmeded/) is an electronic repository sponsored by the Lamar Soutter Library. The Library is collaborating with the Office of Medical Education’s International Medical Education initiative under the direction of Dr. Michael Godkin. Purpose/objective: The purpose of the collaboration is to provide an archive to preserve and promote clinical and language experiences of UMMS students serving in developing countries. Description: The Library is building a database of student trips that includes descriptions of sites and clinical experiences, photos, personal reflections, maps, and advice for future students. Library staff worked with Dr. Godkin to convert paper records into an electronic format and added metadata to enhance searching. Reports are organized by country and year, and are full-text searchable. Conclusion: eScholarship@UMMS offers an efficient and convenient means of promoting student interest in international medical education. More than 50 student trip reports from almost 20 countries have been entered into the database. In just four months the site has already had an impact and generated increased student interest. By archiving these trip reports, eScholarship@UMMS ensures that the information will be available for future UMMS students. Implications: eScholarship@UMMS supports the primary goals of the International Medical Education program: to develop linguistic, cultural and physical diagnosis skills and enable the students to better serve a rapidly expanding immigrant and refugee population in Massachusetts and the United States. Presented at the UMass Global Health Symposium, Shrewsbury, MA, on May 3-4, 2007

Levels Program: A Career Ladder for Support Staff

ObjectiveHow do we manage support staff development in the modern health sciences library? Increasingly, the need for more highly skilled staff is evident. This poster describes a three phase project encompassing the development, approval, and implementation processes necessary to make a career ladder a reality in a medium-sized academic health sciences library. MethodsThe Management Team gathered information from library literature and business and government sources as a starting point. In the development phase, the team posed questions as the foundation for developing a competency-based program to manage support staff development. e.g., What will support staff be doing in the future? Can we define the competencies staff will need? How do we create a flexible system that keeps us poised to respond to change? How do we build a skilled work force and prepare current staff to take on new tasks? How do we develop a measurement framework for objective employee evaluation? In the approval phase, the emphasis was on educating the university’s administration, HR, and the union about the library’s strategic direction and the benefits of the plan to staff. The implementation phase focused on staff buy-in, roll-out timing, and developing training to ensure success for current and future staff. Results and ConclusionsCompetencies, education, and years of service formed the promotion plan’s basis. Managers identified task-based areas of responsibility, divided into achievement stages with frameworks detailed for objective employee evaluation. A policy for advancement, based on performance in multiple areas of responsibility, was developed. The plan allows for growth and promotion, and encourages staff to build a knowledge base across library departments. Throughout the planning process the team met with human resources, the union, and administration to explain program goals, as well as to address their concerns and incorporate their input as we developed the program details, resulting in a smooth approval process. For implementation, one manager assumed responsibility for coordinating orientation and training development. The team was surprised by initial negative staff reaction to increased responsibility and the certification/testing requirements. The team continues to face implementation challenges and issues. Presented at the Medical Library Association Annual Meeting on May 18, 2008, in Chicago, IL

Relationships between leadership behavior and goal attainment in selected academic libraries

The purpose of the study was to investigate the leader behavior of library directors in medium size academic libraries and the influence of the director on selected goal setting activities and goal achievement. Hypotheses were developed to determine if relationships existed between: (1) the leader behavior of library directors as perceived by middle management supervisors and self-perceptions of leader behavior by the director; (2) the middle management perceptions of leader behavior of the directors and the existence of selected goals as perceived by middle --management supervisors; and (3) the middle management perceptions of leader behavior of the directors and the level of goal achievement as perceived by middle management supervisors. The population for the study was identified as medium size academic libraries associated with universities accredited by the North Central Association of Colleges and Secondary Schools. Directors and middle management supervisors in twenty-four universities participated in the study. Participants responded to the Leadership Behavior Description Questionnarie XII and a Selected List of Goal Setting Activities developed for the study. The Hotelling T2 and the Pearson Product-Moment Correlation Coefficient were used to analyze the data.FindingsThe LBDQ-XII mean scores for directors were higher on all subscales than the mean scores for subordinate supervisors.A significant difference was found in leader behavior of directors of academic libraries as perceived by subordinates and self-perceptions by the directors.The subscale of Consideration clearly contributed to the rejection of null Hypothesis I at the .05 level of significance.The subscales of Initiating Structure, Tolerance of Freedom, Production Emphasis, and Predictive Accuracy provided some evidence of a joint contribution to rejection of the hypothesis of no difference. However, the contribution was not great enough for any of the four factors to be independently significant with a critical value derived by application of a conservative Post Hoc t test at the .05 level of significance.Seventy-six percent of all responses for goal existence were circled yes.No correlation was found between middle management perceptions of library director behavior and perceptions about the existence of goals.An average score of 20.832 was observed for goal achievement for all participating libraries. The highest attainable score for achievement on all goals would have been 11.000 and the lowest 55.000.No correlation was found between middle management perceptions of library director behavior and perceptions about the level of goal achievement.Conclusions1. Directors of middle size academic libraries and subordinates do not agree on perceived behavior of library directors on either the Person or the System Dimensions. Library director perceptions are higher on the consideration factor of the People Dimension. Thatrelationships between the director and middle management supervisors as exhibited by trust, respect, and friendship, than are perceived by the middle management supervisors.2. The mean number of yes responses from each respondent indicates a general acceptance of selected goals in middle size academic libraries at the department level is, library directorsperceive stronger social.3. Based on the average response to goal achievement, middle management supervisors generally perceived that the selected goals are being achieved to a moderate degree in middle size academic libraries.4. The LBDQ-XII offers one method of examining the leadership style of an academic library director.Thesis (D. Ed.

The Role of the Institutional Repository in Preserving the Scholarly Record of the University of Massachusetts

The W.E.B. Du Bois Library at UMass Amherst and the Lamar Soutter Library at UMass Worcester are both working to provide faculty with alternative solutions in the rapidly changing nature and practice of scholarship. One example that gives both a showcase for faculty research and an alternative to traditional publishing models is provided by institutional digital repositories

The Role of the Institutional Repository in Preserving the Scholarly Record of the University of Massachusetts

The W.E.B. Du Bois Library at UMass Amherst and the Lamar Soutter Library at UMass Worcester are both working to provide faculty with alternative solutions in the rapidly changing nature and practice of scholarship. One example that gives both a showcase for faculty research and an alternative to traditional publishing models is provided by institutional digital repositories. The first part of the presentation will explore the changing landscape of scholarly publishing such as author’s rights, open access, copyright, preservation of digital scholarly materials, and the creation of digital journals. The repository system has proven to be an effective tool in all of these areas including preserving the scholarly record. The efficiencies of a repository will be described to faculty in the context of giving them more control, visibility and a forum to share their research with colleagues and fellow researchers. The second half will be a demonstration of the institutional digital repository software, showcasing a number of projects from each campus: Department Collections(Amherst)Description: More academic departments are creating scholarly materials online and need a centralized place to store, preserve, and access their journals, projects, databases and other collections. See how the UMass Amherst digital repository is providing a place to showcase this work. Personal Researcher Pages (Amherst)Description: Individual faculty members can easily create their own web pages to showcase their scholarly works, including journal articles, book chapters, supplemental materials in a variety of digital formats, without having to learn html. The library will ensure their long-term preservation and access. Senior Scholars (Worcester)Description: Through the Office of Medical Education, the Senior Scholars program encourages students to take on a research project and submit their findings to a conference. The abstracts from these research projects are being added to the repository to preserve the work and provide the students with a forum to display their work. International Medical Education Program (Worcester)Description: Many of the medical students spend time working abroad as part of their medical education. In order to increase access to their trip reports the Library has added the full text of trip reports, personal reflections, photos and even trip blogs. The students use the collection to search and plan future trips. Presented April 5, 2007 at the Instructional Technology Conference: The Scholarship of Teaching & Learning: Technology & Reflective Practice, University of Massachusetts, April 5, 2007 Sturbridge, MA