Effect of search experience on sustained MEDLINE usage by students.

PURPOSE: While educators agree that medical students should learn to use MEDLINE for clinical application, there is a lack of consensus on an optimal level of exposure to this resource during training that will result in sustained usage. This study sought to identify the level of search experience (1) to increase the odds that the student searcher will continue to search MEDLINE in the absence of search assignments, and (2) to make an appreciable difference in the odds of retrieving items of relevance from the MEDLINE database. METHOD: Search frequencies of MEDLINE via the PaperChase interface by 184 fourth-year students (class of 1992) at the University of Michigan Medical School were analyzed using the log cross-product technique. The students were required to take the Comprehensive Clinical Assessment, an examination that included a search assignment, as they entered their fourth year of medical school. Their levels of MEDLINE use and their retrieval performances before the examination were compared with those achieved during the subsequent five months as fourth-year medical students. RESULTS: For those who searched an average of at least once a month during their first three years of medical school, there was a 7.38:1 chance that they would conduct three searches per month in the fourth year, compared with those who searched less frequently. The odds of retrieving at least one item of definite relevance were 8.27:1 for those who had searched at least one and one-half times per month before the search assignment. CONCLUSION: Searching once a month through the first few years of medical school provided an experience level that improved the odds that a student would continue to search MEDLINE: Data indicated that a history of a minimum of 1.5 online sessions per month increased the odds of retrieving relevant items to 8.27:1. Implications for educational strategy are clear.

Factors affecting students' use of MEDLINE.

MEDLINE search transcripts by a class of third-year medical students were analyzed. The 184 students were divided into three groups according to their search experience in terms of the number of sessions logged at the time of a search assignment. A strong relation was found between the level of search experience and the frequency of use in the subsequent 5 months. Over 80% of the students were able to retrieve a few useful items for an emergency clinical situation. More experienced searchers were able to retrieve more relevant items than less experienced searchers. However, no relation was found between search effectiveness and clinical knowledge as indicated by two scores derived from the University of Michigan's Comprehensive Clinical Assessment examination and Part II of NBME. Similarly, clinical knowledge also did not appear to relate to MEDLINE search experience. More exposure to MEDLINE during medical school could play an important role in developing effective literature searching skills for lifelong learning, which is essential for today's health professionals.

Perusing the literature via citation links.

While MEDLINE searching is recognized as the single most effective means to identify relevant items to solve clinical and research problems, the clinician should also consider the complementary strategy to search for relevant items citing a known key paper. This study reports on the usefulness of citation searching based on the analysis of 89 searches. For each topic, the citations linked to an average of 24% additional relevant materials. At least one relevant item was added to 85% of the searches. The additional effort of scanning another printout is minimal since citation searching for 42% of the searches produced less than 7 additional items, half of which were judged to be useful. Duplicate retrievals were mostly of definite relevance. This alternate strategy appeared to be effective in interdisciplinary topics. Furthermore, the online version of the citation index is known for short turn-around time in processing, a feature important for many rapidly developing specialties.

A quality filtering system for medical literature.

An algorithmic method for selecting quality journal articles is presented. The procedures are based on formalizations of existing evaluation mechanisms in scientific publication. The method was actually applied to the journal literature of the pharmacology of cardiac arrhythmias for the period 1967 to 1970. A comparison with the selected bibliographies of four recent publications showed that the method approximated some of the selections made by conventional subjective judgment.