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Page 1: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

RESOURCES FOR CLINICAL REASONING EXERCISE

KSOM Psychiatry ClerkshipJuly 2010Emily Brennan, MLIS

Page 2: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Library Webpages

NML homepage → By Subject Psychiatry subject guide

http://norris.usc.libguides.com/psychiatry

Mobile Devices subject guide http://norris.usc.libguides.com/mobiledevices

NML homepage → Students Student Portal

Medicine → Year III-IV → Psychiatry Clerkship

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Page 3: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Formulate Research Question3

Scenario: Patient diagnosed with schizophrenia is being treated with an antipsychotic drug (risperidone). This drug is causing patient to gain weight. You wonder if nutrition therapy would be effective for weight loss.

Research question: Is nutrition therapy effective in reducing weight gain caused by antipsychotics?

Page 4: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Search the Literature4

PubMed MeSH database Tutorials

Web of Science Sort by relevance or times cited Includes meeting abstracts/conference proceedings

PsycINFO

Page 5: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Search Strategies5

PubMed: "Antipsychotic Agents"[Mesh] AND "Weight Gain"[Mesh] AND "Nutrition Therapy"[Mesh]

Web of Knowledge: antipsychotic* AND weight gain AND nutrition therapy Try searching with synonyms and narrower terms

E.g., specific drug names in that drug class

Page 6: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Relevant ArticlesBall MP, Coons VB & Buchanan RW. (2001). A program for treating olanzapine-related weight gain. Psychiatric Services, 52(7), 967-

9. “The patients' weight, body mass index, and psychiatric symptoms were assessed and were compared with those of a matched

comparison group who did not attend the Weight Watchers program. Only the men experienced significant weight loss. No correlation was found between weight loss and exercise or change in psychiatric symptoms. “

Blouin M, Binet M, Bouchard RH, Roy MA, Despres JP & Almeras N. (2009). Improvement of metabolic risk profile under second-generation antipsychotics: a pilot intervention study. Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie, 54(4), 275-9.

“This pilot study suggests that patients under SGAs may benefit from a weight management program and improve their metabolic health, as well as their aerobic fitness.”

Faulkner G, Soundy AA & Lloyd K. (2003). Schizophrenia and weight management: a systematic review of interventions to control

weight. Acta Psychiatrica Scandinavica, 108(5), 324-32. “Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.”

Mauri M, Castrogiovanni S, Simoncini M, Iovieno N, Miniati M, Rossi A, et al. (2006). Effects of an educational intervention on weight gain in patients treated with antipsychotics. Journal of Clinical Psychopharmacology, 26(5), 462-6.

“Educational intervention can be an important tool for the management of weight increase in patients treated with APs.”

O'Keefe CD, Noordsy DL, Liss TB & Weiss H. (2003). Reversal of antipsychotic-associated weight gain. Journal of Clinical Psychiatry, 64(8), 907-12.

“Some patients who gain weight while taking antipsychotic medications are able to stop gaining and lose weight over time, largely through behavioral interventions. Dietary interventions appear promising and should be explored further to prevent and reverse weight gain.”

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Page 7: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Select 5 Best Articles7

1. Applicable to your patient

2. Appraise methodology Simple Method for Evaluating the Clinical Literature

3. Publication type

4. Currency

5. Times cited (Web of Knowledge)

Page 8: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Pyramid of Publication Types8

Page 9: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Annotated Bibliography9

Citation style (e.g. APA)

Annotation Discuss content, usefulness, value of each article

Critical appraisal of methodology

Page 10: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Personal Reflection

Essay exploring your personal and general reflections on your interaction with the patient (PPI)

Thoughtful, convincing, insightful, and exploratory; represents your personal self awareness; reveals self-learning; emphasizes your personal feelings and emotions

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Page 11: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Clinical Reasoning/Reflection Exercise

Download from

MedWeb Psychiatry Clerkship Manual

http://medweb.usc.edu/site/clerkships/psych/general_info_psych.pdf

Year III Student Portal – Psychiatry Clerkship tab

http://www.usc.edu/hsc/nml/portals/students/yr3-4.html

Due by 6th week of clerkship

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Page 12: R ESOURCES FOR C LINICAL R EASONING E XERCISE KSOM Psychiatry Clerkship July 2010 Emily Brennan, MLIS.

Questions?

Make an apt for a personal consultation!

Emily Brennan, MLIS

[email protected]

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