Physician use of the curbside consultation to address information needs: report on a collective case study

This study published in the April 2006 issue of the Journal of the Medical Library Association (JMLA) combines CME and librarianship in an interesting way. I have included the recommended guidelines for both participants in the consultation. They pretty much apply to human interaction in general: 

Perley CM. Physician use of the curbside consultation to address information needs: report on a collective case study. J Med Libr Assoc 2006;94:137-144.
 
 Purpose: The author reports key findings from a doctoral dissertation investigating what the curbside consultation is, how and why physicians use it, and what the implications for health sciences library services might be.
 Settings/Informants: Primary informants included sixteen primary care physicians at six sites in one Midwestern state. Additional informants included twenty-eight specialists and subspecialists identified by the primary informants as colleagues who provided curbside consultations.
 Methods: Qualitative research methods were used, including field observations, formal and informal interviews, and conversations with peer review physicians.
 Results: Despite a lack of consensus about what constitutes a "good" curbside consultation, physician informants reported that curbside consultations were part of their medical education and that they continued to take part in them for a number of reasons. Tacit rules govern curbside consultation interactions, and negative consequences result when the rules are misunderstood or not observed.
 Discussion/Conclusion: Acknowledging and understanding physicians' use of the curbside consultation to obtain and construct knowledge may suggest new ways for health sciences librarians to work with physicians in locating, diffusing, and disseminating clinical information.
 PubMed     Free Full Text    JMLA April 2006   
Appendix D.
Guidelines for both participants

• Physician communication is privileged.
• Respect each other's time, expertise, and right to make a living.
• Listen.
• Be friendly in a sincere way.
• Focus on the problem.
• Be concise.
• Stick to essential information.
• Display interest, both verbally and nonverbally.
• Use the conversation as an educational opportunity.

Guidelines for requesting physicians

• Whenever possible, contact people you know and trust—people with whom you have a relationship.
• Ask for help, but be sensitive to the fact that the other person may not want or be able to talk at that time.
• Offer to formally refer the patient, if the person contacted prefers that option.
• Be specific with all the necessary facts.
• Know what you do not know and acknowledge that.
• Speak with confidence.
• Ask a clear, focused question.
• Avoid defensive behavior.
• Do not wait too long to call.
• Be willing to consider new ideas.

Guidelines for consulted physicians

• Avoid the implication that the question asked is stupid.
• Address the question asked.
• Educate in a tactful manner.
• Display interest in the patient.
• Invite physicians from whom you want referrals to contact you for informal consultations as well.
• Provide information that is not only clinically correct but also practical, workable, and appropriate to the requesting physician.

How to identify randomized controlled trials in MEDLINE: ten years on

Glanville JM, Lefebvre C, Miles JN, Camosso-Stefinovic J. How to identify randomized controlled trials in MEDLINE: ten years on. J Med Libr Assoc 2006;94:130-136.
 
 Objective: The researchers sought to assess whether the widely used 1994 Cochrane Highly Sensitive Search Strategy (HSSS) for randomized controlled trials (RCTs) in MEDLINE could be improved in terms of sensitivity, precision, or parsimony.
 Methods: A gold standard of 1,347 RCT records and a comparison group of 2,400 non-trials were randomly selected from MEDLINE. Terms occurring in at least 1% of RCT records were identified. Fifty percent of the RCT and comparison group records were randomly selected, and the ability of the terms to discriminate RCTs from non-trial records was determined using logistic regression. The best performing combinations of terms were tested on the remaining records and in MEDLINE.
 Results: The best discriminating term was "Clinical Trial" (Publication Type). In years where the Cochrane assessment of MEDLINE records had taken place, the strategies identified few additional unindexed records of trials. In years where Cochrane assessment has yet to take place, "Randomized Controlled Trial" (Publication Type) proved highly sensitive and precise. Adding six more search terms identified further, unindexed trials at reasonable levels of precision and with sensitivity almost equal to the Cochrane HSSS.
 Conclusions: Most reports of RCTs in MEDLINE can now be identified easily using "Randomized Controlled Trial" (Publication Type). More sensitive searches can be achieved by a brief strategy, the Centre for Reviews and Dissemination/Cochrane Highly Sensitive Search Strategy (2005 revision).
 PubMed    Free Full Text    JMLA April 2006

An evaluation of a collaborative model for preparing evidence-based medicine teachers

Scherrer CS, Dorsch JL, Weller AC. An evaluation of a collaborative model for preparing evidence-based medicine teachers. J Med Libr Assoc 2006;94:159-165.

Purpose: The authors studied the effectiveness of a train-the-trainer collaboration model between librarians and medical faculty to instruct librarians and health professionals in teaching evidence-based medicine (EBM) principles.
Methods: A telephone survey was administered to graduates of an EBM course who agreed to participate in the study. They were asked if and how they taught EBM on returning to their institutions, if they felt competent to critically appraise an article, if their skill in searching PubMed improved, and if they collaborated with others in teaching EBM.
Results: Most respondents were librarians. The class was successful in that most taught EBM on return to their home institutions. Most initiated collaboration with health professionals. The goals of improving PubMed searching and achieving statistical competency had less success.
Conclusion: This model is effective in preparing librarians to teach EBM. Modeling and encouraging collaboration between librarians and health professionals were successful techniques. Librarians would like more instruction in statistical concepts and less in searching PubMed. Conclusions cannot be made for health professionals because of the low response rate from this group. As evidence-based health care continues to extend to other disciplines, librarians can position themselves to participate fully in the EBM educational process.
PubMed   Free Full Text    JMLA April 2006