Multifaceted Online Interventions to Increase Medical and Nursing Students Searching of Current Best Evidence to Answer Clinical Questions (MPFS-2)

1. Rationale & Objectives

One main barrier to achieving evidence-informed care by clinicians is lack of quick and easy identification, appraisal and synthesis of current best evidence. Clinicians and students information needs are considerable - but about 3000 articles are published in Medline every day. Numerous evidence-based resources have been developed to filter and process the evidence, but although increasingly used, each offer a fragmented and scattered view of information, and none provides comprehensive topic coverage or satisfactory updating.

To address theses problems, McMaster's Health Information Research Unit (Hamilton, Ontario, Canada) has developed and implemented "McMaster Premium LiteratUre Service Federated Search (MPFS)", an online search engine that provides a unique 1-stop search and organized access to current best evidence in daily practice. MPFS provides both alerts to users about new research, and a novel federated search function, with the particular feature of organizing information according to the "pyramid of evidence-based resources", with the most clinically applicable evidence at the top. Thus MPFS simultaneously retrieves evidence from Studies ("Medline", both filtered and unfiltered, at the bottom), then Systematic reviews; Synopses of studies and systematic reviews (selected for methodological rigor and clinical relevance), and, at the top level, online widely used Summaries (e.g."Best Practice").

Combining features of the current best evidence-based resources is not enough to increase access and use of current best evidence. Additional well-known barriers that need to be overcome include logistical barriers (time constraints, forgotten questions, and simplicity of using one single albeit limited resource), as well as educational barriers (eg, lack of awareness of the "architecture" of evidence and limits of other single resources, lack of knowledge and experience of what federated searches can offer, limited searching skills, and lack of reference standards among peers for finding best evidence). 2. Hypothesis

This trial seeks to test 3 innovative online interventions among medical and nursing students registered to MPFS to overcome these barriers and increase the quantity and quality of searching for current best evidence to answer the learning needs and clinical questions. These interventions build on effective models for the teaching of clinical skills at the point of care, so that they are facilitated in using the search engine as a clinical tool, and perceive evidence retrieval skills as true clinical skills. 3. Methods