A multidisciplinary approach to information and critical appraisal instruction.

The formulation of clinical decisions based on evidence requires the ability to locate information and evaluate it critically. A ten-week critical appraisal course for third-year medical students, taught cooperatively by library and Department of Medicine faculty, integrates education in the selection, evaluation, and application of information to patient care. The course is distinctive in that information management skills are taught by a multidisciplinary team in a problem-based format as part of the compulsory medical curriculum. Medical faculty provided instruction in reading and evaluating research methodology, as well as statistical analyses in published reports, using clinical scenarios and related journal articles at weekly sessions. Library faculty provided instruction in locating pertinent research on a sample clinical problem using standard printed and computerized indexes and local library resources, and presented criteria for selecting the most useful and significant works from those retrieved. Library faculty also met individually with students to provide instruction in online literature searching. Based on formal evaluation and informal feedback, the course was well received; it effectively presents the literature search as an integral part of critical appraisal of the medical literature and of the clinical decision-making process.

Sex-specific distinctions in audiogenic convulsions exhibited by severe seizure genetically epilepsy-prone rats (GEPR-9s).

The severe seizure genetically epilepsy-prone rat (GEPR-9) is characterized by a broad-based seizure predisposition and is increasingly recognized as a useful model of epilepsy. When sound stimulated, members of the GEPR-9 colony exhibit complete tonic extensor convulsions. Female GEPR-9s appear to experience a higher frequency of more severe seizures than males when they are sound stimulated. The purpose of this report is to examine and document this observation. Convulsive behavior was evaluated in approximately 4400 GEPR-9s. Each of these animals was sound stimulated 3 times at weekly intervals. Audiogenic response score (ARS), latency to wild running and latency to convulsion were recorded for each animal in each of the 3 tests. For the first 2 weekly tests, females exhibited a significantly higher incidence of complete tonic convulsions, a significantly higher ARS and significantly shorter latencies to wild running and convulsions than did males. The significant differences in latencies persisted through the 3 tests, whereas an increase in the incidence of complete tonic convulsions among males led to a diminution of the differences between males and females in the other parameters. The possible underlying biochemical differences that are responsible for this sex difference in seizure severity are, as yet, unknown.