Should undergraduate medical training in a developing country be different?
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A small group case discussion class would seem to be the ideal setting for a virtual library. Two courses at the Albert Einstein College of Medicine were observed. One hour of observation was of groups with no computer available, one hour of groups with a computer available "incidentally", and two hours of groups with computer integrated case material. Across all groups, at least one student was using a reference source (paper or computer) 55% of the time. In a room with no computer, paper references were used 59% of the time. In a room with a computer, references were used 53% of the time (18% computer only, 13% paper only, 22% both). While the amount of data is insufficient for detecting statistically significant difference, this study does provide important baseline data not previously available concerning reference use behavior for electronic and paper sources.
We have used internet-standard tools to provide access for clinicians to the components of the electronic patient record held on multiple remote disparate systems. Through the same interface we have provided access to multiple knowledgebases, some written locally and others published elsewhere. We have developed linkage between these two types of information which removes the need for the user to drill down into each knowledgebase to search for relevant information. This approach may help in the implementation of evidence-based practice. The major problems appear to be semantic rather than technological. The intranet was developed at low cost and is now in routine use. This approach appears to be transferable across systems and organisations.
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Problem-based learning (PBL) is being adopted by U.S. medical schools. Information-seeking skills are central to the PBL curriculum, which emphasizes self-directed learning and the acquisition of problem-solving and lifelong learning skills. The purpose of this study is to begin exploring the relationship between the PBL curriculum and student information and library use. Medical students in PBL and conventional medical school curricula were compared on library and information-seeking competencies, behaviors, and perceptions. A survey was sent to second-year students in four medical schools, two schools with two curricular tracks (one PBL and one conventional), one PBL school, and one conventional school. The results showed certain significant differences (P less than 0.05) between PBL and conventional curriculum students, suggesting that PBL students were the more frequent library users, used information resources that supported the independent learning process, acquired information-seeking skills at an earlier stage in their medical education, and reported greater ease in using these skills.
DXplain, a computer-based medical education, reference and decision support system has been used by thousands of physicians and medical students on stand-alone systems and over communications networks. For the past two years, we have made DXplain available over the Internet in order to provide DXplain's knowledge and analytical capabilities as a resource to other applications within Massachusetts General Hospital (MGH) and at outside institutions. We describe and provide the user experience with two different protocols through which users can access DXplain through the World Wide Web (WWW). The first allows the user to have direct interaction with all the functionality of DXplain where the MGH server controls the interaction and the mode of presentation. In the second mode, the MGH server provides the DXplain functionality as a series of services, which can be called independently by the user application program.
To assist in the identification of key professional resources for neuropsychologists, 214 Australian clinical neuropsychologists were asked to identify "essential" reference materials. Fifty members of the Australian College of Clinical Neuropsychologists returned useable surveys. Forty-three respondents provided information about which clinical neuropsychology books and journals they considered essential and why. Results showed 15 books, including 3 Australian books, and 31 journals were included in the essential reading list of at least 10% of this sample. Compared to similar previous surveys (predominantly conducted overseas and mostly over 10 years ago), the results of this survey suggest that, Australian neuropsychologists have similar views about the top ranking books and journals in clinical neuropsychology as their overseas counterparts. An exception to this general trend may be the status of reference books containing norms, which appear to be growing in perceived importance. Importantly, the results of this survey may be used to help practitioners identify key professional resources in the area of clinical neuropsychology.
As a basis for thoughts on the roles of reference books and computerized information services in general, a comparison is made of the value to medical libraries of a comprehensive reference tool (the new dual media publication Biomedical Research in Progress) and a comprehensive information center file (the Smithsonian Science Information Exchange, the national resource for information on research in progress). It is concluded that a detailed reference tool which is physically present for library users has several advantages, in particular the provision of both detailed and comprehensive retrieval of all biomedical research information at substantially less annual cost and with faster access time than is possible with comparable questions put to an information center. On the other hand, the information center is able to provide more up-to-date material in more flexible combinations. The recommendation is made that medical libraries avoid treating the comprehensive reference tool and the computerized information file as alternatives and instead view both as necessary and complementary to each other.
The Treasury of Human Inheritance represents the most extensive, and one of the earliest series of documentations and analyses of human genetic disorders. Published between 1909 and 1958, from The Galton Laboratory, London, most of the numerous sections were written by Julia Bell, who represents a key figure in the development of human and medical genetics. Her combination of mathematical training, genetic knowledge and clinical expertise yielded numerous important insights into human inheritance first appearing in the Treasury; it remains a valuable scientific as well as an historical record of the genetics of a range of important inherited disorders.
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Ideally, searches for published articles to solve clinical problems should lead to the best evidence on a given topic quickly and at reasonable expense. This goal can be achieved with modern information skills, sources, and services. In this article, we describe and compare various means, from textbooks to computers, that provide access to information of potential value in addressing clinical problems as they arise. Using the problem of understanding and controlling the risk for the acquired immunodeficiency syndrome among personnel of a community hospital, we examined the following sources for their utility in locating journal literature: general and specialty medical texts, personal reprint collections, expert clinicians, recent journal issues, library textbook collections, the Index Medicus "Bibliography of Reviews" and subject index, and MEDLINE computer searching. For this problem, Index Medicus and MEDLINE were the best sources of up-to-date articles, but MEDLINE was three times as fast.
This project provides educational support for students enrolled in a family practice clerkship by supplying PDA-based clinical references and tools to collect information about the patients they see and the seminars they attend. Each student is supplied with a Handspring Visor Deluxe to use during the clerkship. Supplied software includes a clinical reference (Five Minute Clinical Consult) and Lexidrugs drug reference and a medical calculator. The data collection software consists of a patient log for recording simple demographic and diagnostic information about each patient seen during the clerkship, a seminar evaluation module for recording student feedback about each didactic presentation during the course, and an evaluation form where they students supply their reactions to the use of the Visor. Despite encountering a number of problems, the devices appear to be beneficial tools. The applications provide useful references for students who do not have access to the resources of the University in their family medicine clerkship. They also provide an improved, though not perfect, means to capture data regarding patient encounters and course evaluations. However, the challenge remains to better integrate the PDA with the student s workflow in the clinic.
PURPOSE: To justify and at the same time present caveats from one reproductive endocrinologist discussing diagnoses and treatment of various aspects of infertility. METHODS: Sources of basis of knowledge revealed. RESULTS: Sources for chapter writing includes personal experience, publications (predominantly from the author with some additional sources), national and international meetings, reading of various infertility journals and textbooks. CONCLUSIONS: Hopefully, the chapters will be provocative and provide new insights into diagnosis and treatment of infertility. Only areas where the author is most experienced will be discussed. The author promises a non-conventional approach which will lead to lots of controversy.
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During the late nineteenth and early twentieth centuries, it was not unusual for a public library in the United States to include a collection of medical books among its resources. The origin and development of these collections, the growth of the movement, and the factors which contributed to the eventual withdrawal of these collections from the public library are recounted here.