Installation Instructions for the New Color Printer

A heavier duty color printer will be available in the EVMS Library Computer lab for students beginning on Tuesday, April 1st.  The existing color printer in the Student Lounge will be decommissioned at approximately 4p.m. Friday, April 4th.

All EVMS students who wish to continue printing in color should install the printer driver for the Computer Lab color printer by 3 p.m. on April 4th. Instructions for downloading the drivers are below.

Those who require assistance in downloading the printer driver can find it at the following locations starting on March 31st:

Library Computer Lab
Tuesday to Friday: 7 a.m. to 3 p.m.
Saturday: 11 a.m. to 6 p.m.

Library Circulation Desk
Monday to Thursday: 8 a.m. to 12 midnight
Friday:8 a.m. to 6 p.m.
Saturday:9 a.m. to 7 p.m.
Sunday:10 a.m. to 12 midnight

Student Center
March 31st to April 4th: 8 a.m. to 4 p.m.

Network Information Center
Monday to Friday: 8 a.m. to 6 p.m.

Those who would prefer to install the printer driver themselves can do so via the following instructions:

Printer Driver Installation Instructions

1. Open Firefox or Safari (other browsers may cause issues with iPrint).

2. Type in Wesley2.evms.edu/ipp into the address bar and then hit enter.

3. Click on ColorLabPrinter (this printer driver works for both Macs and PCs).

4. Hit “Yes” to install.

5. If it asks for authentication, enter your EVMS Novell username and password. Make sure to check the box to “Remember my password.”

6. After it is finished installing close the browser and make sure that the printer is  installed by going to Print in any document and checking the printer choices to verify that ColorLabPrinter is listed.

Please direct any queries regarding the new color printer to library@evms.edu.

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App developed by EVMS resident makes iMedicalApps top 10 list

An app developed by an EVMS psychiatry resident was selected as one of the top 10 medical apps released in January 2014. Psych on Demand (#3 of 10) contains “over 20 assessment tools for ADHD, AMS, Dementia, Delirium, and more.” The iMedicalApp review also praises the app’s “beautifully made” user interface and “robust” search interface.

Psych On Demand is available through iTunes for iPhone, iPad or iPod devices.

Remember, EVMS subscription and top free apps are included on the EVMS Library’s Mobile resources page under Quick Links for EVMS Associates.

Reference:
Top 10 iPhone medical apps released in January. Feb 11, 2014 http://www.imedicalapps.com/2014/02/top-iphone-medical-apps-january/

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New Databases: ClinicalKey & VisualDx

The EVMS Library has recently added two new databases to their collection. ClinicalKey is by Elsevier, the producers of the MDConsult database. MDConsult is being phased out this coming year and will be replaced by ClinicalKey. The EVMS Library’s subscription to ClinicalKey is on a one year trial basis.

VisualDx is a clinical point-of-care visual diagnostic decision support system. Thanks to those of you that tested and completed our survey on VisualDx. The responses were unanimously positive.

Keep reading for more information about ClinicalKey and VisualDx.

ClinicalKey

ClinicalKey is a clinical resource designed to provide physicians with fast, clinically-relevant answers from Elsevier’s library of proprietary medical and surgical content.

ClinicalKey serves the information needs of medical and surgical specialties by bringing together content from Elsevier and trusted third parties including over 1,000 books, 500 journals, thousands of videos, and millions of images. ClinicalKey also gives physicians access to point-of-care content from First Consult. ClinicalKey is updated on a continuous basis.

ClinicalKey includes:

  • ALL Elsevier medical and surgical journals (over 500)
  • Selected third-party journals and content sources
    • 3rd party content includes PubMed/ Medline and ClinicalTrials.gov
  • ALL Elsevier medical and surgical reference books (over 1000)
  • ALL medical and surgical clinics of North America
  • ALL First Consult point-of-care clinical monographs
  • ALL Procedures Consult content and associated videos
  • ALL Clinical Pharmacology drug monographs from Gold Standard
  • ALL Elsevier medical and surgical videos (over 13,000+)
  • Millions of medical and surgical images
  • Over 2,000 Practice Guidelines
  • Elsevier and third-party published patient education handouts in both English and Spanish, where available.

VisualDx
VisualDx is a diagnostic clinical decision support system that leverages the innate human ability to recognize visual patterns to assist healthcare providers in making faster, more accurate diagnoses. VisualDx combines high-quality, peer-reviewed medical images and concise, actionable information to support today’s busy physicians in the accurate recognition and management of disease. Health care professionals can input visual clues, symptoms, and patient history to help make the correct diagnosis and avoid costly and dangerous errors at the point of care.

VisualDx speeds up recognition and diagnosis of medication-induced conditions and provides adverse events decision support for hospitals and medical centers. The VisualDX database covers over 100 medication reactions, all linked to PubMed (MEDLINE) evidence. Users can search by medication and see images of drug reactions, along with literature evidence documenting each association, and access management and therapy guidelines.

VisualDx integrates with UpToDate, so you may notice additional content within UpToDate marked with this icon .  There is also a mobile version for Apple and Android devices that you can freely download

VisualDx “Quick Stats”

  • 31 Clinical Scenarios
  • 1,281 unique diagnoses
  • 26,633 unique, medical images
  • 2,633 unique findings
  • 39,356 finding-diagnosis relationships
  • 5,277 medication-diagnosis relationships
  • 200+ common diseases with Patient Handouts

 

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ILLiad Upgrade

ILLiad, our Inter-library loan and document delivery system, has had a “facelift” and will look much cleaner starting this Monday (August 5th) morning. ILLiad is available to all EVMS associates and can be used to request books, articles and other materials not available through the EVMS Brickell Library collection. (EVMS associates that have not registered with the library need to do so before registering and requesting materials through ILLiad. Click here and then click on the attachment for a registration form.)

Many institutions, including UVA, VCU and Johns Hopkins, will lend books or provide electronic copies of journal articles for free. Most out-of-state institutions however, including the National Library of Medicine, charge a fee for this service; and we do pass these costs along to the requester. You are able to enter a maximum cost – up to $15 -  into ILLiad when you request material. This is considerably cheaper than most publishers charge for copies of articles. ILLiad fees for scanning and sending electronic (PDF) copies of articles we own in print are only 15¢ per page.

If you are not sure whether EVMS owns a particular book or journal, the library staff will be happy to answer that for you. If you would like to check yourself, book or print journal titles can be searched through the library’s online catalog, Webcat, and our electronic journal titles can be searched through our Electronic journal portal. Additionally, searching for an article title through Google Scholar will often retrieve a freely available electronic copy.

Please let us know if you have any questions about ILLiad or the new interface.

Phone: 757 446-5850
Email: illiad@evms.edu or library@evms.edu

 

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Enhancements to Exam Master Online

The Exam Master portal is scheduled for migration on Sunday, June 23rd to move to the enhanced version of Exam Master Online. All data in the system as of 12:01 am on Sunday, June 23rd will be migrated to the new portal and available Monday morning (6/24) at 7 am eastern time. You will not be able to login to your Exam Master account on the day of the migration (6/23).

The Exam Master url address will also change; so if you have Exam Master bookmarked, you will be redirected to the new portal url. Your email address and password (case sensitive) will remain the same. The enhanced system has new password requirements (minimum of 8 characters; at least 1 alpha and 1 numeric character), but you will not be affected by these new requirements until you attempt to reset or edit your password.

New and enhanced Exam Master Online user features include:

• the ability to create user exams/studies from various outlines, topics and subjects  Previously users were required to choose a single outline.
• the ability to create exams from missed questions
• the ability to receive a score report (including strengths and weaknesses) from sessions accessed in study mode
• in system email messaging
• enhanced dashboard provides easy access to recently created user exams and score reports

Watch a brief video overview of the enhanced Exam Master Online (user/student view) – http://youtu.be/EYO0VL25aNk and/or Flashcards – http://youtu.be/q2ACqO_D1OQ.

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Crush your board exams this summer with help from the EVMS Library

We can’t take the boards for you, but the EVMS Library subscribes to several online board review tools including ExamMaster and the Q&A content in AccessMedicine that will help you prepare for the USMLE, PANCE and other board exams. Both ExamMaster and AccessMedicine are easily accessed from on or off campus through the Quick Links on the Library’s public (http://www.evms.edu/library/) and private home page (https://myportal.evms.edu/departments/library/

ExamMaster Online contains review modules for the USMLE, the PANCE, as well as modules for the basic sciences, medical specialties and pharmacology. Use your EVMS email address to create an account with ExamMaster and a password will be emailed to you immediately. Log in, change your password if you like, and create a custom exam or take one of the many practice exams available.

Below is an outline of the subjects covered along with the number of questions in each bank.

USMLE

  • USMLE Step 1 Board Preparation (2266 Questions)
  • USMLE Step 1 Medical Subject Review (2266 Questions)
  • USMLE Step 2 CK Board Preparation (2706 Questions)
  • USMLE Step 2 CK Medical Subject Review (2441 Questions)
  • USMLE Step 3 Board Preparation (2716 Questions)
  • USMLE Step 3 Medical Subject Review (2457 Questions)

Medical Certification

  • Internal Medicine Certification Review  (2821 questions)
  • Family Medicine Certification Review  (4407 questions)
  • General Surgery Certification Review  (1070 questions)
  • General Pediatrics Certification Review  (817 questions)
  • SPEX (Special Purpose EXamination)  (4131 questions)

Medical Subject Review

  • Anatomy  (529 questions)
  • Biochemistry  (1375 questions)
  • Cytology and Histology  (1220 questions)
  • Embryology  (346 questions)
  • Gynecology and Obstetrics  (226 questions)
  • Immunology  (226 questions)
  • Internal and Clinical Medicine  (1864 questions)
  • Medical Microbiology (1130 questions)
  • Pathology  (1568 questions)
  • Pediatrics MS  (203 questions)
  • Pharmacology  (310 questions)
  • Physical Diagnosis  (245 questions)
  • Physiology  (1512 questions)
  • Preventive Medicine and Public Health  (360 questions)
  • Psychiatry  (1013 questions)
  • Surgery MS  (181 questions)

Physician Assistant

  • Medical Subject Review for Physician Assistants  (7992 questions)
  • PANCE/PANRE Certification Review  (2887 questions)
  • Clinical Modules for Physician Assistants  (5107 questions)

Pharmacy

  • Pharmacy Review (NAPLEX)  (1776 questions)
  • Supplemental Medical Sciences for Pharmacy  (10104 questions)

Dentistry

  • Dental Subject Review for NBDE Part I  (2163 questions)

To learn more about ExamMaster Online

Access Medicine includes a review tool for the USMLE called USMLE Easy as well as review resources for the basic sciences and some medical specialities. Click on Q&A in the AccessMedicine navigation bar to get to these resources.

USMLE Easy – 100 questions each for Steps 1 through 3.

Clinical Self-Assessment:

  • Harrison’s Principles of Internal Medicine: Self-Assessment and Board Review, 18e Over 1,000 multiple-choice questions accompanied by answers, detailed explanations, and chapter references to Harrison’s Online
  • Williams Obstetrics, 23e Study Guide More than 1700 self-assessment questions and answers, thoroughly covering every major topic in current clinical obstetrics, linked to Williams Obstetrics online for further study.
  • Hurst’s Imaging Tests Imaging cases in cardiology that challenge your test reading skills. Cases present images and video for interpretation.
  • AngiographyIncludes 7 modules

Self-Assessment from the Lange Educational Library

  • Biochemistry: 258 questions from Harper’s Illustrated Biochemistry, 29e
  • Biostatistics: 65 questions from Basic & Clinical Biostatistics, 4e
  • Differential Diagnosis: 188 questions from The Patient History: An Evidence-Based Approach to Differential Diagnosis
  • Endocrine Physiology: 45 questions from Endocrine Physiology, 3e
  • Epidemiology: 145 questions from Medical Epidemiology, 4e
  • Gross Anatomy: 236 questions from The Big Picture: Gross Anatomy
  • Microbiology: 664 questions from Jawetz, Melnick, & Adelberg’s Medical Microbiology, 26e
  • Microbiology: 126 questions from Sherris Medical Microbiology, 5e
  • Medical Biochemistry: 113 questions from The Big Picture: Medical Biochemistry
  • Microbiology & Immunology: 1090 questions from Review of Medical Microbiology and Immunology, 12e
  • Neuroanatomy: 100 questions from Clinical Neuroanatomy, 26e
  • Pathology: 130 questions from Pathology: The Big Picture
  • Pharmacology: 833 questions from Trevor/Katzung’s Pharmacology: Examination & Board Review, 10e
  • Physiology: 261 questions from Ganong’s Review of Medical Physiology, 24e

Please let us know if you have any questions about these resources. Email us at library@evms.edu or call us at 757 446-5851.

Good Luck on your exams!

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VisualDX Trial

The EVMS Library has a trial through the end of June to VisualDX,  a visual clinical point-of-care decision support tool that helps clinicians diagnose visually presenting conditions.

VisualDX integrates with UpToDate, so during our trial you may notice additional content within UpToDate marked with this icon .  There is also a mobile version for Apple and Android devices that you can freely download during the trial.

VisualDx helps in the identification of dermatologic, infectious, genetic, metabolic, nutritional and occupational diseases, benign and malignant growths, drug-induced conditions, and other injuries.  It allows physicians to search by diagnosis, build a patient-specific differential, or look up drug-induced adverse reactions by medication.  It includes over 25,000 images covering more than 1,200 pediatric and adult conditions.

Click here to start searching VisualDX. (EVMS Network account required for off-campus access. Call 757-446-5871 or email comphelp@evms.edu with any Network access problems.)

You can view a quick tutorial here – http://www.visualdx.com/features/video-overview.

Please let us know what you think about VisualDX by completing this short survey - https://www.surveymonkey.com/s/EVMS_VisualDX

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Evidence Based Healthcare and Downton Abbey

Continuity of care, the problem with expert opinion, and evidence-based medicine – sounds like your Epi-Bio class, right? Actually, these topics were all covered in the third season of Downton Abbey.  Family members were divided on whether the very pregnant Sybil should have Dr. Clarkson, the family doctor, attend her delivery or Sir Philip Tapsell, the expert, who had never met her. The expert won out, but Sybil died; since Sir Philip didn’t know what was “normal” for her and failed to diagnose her eclampsia.

According to the American Academy of Family Physicians (AAFP), “Continuity of care is rooted in a long-term patient-physician partnership in which the physician knows the patient’s history from experience and can integrate new information and decisions from a whole-patient perspective efficiently… The continuity of care inherent in family medicine …enables family physicians to be more effective patient advocates and … makes early recognition of problems possible. “1

The family physician, Dr. Clarkson, suspected eclampsia because of subtle changes in Sybil and ordered urinalysis to confirm it.  The expert refused to be swayed by the evidence.

BMJ published a tongue-in-cheek article in 1999 called Seven alternatives to evidence-based medicine. Unfortunately for Sybil, the expert was a proponent of two of these alternatives, Eminence and Vehemence-based medicine. 2

Eminence based medicine—The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence…These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.”

Vehemence based medicine—The substitution of volume for evidence is an effective technique for brow beating your more timorous colleagues and for convincing relatives of your ability.

Sybil’s death caused a rift between her father, Lord Grantham – who put his faith in the expert – and her mother, Cora – who trusted the family doctor. The grandmother, Lady Violet, attempted to heal the rift through the use of evidence-based medicine. She asked Dr. Clarkson to “Look at the evidence honestly and without bias”to see if prompt treatment could have saved her.

Looking at the evidence “honestly and without bias” when treating patients is exactly what we ask of practitioners. It may not always save a marriage, but it will save lives.

1        http://www.aafp.org/online/en/home/policy/policies/c/continuityofcaredefinition.html

2        Isaacs, D and Fitzgerald, D. Seven alternatives to evidence-based medicine. BMJ 1999;319:1618 http://www.bmj.com/content/319/7225/1618

3       Downton Abbey (TV Series) 2012. Episode 3.05.

 

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Remembering David Brown

Outside the Brickell Medical Sciences Library is a display case containing David Brown’s blue jumpsuit.  You’ve probably walked past it dozens, if not hundreds, of times. Today, take a moment to look at some of the items in the case; since it marks the ten year anniversary of the Columbia space shuttle disaster.

David Brown, MD was a 1982 graduate of EVMS and one of the astronauts on the Columbia.  Robert McCombs, the former Dean of Student Affairs, received an email from David the day before the disaster. The email ended with the following: “I will make one more observation. If I’d been born in space, I know I would desire to visit beautiful Earth more than I’ve ever yearned to visit space. It’s a wonderful place.”

 

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Finding Answers to Clinical Questions: the 6 “S” Model

Where do most of you go when you need to find answers to clinical questions?  We posed that question to a group of students recently, and heard a lot of ‘Google’s in the audience.  Google is a great search engine, but what sources give you the best, most reliable evidence about treating patients?  What sources are the quickest and most efficient to use?

According to Dr. Brian Haynes of McMaster University, it’s helpful to think of clinical reference sources as being arranged in a six level hierarchy of evidence with the most efficient to search – i.e., evidence-based Point of Care databases – on the top.    Databases of individual studies make up the bottom of the pyramid.  He calls this the “6′S’” model for the organization of evidence-based information services.” 1

The different levels are outlined below together with some of the representative databases available through EVMS.  Ideally, you should start your search at the top of the pyramid and move down through the levels if you need more detailed information.

Systems are decision support systems that link individual patient records to the best evidence about their conditions.  These are rare at this time, but you may find rudimentary systems at some hospitals.

Summaries provide critically appraised, concise information on all aspects of patient management and derive their information from the best evidence found in the lower “S” levels.  The Brickell library subscribes to several summary type resources.  Most of these are available to EVMS associates from on and off campus through this link: http://www.evms.edu/library/resources/databases/#EBMCat.

Synopses are critically appraised summaries of individual trials or systematic reviews.   Synopses of systematic reviews make up the 3rd level and synopses of individual studies make up the 5th level.  EVMS subscribes to one of the best examples of this type of database.

Syntheses are systematic reviews of individual trials.  Most systematic reviews address treatment or prevention; but the number of systematic reviews answering other types of clinical questions – e.g., diagnosis, etiology, and prognosis – is growing.

  • Cochrane Library (Primarily covers treatment and prevention -  Diagnostic reviews are in the works)
  • DARE Database (free and through the Cochrane Library)
  • PubMed LinkOut/ MEDLINE * (use article type limit “Meta-Analysis” or “Systematic Reviews”)

Studies are the original trials or studies – i.e., the primary literature.  You must critically appraise this evidence yourself before deciding whether it will be helpful for your patients.  Some of the primary research databases licensed by EVMS include

  • PubMed LinkOut or MEDLINE OVID*
    Particularly Clinical Queries (Filters available to limit search to studies of treatment, prognosis, etiology, diagnosis, and systematic reviews.)
  • CINAHL (allied health and nursing literature)
  • PsycINFO (for research with a behavioral or psychological component)

Please contact April Pace in the library (paceaa@evms.edu, 446-5846) if you would like more information or training in the use of any of these databases.  Also contact her if you would like DynaMed on your mobile device.

1. Haynes, Brian.  Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model.  ACP Journal Club. 2009 Sep 15;151:JC3-2.

*PubMed LinkOut and OVID Medline provide links to EVMS full-text electronic journals.

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