1. Using the Literature to Make Decisions

2. 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

3. 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)

4. 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

5. 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

6. 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

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

8. 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)_?

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

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

11. 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

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

13. 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?”

14. 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 resultsBroaden search with OR Results off topicUse limits to choose language preference Results all in “foreign” languages Narrow search with AND Not enough resultsSearch subject field

15. 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.