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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

Diet in the General United States Asian American Population: A Scoping Review

Chan, Sze Wan Celine; Godbole, Neel; LeCroy, Madison N; Kuang, Katherine M; Cheng, Jessica; Beasley, Jeannette M; Laynor, Gregory; Wang, Vivian Hsing-Chun; Ali, Shahmir H; Yi, Stella S
Asian American populations are underrepresented within dietary programs and nutrition-specific funding. Existing understanding amongst Asian American communities focuses on those with pre-existing health conditions. There is a gap in published literature providing an overview of the food groups Asian American populations without noncommunicable diseases consume. This scoping review aims to provide a comprehensive mapping of the Asian American diet with a focus on food groups in the United States within existing literature. A scoping review was conducted from December 2023 to December 2024. Research databases (PubMed/Medline, CABI Digital Library, CINAHL, Scopus, Web of Science, EBSCO, and ProQuest Dissertations) were searched to identify articles published since 2000 that described food group consumption of Asian American populations. A total of 1486 articles were independently screened by 3 reviewers, leaving 165 articles for inclusion in this review. An additional 15 gray literature sources were separately reviewed for complementary information. Key findings (population and geographical focus, dataset, food group outcome, study limitations, and recommendations) were extracted and summarized in narrative form. Within the literature, Asian American adults and children generally consume more refined grains and less dairy than the standard United States population, though specific patterns vary: South Asians report higher saturated fat and dairy intake, while Chinese, Filipino, and Southeast Asian groups often fall short of recommended fruit and vegetable consumption. Dietary staples also differ by ethnicity, ranging from white rice and noodles in East/Southeast Asian diets to breads and buns among South Asian and Filipino communities. Recommendations for improving diets in Asian American communities emphasize culturally tailored nutrition education that incorporates traditional diets, promotes whole-grain substitutions, and adopts family-focused approaches. Future research efforts in Asian American diet and nutrition should better understand meal-sharing practices and cooking methods. Identifying broad insights in Asian American dietary consumption lays an essential framework for developing recommendations and interventions to address dietary behaviors contributing to diet-related disease burden among the Asian American population. This scoping review is registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/K3X8S).
PMCID:13194642
PMID: 42180656
ISSN: 2475-2991
CID: 6039242

Implementing substance use services into acute care settings for pregnant and birthing people: A systematic scoping review of implementation and quality improvement strategies

King, Carla; Fawole, Adetayo; Laynor, Gregory; McNeely, Jennifer; Terplan, Mishka; Lee, Matthew; Choi, Sugy
Pregnant and birthing people with untreated substance use disorders (SUDs) face multiple risks of mortality and morbidity. Acute care settings (i.e., hospital inpatient, labor/delivery and emergency departments) are one opportunity to provide substance use services, but have had limited implementation. This scoping review synthesized studies that used an implementation science or quality improvement (QI) strategy to implement substance use services into acute care settings for pregnant or birthing people. Our aim was to 1) characterize the implemented strategies; 2) assess the inclusion of racial equity in study design and implementation; 3) summarize measures and outcomes used to evaluate implementation; and 4) identify reported barriers and facilitators to implementation. We searched MEDLINE (PubMed), CINAHL Complete (EBSCO), Scopus (Elsevier), and APA PsycINFO (Ovid) for published studies using keywords and structured vocabulary, and supplemented database searches with a grey literature search of conference proceedings. Two authors independently screened then extracted studies that met eligibility criteria. After removing 661 duplicates, we screened 1101 studies by title and abstract and excluded 1037. Thirty-six were excluded after full text review yielding 28 studies for extraction. Studies were observational (n = 20, 71%), QI (n = 7, 25%), and experimental (n = 1, 4%). Twenty (71%) focused on SUDs broadly; 8 (29%) targeted OUD. Five strategy types were identified: 1) education and learning collaboratives (n = 11, 39%); 2) clinical workflows and pathways (n = 7, 25%); 3) brief interventions (n = 2, 7%); 4) peer support (n = 4, 14%); and 5) structural changes (n = 4, 14%). Five studies (18%) considered racial and ethnic equity in design or implementation. Overall, studies highlight promising strategies to implement substance use services for pregnant and birthing people in acute care settings. However, many strategies were not rigorously evaluated and few considered racial and ethnic equity in design or implementation. Future research should focus on more rigorous evaluations of implementation strategies, measure downstream outcomes such as adoption and sustained use of substance use services, and apply a racial equity lens more explicitly.
PMCID:12987426
PMID: 41824393
ISSN: 1932-6203
CID: 6016082

Education Research: EEG Instruction: Findings from a Scoping Review

Fernandez, Andres; Asoodar, Maryam; Laynor, Gregory; Peedin, Alexis; Ratliff, Jeffrey B; Vaid, Urvashi; Karmarkar, Swati A; Sur, Moushumi; van Kranen-Mastenbroek, Vivianne; Papanagnou, Dimitrios; Majoie, Marian H J M; Balmer, Dorene F; Thammasitboon, Satid
BACKGROUND AND OBJECTIVES/UNASSIGNED:Although EEG interpretation is a key skill in neurology, EEG instruction is variable and its landscape remains underexplored. Thus, we conducted a scoping review to expand the literature by providing a structured mapping of the EEG instruction literature and a foundation for future research in EEG instruction. METHODS/UNASSIGNED:We followed a structured methodological framework for scoping reviews and report the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Research questions explored theoretical frameworks, methodologies, learner populations, instructional methods, and assessment approaches. Eligibility criteria were iteratively modified to focus on studies on EEG instruction. A search strategy was developed by a systematic review librarian including the following databases: Scopus, PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, CENTRAL, and Education Resources Information Center. An initial search was conducted in 2021, with a subsequent updated search to cover studies from 2022 to 2024. Screening was conducted in Covidence using dyads, with discrepancies resolved by a third reviewer. Data extraction categories were developed for the included studies. RESULTS/UNASSIGNED:Thirty-three EEG instruction studies were included in this scoping review. Most studies were published since 2014, were conducted in North America, originated in single institutions, and were published in neurology/neuroscience journals. Almost half of the studies had neurology trainee learner populations, but other specialty trainees were also represented. There was a dearth of theoretical frameworks underpinning the studies, and all studies used quantitative methodologies. Instructional approaches clustered around didactic instruction, online-based instruction, and experiential learning, with several studies using multiple modalities. Assessment approaches clustered around multiple-choice question tests, tests based on EEG samples, and standardized summative tests. Several studies used multiple assessment approaches, but most were lower level (Kirkpatrick level 1 or 2). DISCUSSION/UNASSIGNED:Our scoping review reveals a surge in publications on EEG instruction with a trend toward multimodal instructional approaches, with an assessment focus on knowledge. The findings from this scoping review highlight 3 areas for growth and improvement that future research might address: increase the rigor of research on EEG educational interventions, advance the scope of EEG instruction research, and enhance the precision of EEG instruction.
PMCID:12570072
PMID: 41169758
ISSN: 2771-9979
CID: 5961702

Suicide and Self-Harm Events With GLP-1 Receptor Agonists in Adults With Diabetes or Obesity: A Systematic Review and Meta-Analysis

Ebrahimi, Pouya; Batlle, Juan Carlos; Ayati, Aryan; Maqsood, M Haisum; Long, Clarine; Tarabanis, Constantine; McGowan, Natalie; Liebers, David T; Laynor, Gregory; Hosseini, Kaveh; Heffron, Sean P
IMPORTANCE/UNASSIGNED:Bariatric surgery, once the criterion standard in obesity treatment, has a small but concerning association with increased suicidality. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), originally developed to treat diabetes, now provide substantial efficacy in the treatment of obesity. However, concerns of risk of suicidality with these medicines have been raised. OBJECTIVE/UNASSIGNED:To evaluate the risk of suicidality and self-harm in randomized, placebo-controlled trials of GLP-1 RAs in adults with diabetes or obesity. DATA SOURCES/UNASSIGNED:MEDLINE, Embase, ClinicalTrials.gov, and Cochrane databases were systematically searched from inception to August 29, 2023. STUDY SELECTION/UNASSIGNED:Reports of randomized clinical trials (RCTs) lasting 6 or more months comparing GLP-1 RAs with placebo for the treatment of diabetes or obesity published in peer-reviewed journals were identified. Two independent reviewers screened all search-identified studies for inclusion. Records of outcomes were queried from primary papers, ClinicalTrials.gov entries, and corresponding authors. DATA EXTRACTION AND SYNTHESIS/UNASSIGNED:Two independent researchers abstracted data and assessed data quality and validity using PRISMA guidelines. Data were pooled using random-effects models. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Pooled incidence of completed or attempted suicide, occurrences of suicidal ideation, or self-harm. RESULTS/UNASSIGNED:A total of 27 of 144 RCTs meeting inclusion criteria systematically recorded suicide and/or self-harm-related events and included 32 357 individuals receiving GLP-1 RAs and 27 046 treated with placebo, over 74 740 and 68 095 person-years of follow-up, respectively. Event incidence was very low in the GLP-1 RA (0.044 per 100 person-years) and placebo (0.040 per 100 person-years) groups, with no statistically significant difference (rate ratio [RR], 0.76; 95% CI, 0.48-1.21; P = .24). Subgroup analyses did not suggest differences in outcomes based on diabetes status or GLP-1 RA used. Five studies were considered at risk of bias due to the loss of more than 5% of participants to follow-up. Otherwise, studies were not found to be heterogeneous nor at high risk of bias. CONCLUSIONS AND RELEVANCE/UNASSIGNED:There is unlikely to be an increase in the very low incidence of suicide-related adverse events among individuals receiving GLP-1 RAs within the context of RCTs. While these findings may further ease concerns about these adverse effects, continued monitoring is warranted to identify particular patients who may be at risk as extended use of GLP-1 RAs expands.
PMCID:11923776
PMID: 40105856
ISSN: 2168-6238
CID: 5813382

Quality improvement of a community-engaged authorship system: lessons learned from the RECOVER initiative

Esquenazi-Karonika, Shari; Mathews, Patenne D; Wood, Marion J; Mudumbi, Praveen M; Linton, Janelle; Briscoe, Jasmine; Seibert, Elle; Coombs, K; Laynor, Gregory; Katz, Stuart D; Chung, Alicia
BACKGROUND:Inclusion of patients, caregivers, and community members in scientific research should be essential for patient-centered care. Patients’ lived experiences can propose new areas of focus that may not have previously been considered, ensure that potentially sensitive topics are addressed thoughtfully, contribute to the interpretation of findings, and identify future directions of research. Further, their inclusion in the drafting of manuscripts can ensure that research findings are translatable to real-world practice. To achieve this goal, the Researching COVID to Enhance Recovery (RECOVER) consortium developed a Representative Authorship system for development of scientific manuscripts that report RECOVER data. This paper describes a Quality Improvement (QI) project that was conducted to identify system strengths and improvement opportunities. METHODS:An online QI survey was distributed to RECOVER’s Representative Authors about a year into the implementation of the Representative Authorship System. The survey focused on several key aspects, including the clarity regarding the authorship process, training opportunities, the matching process, communication within writing groups, and the perceived impact of the representative engagement on the quality and applicability of research. The survey also explored participants’ satisfaction with compensation, support, and involvement in the system, as well as areas for improvement. RESULTS:The survey was sent to 49 representative authors with 17 respondents (35%). Most respondents reported positive experiences, highlighting the effective matching to manuscripts based on their expertise and the perceived positive impact of their involvement on research outcomes. Additionally, participants felt that including diverse voices enhanced the relevance of research for clinical practice. Several areas for improvement were identified, including communication challenges within writing groups, the utility of manuscript orientation calls, and the fairness of compensation. Respondents also indicated a need for more training opportunities and logistical support. CONCLUSIONS:RECOVER’s Representative Authorship system is effective in fostering collaboration and improving the inclusivity of scientific research. The survey findings indicate that there are logistical changes around communication, training, and compensation that could enhance the experience for all collaborators. Based on these findings, we plan to implement changes to improve awareness, understanding, and collaboration. Additional work is needed to solicit feedback from investigators and administrative staff to obtain a more holistic understanding of the system. SUPPLEMENTARY INFORMATION:The online version contains supplementary material available at 10.1186/s12913-025-12914-3.
PMCID:12225380
PMID: 40611083
ISSN: 1472-6963
CID: 5888422

A Scoping Review on the Development, Implementation, and Evaluation of Nurse Well-Being Initiatives in Academic Health Systems

Withall, Jennifer; Laynor, Gregory; Anglin, Carlita; M Millon, Emma; Bass, Benjamin; Alendy, Fariza; DeMarco, Kathleen; Zavotsky, Kathleen Evanovich
BACKGROUND:Nursing well-being is foundational to the specialties workforce and broader healthcare industry worldwide. Despite frequent reports and descriptions of activities that support nurses' well-being, most reports describe singular activities and programs that lack science-based structures contextualized within academic healthcare systems (AHS) with validated impact. AIMS/OBJECTIVE:To evaluate and synthesize the existing national and international literature on nurse well-being initiatives offered in AHS. METHODS:Over 18 months, an 8-member interprofessional team conducted a scoping review adhering to PRISMA-ScR reporting guidelines. Five databases were searched, and results were screened in a multistep process by researcher pairs. Discrepancies were resolved by a third team member's review. Citations were reviewed uniquely three times to ensure methodological rigor. A final set of 54 articles was extracted for key data elements pertinent to the research question describing setting, population, study design, intervention, and other subsidiary fields. Reviewers additionally analyzed publication quality indicators and trends for additional implications for research and practice. RESULTS:Among the 54 eligible articles, 72% were research and 28% were evidence-based practice, quality improvement, or doctoral dissertations. The concepts studied were psychosocial (e.g., resiliency) and physical (e.g., sleep). The number of instruments used per study ranged from 1 to 11. Thirty percent of studies utilized a framework from various disciplines that included nursing, social and behavioral sciences, and safety science principles. Nurses were included as authors 67% of the time, and 35% received funding from either the public or private sector.
PMID: 40572021
ISSN: 1741-6787
CID: 5874842

Barriers to telehealth uptake and use: a scoping review

Kemp, Mackenzie; Rising, Kristin L; Laynor, Gregory; Miao, Jessica; Worster, Brooke; Chang, Anna Marie; Monick, Andrew J; Guth, Amanda; Esteves Camacho, Tracy; McIntosh, Kiana; Amadio, Grace; Shughart, Lindsey; Hsiao, TingAnn; Leader, Amy E
OBJECTIVES/UNASSIGNED:We conducted a scoping review to identify barriers to telehealth use and uptake from the perspective of patient, provider, and system that were documented in the literature. In addition to identifying and categorizing the barriers, we aimed to assess how barriers differed for studies conducted during the COVID-19 pandemic, as well as how barriers differed between the United States vs internationally based studies. MATERIALS AND METHODS/UNASSIGNED:Comprehensive searches of the PubMed/MEDLINE, CINAHL, and Scopus databases conducted on December 29, 2021 yielded 17 887 results, with 11 221 potentially eligible documents after duplicates were removed. The team conducted an initial title and abstract review, followed by full text review. Data from the included sources were extracted and summarized into primary themes. RESULTS/UNASSIGNED:We identified 395 articles specifically related to barriers of telehealth use. The top 5 barriers, in order of frequency, were: lack of skills or ability (55%), lack of interest (49%), lack of access to technology (45%), limitations of technology infrastructure (45%), and lack of quality of care (42%). Roughly one-third (39%) of studies were related to the COVID-19 pandemic and 54% were US-based studies. The rank order of barriers between COVID-19 vs non-COVID-19 studies and US vs non-US studies was the same; however, patients in the United States and those using telehealth during COVID-19 were more likely to cite barriers related to the lack of access to technology (COVID = 56% vs 38%; United States = 51% vs 38%). DISCUSSION/UNASSIGNED:Interventions to address barriers need to consider the unique needs of specific populations and the ways in which different barriers may intersect. CONCLUSION/UNASSIGNED:This review found that barriers to telehealth uptake and use are multilayered and occur at several levels (individual, structural, technological).
PMCID:11921419
PMID: 40109500
ISSN: 2574-2531
CID: 5813512

Addressing the immigrant screening gap: A protocol for a systematic review on interventions to enhance colorectal cancer screening among immigrants in the United States

McCready, Taylor M; Cohen, Ethan M; Laynor, Gregory; Chebli, Perla; Liang, Peter S; Renson, Audrey
INTRODUCTION/BACKGROUND:Colorectal cancer (CRC) screening rates are lower among immigrant populations in the United States (US) than the general population. Immigrant communities face structural barriers that disincentivize their engagement from CRC screening. A growing body of literature has evaluated the effects of interventions aimed at increasing CRC screening engagement among various immigrant groups, but there has not yet been a systematic synthesis of this literature. OBJECTIVE:This review will systematically evaluate quantitative studies assessing the effects of interventions designed to increase CRC screening rates among immigrant populations residing in the US. METHODS:We will conduct a comprehensive search of English language peer-reviewed and grey literature using specific keywords and database-specific structured vocabulary on interventions to improve CRC screening rates among immigrants published in 7 databases (PubMed, Cochrane Library (Wiley), CINAHL (EBSCO), ClinicalTrials.gov, Embase (Ovid), Scopus (Elsevier), and Web of Science) from January 1, 2000 to December 31, 2024. All studies will be imported into Covidence. Two reviewers will independently screen titles, abstracts, and full-texts for inclusion and exclusion criteria. Pilot screenings and consensus discussions will ensure accuracy and agreement in study selection and data extraction. Iterative data extraction of eligible studies will include critical appraisal using the Risk of Bias 2 (ROB2) for randomized controlled trials, while other study designs will be appraised with the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool. Data synthesis will disaggregate pooled effect estimates by ethnicity, to the extent possible. The study protocol was pre-registered in International Prospective Register of Systematic reviews (PROSPERO): CRD42023488183. EXPECTED OUTPUTS/UNASSIGNED:This systematic review aims to generate an exhaustive summary of the evidence base, including a description of the intervention methods and settings, target populations, recruitment and retention strategies, partnerships and collaborations, and reported outcomes. The results will provide actionable recommendations for public health practitioners, healthcare providers, and policymakers developing tailored interventions and policies aimed at improving CRC screening uptake among diverse immigrant populations in the US.
PMCID:12040244
PMID: 40299980
ISSN: 1932-6203
CID: 5833582

From Questions to Answers: Teaching Evidence-Based Medicine Question Formulation and Literature Searching Skills to First-Year Medical Students

Magro, Juliana; Plovnick, Caitlin; Laynor, Gregory; Nicholson, Joey
INTRODUCTION/UNASSIGNED:Medical students may arrive at medical school with some research background but not necessarily evidence-based medicine (EBM) skills. First-year preclinical medical students require foundational skills for EBM (formulating background and foreground questions, navigating information sources, and conducting database searches) before critically appraising evidence and applying it to clinical scenarios. METHODS/UNASSIGNED:We developed a flipped classroom EBM workshop for preclinical students combining prework modules and a 60-minute in-person session. After completing the online modules on foundational EBM skills, students participated in an in-person activity based on patient cases. In small groups, students formulated background and foreground questions based on a case and looked for evidence in resources assigned to each group. Small groups reported back to the whole group how they searched for information for their patient cases. A total of 105 first-year medical students were required to complete this workshop after concluding their basic sciences courses. RESULTS/UNASSIGNED:= .002). DISCUSSION/UNASSIGNED:This flipped classroom approach to teaching foundational EBM skills may be adapted for different contexts, but educators should consider time limitations, group size, and tools for interactivity.
PMCID:11832641
PMID: 39968292
ISSN: 2374-8265
CID: 5841032