teaching medical students MEDLINE

I tried posting a comment at the Krafty Librarian blog in response to her post on this topic. For some reason, my computer seems to have eaten the comment–perhaps I failed the captcha test or something. Anyway, Michelle wrote,

I thought I would ask what you would do and teach in three one hour classes on how to do Medline. What are things you have learned that work well, that don’t work well? what are some good search questions that illustrate certain aspects of searching Medline? What about mini pre and post test to see how much they have learned?

For one thing, I have to say that only having one hour for MEDLINE instruction is just not much. You can do it if you are working one on one with someone, because then you can tailor it to the person’s needs, but otherwise, it is difficult to teach in less than 1 1/2 hours.

Michelle didn’t state whether she plans to use PubMed or Ovid MEDLINE (or some other version of MEDLINE in her post), but I think that what you choose to teach depends inherently on the platform. For Ovid, you’ve got to talk about MeSH, whereas for PubMed, if you only have an hour, you are better off just looking at various features, like Details, the History, the Clipboard, My NCBI, and etc. Finding full text from either of these databases is pretty critical.

What works well? I find that giving students time to work in pairs or alone on a list of searches works well. Then, I can go around and see when they are having trouble. With a one-hour session, this is probably a no-go. The kinds of questions I have them answer vary on the database, too, but I might have them verify the citation of article comparing the health benefits of shaken versus stirred martinis, find articles on the adverse effects of video games (subheadings–an Ovid search), and find review articles on a particular topic. Since I think her class is for 3rd years (??), I’d also recommend taking a quick look at the EBM tools: Clinical Queries in PubMed and the filters in the Limits in Ovid. One example I always use is the difference between depression and depressive disorder–it can be difficult to figure out which one you are looking for if you don’t know. One of my favorite evil searches is to find information on the effects of sugar substitutes on weight loss–that forces them to think (what are the sugar substitutes?), use OR, and combine searches.

I personally wouldn’t bother with before or after quizzes unless there is a grade or pass/fail component involved. I make my students turn in required homework assignments which I grade on a pass/fail basis. :) It is a good opportunity to learn more about the students you’re working with: who is a perfectionist, who is a slacker, who makes excuses, who is never going to look you in the eye again.

The most important thing, as I think Bob may have pointed out in a comment on one of my earlier posts, is to get the students familiar with your contact information. When I teach first years, in particular, I know full well they will forget everything the minute they finish up my class–but I make sure that they know I am there to help them if they need it.

This year, I will again be using as my MEDLINE training the Mount Sinai Medical School online PubMed tutorial developed by Laura Schimming (forgive me if I misspelled that!). At an excellent presentation at MLA, Laura showed how the self-paced tutorial is just as effective as in-class bibliographic instruction, and in fact, that students prefer it.

List of critical Ovid MEDLINE skills:

  • Knowing what explode and focus are
  • MeSH mapping – scope notes, the tree, not picking more than one at one time from the mapping display are part of that, though less critical
  • subheadings
  • combining searches
  • limiting to English, review articles, by age group
  • saving search results
  • finding full text

Critical PubMed skills

  • Clipboard
  • History
  • Citation view (to find MeSH terms)
  • finding full text
  • Limiting to English, review articles, by age group, etc
  • Using AND
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4 responses to “teaching medical students MEDLINE

  1. All excellent suggestions! I teach a one hour Ovid MEDLINE workshop at our library. We are reworking the curriculum this summer and I think some of your ideas will be most helpful. One of the trickiest things is finding good examples, so I’m going to steal some of yours, if you don’t mind.

    Cheers,
    Martha

  2. Thanks for your thoughtful comments about training medical students. I am given 1 hour to work with third year med students at the beginning of their clinical clerkships. As time is short, I start out in PubMed showing a keyword search results, then move to selecting and applying MeSH headings with a few clinical subheadings and applying standard limits including randomized clinical trials and/or meta analysis. Once they see results from that search, I show them the Clinical Queries feature and state: you can do this ‘by hand’ using MeSH as we just did, or you can use PubMed’s brain to do some EBM filtering for you. I also show them ACP Journal Club, Cochrane Library, BMJ Clinical Evidence as I believe the predigested summaries, written by MDs with many years of clinical experience, is quite valuable to them. They have access to Inforetriever and Lexi-Comp and most put it onto their PDAs, which are required equipment for their 3rd year rotation. Technologically these students are very quick and savvy, and happy to try new gizmos. By the time they get this far through their medical education, they know what they don’t know about finding clinical information and so advice from a librarian is well-timed. I doubt that a first year med student would want to know, or apply, these tools – Harrisons Online and E-Medicine are what they are comfortable using at that point in their education. As each class progresses through 4 years, their information needs and requirements change. It is an interesting progression to be a part of, and witness to. I have added your page to my blogroll on http://creakysites.wordpress.com
    Cheers,
    creaky15

  3. Thanks for the great comments! I find that 1st years have a really wide range of needs–at my institution, anyway, they are very likely to be doing research projects with faculty, so they need to know about doing literature research, etc. For general class work, I see them using books and course materials more than anything else–probably some UpToDate, too. (Sigh.)

  4. I had an interesting question from a first year med student this week. He said he was having trouble finding basic mechanism of action descriptions of how overexposure of UV radiation to skin creates sunburn. (The PBL case is about a genetic skin condition.) My suggestion was to first check Access Medicine which has Harrisons’ Principles of Internal Medicine and also Emergency Medicine. Next, to check the library catalog for basic dermatology texts (such as Fitzpatricks which is online and in the stacks) and then to use one of the available clinical/decision support subscription databases. I checked DynaMed, Up to Date and E-Medicine for this topic. E-Medicine won hands down as the entry for “sunburn” takes you to an excellent paragraph of the mechanism of action for how UV/UVA/UVB exposure to human skin results in sunburn. Up to Date didn’t go into enough detail for the topic. It was a good basic question for those who are migrating from using undergraduate library sources to a complex clinical science setting. The librarians have done such a great job of providing this smorgasbord of online information that perhaps it does appear quite daunting to someone who is required to begin picking the “best” source. They don’t have a great deal of time to investigate 10 or 15 sources in depth. That is why they ask us. The best part about this question is that I got an invite to come in and do a brief demo for the group on Medline. It’s good!
    Creaky15

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