Making the most of features on Queen’s Library website
By Suzanne Maranda, Head Health Sciences Librarian, Queen’s University Library
[Editor’s note: text in italics indicates a hyperlink]
After I demonstrated the Queen’s University Library (QUL) website at the December 2017 UGME Curriculum retreat, Dr Sanfilippo asked me to prepare an entry for this blog with further information about the site. The changes to the website that occurred in the fall of 2016 were quite dramatic and many of you sent us feedback about the new QUL web pages. During the 16 months since the new QUL website was launched, the librarians collected this user feedback and worked closely with the Library staff to implement a few features that would benefit all our users.
The QUL website was redesigned to offer access to all services and resources via the main page. The main library page has an extensive top bar menu that remains on all library pages and can lead users to all the central services, including the library catalogue (QCAT) and Summon, our discovery tool, as well as to the specific subject areas, such as health sciences. For the Health Sciences community there are now two types of library web pages:
- The Bracken Library physical space page: this is where you reserve a library group room, check our hours and other services related to the physical collection (e.g. signing books out, requesting materials) and using the library spaces.
- The health sciences collections subject page: this is where you find access to health sciences databases and resources such as the point-of-care tools, mobile apps, multimedia materials. This page is grouped with all the other subject pages on campus, which you can find on any library page under “Search/Research by Subject” in the top banner and menu.
Based on user feedback, the Health Sciences subject guide was edited in 2017 to provide quick access to health sciences resources. Some of the most important resources are now at the top of the page, e.g. Medline, CINAHL, PubMed1 and Point-of-Care tools. You will however want to look at the subject guides prepared by librarians to support your research and teaching information needs. There are subject guides for Nursing, Medicine, Rehabilitation Therapy, and Life Sciences and Biochemistry. To access health sciences resources quickly, add the relevant subject guide link to your web browser favourites list and learning management software for students in your classes. We also have guides that highlight resources for specific programs or topics (e.g. Aging and Health, History of Medicine), and guides that are more about tools such as citation management, avoiding predatory publishers and the one with approaches and resources to develop systematic reviews and other syntheses. Check out the complete list of guides on the Health Sciences Subject page.
These guides are prepared for you BUT we would love your input: if anything you find worthwhile could be added to the list of resources, please let us know. Any resource format can be included in addition to books and journals: websites, videos, images… if you find something useful, whether in our library collection or on the web (for the latter we will ensure that it can be shared widely), please send us a note. And of course, if you think that a new guide could be developed to support your teaching and research areas, please contact us.
Best wishes for happy searching and be sure to reach out if librarians can help you locate and organize information (remember, we love doing this and just maybe… you have other things to do!). Please continue to tell us what you think of the new library web pages.
1Note that searching Pubmed via a library page brings all the links to full-text available via the QUL collections.
New and improved resources for teaching, research and clinical application
By Suzanne Maranda, Head Health Sciences Librarian, Queen’s University Library
(Italics indicates a hyperlink)
Are you looking for images to include in your presentations or online modules? Two Thieme products are now available online and any materials from these two resources, one in Anatomy and the other in Pharmacology, can be extracted and included in any materials that will be used in a Queen’s course or presentation. Please contact me if you would like the complete license agreement.
Usage statistics of these resources will be collected to inform our decision about renewing or not. There are two other products (Physiology and Biochemistry) from the same publisher that could be added if requested and if funds permit. The two subjects purchased were chosen in consultation with the staff preparing online modules for the BHSC program.
The other tool I would like to highlight is relatively new as it was added in September 2017. Read by QxMD is a mobile app that enables a more direct link to the journal articles subscribed by the Library and to open access journals. The link provided here is to the page of all our mobile apps, please scroll to the instructions on how to get Read to work with the Queen’s resources. When you set up a profile, you can receive email notifications of new articles that match your profile. Check out the new “medical education” option that I requested be added. This company is quite responsive, I would be happy to pass on other topic/category suggestions.
Isabel is a diagnostic support tool that can be useful in clinics and possibly for teaching clinical skills. In December 2017 the librarians participated in a webinar with the developer of Isabel to review software enhancements.
Once a few symptoms are entered, a list of possible conditions is presented for follow-up, the coloured bar on the side (see green arrow) of the list indicates the strength of the likelihood (red is best). Notice the separate tab at the top of the results box for possible drugs ( ) that may cause the symptoms you entered. By clicking on a condition, you are taken to the Dynamed entry by default. If there is no Dynamed entry, then we link to BMJ Best Practice. A few other resources have been added for linking, you see these in the left hand box, so that one can choose to look at a different resource, or even consult more than one. There is a mobile version of this clinical tool, see instructions on our mobile apps guide.
I hope you will try Isabel and consider completing the online survey (at the red arrow) that is linked from the Isabel pages to ask for your feedback about this resource.
As always, do contact us if you have any questions about the above resources or anything else information-related.
Teaching, Learning and Integration Committee Summer Update
By Lindsay Davidson, Director of Teaching, Learning, and Integration
As classes (at least in years 1 and 2) have now ended, and teachers are perhaps thinking about courses that will resume in the fall, I wanted to provide you with an update of items from the TLIC. Some of these may already be familiar to you, but perhaps some are “new”. If you need any further information, please feel free to contact me directly or one of our Educational Developers (Theresa Suart from Years 1 and 2 and Sheila Pinchin for Clerkship and the “C” courses).
- Resources attached to learning events – these include lecture notes, classroom slides, required pre-class readings and optional post-class readings/resources. MEdTech is enabling a new feature for the upcoming academic year. Teachers will be required to review and “publish” each resource every year – with the option of adding in delayed release if appropriate. The goal of this is to provide students with an up-to-date, curated set of resources, deleting old files. Please direct any questions about this to Dr. Lindsay Davidson.
- Remember: “less is more”: Students report that when there are an excessive number of files, they often read few/none of them in advance.
- Clearly designate what is MANDATORY to review PRE-CLASS by indicating this in the “Preparation” field on the learning event, and checking the appropriate boxes on the menu when you review the resources.
- AVOID using dates on your slides/slide file names – students are sometimes disappointed to see that the file dates from 2009 or prior.
- The Curriculum Committee has approved a new learning event type – “Games” – reflecting several sessions already existing in the curriculum. This is defined as “Individual or group games that have cognitive, social, behavioral, and/or emotional, etc., dimensions which are related to educational objectives”. This type of activity might include classroom Jeopardy or other similar activities designed to allow students to review previously taught knowledge (content delivered either independently or in the classroom) and to provide them with formative feedback on their understanding. The instructional methods approved by the Curriculum Committee include:
Please direct any questions about this to Theresa Suart.
- Workforce – The Workforce Committee has recently adopted some changes including the following:
- Addition of credit for teachers who grade short answer questions or team worksheets
- Doubling of credit for teachers who develop new (or significantly renovate) teaching session
- Limit of one named teacher per DIL event
- Limit of one teacher per SGL event (gets additional credit to reflect session design, learning event completion, submission exam questions); additional teachers credited as tutors (credit for time in the classroom) – the Course Director may be asked to clarify who is the “teacher” and who is/are the “tutors”
- Reduction of credit for large classroom sessions (that are not new/newly renovated and/or do not involve grading)
Please direct any questions about this to Dr. Sanfilippo.
- Tagging of Intrinsic Role objectives. The TLIC and the Intrinsic Role leads recently held a retreat. One of the items that was identified was “overtagging” of sessional objectives with intrinsic role objectives such as communicator, collaborator, professional etc. by well meaning teachers. We are undertaking a comprehensive review of how these Intrinsic Roles are taught/assessed in the curriculum and would ask teachers/course directors NOT to tag sessions with these unless there has been a direct communication with the relevant Intrinsic Role lead.
- Communicator: Dr. Cherie Jones: firstname.lastname@example.org
- Collaborator: Dr. Lindsay Davidson: email@example.com
- Leader: Dr. Tony Sanfilippo: firstname.lastname@example.org
- Advocate: Dr. Jenn Carpenter email@example.com
- Professional: Dr. Rachel Rooney rooneyr@KGH.KARI.NET
- Scholar: Dr. Heather Murray firstname.lastname@example.org
Please direct any questions about this to Dr. Lindsay Davidson.
- DIL feedback from students. Over the past year, we have received useful feedback from students regarding the content and structure of Directed Independent Learning (DIL) sessions in Years 1 and 2. This will be collated and communicated to Course Directors shortly. Theresa Suart will be in contact with teachers/Course Directors should any sessions be identified for review/revision.
- Online modules. We have developed a process to facilitate the development of high quality online modules, often used as resources in DIL session. These are highly appreciated by students and are used for review in clerkship as well as pre-MCC exam. The current list of modules is available here: https://meds.queensu.ca/central/community/ugme_ecurriculum If you would like to create (or revise) a module for your course, please complete the linked intake form: https://healthsci.queensu.ca/technology/services/elearning/online_learning_modules/get_help
- New wording of learning event notices. You may have noticed this over the past year. The wording of the 3 email notices received by teachers has been revised. In particular, it has been streamlined and customized to provide specific, focused reminders prior to the scheduled teaching. We would appreciate any feedback or suggestions that you have about this change.
- Video capture In 2016-17, lecture sessions were video captured in select year 1 and 2 classes. We will be analyzing how these videos were used by students over the summer and will likely be continuing this into the fall. Please provide any feedback or comments that you have about this pilot to Theresa Suart.
Feel free to get in touch:
- Dr. Lindsay Davidson – email@example.com
- Sheila Pinchin – firstname.lastname@example.org
- Theresa Suart – email@example.com
Using Copyrighted Images in an Educational Setting: A Primer
By Mark Swartz, Copyright Specialist
Understanding a few of the basic concepts behind Copyright law can help explain why some images can be used in certain situations and others cannot. The most useful concept to consider when thinking about how images can be used is balance.
A Balancing Act
In the landmark Supreme Court case Théberge v Galerie d’Art du Petit Champlain Inc, Justice Ian Binnie characterizes Copyright Law with the following statement:
The Copyright Act is usually presented as a balance between promoting the public interest in the encouragement and dissemination of works of the arts and intellect and obtaining a just reward for the creator.
When you create a work, whether it is a book or an article, a photograph, a painting or any of the other types of expression covered by copyright (Copyright Act, RSC 1985, c C-42, s 5 retrieved on 2015-10-16), you automatically get a bundle of exclusive rights to that work. These rights include the right to copy, to distribute, and to assign your rights to others. The full sets of rights that you get are listed in the Act (Copyright Act, RSC 1985, c C-42, s 3 retrieved on 2015-10-16). And, while these rights are exclusive, they are limited in both time and scope. The balance between exclusive rights and limitations ensures that creators are fairly compensated for their work, while still allowing for some permission-free uses in ways that contribute to the public good.
Limitations to the exclusive rights of copyright holders include the following:
- Copyright protection does not last forever. In Canada, the general rule is that Copyright lasts for 50 years after the death of the copyright holder. After that point, the work will fall into the public domain and can be used for any purpose.
- The Copyright Act lists a number of situations where Copyrighted works can be used with permission from Copyright holders. These situations are called exceptions. The most well-known exception is called the fair dealing exception, which allows for some use of copyrighted material, as long as the use falls under one of the purposes listed in the Act, and if the dealing is fair (Copyright Act, RSC 1985, c C-42, s 29.1 retrieved on 2015-10-16).
If you have determined that you are using a copyright protected image, you need to get permission from the copyright holder or you must ensure that your use falls under one of the exceptions in the Copyright Act.
So what does this mean if I want to use images in my class?
There are a wide variety of exceptions that apply to the use of copyrighted images in a closed, educational setting like a classroom or a Learning Management System. In the classroom, there is an exception that permits the reproduction of copyrighted images for use in PowerPoint presentations on campus (Copyright Act, RSC 1985, c C-42, s 29.4 retrieved on 2015-10-16). Additionally, fair dealing and the publically available materials exception will allow for the inclusion of many images in PowerPoint slides uploaded to Learning Management Systems like MEdtech. For more information, please see the In the Classroom and the On the Internet sections of the copyright and teaching section of my website.
As for images used in student assignments and presentations, most of the images used by students are likely to fall under the fair dealing exception. I do, however, always recommend that students do their best to find copyright free (or suitably licensed) images, so that when students leave the university and are asked to use images in the workplace, they know how to find images that can be easily used without having to get permission. Suggestions for finding these types of images are available on the Resources page of the copyright and teaching section of my website.
What about using images in materials that I post to the open web? What about images in conference presentations, posters and in research projects?
When you move from a closed environment like a Learning Management System to an open environment, it becomes more difficult to rely on exceptions like fair dealing, particularly if you intend to use your work for commercial purposes at any point.
In these situations, I would avoid using copyright protected images without permission and instead rely on finding works that are either licensed through the Creative Commons or that are in the public domain. The “resources” link I included in the section above provides some resources for finding these types of images. Images used in conference presentations and posters are much more likely to be fair than those on the open web, but I would be careful posting these presentations and posters on conference websites.
Finally, most images used in research projects and theses are likely to be fair dealing. One complication is that if you are going to publish in a traditional journal or publication, it is likely that the publisher will require that you get permission for everything. Fair dealing is often perceived to be too much of a risk for these publishers, so, if you are going to go that route, make sure you find materials where permission can be granted easily or is not required.
This is just a brief overview outlining some of the main image-related considerations that you might come across as an instructor or researcher. If you have any further questions about the use of images, please get in touch with me at extension 78510 or at firstname.lastname@example.org.
Théberge v. Galerie d’Art du Petit Champlain inc.,  2 SCR 336, 2002 SCC 34 (CanLII), <http://canlii.ca/t/51tn> retrieved on 2015-10-16.
Copyright Act, RSC 1985, c C-42, s 29.1 <http://canlii.ca/t/52hd7> retrieved on 2015-10-16.
Bringing things into focus: Using focus groups to collect feedback
By Theresa Suart & Eleni Katsoulas
Amongst the plethora of student feedback we solicit about our courses, you may wonder why we sometimes add in focus groups. What could be added to the more than a dozen questions on course evaluation and faculty feedback surveys?
The information we gather in student focus groups doesn’t replace the very valuable narrative feedback from course evaluations, rather, it allows us to ask targeted questions, clarify responses and drill down into the data.
Developed from “focused interviews” around the time of the Second World War, focus groups emerged as a key qualitative research tool in the latter half of the 20th century. Robert K. Merton, a sociologist from Columbia University, is hailed as the “father of the focus group.” (He died in 2003 at age 92.)
Merton used focused interviews to gain insight into groups’ responses to text, radio programs and films. Politicians and marketing companies soon seized upon focus groups to gauge voter and consumer trends. The Queen’s UGME Education Team uses focus groups in a targeted way to augment information gleaned from course evaluation feedback, course director’s meetings with academic reps and other feedback tools.
According to a briefing paper from Carnegie Mellon University, focus groups are “particularly effective” for eliciting suggestions for improvement. “They are also much more flexible than surveys or scales because they allow for question clarification and follow-up questions to probe vague or unexpected responses.” It also helps that faculty rate focus groups as “accurate, useful and believable”.
If you’re asked to participate in a focus group, only agree if you think you have something to contribute to the investigator’s project or purpose. (Sure, it’s fun to come for the free food, but be prepared to contribute in a meaningful way).
- To be informed if the focus group is for research or curricular innovation (or both). Research studies must have approval from the Research Ethics Board and require specific paperwork to document informed consent. Curricular innovation focus groups are less formal, but will still respect confidentiality of participants. These might not have the same paperwork.
- The facilitator to set the ground rules, and guide the discussion. Savvy facilitators will do this with a minimum of fuss: they will listen more than they speak. (But you can certainly ask for clarification if you’re not sure of a question).
- A co-facilitator will likely take notes and monitor any recording equipment used. The co-facilitator may summarize after each question and solicit further input as required.
- You’ll be asked specific questions, and engage in conversation with the other participants.
What you shouldn’t expect:
- A venting session. This isn’t the time to just complain. A focus group is looking for constructive feedback and suggested solutions.
- To always have your say: the facilitator may realize they have reached saturation on a particular question and will move on. This is to respect your time. (You’ll have an opportunity to send additional comments electronically afterwards if you felt there is an important point that was missed).
What you can do to prepare:
- If the questions are provided in advance (this is best practice but not always possible on tight timelines!) you should take some time to think about them.
- Be sure you know where the meeting room is, and arrive on time.
What you can do during:
- Contribute, but make sure you don’t end up dominating the conversation. The facilitator will be looking for a balance of views and contributors.
- Listen attentively to others and avoid interrupting. The facilitator will make sure everyone has a chance to contribute – you’ll get your turn.
What you can expect from data collected at a focus group:
- It will be confidential. Different strategies are employed. For example, you may be assigned a number during the focus group and participants asked to refer to people by number (“Participant 2 said…”).
- In a formal research study, you should be offered an opportunity to review the data transcript after it is prepared. (This is sometimes waived on the consent form, so read carefully so you can have realistic expectations of the investigator).
- The end product is a summary of the conversation, with any emergent themes identified to answer the research questions.
What you can’t expect:
- A magic bullet solution to a challenge in a course or class.
- One hundred percent consensus from all participants – you can agree to disagree.
- For all outlier opinions to be represented in the final report. These may be omitted from summary reports.
We’re always grateful to our students for donating their time to our various focus group requests throughout the year. These contributions are invaluable.
If you think this type of data collection could be useful in your course review and revisions, feel free to get in touch. It’s one of the tools in our qualitative research toolbox and we’re happy to deploy it for you as may be appropriate.
Eleni Katsoulas email@example.com
Theresa Suart firstname.lastname@example.org
June Curricular Leaders Retreat held: EPAs, Remediation and Feedback, oh my!
After bringing another busy semester to a close, UGME curricular leaders took time to reflect on the past year and take part in workshops and discussion groups on a number of areas of the curriculum at their semi-annual Curricular Leaders Retreat on June 19. The aim of the retreat was to share information and to generate ideas and solutions to address teaching and assessment challenges.
In his end of year report, Associate Dean Anthony Sanfilippo highlighted accomplishments of the past year as well as announced new faculty appointments.
After providing an entertaining and informative review of the process of curriculum renewal that UGME has undergone over the last several years, including the development of the “Red Book” objectives, Dr. Sanfilippo discussed how the emerging use of Entrustable Professional Activities (EPAs) will relate to and refine our existing curriculum and assessment processes.
Dr. Sue Moffatt presented an information session on how the three classroom-based “C” courses relate to both clerkship and the rest of the curriculum.
In a discussion about Service-Learning, led by Dr. Sanfilippo, faculty brainstormed ways additional service-learning opportunities could be created for medical students and others as well as ways they could support and encourage students in these endeavours. The Service Learning Advisory Panel will consider their suggestions and recommendations.
As a follow-up to last year’s popular workshop on remediation strategies, Michelle Gibson, Richard Van Wylick and Renee Fitzpatrick presented “Remediation 2” with additional cases and strategies.
For the afternoon, participants chose between a session on writing narrative feedback or one on making ExamSoft work for you.
Designed in particular for faculty working in clerkship, clinical skills and facilitated small group learning (FSGL), for the workshop on narrative feedback, Cherie Jones and Andrea Winthrop provided concrete examples and solutions to situations faculty routinely encounter when needing to provided constructive feedback to students. This included a discussion of ways in which oral and written feedback differ.
In the ExamSoft workshop, Michelle Gibson, Eleni Katsoulas and Amanda Consack worked with faculty to show how to tag mid-term and final assessments to match to assigned MCC presentations and Red Book objectives as well as coding for author and key word. Using these ExamSoft tools upfront makes it possible to use built-in reports to blueprint assessments, rather than having to do so manually. (For more on ExamSoft, check out the team’s poster from CCME at this link.)
To wrap up the day’s activities, pre-clerkship and clerkship course directors brainstormed with competency leads for ways the milestones identified for these intrinsic roles can be met throughout the curriculum. How to highlight and incorporate patient safety in different courses was also considered.
Documents from the Retreat are available to curricular leaders under “Retreats” on the Faculty Resources Community Page.
New career advisor appointed
Dr. Anthony Sanfilippo, Associate Dean of Undergraduate Medicine has announced that Susan Haley has joined the staff of the UGME Student Affairs office as a career advisor. She will be working with Kelly Howse and Renee Fitzpatrick in UGME’s growing Career Advising group.
An anesthesiologist, Dr. Haley has practiced in Kingston for 16 years. Prior to moving to Kingston, she worked at Mount Sinai at the University of Toronto. While in Toronto, she also worked in the area of chronic pain treatment. Her current work interest is obstetrical anesthesiology.
Since coming to Kingston, Dr. Haley has becoming involved in undergraduate medical education and has really enjoyed working with medical students, she said in an interview.
“When this [position] came up, it seemed to be something I’d be interested in, helping students beginning their path to success.”
She noted that her own career has included a variety of experiences, including being a peer assessor at CPSO and sitting on a number of OMA committees.
“I’d like to share the perspective of medicine that involves doing other things besides practicing medicine on a day-to-day basis,” she added.
For appointments with Dr. Haley or any of the Student Affairs advisors, please contact email@example.com , stop by the Student Affairs office in the Undergraduate Medical Office or call the Learner Wellness Assistant at 613-533-6000 x78451.
Wrapping up case-based learning sessions effectively
We often spend a lot of time planning our classes, especially our case-based small group learning (SGL) sessions. We tailor our sessional learning objectives to the course objectives that have been assigned, selected solid preparatory materials, build great cases and craft meaningful questions for groups to work through.
This makes sense, as the small group learning (SGL) format used in Queen’s UGME program is modeled on Larry Michaelsen’s team-based learning (TBL) instructional strategy that uses the majority of in-class time for decision-based application assignments done in teams.
One comment we often read on course evaluation forms and hear directly from students, however, is that sometimes they walk away from an SGL session and still aren’t sure what’s important.
Much of the focus in the literature on TBL is on the doing – setting things up, building great cases, asking good questions to foster active learning. There’s not as much written about how to finish well.
Wrapping up your SGL session should be as much a planned part of your teaching as preparing the cases themselves. If you build the time into your teaching plan, you won’t feel like you’re shouting to learners’ backs as they exit the classroom, or cut off as the next instructor arrives. Nor will you find yourself promising to post the “answers” to the cases on MEdTech. Sometimes it’s not the answers that are important, but the steps students take to get there.
Wallace, Walker, Braseby and Sweet remind us that the flipped classroom we use for SGL (preparation before class, application in class) is one “where students adopt the role of cognitive apprentice to practice thinking like an expert within the field by applying their knowledge and skills to increasingly challenging problems.” One such challenge is figuring out what the key take-away points are from an SGL session. With this in mind, it’s a good idea to plan your session summary, but then have students take the lead since “the expert’s presence is crucial to intervene at the appropriate times, to resolve misconceptions, or to lead the apprentices through the confusion when they get stuck.”
So, have your own summary slide ready – related to your session objectives – but keep it in reserve. In keeping with the active-learning focus of SGL, save the last 10-15 minutes of class to have the groups generate the key take-away points, share them, and fill in any gaps from your own list.
Here’s a suggested format:
- Prompt the groups to generate their own study list: “Now that we’ve worked through these three cases, what are the four key take away points you have about this type of presentation?”
- Give the groups 3-4 minutes to generate their own lists
- Have two groups share with each other
- To debrief the large group, do a round of up four or five groups each adding one item to a study list.
- Share your own list – and how it relates to the points the student raised. This is a time to fill in any gaps and clarify what level of application you’ll be using on assessments.
- If you’d like, preview an exam question (real or mock): “After these cases, and considering these take-away points, I expect that you could answer an exam question like this one.” This can make the level of application you’re expecting very concrete.
Why take the time to wrap up a session this way? Students often ask (in various ways) what the point is of a session. With clear objectives and good cases, they should also develop the skills to draw those connections themselves. This takes scaffolding from the instructor. As Maryellen Weimer, PhD, writes in Faculty Focus, “Weaning students from their dependence on teachers is a developmental process. Rather than making them do it all on their own, teachers can do some of the work, provide part of the answer, or start with one example and ask them for others. The balance of who’s doing the work gradually shifts, and that gives students a chance to figure out what the teacher is doing and why.”
If you would like assistance preparing any part of your SGL teaching, please get in touch. You can reach me at firstname.lastname@example.org
 Wallace, M. L., Walker, J. D., Braseby, A. M., & Sweet, M. S. (2014). “Now, what happens during class?” Using team-based learning to optimize the role of expertise within the flipped classroom. Journal on Excellence in College Teaching, 25(3&4), 253-273.
Enjoy these early and lasting gifts from the Bracken Health Sciences Library
By Suzanne Maranda, Head, Bracken Health Sciences Library
When I meet faculty in person, especially if I’ve not seen them in a while, or if they are new to Queen’s, they often embarrassedly admit that they never come to the library. Over the years, I’ve refined my answer: ”Oh, but you do; you probably just don’t know it. Most links to full-text articles would not work if the Library had not done the behind-the-scenes work.” Medical students are also quite amazed to find out, during their first session of medical school, that a single annual journal subscription can cost more than their tuition! The Queen’s Library spends over $9 million annually on library resources, most of which are electronic. The proportion in the health sciences is among the highest, with well over 90% of the purchases allocated to online materials.
The materials purchased by this library have also changed over time. It used to be that books and journals were the only information sources for serious learning and research. In recent years, in addition to conventional books and journals, with many more online than in print, you may find, among others, point-of-care tools such as Dynamed and BMJ Best Practice, anatomy software and image banks, clinical skills videos, clinical cases, and DVDs ( the latter can be borrowed to show in class or recommended to students).
While the Canadian dollar was still strong, the Library made strategic purchases of journal backfiles, allowing perpetual online access to older journal content. Most of this electronic content is linked to PubMed and Medline and the other databases in the OVIDSP interface for seamless access to full-text.
Tip #1: After completing a database search, it is best to NOT use the “limit to full-text” option in OvidSP because that limit only retains the journals purchased via this interface provider or where it has an agreement with particular publishers. There are MANY more journals that we purchase from other vendors, but the links will display only after clicking on the “Get it at Queen’s” button.
We are also very pleased that the links to full-text have finally been implemented in PubMed! Tip #2: For the links to appear, you must link to PubMed from the Bracken Library homepage (look under Find Articles). When you click on a citation, you will see this link:
in the top right corner, sometimes in conjunction with the publisher’s link. The Queen’s links will let you know exactly what years of the journal were purchased and, if the desired article is unavailable in full-text, you will see a link to order it from our Interlibrary Loans (ILL) service.
This brings me to an important change that will go into effect early in January 2015. All health and life sciences faculty and students will be able to order interlibrary loans using RACER. This service allows you to place orders and keep track of them yourself, but more importantly, it is linked to a desktop delivery system. Requested articles will be delivered as a link embedded in an email message. Remember that the Library no longer charges for interlibrary loan requests. More information will be sent to all health sciences faculty in December.
Course Reserve: Another service has changed this fall: there are now other options to place items on Course Reserve. Faculty have always been able to request that books or print journal articles be placed on reserve for students to sign out. These items are to be highly used by the entire class, and the reserve function allows for very short loans, usually 3 hours, which ensures that the entire class can have access within a reasonable amount of time. This is still the only way to handle a complete print book, but what about a chapter? Or an electronic article? Many faculty now put links to course readings in MedTech Central, and maybe we can help:
Tip #3: Bracken Library staff can scan a book chapter or a journal article and send faculty a pdf file for upload to MEdTech Central. This also applies to existing online materials: a persistent link can be created, which insures that you are using a reliable link over time and that the item is accessible from off campus. Please send requests to email@example.com. Now is the time to plan for the Winter Term!
On behalf of the entire Bracken Library staff, please accept my best wishes for the holiday season and for a healthy and productive 2015.
Medical Student Debt:
Is it a problem, or just a shrewd investment?
By the end of his or her medical education, the average Canadian graduate will owe $71,721. That amount, which has increased by about 7.3% over the past 5 years, may seem either huge or trivial depending on your perspective and stage of life. Interpretation might be enhanced with a few more details:
- 17.5% manage to get through medical school with no debt at all, a figure that has not changed over the past 5 years.
- on the other extreme, 6.2% report debts of over $200,000, which has increased from 4.1% in 2010
- 28.3% report already having debt before even entering medical school (26.4% in 2010), with an average premedical indebtedness of $7,465 or, perhaps more telling, an average of $27,094 for those who report any debt (comparing to $6,506 and $25,968 respectively for 2010).
- 32.5% report having accumulated “non-educational debt” during medical school (eg. credit cards, car loans, mortages) averaging $23,976 (comparing with $31,455 in 2010)
- 28% feel that the amount of financial assistance available to them fails to meet their needs (compared to 31.5% in 2010)
- 3.7% report “no need for financial assistance” (unchanged over the past 5 years)
All this comes from the Canadian Medical School Graduation Survey, which is conducted as part of the Academy of American Medical Colleges Graduation survey and was completed (voluntarily) by 2,048 graduating students in 2014 including (I’m pleased to report) 99% of our graduating class at Queen’s.
At the same time, tuition rates appear to be on the rise (http://studymagazine.com/2011/11/01/tuition-canadas-medical-schools-rises/), currently averaging about $11,000 annually, but with considerable variability between schools, ranging from as low as about $4,000 to highs of over $25,000, according to the Canadian Medical Education Statistics published by the Association of Faculties of Medicine of Canada (http://www.afmc.ca/pdf/CMES2014-Complete-Optimized.pdf).
So, what does all this mean? Is this a problem that we and other medical schools need to engage, or are we observing what is, from a strictly financial perspective, an investment by shrewd and well- informed young people in an education that will lead to a secure, well-paying future in which they should be able to quickly dissipate even the higher levels of indebtedness?
On the “what’s the fuss” side of this argument are those who point out that medical students, once enrolled, have easy access to large loans from banks and other institutions who are confident in their success and financial prospects. They would note that almost all medical students graduate to lucrative careers (unlike most other university graduates), and that even a resident physician’s income, sensibly managed, provides the means after graduation to pay down those loans. They would further point out that there is very little post-graduation default on debts. Finally, they might make the point that these students are, in fact, adults who make conscious and highly informed career and financial decisions, and that medical schools are either their parents nor socially responsible for those decisions.
Those on the “we have a problem” side of this issue might make the following points:
- Although manageable after medical school and a minor issue in retrospect, the perception of increasing debt during medical school is a major stressor for students during an admittedly demanding period of their training, and may therefore distract from their education
- The high debt load may influence career decisions, prompting students to consider specialties with shorter duration of training and greater perceived long-term economic benefits.
- High debt load may discourage students from taking up research, educational or other academic training opportunities, either in parallel with or after their core training.
- The high costs and accumulated debt may discourage many young people from socioeconomically challenged backgrounds from even considering careers in medicine, thus establishing a further barrier to the social diversity that all medical schools and the medical education community are endeavouring to establish. To quote the AFMC’s Future of Medical Education In Canada: A Collective Vision for Medical Education in Canada:
“Achieving this diversity means attracting an applicant base that is more representative of the Canadian population. This will involve, for example, addressing perceived and real barriers to medical education, such as the high debt loads of medical graduates.”
The last point is particularly vexing. It’s easy to imagine that, for a family of limited financial means and with incomplete knowledge of the financial realities, the prospect of over $20,000 in annual tuition and possibly hundreds of thousands in accumulated debt may be sufficient to quash any dreams of medical education very early in life. (see previous blog article http://meds.queensu.ca/blog/undergraduate/?p=1165&preview=true&preview_id=1165&preview_nonce=e904b6e40f&post_format=standard).
In addition, there are considerable financial hurdles a student must face to simply apply to medical school, including three to four years of pre-medical undergraduate medical education, MCAT examinations (including preparation and travel) and quite likely a sense that income-generating jobs should be sacrificed in order to pursue studies or activities deemed more “attractive” to medical school admissions officers. Although considerable financial assistance and loans are available to students once accepted to medical school, there is no similar level of assistance to those in the application process where it would arguably be of greater benefit.
At Queen’s, we are concerned about the rising profile of student indebtedness and it’s impact on both current and prospective students. To further examine this issue, we have established an Advisory Panel on Medical Student Debt, chaired by Dr. Greg Davies and supported by Brian Rutz, UG Financial Officer. The panel is populated by several current students from all years, recent graduates in residency training, not-so-recent graduates now in the early years of independent practice, and several members of faculty and the university community with interest in this issue. That group has already begun its work by undertaking a review of the Canadian medical school environment through the Graduation survey, and current literature. It is focusing on several topics:
- The sources of debt
- The impact of debt on individual students
- Counseling and information sources available to students as they engage financial planning
- Financial aid availability and access
- How support might be provided to young people considering careers in Medicine
Their findings and recommendations, once available, will be brought forward for wide discussion and implementation. I’m sure Greg and his committee would appreciate hearing from readers about any and all of these issues. I know I would.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education