Lovasik Brendan P, Rutledge Hannah, Lawson Emily, Maithel Shishir K, Delman Keith A
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Woodruff Health Sciences Library, Emory University, Atlanta, Georgia.
J Surg Educ. 2020 Sep-Oct;77(5):1069-1075. doi: 10.1016/j.jsurg.2020.03.024. Epub 2020 Jun 15.
Surgical morbidity and mortality (M&M) conference is a primary educational endeavor for trainees and faculty alike. Case presentations are enhanced by inclusion of clinical evidence; however, trainees are frequently limited in their ability to collect and share this type of material.
A surgical evidence web log ("blog") was created in partnership between the Clinical Librarian Service and the Department of Surgery. A clinical librarian attended weekly departmental M&M conferences and reviewed evidence in collaboration with a surgical resident. For each case presented, the clinical librarian created an evidence-based blog post based on specific learning topics encountered in the routine discussion of the M&M conference. The goal of this surgeon-librarian partnership was to enhance M&M's educational value by reinforcing learning topics, serving as a repository of case-based evidence, and involving trainees in evidence-based surgical practice.
Blog posts included summaries of available evidence, critical reviews of seminal studies, and reviews of evidence-based guidelines framed in the context of the case. New blog posts were promoted via direct links in an existing weekly newsletter sent to all trainees and faculty in the department. Within the first year, surgical residents reported increased interaction with the literature, and 100% reported gaining knowledge that they would otherwise not receive through their standard readings, with 73% of residents using this to influence clinical practice and 87% applying knowledge in test preparation. This surgeon-librarian partnership enforces interdisciplinary collaboration through existing resources, and is highly generalizable to both surgical and medical training programs.
In this study, the development of a surgical evidence blog represents an effective resource for promoting evidence-based practices within a case-based learning curriculum. This intervention is the first report in the literature to integrate the expertise and resources of a Clinical Librarian Service with an evidence-based resident educational curriculum in a surgical residency program.
外科手术发病率和死亡率（M&M）会议对学员和教员来说都是一项重要的教育活动。通过纳入临床证据可增强病例报告的效果；然而，学员收集和分享这类资料的能力常常受到限制。
临床图书馆服务部与外科系合作创建了一个外科证据网络日志（“博客”）。一名临床图书馆员参加每周的科室M&M会议，并与一名外科住院医师合作审查证据。对于每个展示的病例，临床图书馆员根据M&M会议常规讨论中遇到的特定学习主题创建一篇基于证据的博客文章。这种外科医生与图书馆员的合作旨在通过强化学习主题、充当基于病例的证据库以及让学员参与循证外科实践来提高M&M会议的教育价值。
博客文章包括现有证据的总结、对开创性研究的批判性综述以及结合病例背景对循证指南的综述。新的博客文章通过直接链接在发送给科室所有学员和教员的现有每周通讯中进行推广。在第一年里，外科住院医师报告称与文献的互动增加，100%的人表示获得了通过标准阅读无法获得的知识，73%的住院医师利用这些知识影响临床实践，87%的人将知识应用于备考。这种外科医生与图书馆员的合作通过现有资源加强了跨学科协作，并且高度适用于外科和医学培训项目。
在本研究中，外科证据博客的开发是在基于病例的学习课程中促进循证实践的有效资源。这项干预措施是文献中首次报道将临床图书馆服务部的专业知识和资源与外科住院医师培训项目中基于证据的住院医师教育课程相结合。
