Drinking From the Fire Hose of Emerging Medical Literature
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We’ve all said to ourselves hundreds of times, “I need to stay more up to date on the medical literature.” For hospitalists with ever-increasing patient care and administrative responsibilities, it can be challenging to keep up with the updates in our field. If you, like us, have the best intentions but sometimes find yourself falling behind on medical literature and expert recommendations, we want to share tips and resources to help you stay current without being overwhelmed.
The volume of medical literature has grown exponentially; even more so because of the pandemic. Despite the overwhelming amount of information, this pandemic may be the best illustration of why remaining informed is imperative. We can harm our patients by providing or promoting unproven treatments like ivermectin or hydroxychloroquine instead of evidence-based treatments such as remdesivir and dexamethasone. We can also unwittingly perpetuate misinformation if we share uninformed opinions, such as on vaccination or mask mandates. To help us sleep at night, we all want to know we’re providing evidence-based, high-level care to our patients. Keeping up with the evidence and guidelines can help ensure our future selves don’t have regrets or lost sleep about our past clinical practice.
How do we stay up to date?
If we use the psychology of habit formation to help us, the best start is building time and space in our lives for medical literature review. We know motivation alone doesn’t create long-term habits. Instead, going to bed with your workout clothes on or leaving your morning medication on your nightstand are ways to maintain habits for the long haul by making the tasks easier. See Table 1 for some of our trusted resources to help simplify the process of staying updated; many of them rely on learning from the work and analysis that others have done to streamline the process. You’ll find suggested methods to make these resources become a habit in the third column of the table.
Keep in mind that you need to choose what’s manageable for you and remember that none of us can keep up with all the literature ourselves. Scheduling a defined time in your calendar to keep up with medical literature can help you stay on track and ensure you’re breaking the task into manageable time commitments, much like planning a larger scholarly project. After spending time reviewing new evidence, reward yourself and reinforce this habit by having a snack, taking a walk outside, spending a few minutes online shopping, or whatever else you enjoy.
What’s the role of journals, meetings, and guidelines?
For the limited number of journals, you want to pay extra attention to, subscribe to email notifications when new issues are released (e.g., Journal of Hospital Medicine, Hospital Pediatrics, Journal of the American Medical Association, Pediatrics, Annals of Internal Medicine, New England Journal of Medicine, etc.). National meetings such as SHM’s Converge can also provide updates in clinical medicine. Journal clubs, local or regional, are another way to share the burden of detailed article reviews while sharing the wealth of information obtained. Guidelines (e.g., from the Infectious Disease Society of America, American Academy of Pediatrics, and American College of Physicians) can be especially helpful to provide high-level, vetted references for patient care that incorporate evidence from numerous studies and that reflect expert consensus—particularly in rapidly changing diagnoses, such as COVID-19. Social media, specifically Twitter (#medtwitter), can be a source for short reviews of clinical topics and articles (some referred to as tweetorials).
How to stay organized
As we review medical literature using any of the methods discussed, we try to maintain a system to save and organize literature we expect to reference, share, or teach. For those materials, using a cloud-based service (e.g., Dropbox, Google Drive, Office 365, etc.) can make them easy to access anywhere. Notes or annotation functions can make future references easier and quicker. If you want to share evidence with your team when you’re on teaching services, saving your notes can also make this process much more efficient. There are also phone apps like Read by QxMD that can be helpful organizational tools.
Why being up to date matters
We all want to provide the best care for our patients and not be fixated on outdated or erroneous diagnostic or management information. During the pandemic, we’ve learned that a health care provider can be an agent of misinformation and that misinformation can spread like wildfire. It can also exacerbate patients’ distrust in our medical system.
If you’re working with trainees in any capacity, being current on the literature provides legitimacy to your teaching and recommendations (in addition to legitimacy to your fellow faculty). It also allows you to serve as a role model and potentially help others who are likely also struggling with managing the deluge of emerging medical literature. Your updated knowledge will keep you on track for board certification exams and may help avoid downstream medicolegal complications too.
For a lifetime of learning and growth, transform the process of keeping up with the medical literature into a habit, just as we hope to do when we try to build exercise into our routine. Long-term change takes intention as well as a willingness to adapt to what fits your schedule. We challenge you to try some of these resources, to find out what works well for you, and give yourself a reward when you do.
Helpful resources to stay updated in clinical medicine and make it a habit
Dr. Manley
Dr. Manley is a hospitalist in the department of pediatrics at the University of Kentucky College of Medicine, Lexington, Ky.
Dr. Maldonado
Dr. Maldonado is a hospitalist in the department of internal medicine at Baylor College of Medicine, Houston.
Dr. Hall
Dr. Hall is a hospitalist in the department of pediatrics and the department of internal medicine at the University of Kentucky College of Medicine.
Dr. Barrett
Dr. Barrett is a hospitalist (locum tenens) in New Mexico.
This content is provided by the SHM Physicians in Training (PIT) committee, which submits quarterly content to The Hospitalist on topics relevant to trainees and early career hospitalists. Learn more about SHM committees here.
