Afp Presentation 6 8 09

OverviewOverview

Eskind Biomedical Library and Vanderbilt Eskind Biomedical Library and Vanderbilt University Medical CenterUniversity Medical Center

Library Training ProgramLibrary Training ProgramIndependent Study: The American Independent Study: The American

Healthcare SystemHealthcare SystemAdditional Projects/ActivitiesAdditional Projects/ActivitiesConclusion / QuestionsConclusion / Questions

Vanderbilt University Medical CenterVanderbilt University Medical Center

600 beds, 150 to be added in 2009600 beds, 150 to be added in 2009 The only level-I trauma center in middle TennesseThe only level-I trauma center in middle Tennesse Hopsitals:Hopsitals:

Vanderbilt University Adult HospitalVanderbilt University Adult Hospital Monroe Carell Jr. Children’s HospitalMonroe Carell Jr. Children’s Hospital Stallworth Rehabilitation HospitalStallworth Rehabilitation Hospital Vanderbilt Psychiatric HospitalVanderbilt Psychiatric Hospital

Medical SchoolMedical School School of NursingSchool of Nursing

Photos courtesy of www.mc.vanderbilt.edu

Eskind Biomedical LibraryEskind Biomedical Library An information and consultation unit in the Vanderbilt University An information and consultation unit in the Vanderbilt University

Medical Center Informatics Center (IC)Medical Center Informatics Center (IC) 40+ Staff40+ Staff 6,000 electronic resources6,000 electronic resources Home grown Main Digital Library, including 11 user-specific digital Home grown Main Digital Library, including 11 user-specific digital

libraries libraries www.mc.vanderbilt.edu/diglibwww.mc.vanderbilt.edu/diglib

GoLocal Provider GoLocal Provider www.golocalTN.comwww.golocalTN.com

Historical Collection & Archives–an NLM Turning The Pages™ Historical Collection & Archives–an NLM Turning The Pages™ sitesite

www.mc.vanderbilt.edu/sc_diglib/ttp/

Overview:Overview:IC Knowledge Management at EBLIC Knowledge Management at EBL

Knowledge management: beyond standard library Knowledge management: beyond standard library services services Provides value-added information and resources to Provides value-added information and resources to the the Vanderbilt University Medical CenterVanderbilt University Medical Center

EBL Training ProgramEBL Training Program


Opportunity for entry-level librarians to Opportunity for entry-level librarians to receive first-hand training in information receive first-hand training in information support of evidence-based practicesupport of evidence-based practice

Customized learning plan Customized learning plan • Builds on an individual’s skills to meet EBL and Builds on an individual’s skills to meet EBL and

individual skill development goalsindividual skill development goals

First-hand training:First-hand training:• Live questions Live questions • Shadowing clinical Shadowing clinical librarians on roundslibrarians on rounds

• Assisting with digital resource projectsAssisting with digital resource projects


EBL Training ProgramEBL Training ProgramFormal curriculum units, covering 50+ topicsFormal curriculum units, covering 50+ topicsDraws on:Draws on:

Library expertise Library expertise University-wide education and training opportunities University-wide education and training opportunities

(lectures, courses, workshops, seminars, etc.)(lectures, courses, workshops, seminars, etc.)

Guided, self-motivated, adult learning approachGuided, self-motivated, adult learning approachWeb-based tutorial and practical componentsWeb-based tutorial and practical componentsVerification sessions confirm knowledge Verification sessions confirm knowledge

acquisitionacquisitionTraining activities moderated and monitored by Training activities moderated and monitored by

training staff training staff Giuse NB, Kafantaris SR, Huber JT, Lynch F, Epelbaum M, Pfeiffer J. Developing a culture of lifelong learning in a library environment. Bull Med Libr Assoc. 1999 Jan;87(1):26-36.

EBL Training ProgramEBL Training ProgramTraining program seeks to guide librarians Training program seeks to guide librarians

to see beyond “Fish is Fish”to see beyond “Fish is Fish”

Images courtesy of www.pbs.org, www.nas.org,and www.blogs.psu.edu

EBL Training ProgramEBL Training ProgramIntroductory UnitsIntroductory Units

Introduction to Internet and Web ResourcesIntroduction to Internet and Web Resources Learn from EBL librarians to develop knowledge of Learn from EBL librarians to develop knowledge of

internet sources of medical information, quality internet sources of medical information, quality evaluationevaluation

Searching in the Health Sciences and ReferenceSearching in the Health Sciences and Reference Focus on broadening familiarity w/ resources Focus on broadening familiarity w/ resources

Clinical Knowledge Base Development: Clinical Knowledge Base Development: Anatomy and Physiology and Medical TerminologyAnatomy and Physiology and Medical Terminology

EBL Training ProgramEBL Training ProgramIntermediate UnitsIntermediate Units

Train-The-TrainerTrain-The-Trainer 6-week course, develops good presentation and teaching 6-week course, develops good presentation and teaching

skillsskills Increased awareness of learning styles and educational Increased awareness of learning styles and educational

stylesstyles Presented a diagnostic test segment of the “Teaching Presented a diagnostic test segment of the “Teaching

Clinical Skills to Medical Librarians” an MLA-sponsored CE Clinical Skills to Medical Librarians” an MLA-sponsored CE event at the University of Maryland HSHSLevent at the University of Maryland HSHSL

Train-The-Trainer: Molecular BiologyTrain-The-Trainer: Molecular Biology 14-week course, introduction to molecular biology and 14-week course, introduction to molecular biology and

related resources related resources Practice presentations with EBL librariansPractice presentations with EBL librarians Goal: Info Hubs and single resource presentation to research Goal: Info Hubs and single resource presentation to research

students this summerstudents this summer

Lyon J, Giuse NB, Williams A, Koonce T, Walden R. A model for training the new bioinformationist. J Med Libr Assoc. 2004 Apr;92(2):188-95.

EBL Training ProgramEBL Training ProgramAdvanced UnitsAdvanced Units

Filtering:Filtering: In-depth training in study design and quality In-depth training in study design and quality

appraisalappraisal Key resources: active clinical questions and Key resources: active clinical questions and

resources of prior questions – CICS databaseresources of prior questions – CICS database Evidence Summary Packet development for Evidence Summary Packet development for

Geriatrics, Trauma, and Emergency Geriatrics, Trauma, and Emergency DepartmentsDepartments

Training opportunity – participated on Training opportunity – participated on AHRQ-funded systematic review groupAHRQ-funded systematic review group

Developed search strategies for systematic Developed search strategies for systematic

evidence retrievalevidence retrieval Evaluated 200 abstracts for quality and Evaluated 200 abstracts for quality and

relevance to systematic inclusion criteriarelevance to systematic inclusion criteria

EBL Training ProgramEBL Training ProgramAdvanced UnitsAdvanced Units

EBL Training ProgramEBL Training ProgramAdditional Learning OpportunitiesAdditional Learning Opportunities

In-house knowledge-development sessionsIn-house knowledge-development sessions

Filtering / Training Sessions (FTC)Filtering / Training Sessions (FTC)Experienced librarians pass on their knowledge of skills for critical Experienced librarians pass on their knowledge of skills for critical appraisal and search designappraisal and search design

Search Talk Search Talk Experienced librarians pass on their knowledge of resources, Experienced librarians pass on their knowledge of resources, searching methodologysearching methodology

Knowledge BuildingKnowledge BuildingIC/EBL-affiliated physician guides basic learning of medical topics to IC/EBL-affiliated physician guides basic learning of medical topics to inform filtering knowledge baseinform filtering knowledge base

EBL Training ProgramEBL Training ProgramAdditional Learning OpportunitiesAdditional Learning Opportunities

Rounding Rounding Vital to understand unique information needs of Vital to understand unique information needs of

cliniciansclinicians Attended rounds with Trauma, MICU, NICU, Attended rounds with Trauma, MICU, NICU,

Emergency Department, GeriatricsEmergency Department, Geriatrics

Key observation goals:Key observation goals:•Unique workflow for each groupUnique workflow for each group•Substantial differences in types Substantial differences in types of information required and of information required and timeframe timeframe •Depth of understanding of Depth of understanding of medicine required to be a quality medicine required to be a quality information provider – lifelong information provider – lifelong learning commitmentlearning commitment


Individualized learn plan topics:Individualized learn plan topics: Acorn (library catalog and related Acorn (library catalog and related

resources)resources) Building and Equipment IssuesBuilding and Equipment Issues Circulation ActivitiesCirculation Activities CoachingCoaching Collection ArrangementCollection Arrangement Document Delivery ServicesDocument Delivery Services Filtering and Evaluating InformationFiltering and Evaluating Information Internet Searching and Medical Internet Searching and Medical

ResourcesResources Library Computing EnvironmentLibrary Computing Environment Library PrivilegesLibrary Privileges Medical TerminologyMedical Terminology

Overview of Reference and Overview of Reference and Research ServicesResearch Services

ReferenceReference Searching in the Health Searching in the Health

SciencesSciences Special Collections OverviewSpecial Collections Overview Technical Services OverviewTechnical Services Overview Train-The-TrainerTrain-The-Trainer Train-The-Trainer: Molecular Train-The-Trainer: Molecular

BiologyBiology Graphic Design Graphic Design Foundations of Bioinformatics Foundations of Bioinformatics

(audit)(audit) Computer Science 101 (audit)Computer Science 101 (audit) Clinical Trials (MPH course)Clinical Trials (MPH course)

Independent Study: Independent Study: The American Healthcare The American Healthcare

SystemSystem

Independent Study: Independent Study: The American Healthcare SystemThe American Healthcare System

Under direction of Dr. Nancy Lorenzi, Under direction of Dr. Nancy Lorenzi, Assistant Vice-Chancellor for Health Affairs and Professor of Biomedical InformaticsAssistant Vice-Chancellor for Health Affairs and Professor of Biomedical Informatics

Curriculum: Curriculum: Readings and discussion of current issues in Readings and discussion of current issues in

healthcare healthcare Opportunities to directly observe an active healthcare Opportunities to directly observe an active healthcare

environmentenvironment Orthopedics wing EMR demo w/ nurse informaticistOrthopedics wing EMR demo w/ nurse informaticist VU Children’s Hospital EMR procedure change rounds VU Children’s Hospital EMR procedure change rounds

w/ nurse informaticistw/ nurse informaticist CPOE use by pharmacists – main hospital demo w/ CPOE use by pharmacists – main hospital demo w/

PharmD. and pharmacy techniciansPharmD. and pharmacy technicians


Goal: Develop core knowledge Goal: Develop core knowledge management system analysis techniques management system analysis techniques through a case studythrough a case study

Focus: Organizational needs for Focus: Organizational needs for successful learning management system successful learning management system implementation and subsequent implementation and subsequent knowledge transferknowledge transfer


Process:Process:

1. Gain understanding of knowledge needs in 1. Gain understanding of knowledge needs in an academic medical center an academic medical center

Interviews with those involved in major Learning Interviews with those involved in major Learning Management System/Knowledge Management Management System/Knowledge Management systemssystems

• Library web teamLibrary web team• Office of Institutional LearningOffice of Institutional Learning

Literature scanLiterature scan

Independent Study: The American Independent Study: The American Healthcare SystemHealthcare System

2.2. Gain an understanding of types of Gain an understanding of types of resources available and barriers to resources available and barriers to facilitating knowledge transmission via facilitating knowledge transmission via case study readingscase study readings

• FinancialFinancial• Human ResourcesHuman Resources• IT infrastructureIT infrastructure• Organizational supportOrganizational support


3. 3. Gain an improved understanding of Learning Gain an improved understanding of Learning Management System capabilities and Management System capabilities and requirementsrequirements

Systematic review of commercially-available and home-Systematic review of commercially-available and home-grown LMSes for grown LMSes for Start-up/infrastructure requirementsStart-up/infrastructure requirements Maintenance requirementsMaintenance requirements CustomizabilityCustomizability Applicability to particular user groups (corporate, academic, etc.)Applicability to particular user groups (corporate, academic, etc.) Suitability for particular types of information (i.e. patient data; Suitability for particular types of information (i.e. patient data;

procedural videos, point-of-care or mobile access, etc.)procedural videos, point-of-care or mobile access, etc.) Aspects of library involvementAspects of library involvement


4.4. Learn to apply familiarity with these factors to analyze Learn to apply familiarity with these factors to analyze the implementation of a LMS in a healthcare contextthe implementation of a LMS in a healthcare context

Case study: Implementation of the Knowledge Case study: Implementation of the Knowledge Map/Learning Portfolio System for Geriatrics Education Map/Learning Portfolio System for Geriatrics Education

and Curricular Support at Vanderbilt University Hospitaland Curricular Support at Vanderbilt University Hospital (Reynolds Foundation Geriatrics Education Grant)(Reynolds Foundation Geriatrics Education Grant)

• How has an advanced level of organizational, How has an advanced level of organizational, technological, and institutional support for an LMS aided or technological, and institutional support for an LMS aided or been a barrier to the development, implementation, and been a barrier to the development, implementation, and maintenance of a LMS?maintenance of a LMS?


Knowledge Map/Learning PortfolioKnowledge Map/Learning Portfolio A home-grown learning and content management system that uses A home-grown learning and content management system that uses

natural language processing tools and information from learner’s clinical natural language processing tools and information from learner’s clinical notes and the medical school curriculum notes and the medical school curriculum

Helps students, residents, fellows, and faculty analyze the Helps students, residents, fellows, and faculty analyze the comprehensiveness of the curriculum and their clinical education and comprehensiveness of the curriculum and their clinical education and identify gaps identify gaps

Independent Study: Independent Study: The American Healthcare SystemThe American Healthcare System Case study process:Case study process:

Interviewed key players in implementation of Knowledge Interviewed key players in implementation of Knowledge Map/Learning Portfolio for geriatrics educationMap/Learning Portfolio for geriatrics education

Currently interviewing the system designers Currently interviewing the system designers

Initial observations:Initial observations: High-level learning management systems require substantial High-level learning management systems require substantial

levels of infrastructure and organizational support uncommon levels of infrastructure and organizational support uncommon at most institutionsat most institutions

Facilitates LMS customizationFacilitates LMS customization Negatively affects the level of transferability of the LMS to Negatively affects the level of transferability of the LMS to

other institutionsother institutions Intermediate-level solutions may be required to advance the Intermediate-level solutions may be required to advance the

fieldfield

Additional Projects/ActivitiesAdditional Projects/Activities

Developed and coded a web page of publishers’ Developed and coded a web page of publishers’ resources for developing countriesresources for developing countries

Audited Java and Introduction to Bioinformatics Audited Java and Introduction to Bioinformatics classesclasses

Development of personal EBM resource and clinical Development of personal EBM resource and clinical knowledge baseknowledge base

Created five new health topics for the Created five new health topics for the MyHealthAtVanderbilt patient/provider portalMyHealthAtVanderbilt patient/provider portal

Additional Projects/ActivitiesAdditional Projects/ActivitiesAttended Informatics and Geriatrics Department Attended Informatics and Geriatrics Department

seminarsseminars

Observed outreach training sessionsObserved outreach training sessions

Taught training sessions to new house staff (end of Taught training sessions to new house staff (end of June)June)

Attended AMIA Annual Symposium and MLA Annual Attended AMIA Annual Symposium and MLA Annual MeetingMeeting

Volunteered at the adult hospital – acute care unitVolunteered at the adult hospital – acute care unit

Closing CommentsClosing CommentsDeeply clinical experienceDeeply clinical experience

Increased awareness of what goes in to Increased awareness of what goes in to providing information in a clinical settingproviding information in a clinical setting

Have the proper tools to always be working Have the proper tools to always be working effectively towards improving patient care effectively towards improving patient care through informationthrough information

Are my eyes bigger than my stomach? Are my eyes bigger than my stomach? PA, NP, MD?PA, NP, MD?

Questions?

Thank you!Thank you!

Joanna L. KarpinskiJoanna L. Karpinski

[email protected]@vanderbilt.edu

Slides: www.slideshare.net/karpinsJLSlides: www.slideshare.net/karpinsJL

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