2014/2015 Instructor Information Instructor Email Office Location & Hours
Course Information Course Description This 16-week course will help 3 rd & 4 th year medical students and residents understand what evidence-based medicine is, how to evaluate biomedical literature for research and clinical use, how to develop a clinical question, and how to integrate EBM into clinical practice. The course will also demonstrate effective ways to stay current with research and clinical guidelines found in the biomedical literature. Upon completion of this course, you will receive a certificate of completion and one (1) CME credit. Course Objectives By the end of the course students should be able to: Explain what evidence-based medicine is and how it can be applied to clinical practice Differentiate between the types of resources available and the hierarchy of research Utilize scientific and biomedical databases in an advanced way Construct a search string, clinical question, and RSS feed Identify mobile applications and web tools that will help them stay current Course Expectations Students are expected to read the assigned readings each week, listen to the podcast lectures and complete assignments on time (see Course Policies, p #). The course is fast-paced, but organized in such a way that readings and quizzes can be completed in the allotted time. All students are expected to participate in the online discussions, and be respectful of their fellow classmates. Lecture attendance is optional, as these will be podcasted and available in the online modules. Weeks 6 (Library appointment) and 13 (Presentation) do require you to be on campus. Course Materials Required Text The required text schedule can be found in the Readings Schedule (page 3). Greenhalgh, T. (2014). How to Read a Paper: The Basics of Evidence-Based Medicine (5 edition.). Chichester, West Sussex: BMJ Books.
University, M. (2014). Users Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3E (3 edition.). New York: McGraw-Hill Professional. Supplemental Readings Supplemental readings will be available through the shared Zotero library (see page 3), and will be located in folders dedicated to each week of the course. The schedule can be found in the Readings Schedule section of the syllabus (page 3). Page 2 Course Schedule Heavy Reading Quiz Week Week Topic Reading/Podcast Assignment/Discussion 1 Course Intro What is EBM? Zotero Week 1 Podcast #1 (15 min) Make Library appt (for week 6) Discussion #1 2 EBM & Controversy EBM Hierarchy of Research Zotero Week 2 Podcast #2 (15 min) Discussion #2 EBM Hierarchy Assignment Quiz 1: What is EBM? (15 pts) 3 Selecting and evaluating resources What makes a good journal? article? Zotero Week 3 Podcast #3 (30 min) CRAAP Test Assignment (opt) Favorite Journal Discussion 4 Biomedical/Scientific Database Overview Getting started with research Zotero Week 4 Podcast #4 (45 min) Discussion #3 (Assigned database) Research Map: Section 1 Quiz 2: Selecting and Evaluating Resources (15 pts) 5 Biomedical/Scientific Database Overview cont Zotero Week 5 Database analysis paper 6 How Librarians Can Help How to Search: Boolean, Advanced Databases Zotero Week 6 Podcast #5 (20 min) Appointment with Librarian Research Map: Section 2-3 Quiz 3: How to Search (15 pts) 7 Developing a Clinical Question Zotero Week 7 Podcast #6 (35 min) Discussion #4 (Assigned case) Search String Assignment 8 How to Read for: Diagnosis Zotero Week 8 Podcast #7 (20 min) Discussion #5 Worksheet #1 9 How to Read for: Therapy and Prognosis Zotero Week 9 Podcast #8 (20 min) Discussion #6 Worksheet #2, Worksheet #3 10 Applying EBM to the Research Process What are YOU interested in researching? Zotero Week 10 Podcast #9 (15 min) Discussion #7 Topic Abstract w/ sources 11 Integrating EBM into Clinical Practice Mobile Apps for EBM Zotero Week 11 Podcast #10 & 11 (15 min, 10 min) Discussion #8 (Assigned case) Mobile Apps Chosen Quiz 4: Developing a Clinical Question (15 pts) 12 Integrating EBM at Point-of-care Zotero Week 12 Podcast #12 (15 min) Discussion #9 (Assigned case) (opt) Favorite Article Discussion 13 Staying Current: RSS, listservs, journal clubs Podcast #13 (10 min) Mobile App Presentation 14 PubMed Can Help!: MY NCBI Podcast #14 (15 min) PubMed Tutorial Overview 15 Review Week NONE Discussion #10 (Reflection) 16 Putting it all Together NONE (opt) Moving Forward Discussion Course Evaluations Due Final Quiz: EBM Essay (40 pts) Page 3 Readings Schedule Highlighted weeks are heavy reading, plan accordingly Week Required Text Readings Supplemental Articles/Sites Zotero Folder* 1 University: Chapters 1-2 Sackett et al; Belsey; PLoS Med Ed Greenhalgh: Chapter 1 Canadian Institute of Health Research Week 1
2 University: Chapter 5 Darlenski et al; Yamey; Harrison; Greenhalgh: Chapter 2 Rahman and Applebaum Week 2
3 University: Chapter 4 du Prel et al; University College London Greenhalgh: Chapter 3-4 Institute of Child Health Library Week 3
10 University: Chapters 18-20.4 Faulkner, A; Thomas, D; Giacomini, M; Paul, R & Clay, A; Sayer, A Week 10
11 University: Chapters 11-11.5 Straus, SE & Sackett, DL; Straus et al; Greenhalgh: Chapter 15 Glasziou et al Week 11 12 University: Chapters 21-22.2 Banzi et al; Bjerre et al; McCord et al; Van Dijk et al Week 12
*The link to the course Zotero folder will be emailed to the classalong with access instructionsa week before the course opens. While supplemental readings are not required, they will greatly enhance class discussions and provide you with valuable insight into the practice of evidence-based medicine. They will also help you complete the final essay, which will require at least five (5) citations.
Page 4 Quizzes and Assignments
Quizzes Quizzes will contain only the information found in the lectures (podcasts) and will be a mixture of 10, multiple-choice, true/false and one short essay question (11 questions total). Each quiz will open at the start of the week it is assigned (Monday) and will remain open until 5 p.m. the following Friday. The one exception is the Final Quiz in week 16, which will open on Monday, but remain open until 11:59 pm the following Sunday. This gives students the week to prepare for the essay (1500 word max.) and the weekend to write the essay. Quizzes will be worth 15 points each. Ten for correct multiple choice and true/false answers, and up to 5 points for the short essay (200 word max.) The quizzes will be available for retake the Saturday after the quiz has closed. Students may use the quizzes to help them study, but the quizzes will no longer be for points. The quizzes will remain open until the end of the course. The final quiz question(s) will be posted at the end of Week 15. There will be four essay questions, and students may choose to write about one. The final essay will be worth 40 points.
Assignments
EBM Hierarchy Assignment (5 pts) Based on the levels of evidence discussed in class, students will find a primary resource that represents each level, and write a short description of each resource found. The assignment should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.
CRAAP Test Assignment (5 pts) Utilizing the CRAAP test, students will evaluate a print resource (can be an electronic periodical) and a web source (blog, trade publication website etc). An example of the CRAAP Test table will be uploaded to the module. The assignment should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.
Research Map (10 pts) Students will complete the research map over the duration of the course. The Map will be due during the Review Week of the course, but students can upload the Map at any point before the Review Week if they feel they have adequately completed the assignment.
Database Analysis Paper (10 pts) Databases will be assigned during Week 4 of the course. Students will write a 2-3 page analysis/usability review on their assigned database. The assignment will be due Saturday at 5:00 pm the following week (Week 5).
Consultation with a Librarian (10 pts) Each student will need to schedule a consultation with one of the biomedical librarians on campus sometime between Weeks 1-6. You CANNOT schedule the consultation after Week 6. You will bring your Research Map with you to the consultation, and fill out a 10-question survey after the consultation.
Page 5 Search String Assignment (5 pts) After your library consultation, students will create a search string in PubMed. The search string should utilize ONE advanced Boolean strategy and TWO filters. The assignment should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.
Worksheets (#1-3) (5 pts ea.) eWorksheets will be assigned during Weeks 8 & 9, and will need to be completed no later than Sunday at 11:59 pm the weeks they are assigned. You can also print the worksheets for use further on in the course and turn in up to THREE for extra credit (1 point each) at the end of the course.
Topic Abstract w/ Sources (10 pts) Students will choose a research topic during their librarian consultation and then develop a research proposal abstract (1 page or less). They will also need to include at least five resources in the form of a bibliography (AMA or APA format). The assignment should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.
Mobile App Presentation (20 points) Students will choose a mobile application from the list provided in the Week 11 module. They will test the app over the next two weeks and create a presentation TO BE GIVEN IN CLASS during Week 13. The presentation should be between 10- 15 minutes in length.
Class Participation and Discussion (10 pts) Students are expected to participate in all required class discussions. There are 10 required discussions, which will open at the beginning of the week they are assigned and be available until Sunday at 11:59 pm of the week they are assigned. There are three optional discussions that students can participate in for extra credit. Discussion 1: Introductions Discussion 2: What is Evidence-based Medicine? Discussion 3: (Assigned database) Database Overview Discussion 4: (Assigned case) Developing a Clinical Question Discussion 5: What is the most difficult aspect of reading for diagnosis? Discussion 6: How can you read for therapy effectively? OR What was difficult about defining prognosis? Discussion 7: Individual Research Discussion Discussion 8: What technologies do you (or would you) use at point-of-care? Discussion 9: How can evidence-based medicine enhance the patient point-of-care experience? Discussion 10: Course Takeaways
Extra Credit (6 pts) There are three optional discussions (Week 3, Week 12, Week 16) that students may choose to participate in for extra credit. These discussions will help students tie the subject matter in the course back to real-life examples. There are also three worksheets (1 pt). Optional Discussion: What journal(s) do you subscribe to? Read often? Are relevant to your field? Optional Discussion: What required reading for this course did you enjoy? Dislike? Optional Discussion: How will you apply what you learned in this course to your practice of medicine?
Page 6 Grades Grading Scale
Policies and Services Grading Policy As indicated in the Academic Catalog, the basic system is an A, B, C, D, F system, where A, designates above-average graduate work; B, average graduate work; C, passing but not average graduate work; D and F, failing graduate work. D and F work does not count toward a degree. The letter P is used in this system only to indicate participation in thesis, dissertation and research enrollments (related to thesis or dissertation), and in the first semester enrollment of a two-semester sequence course. Upon completion of thesis/dissertation or research hours leading to a masters or doctoral degree, the P remains on the final transcript except for the last semester of enrollment. A letter grade (A, B, C, D, or F) is assigned in the last semester of enrollment to characterize the quality of the final product. The I grade is not appropriate for enrollment in thesis, dissertation, or research, and is not accepted. For enrollments other than thesis, dissertation or research, the letter I is used to indicate course work that has been of passing quality, some part of which is, for good reason, unfinished (incomplete). A student who has an I posted for a course must make up the work by the date determined by the instructor, in consultation with the student, which may not exceed one calendar year, or the last day of the term of graduation, whichever comes first. An I not removed according to this rule shall automatically convert to a grade of F or U, or the lapse grade assigned by the course instructor, and shall be indicated on the students record. The grades of S and U may be used to designate satisfactory and unsatisfactory performance, respectively, in continuing education, workshop and institute courses upon the recommendation of the department offering the course. No more than six hours total of graduate courses graded S are permitted to count toward a degree. In courses numbered 800 or above for which specific authorization has been given, the instructor may report a grade of S for students who have satisfactorily attended the course but for whom it has not been possible to evaluate the quality of performance. Once the S grade for a particular course (or a particular faculty members section of a multi-section course) has been recommended by the department and approved by the Office of Graduate Studies, it must be applied to the entire student enrollment in the course or section. This applies to those 800- or 900-level courses eligible for the S grade (or its alternative of F) as well as to Continuing Education, institute, and workshop courses. The Credit/No Credit option is not authorized for graduate students enrollments, including, but not limited to, courses taken to fulfill the research skills requirements, undergraduate deficiencies, etc. Points Grade 106-90 Superior 80-87 High Satisfactory 70-79 Satisfactory <69 Unsatisfactory* *Students who receive a grade of Unsatisfactory will need to complete a quality improvement remediation project under the direction of a faculty advisor. Page 7 All masters and doctoral students must maintain a B average to retain good academic standing. Courses graded less than C may not be counted for graduate credit. Performance is graded Honors, Satisfactory, or Unsatisfactory for the following examinations: 1. The general examination for the masters degree. 2. The general examination for the degree of Specialist in Education. 3. The comprehensive oral examination for the doctorate. 4. The final examination for the doctorate. Students who would like a review of their course grades can contact the course coordinator for the course in question, and the coordinator will begin the appeals process if it is determined that the grade received is insufficient. Grades are not final until a week after the end of the course.
Other Policies KU SoM Absence Policy The School of Medicine attendance policy allows a student to miss up to 2 days of a clerkship - if the time is approved and excused by Dr. Mark Meyer. A student may be given some leeway for brief absences for illness or absences that are due to other medical school activities (e.g. meeting presentations, shelf exam retakes). Absences for personal reasons (skiing holiday, vacations, tennis tournaments, routine doctor appointments, graduations, etc.) will not be granted. Unexcused absences from clinical duties can result in required remediation, and would most likely be adversely reflected in your final grade. If additional time off beyond 2 days is required for extreme circumstances, the clerkship director can work with you to set up time to remediate. No more than 2 days of a 4-week clinical/fourth year experience may be excused. Academic Dishonesty At this University, academic dishonesty is a basis for disciplinary action. Academic dishonesty includes but is not limited to activities such as cheating and plagiarism (presenting as one's own the intellectual or creative accomplishments of another without giving credit to the source or sources.)
The faculty member in whose course or under whose tutelage an act of academic dishonesty occurs has the option of failing the student for the academic hours in question and may refer the case to other academic personnel for further action. The University may impose penalties for academic dishonesty up to and including expulsion from the university.
Counseling Services We provide comprehensive educational support, writing, psychological, and psychiatric services to students, medical residents, and medical fellows as they pursue their professional goals. Our approach to excellence in service is proactive, collaborative, confidential, and respectful. Services are available at Student Counseling & Educational Support Services by calling 913-588-6580 or visiting G116 Student Center.
Disability Services Access to education is one key to opening the doors of mainstream society to people with disabilities. The University of Kansas Medical Center is committed to helping all admitted students reach their academic goals. Academic Accommodations for students with disabilities is a program within the Division of Student Services in coordination with Human Resources and the Student Affairs offices of the Schools of Health Professions, Medicine, and Nursing. Students may contact Connie Hesler, chesler@kumc.edu, or 913-945-7035 to discuss accommodations. The Americans with Disabilities Act (ADA) was enacted in 1990. In general, the ADA requires that people with disabilities have an equal opportunity to benefit from or participate in services. A disability is defined as a physical or mental impairment that substantially limits one or more major life activities and/or bodily functions.