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June 2020 Summer Study Break CalendarMove your body, appreciate the small things, see the great outdoors and be part of the GW community via activities and recommendations on the June Healthy Living @ Himmelfarb Summer Study Break calendar!

Someone filling in multiple choice test question bubbles.
Image by Alberto G. on flickr.

In Wednesday’s blog post we shared Himmelfarb Library’s electronic clinical case study resources to incorporate in your online instruction. Today we’d like to share some of the electronic question banks Himmelfarb provides access to. While Himmelfarb provides access, in order to unlock all features you must create a personal account. Instructions for doing so are provided.

Exam Master Medical Subject Review provides over 9,000 questions and explanations to prepare for the USMLE Steps 1, 2, and 3. Exam Master tries to emulate the board exams, helping students build confidence by identifying strengths and improving on weaknesses. In order to use Himmelfarb’s Exam Master, you must make a free Exam Master account, then access Exam Master while on campus or when logged in to the VPN.

USMLEasy offers questions and answers to prepare for Steps 1, 2 CK, and 3. Their customization feature allows you to select topic coverage and the number of questions. You’re also able to annotate exam questions and answers. In order to access USMLEasy, access the webpage through the provided link and create a personal profile.

BoardVitals provides test banks for NBME Shelf Exams in seven different medical subjects. Features include timed test conditions, study tips, and individualized study recommendations based on practice test performance. In order to register, connect via the VPN and create an account at the link provided. After you’ve logged in once while connected to the VPN, you’ll be able to access your account from anywhere.

PA Exam Prep offers practice questions for PANCE and PANRE, as well as customizable features like topic coverage, number of questions, and annotation. In order to unlock these customizations, create a free account at the provided link.

For additional online instruction resources, check out Himmelfarb’s Online Instruction Research Guide. Our librarians are happy to assist with any questions you might have as well. Email us at himmelfarb@gwu.edu, or connect via our Ask Us chat.

Access Medicine & Case Files Collection LogoTeaching online can pose its share of challenges. Finding clinical cases to include in your online instruction doesn’t have to be one of them. Using clinical case studies, especially during a time when students are not able to have first hand clinical experiences, can help your students hone their clinical decision making, critical thinking, and clinical reasoning skills. Himmelfarb Library provides access to cases with supporting text and multimedia materials. All materials are licensed for use in instruction. 

AccessMedicine Cases provides access to more than 900 basic sciences and plus selected clinical cases drawn from the Case Files series. AccessMedicine’s clinical case collections include: 

  • Family Medicine Board Review 
  • Internal Medicine drawn from Resident Readiness Internal Medicine
  • Vanderbilt Internal IM/Peds
  • Case Files (note: selected cases available in AccessMedicine and complete collection available via Case Files Collection)

Himmelfarb also provides access to the complete Case Files Collection which includes more than 1,150 cases, explanations, and quizzes. In addition to basic science cases, the Case Files Collection provides full access to clinical rotation cases for anesthesiology, cardiology, emergency medicine, family medicine, internal medicine, medical ethics & professionalism, obstetrics/gynecology, pediatrics, and surgery. Case Files Collection also provides additional cases at the post-graduate level on cardiology, geriatrics, gynecologic surgery, and orthopaedic surgery.  The Case Files Collection ebooks are also available through Himmelfarb’s catalog.

Case File book covers

To integrate cases into your online instruction, start with a relevant patient case. Students can use cases to practice taking a patient history using Smith’s Patient-Centered Interviewing. Students can expand their physical exam skills in an online instruction setting through physical exam videos. Students can then do additional research by looking up current recommendations and reading article summaries on relevant topics. Students can then decide on appropriate next steps for the patient case including diagnostic tests to be ordered, and creating a treatment plan by looking through mini-textbooks, and the provided drug monograph library. Quizzes are available at the end of cases and can be emailed to instructors when completed.

Do you want to explore topics beyond specific medical conditions? Cases in Medical Ethics and Professionalism include opportunities to explore communication, conflict resolution, ethics, and professionalism skills in addition to the medical case at hand. 

Himmelfarb provides full-access to both AccessMedicine and Case Files collection although some features are accessible only after users create a free personal MyAccess Profile. To create a MyAccess Profile, click on Sign In in the upper right corner of AccessMedicine or Case Files Collection.

Librarian Reserve Corps

Stacy Brody is a Master of Information. Literally. That’s what it says on her degree from Rutgers University School of Communication and Information, at least. And she is using her skills to contribute to the fight against the COVID-19 infodemic.

 

Stacy was warmly welcomed to the Himmelfarb Library team three months ago. Like many of you, she isn’t sure whether those are short or long months - her perception of time seems to have been affected by the pandemic.

As a member of the Himmelfarb team, she supports the work of clinicians and researchers by conducting literature searches, compiling resources for the weekly Intelligence Reports, and maintaining the COVID-19 Research Guide.

Keeping up-to-date with, and searching for, COVID-19 literature requires some creativity. The research is coming out in torrents. New publications are posted on preprint servers and publisher websites, then picked up on Twitter and by the news media before the research community has had the opportunity to evaluate them. The quality of research described in scholarly articles is variable. Original research is showing up in Commentaries and Editorials for rapid dissemination. The delay between publication and appearance on PubMed and other databases is becoming more apparent and more critical.  The norms of scholarly communication and publishing are being challenged in a big way.

Finding and evaluating the evidence to support evidence-based medicine is more difficult when it comes to COVID.

Which is why, when Stacy saw the call on the Medical Library Association’s listserv to support the global response by indexing COVID-19 research publications, she signed up. She hoped that, by applying topic tags to articles, she, in her small way, could make the evidence more findable and usable to the global audience of responders, clinicians, and researchers.

As she hit the Reply button, she didn’t know that she would become co-lead of the Librarian Reserve Corps. She hadn’t yet met her Librarian Reserve Corps co-lead Sara Loree, a medical librarian at St. Luke’s Health System in Idaho, or the visionary Librarian Reserve Corps founder Elaine Hicks, Research, Education and Public Health Librarian at Tulane University. Hicks, reflecting on her own professional experience in public health and emergency preparedness, recognized that the need of Tulane University epidemiologist and GOARN (Global Outbreak Alert and Response Network)-Research lead Dr. Lina Moses, was one no librarian could meet alone. Members of GOARN, a WHO network of 250-plus agencies, institutes, and universities organized to respond to outbreaks, need the literature to support evidence-based public health response efforts. As described above, that evidence is hard to find in an infodemic. For evidence-finding at a global scale, you need an international army of librarians. Hicks, seeing this and dreaming of just such an army, put out a call to the Medical Library Association listserv. The newly formed Librarian Reserve Corps, modeled after the Medical Reserve Corps, supports evidence-based response efforts by providing resources for evidence-based public health.

The initial efforts to tag articles quickly grew - not only because the number of COVID-19 research articles has grown but also because we have learned more about the skills and expertise of our volunteers and the needs of GOARN-Research! Librarian Reserve Corps volunteers continue to index articles on a daily basis and have since expanded their services. Volunteers now conduct literature searches and monitor the media. They work to connect groups working on systematic reviews and meta-analyses.

Librarians have the skills needed to fight the infodemic and help our public health and medical professionals fight the pandemic.

Stacy recognizes that many of the Librarian Reserve Corps’s volunteers contribute to the infodemic-pandemic response at this global level and at the local level. They provide search support for clinicians and researchers. They help students and faculty access the library resources they need to continue their work virtually. They help professors transition to online instruction. As librarians, Stacy acknowledges, we are often in behind-the-scenes roles. She is honored to be part of this amazing, talented, dedicated team of volunteers making librarians famous.

Himmelfarb Staff Member 3D Prints Face Shields for Health Care Workers

GIF of face shield being printed
Click to watch: 3D printing process

 

John Lopez, Himmelfarb Library’s Data Technician, has joined an initiative to 3D print face shields for healthcare workers. John shares how he became involved in the project, and what the process entails.

How did you learn about the face shield printing initiative?

I initially read an article about a hospital in Brescia, Italy which was hit hard by the pandemic. They were running out of valves used for their respirators which the manufacturer couldn't provide quickly enough, so a small startup company reversed engineered the valve and began 3D printing them, which the hospital then used. The article quickly became viral just as COVID-19 reached the states.

I began noticing online 3D printing communities around the world organizing similar efforts once Josef Prusa - the founder of Prusa Lab in Prague, Czech Republic - released an open-source face shield design, made available for anyone with a 3D printer to produce. Various iterations were soon released, but the Prusa face shield design proved to be the most effective among health care workers.

image of a face shield
3D-printed face shield

Are you partnering with a particular organization or initiative?

I joined the volunteer effort started by Open Works, a makerspace workshop based in Baltimore who were among the first to mobilize volunteer makers with an organized and efficient plan to provide face shields to local healthcare systems and hospitals. A chain of custody is established via email registration, as each 3D print file is assigned a unique parts number which helps keep track of how many face shields were printed by a volunteer.

What part of the shield is 3D-printed?  What other materials do you need for assembly, and where can you get them? Is there a standard for what material the face shield should be made of (e.g., thickness)?

image of face shield components
Face shield components

image of face shield components

image of face shield components

The face shield is actually a printable headband, as well as a printable chin strap which serves as a mount for the visor; both are included in the 3D print file. An elastic cord, along with the actual clear acrylic visor, are required to complete assembly, both of which are done at Open Works once they receive completed face shields.

PETG is the type of filament material primarily used to print the face shields, which can be purchased on Amazon for example. It's preferred due to its rigidity and because it can be sterilized more efficiently than other types of printing material such as PLA. There is indeed a printing guideline for makers to follow which sets the parameters to prevent the face shield from breaking.

How long does it take to print the shield frames?

The average print time when following the recommended print settings can take up to 6 hours for a single face shield. There are certainly a variety of ways to print faster by tinkering with hardware, such as changing the nozzle size, but it's not encouraged as strength and quality of the model are prioritized over speed.

Are you using the library’s 3D printer?

I'm grateful for my two 3D printers at home since the library's 3D printer service hasn’t been accessible.

Roughly how many have you assembled so far?

Volunteers had been asked to print at least three face shields each during the early weeks of the pandemic. The incredible response from volunteers reached a saturation point in mid-April as thousands of face shields had been made. Since then my focus has been printing ear straps for face masks.

face shield components
Face shield components

Once they’re assembled, how do you get them to their destination?

Once a face shield is done printing, I wear nitrile gloves to remove the part from the print bed and follow the sanitation checklist provided by Open Works. A liability waiver is also signed then sent along with the face shields through USPS.

Is there a website (or several websites) you would recommend people visit for more information?

A good starting point for anyone with a 3D printer looking to join local volunteer efforts in their area

https://getusppe.org/makers/

COVID-19 Supply Chain Response: Essential Information

https://3dprint.nih.gov/collections/covid-19-response/essential-info

Article re: 3D printed valve parts used in hospitals throughout Italy
https://www.bbc.com/news/technology-51911070

Blog post from Josef Prusa about face shield design
https://blog.prusaprinters.org/from-design-to-mass-3d-printing-of-medical-shields-in-three-days/

Open Works/Makers Unite/We the Builders - the volunteer org I had joined for printing the face shields
https://www.wethebuilders.com/projects/11

The group was mentioned in a recent article from The Economist:

https://www.economist.com/united-states/2020/04/30/americas-makers-and-tinkerers-turn-their-hands-to-ppe

NIH’s 3D Print Exchange now has downloadable designs for PPE and devices, including the Prusa face shield and face mask ear savers:

Prusa Protective Face Shield

https://3dprint.nih.gov/discover/3dpx-013409

Surgical Mask Tension Release Band for Ear Comfort & Extended Use

https://3dprint.nih.gov/discover/3dpx-013410

After Himmelfarb Library closed its physical space, we made changes to Health Information @ Himmelfarb to make searching for electronic content easier.  The default search mode was switched from Articles + Himmelfarb Catalog to Online Access.  The online access search limits items retrieved to those available full-text online. This includes article, book chapter, and e-book content, as well as some streaming media.

Online access search default image

Searchers can still search physical content by switching the search mode to any of the “catalog” options:

All search scopes image

Requesting holds on books and Consortium Loan request options are turned off until Himmelfarb and other Washington Research Library Consortium libraries reopen. Library users can continue to request items that can be sent digitally through our Documents2Go service.

Have you ever wanted to keep filters you applied in a search active throughout a search session, or easily remove all of them? Now you can! A new enhancement allows setting and keeping multiple filters active with “Remember all filters” or removing all with “Reset filters”. These options become available at the top of the left column menu whenever filters are applied.

Filter management image

If you have questions about Health Information @ Himmelfarb or need assistance with searching, contact Himmelfarb’s Information Desk staff!

Stack of papersDo you want to utilize a diagram from a published article in your own publication, but are unsure whether you should do so? Do you have questions about fair use? In this webinar we explore many of the most common copyright questions that authors encounter while putting together an article.

The final installment of our Scholarly Communications Webinar series will be released on Wednesday, May 20th at noon EST. Copyright for Authors is provided by Anne Linton, Himmelfarb Library's director, and Sara Hoover, our Metadata and Scholarly Publishing librarian. This session will help you learn more about the importance of copyright and how you can safely avoid infringing on guidelines. They will also address Fair Use and other common copyright questions.

More information can be found on our Scholarly Publishing webpage. The Himmelfarb team looks forward to hearing your questions about Fair use, and copyright!

screenshot of new PubMed home page

The new PubMed is here! Himmelfarb previously announced a transition from PubMed’s old interface to their newer, more modern interface. As of May 18th, the NLM will fully transition to the new PubMed interface with a host of new features, available on mobile and desktop devices alike.

The new PubMed interface includes quality of life updates, like abstract excerpts available in the results list and updates to the interface to make the site more navigable, and as well as significant behind-the-scenes updates, including the algorithm that produces the new Best Match sort order. Additionally, your My NCBI saved searches and collections will continue to work with the new PubMed, so no starting over from scratch!

When accessing the new PubMed, be sure to go through the link on Himmelfarb’s home page, in the “Popular Resources” box, to ensure Himmelfarb’s full-text links and other customizations load. The new PubMed also offers full integration with our LibKey Nomad browser plugin (available on Google Chrome), which enhances  full-text linking by directly loading a PDF if one is available!

The NLM has a number of resources to help you familiarize yourself with the new PubMed interface. Their New PubMed Transition FAQ broadly covers the changes and updates made. The New PubMed Trainer’s Toolkit consists of short videos (1-4 minutes each), slides, handouts, and webinars that can be embedded in Blackboard courses. For those of you looking for a deeper dive into the new PubMed, the webinar series How PubMed Works does a deep dive into what PubMed is and how it functions. The PubMed User Guide is also readily available, with an in-depth coverage of frequently asked questions and instructions on how to use the various features the new PubMed offers.

Of course, we here at Himmelfarb are also available as a resource. We’ve been familiarizing ourselves with the new interface, and are happy to answer any questions you may have about the new PubMed. Email us at himmelfarb@gwu.edu, or chat with us via our Ask A Librarian instant messaging service.

The COVID-19 pandemic has caused dramatic upheaval in the world of professional conferences. Most conferences have either been  postponed to a later date or canceled for the year, leaving scholars with posters and presentations that can't be shared with their peers until late 2020 or 2021 at the earliest. Fortunately, the Himmelfarb Library has an excellent resource available that allows for asynchronous virtual conferencing. With the Health Sciences Research Commons, (HSRC), members of the George Washington University Medical, Health Sciences, Public Health and Nursing communities have the ability to archive and present their research to scholars around the globe. 

With Health Sciences Research Commons, it is possible to archive presentation materials such as poster PDFs or videos via native streaming or a 3rd party platform (i.e. YouTube).  If you have content that you would like to share, simply send an email to hsrc@gwu.edu and we will be happy to find an appropriate collection, create the necessary metadata, and send you a link to your archived projects.  Have questions related to archiving and potential future publications? We are happy to answer those questions as well. 

Using the HSRC as a presentation platform is an asynchronous experience which is  different from than the in-person conference. But archiving your project in HSRC has unique benefits such as the ability to generate usage statistics using PlumX metrics and Altmetircs located on the right hand side of an entry. 

As we adapt to a life and workflow that is reliant on virtual workspaces, it is important that we continue to collaborate and share current research with the larger medical community. The HSRC is a wonderful space for archiving and presenting research. If you have any additional questions on using the repository, feel free to reach out to Sara Hoover,  Metadata and Scholarly Publishing Librarian at shoover@gwu.edu.


Please note: This blog post was updated on May 18, 2020 to better reflect the process for submitting to the HSRC.

Impact of Climate Change on Human HealthI recently finished grading presentations by our first-year medical students in their Clinical Integration Sessions. As you might assume any good librarian might do, I reviewed their references and made sure they correctly formatted their lists. I also looked for other skills built into their curriculum, skills like interactivity and timing.

One of the first skills they learn in CIS, and one that is reinforced in each round of student presentations, is their introduction. As presenters, they need to tell me - their audience - who they are, what they’re talking about, and why I need to listen up.

The “why I need to listen up” piece is critical. It’s how they get my attention and keep it, for the whole five minutes they are presenting.

Neelu TummalaIf they need inspiration on how to do this effectively, they might look to Dr. Neelu Tummala, a clinical physician with GWU’s MFA and a member of the inaugural cohort of Public Voices Fellowship on the Climate Crisis at the Yale Program on Climate Communication. Her class includes political activists, researchers, and consultants. Many of her classmates describe an interest in advancing human health, however, she is the only doctor in the group.

When I asked about the connection she sees between her work in medicine and climate change, Dr. Tummala told me that her medical lens helps her communicate to broader audiences about climate change. “No one,” she says, “is immune from the health effects of climate change.” By relating a grand problem to personal experience, she can hook in an audience that might otherwise not have “listened up”.

Several of my CIS students have started their presentations with case studies. They’ve shown radiographic images, told stories, and introduced scenarios. Dr. Tummala often does the same thing when presenting information - she provides examples of patients seen in Emergency Rooms and clinics, patients who have been affected by climate change and other environmental issues. This concretization of the abstract, this story-telling, captures our interest.

And it is not only the story-telling that is important. It is the basic science behind these stories, the mechanistic reasoning and research that explains why climate change impacts our health. Dr. Tummala keeps up with the latest literature in NEJM and The Lancet and stays abreast of environmental reporting with The Guardian. By following conversations in both scientific research and the news media, Dr. Tummala is able to evaluate sweeping claims and participate in the conversation.

A year-and-a-half in to the GWU community, Dr. Tummala is engaging in these important conversations at the local level. Though she acknowledges it was initially a slow process, she has now found other colleagues interested in addressing climate and health, through whom she has engaged in clinical research and teaching, including Dr. Hana Akselrod, Assistant Professor of Medicine, GW SMHS and Dr. Rachel Harold, Infectious Disease Fellow, GW SMHS.  In addition, she is also planning on working with collaborators across traditional disciplinary boundaries including Dr. Susan Anenberg, Associate Professor, GWSPH. Their grant proposal, “Advancing GW Cross-Disciplinary Collaboration in Climate Change and Public Health Research”, written by Drs. Anenberg and Akselrod, was recently awarded monies from the GWU Cross-Disciplinary Research Fund.

And what is one of the keys to getting a grant? Writing a good proposal, which should tell your potential funders who you are, what you’re going to research, and why they need to listen up.

Interested in Learning more about Climate Change and Medicine? Check out these resources

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