A Centralized Practice-Based Learning and Improvement Curriculum for Residents and Fellows: A Collaboration of Health Sciences Librarians and Graduate Medical Education Administration
Bradley, Doreen R., Rana, Gurpreet K., Lypson, Monica L., Hamstra, Stanley J., Journal of the Medical Library Association
Health sciences librarians have been involved in the education of medical residents and fellows for many years, traditionally providing orientation to library resources or refreshers on MEDLINE searching [1-4]. With the increased focus on evidence-based medicine (EBM) in residency education, health sciences librarians have found a natural partnership in teaching EBM search skills in the postgraduate curriculum . However, even with EBM opening the door for increased librarian instruction, the level of librarian involvement in residency education varies greatly by institutional or departmental interest, institutional culture, program directors, librarian expertise, and marketing techniques.
In 2002, the Accreditation Council on Graduate Medical Education (ACGME) mandated the use of outcomes assessment in ACGME-accredited programs. One area of particular interest to librarians was the practice-based learning and improvement (PBLI) competency, which included information-searching and -management skills. Specifically, PBLI competencies include "the ability to locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems and to use information technology to optimize learning," as well as other competencies related to lifelong learning . Teaching and evaluating PBLI is challenging for many graduate medical education (GME) programs because it includes competencies in areas many medical school faculty do not possess expertise in and may themselves be in need of skill development [14-18]. In addition, few tools have been developed to measure resident learning in this area [17, 19, 20].
CREATION OF AN INNOVATIVE PARTNERSHIP
Over the past seven years, librarians at the University of Michigan (UM) Health Sciences Libraries (HSL) have had moderate success in partnering with several GME (residency) programs on a department-bydepartment basis. In general, it took several years to establish credibility before these partnerships began to flourish. Despite this integration, most programs remained unaware of how librarians were helping meet the ACGME competencies and could share their expertise. The librarians, too, focused on coordinating instruction in individual departments, with no broadscale approach in instruction.
DEVELOPMENT OF AN INFORMATION SKILLS CURRICULUM
With the goal of increasing collaboration in resident education, two HSL librarians and the assistant and associate deans of GME reviewed the manner in which instructional librarians were participating in GME programs. Through multiple meetings, the librarians and the assistant dean of GME decided to pursue a modular approach to instruction in information skills. A curriculum and evaluation tools were discussed that would allow the GME programs to meet, teach, and eventually evaluate residents in the ACGME competencies, in particular PBLI. This curricular development would also aid in ensuring the sponsoring institution requirements were met. The curriculum was based on prior teaching requests in GME programs, the new PBLI competency requirement, librarian expertise, and faculty input.
Using a team approach that captured each librarian's expertise and created a sense of ownership, the HSL librarians developed the description, content, and learning outcomes for each module. This iterative process led to many constructive discussions of what is taught, how it is taught, and what best promotes lifelong learning among clinicians. This process also allowed the librarians to take a more objective look at instruction, perhaps much more critically than in the past. Through this process, the librarians achieved consensus on each instructional module.
Although the HSL librarians have very different teaching styles and are encouraged to build on their strengths, it was essential that the core content remains consistent and the modular approach to GME instruction facilitate this consistency. …