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Objective: To determine if the library resources being utilized most frequently by medical residents correlate to the cost of the resource and the clinical value of the resource. To determine the quality of medical library services provided to residents. Methods: A survey analysis was conducted of 217 medical residents from the 2005/06 East Tennessee State University Quillen College of Medicine class in surgery, family medicine, internal medicine, obstetrics/gynecology, psychiatry, pediatrics, and pathology with a return rate of 48.4%. Quantitative analysis was performed with the SPSS (v. 14.0 for Windows) software program. The results were expressed in percents in graphical or tabular form. The data were analyzed using descriptive statistics (frequencies, mean, median, and mode), and inferential statistics (Mann-Whitney U test and chi-square test.) Results: The most frequently used resources by residents were Google, PubMed, UptoDate, and free web resources. The resources that were rated with the highest clinical value and rated by at least 25% of the respondents were online journals, InfoRetriever, MDConsult, and the Cochrane databases. When clinical value, frequency of use, and cost were combined, the highest ranking resources were Google, free web resources, PubMed, and Up-ToDate. Conclusions: As suspected, medical residents heavily use the web for information. Although online journals are expensive, residents highly rate their clinical value. Medical librarians need to frequently measure the resource use patterns of their different patron groups to plan for training and to make wise purchase decisions.

Objective: To determine what information training needs and behaviors medical residents have such as (1) information training provided by attending physicians, (2) formal evidence-based medicine (EBM) training programs, (3) information training provided by medical librarians, (4) preferred topics for information training, and (5) the desire to have a clinical librarian. Methods: A survey analysis was conducted of 217 medical residents from the 2005/06 class in surgery, family medicine, internal medicine, obstetrics/gynecology, psychiatry, pediatrics, and pathology on their training needs and behaviors with a return rate of 48.4%. Quantitative analysis was performed with the SPSS (v. 14.0 for Windows) software program. The results were expressed in percents in graphical or tabular form. The data were analyzed using descriptive statistics (frequencies, mean, median, and mode) and inferential statistics (Mann-Whitney U test and chi-square test.) Results: Sixty-one percent of residents indicated that they had received clinical information training from their attending physicians. Sixty-four percent of residents indicated they had formal EBM training in their program. Sixty-nine percent indicated they had received clinical information training from medical librarians. The top two training topics desired by residents were an overview of all available library resources and services and instruction on searching databases. Eighty-three percent of residents indicated that they would like a clinical medical librarian (CML) for their program. The Cramer’s V statistic indicated a moderately strong relationship between residency program and desire for a CML. Conclusions: The desire for instruction by residents from librarians is strong. Medical librarians must more aggressively seek to provide instructional opportunities for medical residents. Librarians must periodically survey residents as to the content, time, and place where this instruction takes place so that it might be best utilized by residents.

Question: How effective is East Tennessee State University (ETSU) medical library in preparing its residents to be information masters when they get into private practice? Design: The study was designed as an effectiveness study using survey instruments to determine the informationseeking behaviors, information skill levels, information training adequacy, and sufficiency of information services/resources provided for ETSU resident physicians to prepare them as information masters when they get into private practice. Setting: The population is ETSU residents, who were enrolled in a residency program in the spring of 2006 at an academic medical center. Participants: ETSU has nine residency programs. There were 220 medical residents at ETSU. The whole population was surveyed as well as 150 attending physicians who work with residents. Interventions: Two survey instruments were utilized to discover information that will lead to better user satisfaction with ETSU information training and information resources/services, thus measuring quality. One aspect of this is better understanding the clients’ information-seeking behaviors. Main Outcome Measures: Quantitative analysis was performed with the SPSS software program. The data was analyzed using descriptive statistics. Inferential statistics were used to analyze relationships and differences Results: ETSU residents frequently had information needs yet infrequently sought answers. When they sought an answer they were usually successful. They preferred electronic resources and indicated time was their greatest barrier. The majority were PDA users. They believed evidence-based medicine was very important to their practice and indicated that the information received from the library changed their patient care. Most indicated a desire to have a clinical medical librarian for their program. The most frequently used resources were Google and the Web, yet they indicated these had low clinical value.

Indiana University-Purdue University Indianapolis (IUPUI) / High-fidelity patient simulation (HFPS) recreates clinical scenarios by combining mock patients and realistic environments to prepare learners with practical experience to meet the demands of modern clinical practice while ensuring patient safety. This research investigated the efficacy of HFPS in medical education through a case study of the Indiana University Bloomington Interprofessional Simulation Center. The goal of this research was to understand the role of simulated learning for attaining clinical selfefficacy and how HFPS training impacts performance. Three research questions were addressed to investigate HFPS in medical education using a mixed methods study design. Clinical competence and self-efficacy were quantified among medical students at IUSMBloomington utilizing HFPS compared to two IUSM campuses that did not incorporate this instructional intervention. Clinical competence was measured as performance on the Objective Structured Clinical Examination (OSCE), while self-efficacy of medical students was measured through a validated questionnaire. Although the effect of HFPS on quantitative results was not definitive, general trends allude to the ability of HFPS to recalibrate learners’ perceived and actual performance. Additionally, perceptual data regarding HFPS from both medical students and medical residents was analyzed. Qualitative results discovered the utility of HFPS for obtaining the clinical mental framework of a physician, fundamental psychomotor skills, and essential practice communicating and functioning as a healthcare team during interprofessional education simulations. Continued studies of HFPS are necessary to fully elucidate the value of this instructional adjunct, however positive outcomes of simulated learning on both medical students and medical residents were discovered in this study contributing to the existing HFPS literature.

Objective: To analyze what information skills medical residents have in PDA use, evidence-based medicine (EBM), Loansome Doc use, and off-campus access to databases. Methods: A survey analysis was conducted of 217 medical residents from the 2005/06 East Tennessee State University Quillen College of Medicine class in surgery, family medicine, internal medicine, obstetrics/gynecology, psychiatry, pediatrics, and pathology with a return rate of 48.4%. Quantitative analysis was performed with the SPSS (v. 14.0 for Windows) software program. The results were expressed in percents in graphical or tabular form. The data were analyzed using descriptive statistics (frequencies, mean, median, and mode), and inferential statistics (Mann-Whitney U test and chi-square test.) Results: On a Likert-type scale of 1–7, medical residents rated their PDA skills at a mean of 5.11. By the KruskalWallis Analysis of Variance statistic, there were no signifi - cant differences between residency programs. By use of the Mann-Whitney U Test statistic, it was determined that there was no statistically signifi cant difference between the PDA skills or residents and their attendings. On a Likert-type scale of 1–7, medical residents rated their EBM skills at a mean of 4.82. There was a signifi cant differences between residency programs as determined by the Kruskal-Wallis Analysis of Variance statistic. Residents were infrequent Loansome Doc users, and a disturbing 49.5% did not know how to access medical databases from off-campus. Conclusions: Residents need more training by medical librarians in the clinical information skills of PDA use, EBM, Loansome Doc, and off-campus access.

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The opportunity to educate obese patients on healthy lifestyle practices and address habits related to chronic disease development is present among many physician office visits, though this opportunity is often overlooked (Flocke, Stange, & Goodwin, 1998). Understanding ways to improve the medical education and enhance the counseling skills of future physicians are of practical and personal relevance to current research. By improving the ways in which physicians counsel obese patients on weight management practices, the healthcare paradigm is poised to create an indelible mark on the wellbeing of our nation. Based on the need to address patient education and counseling, the purpose of this study was to investigate the relationship between physician attitudes and health behaviors on their overall communication and communication skills. The study surveyed 38 second-year medical residents at the New York University Bellevue School of Medicine using the Weight Management Survey developed by NYU researchers. Communication and counseling skills were measured using scores from Objective Structured Clinical Exams (OSCEs) administered on the same day as the Weight Management Counseling survey. Results of the survey and the OSCEs were analyzed to investigate relationships between each survey item of three categories of questions (attitudes toward weight management counseling, attitudes toward obese patients, physician health habits) and each of two sets of OSCE scores (obesity-related communication skills and overall counseling skills). Results of the data analysis suggest significant relationships between physicians' personal health habits–specifically dietary habits–and obesity counseling–related communication skills. Results also suggest a significant relationship between physicians' attitudes toward obesity counseling-related communication skills and overall communication skills. Although an extensive body of evidence corroborates these relationships, future investigations should administer the surveys and methods used in this study in rural as well as other urban locations in order to improve variability among medical residents surveyed and assessed. These results also highlight the need to investigate more information about the learning environment of medical residents and also the working environment of physicians, in a variety of settings, in order to provide more depth to the body of literature suggesting providers' health habits improves patient health outcomes. / Ph. D.