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Responding to a new generation of proprietary study resources in medical education

O'Hanlon, Robin; Laynor, Gregory
Traditionally, health sciences libraries have supported patrons who are preparing for medical licensure examinations by collecting and making accessible board exam preparation resources, such as question banks and study guides. However, when online board exam preparation resources are not available for licensing, providing equitable access to all library users can be a challenge. In recent years, a new generation of online study resources has emerged. Sites such as SketchyMedical and Picmonic use visual learning mnemonics, while resources such as Quizlet leverage crowd-sourcing to generate study content. While some of the content from these resources is made freely available, these resources are often limited to paid individual subscribers. This new generation of study resources, thus, presents a conundrum for health sciences librarians. On the one hand, these innovative resources offer new insights into how students learn and study, reflecting pedagogical trends in self-directed learning. On the other hand, the proprietary individual subscription-based model of these resources can widen the achievement gap between students who can afford to pay subscription costs and those who cannot. This commentary provides an overview of some of the most popular medical board examination preparation resources that have emerged in recent years. The authors suggest that health sciences librarians collaborate with medical students and educators to better understand and evaluate these resources.
PMCID:6466489
PMID: 31019395
ISSN: 1558-9439
CID: 5266112

Strategies to improve delivery of equitable and evidence-informed care for pregnant and birthing people with a substance use disorder in acute care settings: A scoping review protocol

King, Carla; Laynor, Gregory; McNeely, Jennifer; Fawole, Adetayo; Lee, Matthew; Terplan, Mishka; Choi, Sugy
This protocol outlines a proposed scoping review to characterize evidence on implementation and quality improvement (QI) strategies that aim to improve equitable, evidence-informed care delivery for pregnant and birthing people with substance use disorder (SUD) in acute care. Untreated SUD during pregnancy is associated with an increased risk of overdose and severe maternal morbidity. Acute care settings are one important place to deliver equitable, evidence-informed clinical care. While clinical practice guidelines for substance use treatment and care of pregnant and birthing people with SUD exist, there are gaps in implementation. Our population of interest is pregnant and birthing people with SUD in an acute care setting. We will include US-based studies that describe or evaluate implementation or QI strategies, including experimental, observational, and descriptive studies published from 2016 to 2023. The proposed scoping review will be conducted in accordance with JBI methodology for scoping reviews and registered at OSF (registration number: BC4VZ). We will search MEDLINE (PubMed), CINAHL Complete (EBSCO), Scopus (Elsevier), and APA PsychInfo (Ovid) for published studies. Conference proceedings and Perinatal Quality Collaborative websites will be searched for grey literature. Two reviewers will independently screen then extract studies that meet inclusion criteria using a data extraction tool. The completion of this scoping review will help illuminate strengths and gaps in research and practice that aim to inform substance use treatment and care in acute care settings for pregnant and birthing people with SUD.
PMCID:10947689
PMID: 38498563
ISSN: 1932-6203
CID: 5640152

A Prioritized Patient-Centered Research Agenda to Reduce Disparities in Telehealth Uptake: Results from a National Consensus Conference

Rising, Kristin L.; Kemp, Mackenzie; Leader, Amy E.; Chang, Anna Marie; Monick, Andrew J.; Guth, Amanda; Camacho, Tracy Esteves; Laynor, Gregory; Worster, Brooke
Introduction: We hosted a national consensus conference with a diverse group of stakeholders to develop a patient-centered research agenda focused on reducing disparities in telehealth use. Methods: Attendees were purposively invited to participate in a 2-day virtual conference. The group developed a prioritized research agenda focused on reducing disparities in telehealth uptake, with discussion informed by findings from a scoping review. All work was conducted in partnership with a Steering Committee of national experts in telehealth and patient-centered care (n = 5) and a community-based Telehealth Advisory Board with experience with telehealth use and barriers (n = 8). Results: Sixty individuals participated in the conference and discussion resulted in a final list of 20 questions. Fifty-two attendees voted on the final prioritization of these questions. Results were aggregated for all voters (n = 52) and patient-only voters (n = 8). The top question identified by both groups focused on patient and family perspectives on important barriers to telehealth use. The entire group voting identified telehealth's impact on patient outcomes as the next most important questions, while the patient-only group identified trust-related considerations and cultural factors impacting telehealth use as next priorities. Conclusions: This project involved extensive patient and stakeholder engagement. While voting varied between patients only and the entire group of conference attendees, top identified priorities included patient and family perspectives on important barriers to telehealth, trust and cultural barriers and facilitators to telehealth, and assessment of telehealth's impact on patient outcomes. This research agenda can inform design of future research focused on addressing disparities in telehealth use.
SCOPUS:85182983700
ISSN: 2692-4366
CID: 5630492

Recognizing the value of meta-research and making it easier to find

Stevens, Elizabeth R; Laynor, Gregory
Meta-research is a bourgeoning field studying topics with significant relevance to health sciences librarianship, such as research reproducibility, peer review, and open access. As a discipline that studies research itself and the practices of researchers, meta-research spans disciplines and encompasses a broad spectrum of topics and methods. The breadth of meta-research presents a significant challenge for identifying published meta-research studies. Introducing a subject heading for meta-research in the controlled vocabularies of literature databases has the potential to increase the visibility of meta-research, further advance the field, and expand its impact on research practices. Given the relatively recent designation of meta-research as a field and its expanding use as a term, now is the time to develop appropriate indexing vocabulary. We seek to call attention to the value of meta-research for health sciences librarianship, describe the challenges of identifying meta-research literature with currently available key terms, and highlight the need to establish controlled vocabulary specific to meta-research.
PMCID:10621717
PMID: 37928126
ISSN: 1558-9439
CID: 5635132

Mapping the pathways to health sciences librarianship: reflections and future implications from an immersion session

Laynor, Gregory; Tagge, Natalie; Magro, Juliana; Armond, Megan De; Rau, Renée A; Vardell, Emily
OBJECTIVE/UNASSIGNED:Many health sciences librarians enter the profession without specific health sciences training. Some LIS programs have health sciences courses or tracks, but health sciences training within an LIS program is only one path to entering health sciences librarianship. To develop a map of pathways into health sciences librarianship, an immersion session at the Medical Library Association conference in 2022 asked health sciences librarians to share how they entered the profession. METHODS/UNASSIGNED:The immersion session was structured in three parts: facilitator introductions, small group discussions, and a whole group summary discussion. Guided by questions from the facilitators, small groups discussed what pathways currently exist, how to promote existing pathways, what new pathways should be created, and how to develop and promote pathways that make the profession more equitable, diverse, and inclusive. RESULTS/UNASSIGNED:Through in-the-moment thematic analysis of the small group discussions, the following emerged as key pathways: library school education; internships and practica; the Library and Information Science (LIS) pipeline; on-thejob training; mentoring; self-teaching/hands-on learning; and continuing education. Themes of equity, diversity, and inclusion arose throughout the session, especially in the concluding whole group discussion. CONCLUSION/UNASSIGNED:Small group discussions in a conference immersion session showed the value of community building in a profession that has multiple pathways for entrance, highlighting the importance of unearthing hidden knowledge about avenues for exploring and enhancing career pathways. The article seeks to address barriers to entry into the profession and adds to the literature on strengthening the field of health sciences librarianship.
PMCID:10621722
PMID: 37928122
ISSN: 1558-9439
CID: 5609772

Characteristics of programmes designed to link community-dwelling older adults in high-income countries from community to clinical sectors: a scoping review protocol

Gofine, Miriam; Laynor, Gregory; Schoenthaler, Antoinette
INTRODUCTION:the healthcare sector is nascent. CCLMs implemented for the general adult population are not necessarily accessible to older adults. Given the recency of the CCLM literature and the seeming rarity of CCLM interventions designed for older adults, it is appropriate to employ scoping review methodology in order to generate a comprehensive review of the available information on this topic. This protocol will inform a scoping review that reviews characteristics of community-based programmes that link older adults with the healthcare sector. METHODS AND ANALYSIS:The present protocol was developed as per JBI Evidence Synthesis best practice guidance and reporting items for the development of scoping review protocols. The proposed scoping review will follow Levac and colleagues' update to Arksey and O'Malley's scoping review methodology. Healthcare access at the system and individual levels will be operationalised in data extraction and analysis in accordance with Levesque and colleagues' Conceptual Framework of Access to Health. The protocol complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Beginning in August 2023 or later, citation databases (AgeLine (Ebsco); CINAHL Complete; MEDLINE (PubMed); Scopus Advanced (Elsevier); Social Services Abstracts (ProQuest); Web of Science Core Collection (Clarivate)) and grey literature (Google; American Public Health Association Annual Meeting Conference Proceedings; SIREN Evidence & Resource Library) will be searched. ETHICS AND DISSEMINATION:The authors plan to disseminate their findings in conference proceedings and publication in a peer-reviewed journal and deposit extracted data in the Figshare depository. The study does not require Institutional Review Board approval. REGISTRATION DETAILS:Protocol registered in Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2EF9D).
PMCID:10503318
PMID: 37699628
ISSN: 2044-6055
CID: 5594092

How Ophthalmologists Can Decarbonize Eye Care: A Review of Existing Sustainability Strategies and Steps Ophthalmologists Can Take

Sherry, Brooke; Lee, Samuel; Ramos Cadena, Maria De Los Angeles; Laynor, Gregory; Patel, Sheel R; Simon, Maxine dellaBadia; Romanowski, Eric G; Hochman, Sarah E; Schuman, Joel S; Prescott, Christina; Thiel, Cassandra L
TOPIC/OBJECTIVE:Understanding approaches to sustainability in cataract surgery and their risks and benefits CLINICAL RELEVANCE: In the United States, healthcare is responsible for approximately 8.5% of greenhouse gas (GHG), and cataract surgery is one of the most commonly performed surgical procedures. Ophthalmologists can contribute to reducing GHG emissions, which lead to a steadily increasing list of health concerns ranging from trauma to food instability. METHODS:We conducted a literature review to identify the benefits and risks of sustainability interventions. We then organized these interventions into a decision tree for use by individual surgeons. RESULTS:Identified sustainability interventions fall into the domains of advocacy and education, pharmaceuticals, process, and supplies and waste. Existing literature shows certain interventions may be safe, cost-effective, and environmentally friendly. These include dispensing medications home to patients after surgery, multi-dosing appropriate medications, training staff to properly sort medical waste, reducing the number of supplies used during surgery, and implementing immediate sequential bilateral cataract surgery where clinically appropriate. The literature was lacking on the benefits or risks for some interventions, such as switching specific single use supplies to reusables or implementing a hub-and-spoke style theatre setup. Many of the advocacy and education interventions have inadequate literature specific to ophthalmology but are likely to have minimal risks. CONCLUSIONS:Ophthalmologists can engage in a variety of safe and effective approaches to reduce or eliminate dangerous GHG emissions associated with cataract surgery.
PMID: 36889466
ISSN: 1549-4713
CID: 5432802

Is Machine Learning Changing Evidence-Based Medicine?

Laynor, Gregory
The paradigm of evidence-based medicine has become a fundamental part of health care and health professions education since the 1990s, even as it has drawn criticism. Meanwhile, in the past decade, increased data collection and computational power have brought about advances in machine learning, such as diagnostic algorithms for pattern recognition in medical images. Machine learning has potential to address some of the limitations of evidence-based medicine, but also presents new questions about what counts as evidence in medicine. Critical appraisal of machine learning can become part of the teaching of evidence-based medicine.
SCOPUS:85148660951
ISSN: 1542-4065
CID: 5445762

Are Spaced Repetition Study Tools Changing Health Professions Education?

Laynor, Gregory
Spaced repetition study tools aim to optimize study time and maximize learning retention. An alternative to cramming (and then forgetting) information, spaced repetition reinforces learning by revisiting information over time in optimal intervals. Study tools utilizing spaced repetition algorithms have become widely used among students in many health professions, often forming a parallel curriculum to the official curriculum of textbooks and lectures. Examples of these tools include the open-source flashcard program Anki and the subscription-based visual learning platforms Osmosis and Picmonic. Health professions educators, including health science librarians, can learn from learners how they use spaced repetition study tools and thus potentially adjust teaching strategies and library collections.
SCOPUS:85166919884
ISSN: 1542-4065
CID: 5619462

Continuous glucose monitoring metrics for earlier identification of pre-diabetes: protocol for a systematic review and meta-analysis

Gottfried, Sara; Pontiggia, Laura; Newberg, Andrew; Laynor, Gregory; Monti, Daniel
INTRODUCTION:Glycaemic variability and other metrics are not well characterised in subjects without diabetes. More comprehensive sampling as obtained with continuous glucose monitoring (CGM) may improve diagnostic accuracy of the transition from health to pre-diabetes. Our goal is to investigate the glycaemic system as it shifts from health to pre-disease in adult patients without diabetes using CGM metrics. New insights may offer therapeutic promise for reversing dysglycaemia more successfully with dietary, nutritional and lifestyle change before progression occurs to pre-diabetes and diabetes. METHODS AND ANALYSIS:This systematic review will include comprehensive searches of the PubMed, Scopus, Cochrane Library and ClinicalTrials.gov databases, with restrictions set to studies published in the last 10 years in English and planned search date 10 March 2022. Reference lists of studies that meet eligibility criteria in the screening process will subsequently be screened for the potential inclusion of additional studies. We will include studies that examine CGM use and report diagnostic criteria such as fasting glucose and/or haemoglobin A1c such that we can assess correlation between CGM metrics and established diagnostic criteria and describe how CGM metrics are altered in the transition from health to pre-diabetes. The screening and data extraction will be conducted by two independent reviewers using Covidence. All included papers will also be evaluated for quality and publication bias using Cochrane Collaboration risk of bias tools. If there are two or more studies with quantitative estimates that can be combined, we will conduct a meta-analysis after assessing heterogeneity. ETHICS AND DISSEMINATION:The systematic review methodology does not require formal ethical review due to the nature of the study design. Study findings will be publicly available and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER:CRD42022308222.
PMCID:9422846
PMID: 36008066
ISSN: 2044-6055
CID: 5331762