• What did you like or dislike about taking an asynchronous online course?
I especially liked that we could work at our own pace and that the submission requirements were very spaced out allowing us time to plan on completing the submission requirements based on our class schedule. I liked that it was accessible anywhere and that it did not require me to be at any one location at any specific time, which improved flexibility around other very demanding courses.
If all the courses were asynchronous, I would miss the face to face interaction with other students and instructors, however since the program is blended – I do believe it is beneficial to have several courses designed in this manner throughout the duration of the program.
• What topic did you learn the most about and what was your favorite topic? What did you like least?
The topic that I learned the most from involved the Information Retrieval for which I investigated CINAHL – as it allowed me a real opportunity to work with that retrieval system and get to know many more of its functions. As a result I’ve actually used this website several times since completing that assignment to complete Papers and the like.
My favorite topic involved security as this is something that I’ve had a substantial amount of experience with involving both hardware and software firewalls, encryption, physical disconnect options and SSL to name a few. I think that a comprehensive understanding of these requirements especially when working in healthcare. I was the administrator of a small healthcare facility which required implementing many of these components to ensure privacy of patient and employee information. I always enjoy reading and learning about advances in these areas and it never fails to amaze me how quickly related technologies advance which really demonstrates the need to be continually updating one’s knowledge base of such topics.
• If you were the instructor, and this being the first course for all DNP and Master students, what would you change about the course?
I think that the course is well designed and the textbook is very easy to read and is a useful tool at a beginner to medium level user (which I would expect most nurses in such a program would be). It is an easy read and actually maintained my interest more than expected.
I think the amount of information provided and delivery format (blended with books, online articles, websites and videos) is very effective as it helped to maintain my interest since it varied for each module. I think that it is important for the instructor to know that the students appreciate this and that the monotony of a text/lecture only delivery method can be quite under-stimulating and that keeping it dynamic, I believe truly enhances my learning experience and actual retention of information.
Sunday, April 4, 2010
Sunday, March 28, 2010
Ethics and AHRQ, accreditation/reimbursement, and regulatory accreditation
With respect to healthcare system information use and design there are numerous links to healthcare data involving nearly every facet within the healthcare arena, some of which includes: accessibility, ambulatory, emergency, healthcare spending, health care disparities, healthcare use, HIV, Hospitalizations by payer and by state. All of these links provide a wealth of knowledge and information specific to those universal topics.
With respect to regulatory and accreditation the entire section under quality and patient safety addresses specific components meeting those compliance requirements. They provide data which was obtained from AHRQ funded reports specific to the usability of Electronic Health Record (EHR) systems. These studies were conducted to identify and promote standards specific to usability and design of such systems. The development of frameworks to evaluated existing system designs was a priority in establishing a baseline for those standards. A focus on User-Interface design was also identified as this is an important factor for integration throughout departments, professions, organizations, reimbursement and regulatory bodies. It is easy to recognize the regulatory emphasis through the use of “government-supported efforts like Practice-Based Research Networks, which are designed to improve the ability to track and evaluate actual HER use through expanded use of captured audit trail data and structured analysis of navigation patterns.” (Ahrq.gov, 2010).
The apparent potential expansiveness of these systems is almost unimaginable and therefore undoubtedly possessing many concerns involving ethics. Confidentiality being one of the central ethical concerns due to the potential limitless accessibility. Despite advances in privacy promotion through policy development, HIPAA, encryption, hardware and software firewalls and the like, there always seems to be a potential weakness or gap in any and all of such preventative measures. Personally, I believe that the benefits outweigh the negatives of such development simply because logic indicates that this has the potential to benefit the greater good with faster, comprehensive, universal access to necessary medical information in an instant. To me, when a critical situation or upcoming event is highly dependent on these factors (timeliness, completeness, and accuracy), the debate is really a non issue. To me the focus needs to be directed towards security.
Medical Informatics is a new up and coming specialization which will likely continue to take on a life of its own as it is molded and shaped through the advent of technology and its subsequent use and misuse. I feel that we as Professional practitioners need to keep abreast of these advancing technologies to promote the best interest of our patients and profession. Unfortunately this will not be an easy task anytime soon due to the rapid technological advances, rapid adoption, opportunistic individuals and apparent policy vacuums that continue to exist.
Fortunately organizations such as the AHRQ will assist with our agenda through continued services such as those identified on the website that involve technology assessment tools, Preventative services and taskforces, practice guidelines as well as grant and funding opportunities among countless other services and information are available to assist in development.
Reference:
AHRQ (2010). http://www.ahrq.gov/
With respect to regulatory and accreditation the entire section under quality and patient safety addresses specific components meeting those compliance requirements. They provide data which was obtained from AHRQ funded reports specific to the usability of Electronic Health Record (EHR) systems. These studies were conducted to identify and promote standards specific to usability and design of such systems. The development of frameworks to evaluated existing system designs was a priority in establishing a baseline for those standards. A focus on User-Interface design was also identified as this is an important factor for integration throughout departments, professions, organizations, reimbursement and regulatory bodies. It is easy to recognize the regulatory emphasis through the use of “government-supported efforts like Practice-Based Research Networks, which are designed to improve the ability to track and evaluate actual HER use through expanded use of captured audit trail data and structured analysis of navigation patterns.” (Ahrq.gov, 2010).
The apparent potential expansiveness of these systems is almost unimaginable and therefore undoubtedly possessing many concerns involving ethics. Confidentiality being one of the central ethical concerns due to the potential limitless accessibility. Despite advances in privacy promotion through policy development, HIPAA, encryption, hardware and software firewalls and the like, there always seems to be a potential weakness or gap in any and all of such preventative measures. Personally, I believe that the benefits outweigh the negatives of such development simply because logic indicates that this has the potential to benefit the greater good with faster, comprehensive, universal access to necessary medical information in an instant. To me, when a critical situation or upcoming event is highly dependent on these factors (timeliness, completeness, and accuracy), the debate is really a non issue. To me the focus needs to be directed towards security.
Medical Informatics is a new up and coming specialization which will likely continue to take on a life of its own as it is molded and shaped through the advent of technology and its subsequent use and misuse. I feel that we as Professional practitioners need to keep abreast of these advancing technologies to promote the best interest of our patients and profession. Unfortunately this will not be an easy task anytime soon due to the rapid technological advances, rapid adoption, opportunistic individuals and apparent policy vacuums that continue to exist.
Fortunately organizations such as the AHRQ will assist with our agenda through continued services such as those identified on the website that involve technology assessment tools, Preventative services and taskforces, practice guidelines as well as grant and funding opportunities among countless other services and information are available to assist in development.
Reference:
AHRQ (2010). http://www.ahrq.gov/
Monday, March 8, 2010
Question 2
2. How does nursing data quality relate to decision support?
I readily recognize that many barriers exist which may limit nurses’ ability to consistently implement knowledge from evidence based practice in the actual setting. Lack of technology and related support systems, lack of administration support, lack of co-worker knowledge and support, knowledge gaps among co workers as a result inconsistencies of educational background and specializations, resistance to technology and subsequent adoption into practice and inaccurate data entry. Therefore to promote data quality it is important to recognize the potential barriers and address each of them to reduce potential negative impact. Employee education specific to data entry and retrieval should be continually provided. Conducting a system check and establishing fail safes to ensure accurate and timely data input is maintained is important. Developing and maintaining data verification practices assists in ensuring data accuracy. The skill of the employees along with the actual data usage is important to consider when determining an organization’s decision support system. Off-the-shelf software may be appropriate for some organizations, however due to the various sub specialties in healthcare , homegrown software often needs to be developed completely or adapted to scalable off-the-shelf versions. Therefore depending on the skill level and needs of the organization will direct the use of particular decision support systems. Nursing data quality and decision support are interdependent on one another in order to achieve the most benefit which results in quality care. An efficient, user friendly, decision support system will complement the provision of quality care and vice versa as with the required input of quality data into the system.
I readily recognize that many barriers exist which may limit nurses’ ability to consistently implement knowledge from evidence based practice in the actual setting. Lack of technology and related support systems, lack of administration support, lack of co-worker knowledge and support, knowledge gaps among co workers as a result inconsistencies of educational background and specializations, resistance to technology and subsequent adoption into practice and inaccurate data entry. Therefore to promote data quality it is important to recognize the potential barriers and address each of them to reduce potential negative impact. Employee education specific to data entry and retrieval should be continually provided. Conducting a system check and establishing fail safes to ensure accurate and timely data input is maintained is important. Developing and maintaining data verification practices assists in ensuring data accuracy. The skill of the employees along with the actual data usage is important to consider when determining an organization’s decision support system. Off-the-shelf software may be appropriate for some organizations, however due to the various sub specialties in healthcare , homegrown software often needs to be developed completely or adapted to scalable off-the-shelf versions. Therefore depending on the skill level and needs of the organization will direct the use of particular decision support systems. Nursing data quality and decision support are interdependent on one another in order to achieve the most benefit which results in quality care. An efficient, user friendly, decision support system will complement the provision of quality care and vice versa as with the required input of quality data into the system.
Sunday, March 7, 2010
Module 4
1. How did the readings influence your perception of your own clinical decision-making? How do we reconcile the value of nursing experience with known heuristics and biases used in human decision making?
The use of heuristics is innate and with this comes innate misperceptions involving judgment and probability. Personally, I do incorporate previous experience of probabilities when making judgments about situations. Understanding the existence of such biases is important if one is to offset their potential erroneous influence as it relates to making clinical decisions. When considering insensitivity to sample size, despite a perceived decent understanding of statistics, I too rationalized what the majority assumed, however after reading on remembered that larger sample sizes are less likely to experience significant deviations from a known average. From this it is apparent that I need to consciously evaluate each individual situation and possibly even conduct some basic research prior to making a decision which could help to reduce the occurrence of such biases. To me, after rationalizing each of the individual topics specific to known heuristics and biases, the correct assumption is always understandable which I attribute to my experience and education, however despite this background, it is easy to see how such mistakes can be made. It is clear why using Evidence Based Practice is so important as its use can obviously reduce the occurrence of making judgment errors if one is closely adhering to the highly supported practices it promotes.
The use of heuristics is innate and with this comes innate misperceptions involving judgment and probability. Personally, I do incorporate previous experience of probabilities when making judgments about situations. Understanding the existence of such biases is important if one is to offset their potential erroneous influence as it relates to making clinical decisions. When considering insensitivity to sample size, despite a perceived decent understanding of statistics, I too rationalized what the majority assumed, however after reading on remembered that larger sample sizes are less likely to experience significant deviations from a known average. From this it is apparent that I need to consciously evaluate each individual situation and possibly even conduct some basic research prior to making a decision which could help to reduce the occurrence of such biases. To me, after rationalizing each of the individual topics specific to known heuristics and biases, the correct assumption is always understandable which I attribute to my experience and education, however despite this background, it is easy to see how such mistakes can be made. It is clear why using Evidence Based Practice is so important as its use can obviously reduce the occurrence of making judgment errors if one is closely adhering to the highly supported practices it promotes.
Sunday, February 21, 2010
Module 3
What strengths were highlighted in the results of your multiple intelligence test?
Intrapersonal, Interpersonal and Body Kinesthetic were the two dominant intelligence types that I scored highest on.
Personal Cognisance and Physical Agility respectively, would probably be my two most notable strengths as they relate to those categories. I also seem to have an enhanced ability to relate to other which I feel has been a beneficial quality to possess while working in healthcare.
How do you interpret these results?
I feel that these result are really quite accurate. I have completed similar tests in the past which have indicated that I score high with respect to EQ (Emotion Quotient / Intelligence) – which this test reaffirmed. I believe the results that indicate I have a high level of self-awareness which is evidenced by my continued drive to change my personal thoughts, beliefs and behaviors. Through the completion of 3 University Degrees and commencing a fourth being that of my DNP, I would say that the focus of my learning has had a tremendous effect on the development of my EQ. Obviously one could never maintain all the information that they have been exposed to, however I feel that pertinent components of every course has helped contribute to the development of a greater understanding of “the big picture.” This is what leads to the development of one’s EQ.
I believe that Body Kinesthetics is also an accurate descriptor since I am and always have been an athlete. I’ve played a number of sports at a highly competitive level. I also continue to lift weights and have over a 2:1 strength to weight ratio for most large muscle exercises. I believe that physical strength enhances one’s mental strength and vice versa. In order to for me to develop a true overall confidence in my abilities, I’ve needed to direct my energies in both Physical and Intellectual activities. I have always been very goal directed and task oriented which supports components of the intelligence type in that the building process is cumulative and that each step leads to the development of the next.
Interpersonal Intelligence type is also a definite quality I possess. I believe that my broad range of personal experiences and occupations allows me a greater ability to relate to a broader range of people. In chronological order I’ve worked in a grocery store, meat cutter, farmer, truck driver, mechanic, welder, tire shop, which were all part of our family business. In healthcare I’ve worked as a Hospital Supervisor, Psych RN, ECT – technician and Supervisor, Program Developer, Utilization management, Staff Development, ICU RN, Director of Nursing and Executive Director / CEO.
What technologies might you incorporate to augment your personal learning based on these results?
Richardson identified that students need to focus on developing their non dominant learning styles instead of relying on styles in which they demonstrate the most strength. This will allow them enhanced ability to adapt during those times in which they are required to utilize non-dominant styles. The two areas in which I scored lower on with regards to the Multiple Intelligence Test were Linguistic Intelligence, Mathematical and Musical.
To increase Linguistic Intelligence – I think that engaging in Distance Education would be one method to increase written interpretation. I think that the high level of reciprocal action involved in this style of technological learning could greatly enhance my learning style as well. The reduced travel time would allow more time for to focus on retention of learned materials.
E-learning may provide an opportunity to enhance analytical skills due to the ability to utilize streaming video, allowing me to pause, rewind and review the material enhancing the ability to mentally process material that requires extra concentration or review in order to assimilate it. I think that this style of learning would be best to promote deficiencies in logical / mathematical as well as musical learning due to the ability to develop an awareness and appreciation through the use of sound.
Intrapersonal, Interpersonal and Body Kinesthetic were the two dominant intelligence types that I scored highest on.
Personal Cognisance and Physical Agility respectively, would probably be my two most notable strengths as they relate to those categories. I also seem to have an enhanced ability to relate to other which I feel has been a beneficial quality to possess while working in healthcare.
How do you interpret these results?
I feel that these result are really quite accurate. I have completed similar tests in the past which have indicated that I score high with respect to EQ (Emotion Quotient / Intelligence) – which this test reaffirmed. I believe the results that indicate I have a high level of self-awareness which is evidenced by my continued drive to change my personal thoughts, beliefs and behaviors. Through the completion of 3 University Degrees and commencing a fourth being that of my DNP, I would say that the focus of my learning has had a tremendous effect on the development of my EQ. Obviously one could never maintain all the information that they have been exposed to, however I feel that pertinent components of every course has helped contribute to the development of a greater understanding of “the big picture.” This is what leads to the development of one’s EQ.
I believe that Body Kinesthetics is also an accurate descriptor since I am and always have been an athlete. I’ve played a number of sports at a highly competitive level. I also continue to lift weights and have over a 2:1 strength to weight ratio for most large muscle exercises. I believe that physical strength enhances one’s mental strength and vice versa. In order to for me to develop a true overall confidence in my abilities, I’ve needed to direct my energies in both Physical and Intellectual activities. I have always been very goal directed and task oriented which supports components of the intelligence type in that the building process is cumulative and that each step leads to the development of the next.
Interpersonal Intelligence type is also a definite quality I possess. I believe that my broad range of personal experiences and occupations allows me a greater ability to relate to a broader range of people. In chronological order I’ve worked in a grocery store, meat cutter, farmer, truck driver, mechanic, welder, tire shop, which were all part of our family business. In healthcare I’ve worked as a Hospital Supervisor, Psych RN, ECT – technician and Supervisor, Program Developer, Utilization management, Staff Development, ICU RN, Director of Nursing and Executive Director / CEO.
What technologies might you incorporate to augment your personal learning based on these results?
Richardson identified that students need to focus on developing their non dominant learning styles instead of relying on styles in which they demonstrate the most strength. This will allow them enhanced ability to adapt during those times in which they are required to utilize non-dominant styles. The two areas in which I scored lower on with regards to the Multiple Intelligence Test were Linguistic Intelligence, Mathematical and Musical.
To increase Linguistic Intelligence – I think that engaging in Distance Education would be one method to increase written interpretation. I think that the high level of reciprocal action involved in this style of technological learning could greatly enhance my learning style as well. The reduced travel time would allow more time for to focus on retention of learned materials.
E-learning may provide an opportunity to enhance analytical skills due to the ability to utilize streaming video, allowing me to pause, rewind and review the material enhancing the ability to mentally process material that requires extra concentration or review in order to assimilate it. I think that this style of learning would be best to promote deficiencies in logical / mathematical as well as musical learning due to the ability to develop an awareness and appreciation through the use of sound.
Wednesday, January 27, 2010
Instructions for Importing to EndNote from PubMed
DOWNLOAD INSTRUCTIONS
1. Go to the PubMed website in your web browser. The address is http://www.ncbi.nlm.nih.gov/entrez.
2. Execute your searches to obtain search results (Select "Clipboard" from the "Send to" drop down in the PubMed navigation bar to save records from multiple searches as you work).
3. On the search results page, select "MEDLINE" in the Display dropdown menu in the PubMed navigation bar, which is set to Summary by default.
4. Choose "File" from the "Send to" drop down menu in the PubMed navigation bar. This should bring up a dialog box allowing you to save the text file containing your selected references.
Note: If you use File > Save from your browser, instead of the Send To pull down, the file will not import.
If you have a popup blocker enabled, such as the one that comes by default from Windows XP Service Pack 2, you may need to disable the popup blocker temporarily to allow the PubMed website to send you the file.
5. When the Save dialog box comes up for you to save the file to your computer, click on the "Save" button and save the file somewhere easily accessible such as your desktop (we recommend saving with the file extension *.txt).
6. In EndNote, open the database where you would like these references saved.
7. Under the File menu select "Import".
8. In the Import Option field, select the Other Filters... option and select this import filter which is called "PubMed (NLM)".
9. In the Import Data File field, select the Choose File... button, and then select your downloaded *.txt file.
10. Click the Import button and your references will be imported.
1. Go to the PubMed website in your web browser. The address is http://www.ncbi.nlm.nih.gov/entrez.
2. Execute your searches to obtain search results (Select "Clipboard" from the "Send to" drop down in the PubMed navigation bar to save records from multiple searches as you work).
3. On the search results page, select "MEDLINE" in the Display dropdown menu in the PubMed navigation bar, which is set to Summary by default.
4. Choose "File" from the "Send to" drop down menu in the PubMed navigation bar. This should bring up a dialog box allowing you to save the text file containing your selected references.
Note: If you use File > Save from your browser, instead of the Send To pull down, the file will not import.
If you have a popup blocker enabled, such as the one that comes by default from Windows XP Service Pack 2, you may need to disable the popup blocker temporarily to allow the PubMed website to send you the file.
5. When the Save dialog box comes up for you to save the file to your computer, click on the "Save" button and save the file somewhere easily accessible such as your desktop (we recommend saving with the file extension *.txt).
6. In EndNote, open the database where you would like these references saved.
7. Under the File menu select "Import".
8. In the Import Option field, select the Other Filters... option and select this import filter which is called "PubMed (NLM)".
9. In the Import Data File field, select the Choose File... button, and then select your downloaded *.txt file.
10. Click the Import button and your references will be imported.
Information Retrieval
In this module, use your blog to reflect on the following questions:
1. Describe your clinical problem and choice of electronic index. How did the index facilitate (or impede) your ability to construct an efficient search? How time consuming was your search? Would there be barriers to using the index in daily practice?
I chose a clinical treatment problem that I am currently working on in another class, being that of gastoresophageal reflux disease, since this will enable me to supplement my paper with additional references. Normally, I'd make it easy on myself and use an electronic index that I'm a little more familiar with being that of CINAHL, but this was an opportunity to expand my horizons so I chose to give PubMed a try. After watching both PubMed tutorials, I felt pretty comfortable using the search application. I found it relatively easy to use and providing you know what Boolean operators are and how to use them, it is easy to find a tremendous amount of information on the topic I was searching. The search itself was not very time consuming, however when it came to importing it to my EndNote program that was a totally different story. I've used CINAHL before which saves your searches and e-mails them to your account where you can simply upload them to EndNote. For some reason PubMed didn't seem to want to do this quite as easily, which resulted in taking over an hour to finally get it to work. Without having this process pre-estabilished this could easily become a barrier if you were under tight time constraints. Other than having to create an account to utilize all the options I really don't see any other serious time consuming aspect to the process. The indes itself is similar to CINAHL, allowing you to precisely search by authors, article code, publication dates, and of course specific key words or phrases. I will be sure to attach the "Import" process in my blog for anyone else who is having problems with that process as well.
2. What features in your chosen reference management software can be used to sort, classify, and otherwise organize references? Describe software functionality that allows you to better organize and share information for efficient retrieval and use.
Endnote allows you to create several bibliographies in one Word document as well as allowing you to specify the end of chapters or end of document. I created and labelled additional libraries by adding them on the left tab bar. It allows you to easily highlight and transfer references from one file to another. I can organize my references by author, year, Journal or reference type to name the main methods. You can also organize references by the type of search engine used. It also enables the ability to link to full text articles.
This bibliography and management maker allows the user to format citations, figures and tables right into Word with the “Cite While Your Write” feature.
It allows me to format, retrieve, import and export more than ten references from a remote database.
I am able to e-mail directly to this program, which also allows me to organize and store my full text files. I can also organize figures, including charts, tables pictures and equations. (Endnote.com, 2010).
When your logged in you have several features at the top of the screen after conducting your search you simply hit “Save Search” then hit “Save” You can then receive e-mail updates of specific to your searches you’ve saved and can even select how often you want them e-mailed to whatever e-mail you specify. You can also go in and change under the “settings” option any of these options. The “Last Searched” option shows how many days ago the search was conducted. To review any of the saved searches you just pick one and click on it. Using this same screen you can modify and delete any searches as well. RSS (Really Simple Syndication) can be used to e-mail new results to anyone using the RSS feed readers. I have not personally tried this but understand the concept and feel it would be useful if one were conducting a longer term study/research where such an exchange would benefit several participants. So in addition to saving your searches, One can Sort and classify your results by developing a “collection” which has recently been increased from 500 to 5000. You can adjust your filters and links to free text articles from this application page as well.
3 You used an electronic index, a guideline index, and a web search engine to retrieve information relevant to your clinical problem. Compare and contrast your results. Which resources were useful/ not useful for your information retrieval task, and why? Identify some alternative strategies for retrieving relevant information - would context relevant information retrieval be useful? (You must be fairly detailed here, so that your blog entry evidences your use of NGC and google).
NGC Search test
When using the NGC (National Guideline Clearinghouse) search – under the general search using the same search terms (Gastroesophageal Reflux Disease GERD) produced only 31 results. None of the articles were published before 2007. The website did provide a link to full free articles (e.g. for Role of endoscopy in the management of GERD.) Only eleven of the first twenty articles were directly related to the search topic. It would not allow me to view the next eleven results as it repeatedly said an “Error” occurred while processing the request.
After attempting to obtain more specific articles I used the “Detailed Search” and used only minimal “limits” which resulted in zero articles.
Limits used:
Keyword: Gastroesophageal Reflux Disease GERD
Intended Users: Advanced Practice Nurses
Methods Used to Analyze the Evidence: Meta-Analysis of Randomized Controlled Trials
Publication Date(s): 2010, 2009, 2008, 2007
Sort Order: Relevance
Google Search test
The search (Gastroesophageal Reflux Disease GERD) yielded 582,000 results. Despite the large number of results, most of the them consisted of websites containing various related information to the disease. These sites would not be considered appropriate resources for scientific or professional research papers, however can be quite useful to the likely audience they are intended, being that of generally uninformed consumers looking to obtain related information. For my particular purpose the general Google search was not useful.
An alternative to this search and to supplement this test I attempted to conduct the same search in Google Scholar which produced 71,300 results. Google scholar does provide an advanced search option that allows one to search by Author, Publication, Date, Collections and Journals. Upon attempting to look up specific articles I found that most using this search tool only provided abstracts and required registration / payment for most useful articles. I would not use this particular tool if this was found to be the rule rather than the exception.
As evidenced by the quality and quantity of results the electronic index (PubMed) was the most useful tool. It produced the most relevant and subsequently useful information specific to the topic searched. It required the least amount of time to sort through the data, allowing more time to analyze the information provided rather than searching for the articles themselves. I can state with a great deal of certainty, that while I continue to have free access to electronic indexes, I will continue to use them as an initial and preferred method of researching for information. I have determined that the use of such context relevant information retrieval is undoubtedly the most technical and subsequently accurate and useful tool to use for such specific searches. Google appears to be a relatively context insensitive tool when it comes to producing really specific results, which validates my rationale to not rely on it for my professional works.
1. Describe your clinical problem and choice of electronic index. How did the index facilitate (or impede) your ability to construct an efficient search? How time consuming was your search? Would there be barriers to using the index in daily practice?
I chose a clinical treatment problem that I am currently working on in another class, being that of gastoresophageal reflux disease, since this will enable me to supplement my paper with additional references. Normally, I'd make it easy on myself and use an electronic index that I'm a little more familiar with being that of CINAHL, but this was an opportunity to expand my horizons so I chose to give PubMed a try. After watching both PubMed tutorials, I felt pretty comfortable using the search application. I found it relatively easy to use and providing you know what Boolean operators are and how to use them, it is easy to find a tremendous amount of information on the topic I was searching. The search itself was not very time consuming, however when it came to importing it to my EndNote program that was a totally different story. I've used CINAHL before which saves your searches and e-mails them to your account where you can simply upload them to EndNote. For some reason PubMed didn't seem to want to do this quite as easily, which resulted in taking over an hour to finally get it to work. Without having this process pre-estabilished this could easily become a barrier if you were under tight time constraints. Other than having to create an account to utilize all the options I really don't see any other serious time consuming aspect to the process. The indes itself is similar to CINAHL, allowing you to precisely search by authors, article code, publication dates, and of course specific key words or phrases. I will be sure to attach the "Import" process in my blog for anyone else who is having problems with that process as well.
2. What features in your chosen reference management software can be used to sort, classify, and otherwise organize references? Describe software functionality that allows you to better organize and share information for efficient retrieval and use.
Endnote allows you to create several bibliographies in one Word document as well as allowing you to specify the end of chapters or end of document. I created and labelled additional libraries by adding them on the left tab bar. It allows you to easily highlight and transfer references from one file to another. I can organize my references by author, year, Journal or reference type to name the main methods. You can also organize references by the type of search engine used. It also enables the ability to link to full text articles.
This bibliography and management maker allows the user to format citations, figures and tables right into Word with the “Cite While Your Write” feature.
It allows me to format, retrieve, import and export more than ten references from a remote database.
I am able to e-mail directly to this program, which also allows me to organize and store my full text files. I can also organize figures, including charts, tables pictures and equations. (Endnote.com, 2010).
When your logged in you have several features at the top of the screen after conducting your search you simply hit “Save Search” then hit “Save” You can then receive e-mail updates of specific to your searches you’ve saved and can even select how often you want them e-mailed to whatever e-mail you specify. You can also go in and change under the “settings” option any of these options. The “Last Searched” option shows how many days ago the search was conducted. To review any of the saved searches you just pick one and click on it. Using this same screen you can modify and delete any searches as well. RSS (Really Simple Syndication) can be used to e-mail new results to anyone using the RSS feed readers. I have not personally tried this but understand the concept and feel it would be useful if one were conducting a longer term study/research where such an exchange would benefit several participants. So in addition to saving your searches, One can Sort and classify your results by developing a “collection” which has recently been increased from 500 to 5000. You can adjust your filters and links to free text articles from this application page as well.
3 You used an electronic index, a guideline index, and a web search engine to retrieve information relevant to your clinical problem. Compare and contrast your results. Which resources were useful/ not useful for your information retrieval task, and why? Identify some alternative strategies for retrieving relevant information - would context relevant information retrieval be useful? (You must be fairly detailed here, so that your blog entry evidences your use of NGC and google).
NGC Search test
When using the NGC (National Guideline Clearinghouse) search – under the general search using the same search terms (Gastroesophageal Reflux Disease GERD) produced only 31 results. None of the articles were published before 2007. The website did provide a link to full free articles (e.g. for Role of endoscopy in the management of GERD.) Only eleven of the first twenty articles were directly related to the search topic. It would not allow me to view the next eleven results as it repeatedly said an “Error” occurred while processing the request.
After attempting to obtain more specific articles I used the “Detailed Search” and used only minimal “limits” which resulted in zero articles.
Limits used:
Keyword: Gastroesophageal Reflux Disease GERD
Intended Users: Advanced Practice Nurses
Methods Used to Analyze the Evidence: Meta-Analysis of Randomized Controlled Trials
Publication Date(s): 2010, 2009, 2008, 2007
Sort Order: Relevance
Google Search test
The search (Gastroesophageal Reflux Disease GERD) yielded 582,000 results. Despite the large number of results, most of the them consisted of websites containing various related information to the disease. These sites would not be considered appropriate resources for scientific or professional research papers, however can be quite useful to the likely audience they are intended, being that of generally uninformed consumers looking to obtain related information. For my particular purpose the general Google search was not useful.
An alternative to this search and to supplement this test I attempted to conduct the same search in Google Scholar which produced 71,300 results. Google scholar does provide an advanced search option that allows one to search by Author, Publication, Date, Collections and Journals. Upon attempting to look up specific articles I found that most using this search tool only provided abstracts and required registration / payment for most useful articles. I would not use this particular tool if this was found to be the rule rather than the exception.
As evidenced by the quality and quantity of results the electronic index (PubMed) was the most useful tool. It produced the most relevant and subsequently useful information specific to the topic searched. It required the least amount of time to sort through the data, allowing more time to analyze the information provided rather than searching for the articles themselves. I can state with a great deal of certainty, that while I continue to have free access to electronic indexes, I will continue to use them as an initial and preferred method of researching for information. I have determined that the use of such context relevant information retrieval is undoubtedly the most technical and subsequently accurate and useful tool to use for such specific searches. Google appears to be a relatively context insensitive tool when it comes to producing really specific results, which validates my rationale to not rely on it for my professional works.
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