Medical Professionalism

1
Medical Professionalism

• Finding Information Using 
• Alumni Medical Library Resources

2
Bioethics Subject Guide Page

• Subjects A-Z tab on library homepage
• The Bioethics Subject Guide contains links to the
  library catalog, relevant e-texts, databases,
  journals, and recommended websites that are good
  starting places for an information search.

3
Print Materials Library Catalog

• Search the library catalog for books on a topic.
• There are three main ways it may be helpful to
• search the catalog by Keyword, by Subject,
• and using MeSH (Medical Subject Headings)

4
Searching the Catalog Keywords

• A keyword search looks for the terms you enter
• in the title or description of the item.
• Here, you can simply use medical
  professionalism."

5
Searching the Catalog Subject

• Choose Advanced Search option

6
Searching the Catalog Subject

• Select Subject
• from menu
• Subject terms to try
• Bioethics
• Medical Ethics
• Physicians Professional Ethics

7
Searching the Catalog MeSH

• MeSH (Medical Subject Headings) is the vocabulary
• used to index articles in Ovid MEDLINE and
  PubMed.
• You can also search the library catalog using
  these
• terms. 
• The next slide shows MeSH terms that may be
  useful in
• locating print information on Medical
  Professionalism.

8
MeSH Terms for the Catalog

• Professionalism/ethics
•  
• Bioethics
• Ethics, Medical
• Physician's Role
• Professional Practice

• Specific issues
•  
• Confidentiality
• Conflict of Interest 
• Privacy
• Truth Disclosure

9
Searching for Journal Articles

• Often you will not find a print book on your
  topic, and will wish to search one or more of the
  library's databases to locate useful journal
  articles.
• The premier database for biomedical journal
  literature is the National Library of Medicine's
  MEDLINE, accessible either through PubMed or
  through the Ovid MEDLINE interface, provided by
  the Alumni Medical Library.
• Both use the MeSH vocabulary.

10
Ovid MEDLINE Overview

• Millions of citations to articles in biomedical
  journals
• No login needed on 11th and 12th floors of
  library
• For offsite access, use Ovid login and
  password (apply in the library not the same as
  BU ID and Kerberos password)

11
MeSH Notes

• Many more MeSH terms are useful for article
  searches in Ovid MEDLINE than are likely to be
  used for print items in the library catalog.
• Medical Professionalism is a broad and varied
  topic with many potentially relevant terms, so
  you may need to try different combinations of
  headings depending on exactly what you're looking
  for.
• It is almost always a good idea to use a
  controlled vocabulary (like MeSH) if one is
  available, since a human is responsible for
  assigning these terms.

12
Ovid MEDLINE

• For current materials, use top MEDLINE link,
  covering past 10 years.
• For retrospective and/or comprehensive search,
  use third MEDLINE link for entire database back
  to 1950.

13
Ovid MEDLINE Searches

• Enter search terms one at a time. 
• Make sure the box is checked to 'Map Term to
  Subject Heading.'
• The next slide shows MeSH terms that may be
  helpful for locating materials on Medical
  Professionalism.
• Choose those that seem most promising for your
  topic.

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MeSH Terms for Ovid MEDLINE

• Professionalism/ethics
•  
• Bioethics
• "Codes of Ethics"
• Ethics, Medical
• Physician's Role
• Physicians (with Ethics and Standards 
• subheadings)
• Professionalism (as a keyword .mp in Ovid)
• Professional Practice

• Specific issues
•  
• Confidentiality
• "Conflict of Interest" 
• Disclosure
• Drug industry
• Gift Giving
• Industry
• Privacy
• Truth Disclosure

15
Ovid MEDLINE MeSH Terms

• Check Explode to include more-specific terms
  (recommended to keep the search broad).
• Check Focus to retrieve only articles for which
  the search term is a main subject (not
  recommended for initial search--may eliminate
  useful results).
• Click the blue "i" (Scope) for a definition of
  the term, if desired. Then click Continue.

16
Ovid MEDLINE Keyword Searches

• If there is no MeSH term for a concept, you will
  see a list of other terms you may wish to use
  instead.
• You also have the option to search for the
  original term as a keyword.
• Since the word "professionalism" may be used by
  authors even though it is not a MeSH term, it is
  a good idea to run this keyword search.

17
Ovid MEDLINE Subject Headings

• Each MeSH term may be associated with one or more
  subheadings, which narrow the search to specific
  aspects of a topic for example, only historical
  information on Ethics, Medical.
• As a general rule, click Include All Subheadings
  to keep the initial search as broad as possible.
• Click Continue to see results.

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Note on Subject Headings

• Sometimes you will want to select a few
  subheadings rather than including them all. For
  example
• The MeSH term 
• Physicians 
• is extremely broad.
• Using the 
• Ethics 
• and 
• Standards 
• subheadings limits the results to those most
  likely to be relevant to the topic of Medical
  Professionalism.

19
Ovid MEDLINE Search Results

• When you have several results sets for searches
  on different terms, check the boxes next to two
  or more and combine the sets with
• AND (if you want results to contain both of the
  terms from the initial searches) 
• OR (if you want results to contain either of the
  terms from the initial searches)

20
Ovid MEDLINE Using OR

• If there is no MeSH term for a concept, as
  with Medical
• Professionalism, it may be helpful to run several
• searches for related terms and combine the
  results sets
• with OR to create one 'superset' covering that
  broader
• concept.

21
Ovid MEDLINE Using AND

• If you are interested in medical professionalism
  as it
• relates to a specific issue, for example
  "conflict of
• interest," you can then search for this term...
• ...and combine it with your 'superset' using AND.

22
Ovid MEDLINE Refining Results

• If you get too many results to easily review, add
  more search terms, or try Limits.
• Popular limits are listed below
• the search box to see others
• click Additional Limits.
• Limits can narrow search results 
• by article type, publication year, 
• subject criteria, language, and more.
• It is advisable to apply limits one at 
• a time, to see how each affects the search
  results.

23
Ovid MEDLINE Viewing Results

• Scroll down the page to see results of the latest
  search, or click Display next to any set to see
  those results.
• Click the blue links at the right of each
  reference to see abstract (if available) or
  complete reference, access full text online (if
  available), or search the library catalog for the
  journal in which the article appears.

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Ovid MEDLINE Complete Reference

• Complete Reference shows all available
  information about an article, including abstract
  (if present) and a list of MeSH terms used to
  index the article.
• Terms you searched will be in red. If one of the
  others seems useful, click to automatically run a
  search for it.

25
Ovid MEDLINE Help

• Alumni Medical Library tutorials 
• http//medlib.bu.edu/tutorials/medline/
• Reference Desk, staffed 830am-500pm weekdays
• Meet with a librarian call or email to make an
  appointment

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Other Useful Databases

• MEDLINE is the primary resource for biomedical
  journal articles, but other databases may also be
  helpful
• Academic OneFile
• CINAHL (Cumulated Index of Nursing and Allied
  Health Literature)
• PsycINFO
• Web of Knowledge

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Accessing Databases

• Access databases on the Alumni Medical Library
• homepage under E-Resources

28
Academic OneFile

• Academic OneFile lists articles from journals
  covering a
• broad range of subjects.
• While it does not primarily focus on medical
  topics,
• useful articles can still be found here.

29
Academic OneFile Subject

• Subject Guide Search
• Medical Ethics
• Professional Ethics
•  
• Also, click 'related subjects' to see subject
  headings for specific ethical issues

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Academic OneFile Keyword

• Advanced Search
• Keyword medical 
• And
• Keyword professionalism

31
Academic OneFile Results

• You can refine results by adding more search
  terms, or by limiting to publication type,
  document type, date, etc.

32
CINAHL

• CINAHL (Cumulated Index to Nursing and Allied
  Health
• Literature) covers major nursing and allied
  health
• journals.
• It will not always be relevant for biomedical
  searches,
• but it can be a good source of information on
  some
• topics.

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CINAHL Subject

• CINAHL Headings (subject search) 
• Professionalism 
• Ethics, Professional
• Ethics, Medical

34
CINAHL Keyword

• Advanced Search 
• Select TX All Text and enter keywords
• medical
• and
• professionalism

35
CINAHL Results

• You can narrow and limit results, add extra
  search terms, or search the library catalog for
  the journal.

36
CINAHL Results

• Click an article title to see the full reference
  and the subject terms used to index it. 
• If one of them seems relevant, you can click to
  run a search for that term.

37
PsycINFO

• PsycINFO (and PsycARTICLES, a subset that
  includes only full-text articles) searches the
  psychological literature.
• PsycINFO is larger (including all information
  from the PsycARTICLES subset), so for a broad
  search, you will want to use it even though many
  results are not full-text.
• If you want only full-text results, you may wish
  to use PsycARTICLES.
• Both may be searched in the same way.

38
PsycINFO Subject

• Thesaurus (Subject) Search
• Bioethics
• Professionalism
• Professional Ethics
• Professional Standards
• And
• Physicians

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PsycINFO Combining Subjects

• Try combining subject headings 
• ((DE "Professionalism" or DE "Professional
  Standards" or DE "Professional Ethics" or DE
  "Bioethics")) and (DE "Physicians")
• You can also apply various limits to narrow the
  search.

40
PsycINFO Keyword

• Advanced Search 
• Select TX All Text and enter "medical
  professionalism."
• Depending on the specific topic of your search,
  you may also wish to try other keywords.

41
PsycINFO Results

• You can narrow and limit results, add extra
  search terms, or access full text (if available).

42
PsycINFO Results

• Click the article title to see the full reference
  and subject
• terms used to index it. 
• If one of the other indexing terms seems
  relevant, you
• can click to run a search for that term.

43
Web of Knowledge

• Web of Knowledge is a major source for articles
  in a
• wide range of fields, including the sciences,
• social sciences, and humanities.
• The subset database Web of Science is an
  excellent
• place to find articles from scientific journals
  that may not
• be included in MEDLINE.

44
Web of Knowledge Search

• Web of Knowledge (and its subset database, Web of
  Science) does not use a controlled vocabulary to
  index items, so effective use of keywords is
  necessary.
• Try "medical professionalism" as a topic phrase.

45
Web of Knowledge Results

• Refine the search by adding 
• additional terms related to the 
• specific issue (i.e. "confidentiality") 
• or by checking off specific categories 
• or subject areas.
• You can also try additional topic
• keywords.
• Since there is no standardized list
• of subject terms, you may need to 
• try the search with several different
• terms and combinations.

46
Web of Science

• This science-focused subset of Web of Knowledge
  also lacks a standardized subject vocabulary, but
  does offer an Advanced Search option (it can also
  be searched in the same way as Web of Knowledge
  using the default Search mode).
• Access Web of Science from its tab on the main
  Web of
• Knowledge page.

47
Web of Science Search

• In the Advanced Search mode, you must use the
  listed "field tags," i.e. TS for a Topic (or
  subject).
• Boolean operators (AND, OR, NOT) may also be
  used.

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Web of Science Search

• Try for example
• (tsmedical OR tsphysician) AND
  (tsprofessionalism OR tsprofessional ethics)
• Scroll to Search History at the bottom of the
  page and click on the number of results to
  display.

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Web of Science Results

• You can then narrow the results 
• by adding more terms or checking 
• a desired Subject Area, 
• Document Type, etc.
• Again, you may need to try several 
• combinations of keywords since
• there is no standardized list
• of subject terms.

50
Web Searching Google Scholar

• Google Scholar (http//scholar.google.com) can be
  a way to locate relevant materials that are not
  published in journals position papers,
  association guidelines, policy statements, etc.
• Try combining various synonyms of your keywords
  with Boolean operators (AND, OR) to focus your
  query. 
• For example
• (medical OR physician) (professionalism OR
  professional ethics OR professional standards)

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For Additional Assistance

• If you have questions about any of the library's
  resources, or would like advice on a search
• Call or visit the Reference Desk 830am-500pm,
  Monday through Friday [phone] 
• Email your question to refquest_at_bu.edu
• Call or email to make an appointment to meet with
  a librarian 
• Your library is here for you!
• ?

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Additional Resources

• Fundamentals of Medical Ethics, World Medical
  Association Course offering 8 CME hours.
• Gender in Medical Education Professionalism,
  Gender and Health Collaborative Curriculum
  Module examining professionalism and gender.
• Professionalism Social Responsibility in
  Medicine PDF, National Health Care for the
  Homeless Council Practice cases on ethical
  issues of providing care to homeless persons and
  undocumented immigrants.
• What You Should Know About Gifts to Physicians
  From Industry, American Medical Association
  Series of self-study CME modules on professional
  relations with industry.