Strategic Opportunity Program Grant Proposal, May 2016 Ariel Pomputius

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Outreach and Instruction to Off-Campus Clinics: Bringing Instruction and Innovative Technologies to Liaison Departments Outside of the Academic Health Center Campus

Proposal Narrative

Project Description The Health Science Center Library (HSCL) offers a number of standalone workshops on information resources on campus, including a workshop on Mobile Resources for Health, but clinicians, staff, and students working in off-campus departments and clinics find it difficult to attend due to limited available time and geographic distance. This proposal seeks $4,822.72 to bring workshops on information resources and mobile technology to the off-campus clinics and departmental offices through a Mobile Tech Toolkit consisting of ten mobile tablets with preloaded apps, two adapter cables to link a tablet to a projector for live demonstrations, a PICO projector, and a sturdy case to hold the technology. This pilot program will serve as information resource outreach for the liaison departments of the Health Sciences Liaison Librarian:

• Pathology, Immunology, and Laboratory Medicine • Dermatology • Aging and Geriatrics • Radiation Oncology • Radiology • Ophthalmology • Community Health and Family Medicine • Obstetrics and Gynecology

Classes offered will include instruction on advanced literature searching techniques (such as IACUC searches, the use of ORCiD researcher IDs, and My NCBI), citation management software, NIH Public Access Policy, Systematic Reviews, and mobile technology information resources that can be used for patient care and research. In order to facilitate access to the mobile resources that are available through the library, all the classes will integrate mobile technology specific to the instructional material and the department. The goal is to teach at least 3 classes in the first 3 months of the project, and then, based on the success of that first quarter, teach more or less in the subsequent quarters. The project team estimates at least 10 classes for the first year and plans to develop at least 4 new relationships with departments that are not regular library patrons.

The goals of this pilot program are to strengthen liaison relations to departments with clinics off-campus through instructional outreach to faculty, staff, residents, and medical students, encourage widespread use of information resources and mobile resources that are available through the library, and advocate for library resources in support of campus research initiatives.

Project Importance This project serves the Smathers Library mission to “facilitate knowledge creation that contributes to UF’s standing as a preeminent public research university” ("George A. Smathers Libraries Strategic Directions," 2014). By meeting library users in their spaces and bringing the instruction and mobile technology to them, this project will increase the familiarity of UF faculty, staff, and students with the information resources available through the library to support patient care and research endeavors. With the Mobile Tech Toolkit this project proposes, library users will learn more about the mobile technology increasingly used for clinical diagnosis and research in their liaison departments and discover the apps and mobile websites available through the library. By increasing knowledge and access to mobile device technology, the Mobile Tech Toolkit supports the Smathers Library goal

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to provide library users with access to technology that will “foster innovation, enhance learning, and improve collaboration”("George A. Smathers Libraries Strategic Directions," 2014).

Why Off-Campus Clinics and Departments? Although the standalone workshops offered in the library see faculty, staff, and students from a variety of departments, the participants who attend seldom include clinical faculty, researchers, staff, residents, or medical students who work in the off-campus clinics. Faculty, residents, and medical students at these off-campus clinics find it difficult to journey to campus for an instructional session given their limitations of time and distance. The reference questions asked by off-campus faculty often demonstrate a lack of familiarity with the range of resources available through the library. The off-campus faculty deserve an equal opportunity to learn and this program offers the solution to the problem of inequity. This pilot project seeks to provide all the liaison departments with off-campus clinics or external department offices with the same standard of library support and instruction that library users on campus benefit from in attending our standalone workshops.

The HSCL offers “house calls”—when faculty request a librarian to visit their office for a quick demonstration or assistance on a library resource—and occasionally liaison librarians get requests to provide brief updates on library resources to the clinics. This pilot project seeks to bring instruction on the library’s information resources and mobile technologies to the external clinics in a concentrated effort. Unfortunately, the mobile devices the HSCL has available for circulation and that the reference librarians can use for their workshops cannot travel outside the library for instructional sessions. The funding from this grant will provide for a Mobile Tech Toolkit to bring instruction and demonstration of the library’s mobile resources and apps outside the library to liaison groups that use this technology for patient care and research.

Project Comparison Although the use of mobile devices for clinical care and research is not a new concept, application of mobile technology in health care is constantly growing and changing. Many library grants for emerging technologies feature a mobile device or a collection of mobile devices as part of the project (Lobo et al., 2013; Nuss, Hill, Cervero, Gaines, & Middendorf, 2014). The literature contains numerous survey discussions on who uses mobile devices, what kind of devices are being used and what the devices are being used for at point-of-care (Boruff & Storie, 2014; Sclafani, Tirrell, & Franko, 2013). The University of Southern California created a technology survey in which the University of Florida and five other health science libraries from around the United States participated (Wu, Chatfield, Hughes, Kysh, & Rosenbloom, 2014). The HSCL distributes a version of this technology survey annually to students, staff and faculty to track changes in technology use at the HSC. Based on requests from this survey of UF HSCL users from this past year, the librarians developed a standalone instruction on apps available for mobile health information and are looking to integrate these materials into more of instructional sessions. This pilot program is unique in that it will take the roster of library standalone workshops, tailor these to the liaison groups involved in the project, integrate mobile technology education on library resources into the pre-existing classes, and bring the modified instruction to the off-campus clinics.

Outreach efforts to off-campus clinics are not new, even for the HSCL. A few years ago, the internal medicine liaison librarian had a program at off-campus clinics that provided patients with consumer health and patient education resources. The HSCL’s Biomedical and Health Information Services (BHIS) department also instituted a “house calls” program where faculty could request that a librarian come to their clinic or department to offer instruction in library resources (Tennant et al., 2012). This pilot program aims to reach the liaison groups with limited available time who work at a greater geographic distance by bringing the instruction sessions, including a focus on mobile technology for use in clinical and research settings, to their clinics and offices. At the end of this

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pilot project, assessment will prove the value of the program for instruction and outreach to the faculty and students in the library’s underserved liaison groups.

Project Resources To bring the library’s standalone workshops to the off-campus clinics and departments, the project will need to purchase 5 Samsung Galaxy Tab S2 8” tablets and 5 iPad Air 2s to use for instruction in mobile technology related to healthcare, both an Apple lightning-HDMI adapter and a Galaxy HDMI adapter to connect the mobile devices to a projector for live demonstrations, one PICO projector to allow for ease of instruction and 10 silicon tablet cases and one protective travel case to keep the collection safe while the devices travel to and are used for the off-campus instructional sessions. Tablets that operate on Android and iPads that run iOS will be purchased so that demonstration and instruction can include the two most popular app platforms.

Since the offices and clinics this pilot program serves are off-campus, the project will entail the PI travel to the various off-campus clinics around Gainesville to offer instruction in library information services and mobile technology applications for clinical and research use. The PI will consult with BHIS department members who teach the standalone workshops offered at the library in order to develop adapted trainings for participating departments. Michele Tennant, the Associate Director of the UF HSCL, will work with the PI to develop appropriate assessment tools, submit the IRB-02 required for project evaluation, analyze the data collected, and assist in the review of any resulting presentations or publications resulting from this project. Nancy Schaefer, Associate University Librarian at the HSCL, will assist the PI in the modification of instructional materials, the development of evaluation tools, and the creation of any resulting presentations or publications. UF Smathers Library IT staff who are currently involved with the circulating iPads and have worked on similar mobile device grants before will be consulted as IT troubleshooting support for the devices and their preloaded apps, but the PI will be responsible for downloading and updating the mobile apps and tablet software.

Project Plan of Action Time Period Activity People involved

July 1-15 Talk to chairs, research and residency coordinators to assess the instructional needs of their department

Pomputius

July 1-15 Submit purchase order for tablets Pomputius July 1-31 Submit IRB-02 for pre-test, post-test, and post-post test Pomputius, Schaefer,

Tennant August 1-31 Based on the pre-existing instructional materials and discussion with instructors, modify

current standalone workshop curriculums to address the requested needs of the department Pomputius, Schaefer

August 1-31 Set up tablets with collection of apps for use in instruction Pomputius August 1-

December 31 Schedule and teach requested instructional courses, with pre-test/post-test evaluation. Post-post-test will be submitted 3 months after initial instruction.

Pomputius

December 31 Preliminary analysis of data to determine potential need for changes to program in the second half of the grant

Pomputius, Schaefer, Tennant

January 1-May 31

Schedule and teach new classes. Pre-test, post-test, and post-post-test administered Pomputius

June 1-July 31 Analyze data collected from pre-test, post-test, and post-post-test in order to determine impact of the program.

Pomputius, Schaefer, Tennant

Project Collection Details The collection material used for this outreach instruction pilot program is a Mobile Tech Toolkit consisting of 5 tablets, 5 iPads, 10 chargers, two adapters for use with projectors, and a travel case. The mobile tablets will be

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preloaded with a small collection of apps related to the library’s information resources, apps related to clinical care and research, and apps specific to the departments included in this pilot program. The full list of apps is available in Appendix B. This equipment will belong to the University of Florida Health Science Center Libraries Biomedical and Health Information Services department for use in mobile health instruction and will be located in the BHIS offices at the HSCL.

Project Assessment The assessment of the project depends on results of the evaluation materials. Pre-tests and post-tests will be administered before and after the instruction session to test materials learned and a post-post-test will be taken three months later to test the effectiveness of the outreach program. Through this extended assessment, the project team plan to show that bringing an instructional session to the off-campus clinics results in greater familiarity with information resources and mobile apps available through the library and allows clinicians, researchers, staff, and medical students to understand the role that the library can serve for their work in the future. By providing the standalone workshops that the library offers to the off-campus clinics, the project will support research and clinical decision-making through an increased understanding of what resources the library has available and how to use them effectively in the medical field. Based on the assessment of this pilot program, other HSCL librarians with liaison groups off-campus may be interested in adapting the program to meet the needs of their own departments.

Project and Results Information Dissemination Information about the project will be sent to the department chairs, residency coordinators, research coordinators, clerkship directors, and chief residents of the liaison departments with off-campus clinics or offices with the request to schedule instructional sessions. The PI plans to share the results of her project with the larger library community by submitting abstracts to the Medical Library Association Annual Conference 2017 and the Southern Chapter of MLA conferences.

Project’s Long-Term Financial Implications Following the completion of this pilot program, the PI plans to share the resulting Mobile Tech Toolkit—consisting of Samsung tablets, Apple iPads, PICO projector, preloaded apps, and adapter cables—and instruction materials with the other liaison librarians who also have off-campus departments. Eventually the PI plans to expand the project for medical students, but that expansion relies on the results of the assessment and future collaborations.

Project Equipment Use The Mobile Tech Toolkit, when not traveling to the clinics for instruction sessions, will remain charging in the Biomedical and Health Information Sciences suite. After this pilot program ends, the Mobile Tech Toolkit will remain regularly updated—both in terms of content and software—for BHIS librarians and other librarians with a focus on the Health Sciences to use when providing information resource instruction outside of the library. Smathers IT will serve as a resource for troubleshooting any problems with the technology, but the PI will remain responsible for updating the apps and software of the mobile devices.

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Appendix A: Letter of Support

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Appendix B: Pre-Loaded Apps for Mobile Technology Instruction

Library Reference Apps 1 Mobile Resources for Health

link free http://guides.uflib.ufl.edu/mobilehealth

2 PubMed Mobile free http://www.ncbi.nlm.nih.gov/m/pubmed/

3 PubMed for Handhelds free https://pubmedhh.nlm.nih.gov/

4 EBSCOhost UF subscription http://support.epnet.com/knowledge_base/detail.php?id=5718

5 AccessMedicine UF subscription http://accessmedicine.mhmedical.com/

6 Access Pharmacy UF subscription http://accesspharmacy.mhmedical.com/

7 Stat!Ref Mobile Apps UF subscription http://www.statref.com/products/srMobile.html

8 Browzine UF subscription http://thirdiron.com/download-browzine/

9 EndNote UF subscription http://endnote.com/product-details/ipad

10 RefMobile UF subscription https://www.refworks.com/content/products/refmobile/content.asp

11 Mendley Free https://www.mendeley.com/

12 CASP Free https://itunes.apple.com/us/app/casp/id961788886?mt=8

General Medical Apps 1 drawMD Free http://www.epocrates.com/mobile

2 Medscape free http://www.medscape.com/public/applanding

3 Epocrates Free http://www.medscape.com/public/mobileapp

4 Micromedex UF subscription http://www.micromedexsolutions.com/micromedex2/librarian/ND_T/evidencexpert/ND_PR/evidencexpert/CS/C7A5C1/ND_AppProduct/evidencexpert/DUPLICATIONSHIELDSYNC/E8D73C/ND_PG/evidencexpert/ND_B/evidencexpert/ND_P/evidencexpert/PFActionId/evidencexpert.Mobile

5 Clinical Pharmacology UF subscription https://www.clinicalpharmacology-ip.com/Offsite/CpMobileApp.aspx

6 ICD-10 Consult 2016 Free Free http://www.regularrateandrhythm.com/apps/icd9-consult/

7 Medline Plus Free https://www.nlm.nih.gov/medlineplus/

Obstetrics/Gynecology 1 The American Congress of

Obstetricians and Gynecologists (ACOG)

Free https://itunes.apple.com/us/app/american-congress-obstetricians/id616323665?mt=8&ign-mpt=uo%3D8

2 Preconception Care App Free https://itunes.apple.com/us/app/preconception-care-app/id1053958329?mt=8&ign-mpt=uo%3D8

3 drawMD OBGYN Free http://visiblehealth.com/drawmd/obgynapp-2/

4 Medrills Obstetrical Emergencies

$3.99 ($39.90 for 10)

https://play.google.com/store/apps/details?id=com.archiemd.emt_pt2.obstetrical_emergencies&hl=en

Community Health and Family Medicine 1 AHRQ ePSS Free http://epss.ahrq.gov/PDA/index.jsp

2 ACP Immunization Advisor Free http://immunization.acponline.org/app/

3 CDC Vaccine Schedule Free http://www.cdc.gov/vaccines/schedules/hcp/schedule-app.html

Ophthalmology 1 drawMD Ophthalmology Free http://visiblehealth.com/drawmd/ophthalmologyapp/

2 EyeTube Free https://itunes.apple.com/us/app/eyetube/id473354087?mt=8

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3 Eye Handbook Free https://itunes.apple.com/us/app/eye-handbook/id335546959?mt=8

Radiology 1 Radiology Toolbox Pro $3.99 ($39.90

for 10) https://itunes.apple.com/app/radiology-toolbox-pro/id466281848

2 Radiology 2.0: One Night in the ED

Free https://itunes.apple.com/us/app/radiology-2.0-one-night-in/id397926581?mt=8

3 Diagnostic Radiology Free https://itunes.apple.com/us/app/diagnostic-radiology-dynamic/id523516157?mt=8

4 Mobile MIM Free https://itunes.apple.com/us/app/mobile-mim/id281922769?mt=8

Radiation Oncology 1 Rad Onc Resources Free https://play.google.com/store/apps/details?id=com.falchook.radiatio

noncologyapplicationresource 2 Virtual Library of NCCN

Guidelines Free https://www.nccn.org/apps/

3 BED Calculator Free https://itunes.apple.com/us/app/bed-calculator-radiation-dose/id397088240?mt=8

Aging and Geriatrics 1 AGS Multimorbidity GEMS Free http://geriatricscareonline.org/ProductAbstract/multimorbidity-

gems-mobile-app/B021 2 AGS iGeriatrics Free https://itunes.apple.com/us/app/igeriatrics/id365560773?mt=8

Dermatology and Cutaneous Surgery 1 AAD Chronic Urticaria App Free http://aadhives.azurewebsites.net/

2 AAD Mohs Appropriate Use Criteria

Free https://play.google.com/store/apps/details?id=org.aad.mohsauc&hl=en

3 ClearPath Free https://itunes.apple.com/us/app/clearpath/id540260769?mt=8&ign-mpt=uo%3D8

Pathology, Immunology, and Laboratory Medicine 1 Johns Hopkins Atlas of

Pancreatic Pathology Free https://itunes.apple.com/ie/app/johns-hopkins-atlas-

pancreatic/id474845392?mt=8

2 Johns Hopkins Atlas of Pancreatic Cytopathology

Free https://itunes.apple.com/ie/app/johns-hopkins-atlas-pancreatic/id580500693?mt=8

3 HeartMaster Free https://play.google.com/store/apps/details?id=com.newedwards.mitraltricuspidvalves&hl=en

Basic Sciences/Research 1 Promega Free http://www.promega.com/resources/mobile-apps/

2 Cloning Bench Free https://itunes.apple.com/us/app/cloningbench-calculators-tools/id458617777?mt=8

3 BioGene Free http://cbio.mskcc.org/tools/handheld-devices/index.html

4 iProtein Free https://itunes.apple.com/us/app/iprotein/id380060128?mt=8

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Appendix C: References Boruff, J. T., & Storie, D. (2014). Mobile devices in medicine: a survey of how medical students, residents, and

faculty use smartphones and other mobile devices to find information. J Med Libr Assoc, 102(1), 22-30. doi:10.3163/1536-5050.102.1.006

Bushhousen, E., Norton, H. F., Butson, L. C., Auten, B., Jesano, R., David, D., & Tennant, M. R. (2013). Smartphone use at a university health science center. Med Ref Serv Q, 32(1), 52-72. doi:10.1080/02763869.2013.749134

George A. Smathers Libraries Strategic Directions. (2014). In U. o. F. G. A. S. Libraries (Ed.), (pp. 1-8). Gainesville, FL.

Lobo, M. J., Crandley, E. F., Rumph, J. S., Kirk, S. E., Dunlap, N. E., Rahimi, A. S., . . . Read, P. W. (2013). Pilot Study of iPad Incorporation Into Graduate Medical Education. J Grad Med Educ, 5(1), 142-144. doi:10.4300/jgme-d-12-00007.1

Nuss, M. A., Hill, J. R., Cervero, R. M., Gaines, J. K., & Middendorf, B. F. (2014). Real-time use of the iPad by third-year medical students for clinical decision support and learning: a mixed methods study. J Community Hosp Intern Med Perspect, 4(4). doi:10.3402/jchimp.v4.25184

Sclafani, J., Tirrell, T. F., & Franko, O. I. (2013). Mobile tablet use among academic physicians and trainees. J Med Syst, 37(1), 9903. doi:10.1007/s10916-012-9903-6

Tennant, M. R., Auten, B., Botero, C. E., Butson, L. C., Edwards, M. E., Garcia-Milian, R., . . . Norton, H. F. (2012). Changing the face of reference: adapting biomedical and health information services for the classroom, clinic, and beyond. Med Ref Serv Q, 31(3), 280-301. doi:10.1080/02763869.2012.698172

Wu, J., Chatfield, A. J., Hughes, A. M., Kysh, L., & Rosenbloom, M. C. (2014). Measuring patrons' technology habits: an evidence-based approach to tailoring library services. J Med Libr Assoc, 102(2), 125-129. doi:10.3163/1536-5050.102.2.014

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Outreach and Instruction to Off-Campus Clinics: Bringing Instruction and Innovative Technologies to Liaison Departments Outside of the Academic Health Center Campus

Budget Narrative

Expense Calculation Independent research was done in advance and the IT department was consulted. The prices were calculated using Samsung.com and Apple.com to ensure that the devices and adapters researched were correct. In order to ensure that instruction could be provided in any environment, IT recommended the PICO projector as a reasonably priced and travel-ready projector that could be easily used anywhere. The estimates for the tablet cases were taken from Amazon.com in order to get the most cost-effective protection for each of the tablets. The travel case was selected as a lightweight, inexpensive solution for carrying the tablets and the protective foam sleeves for each case are custom made and protect the tablets while in transit. The apps selected for this project are mostly free or licensed by the library; the exceptions are Radiology Toolbox Pro and Medrills: Obstetrical Emergencies, the costs of which were calculated in the Apple iTunes Store and Google Play Store.

Expense Justification This proposal seeks to bring Health Science Center Library workshops on information resources and mobile technology to the faculty, staff, and students of the off-campus clinics and departmental offices through a Mobile Tech Toolkit consisting of ten mobile tablets with preloaded apps, two adapter cables to link a tablet to a projector for live demonstrations, a small projector to allow for instant instruction at any location, and a sturdy case to hold the technology. The project requires ten mobile tablets because the groups of faculty and residents can be between 6 to 20 people based on past instructional experiences. The Mobile Tech Toolkit contains both iPads and Samsung Galaxy tablets because the operating system for each mobile device allow for different apps and app interfaces. The adapter cables are required to link the devices to computers, televisions, or projectors that would allow for live demonstration of different mobile applications to a large group. The PICO projector was chosen as a reasonably priced but effective option for teaching in any environment. The tablet cases and travel case serve to protect the collection for its intended purpose of traveling outside of the library to a large group of users.

Role of the Primary Investigator As the primary investigator, Ariel Pomputius, Health Sciences Liaison Librarian, will serve as the project coordinator, instructor and assessment data collector. She will schedule the off-campus workshops with the various participating departments, order the equipment for the mobile technology kit, modify the current standalone workshop curriculums to best suit her audience, present the instruction and lead the hands-on demonstrations, and assess the project based on the resulting data.

Contributed Cost Share HSCL Associate Director Michele Tennant will work with the primary investigator to submit the IRB forms required for assessment, aid in the creation of evaluation materials, and provide peer review in the development of any publications or presentations resulting from the project. No more than 1% of her salary time would be spent on this project.

Nancy Schaefer, Associate University Librarian at the HSCL, will assist the primary investigator in modifying the instructional materials, creating an assessment tool, evaluating the data collected, and developing any publications and presentations. An estimated 1% of her salary time would be spent on the project.

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Strategic Opportunities Grant Budget Form 2016-2017 Please add lines to table as needed. If you need help completing this form, please contact Bess de Farber, PH# 273-2519. 1. Salaries and Wages (no fringe benefits required)

Name of Person Salary times % of effort Grant Funds Cost Share Total Ariel Pomputius Salary Plus Fringe x 10% $0.00 $6,009.00 $6,009.00 Nancy Schaefer Salary Plus Fringe x 1% $0.00 $898.00 $898.00 Michele Tennant Salary Plus Fringe x 1% $0.00 $1,236.00 $1,236.00 SUBTOTAL $0.00 $8,143.00 $8,143.00 2. Equipment

Item Quantity times Cost Grant Funds Cost Share Total iPad Air 2 5 X $399.99 $1,999.95 $0.00 $1,999.95 Samsung Galaxy Tab S2 8" 5 X $399.99 $1,999.95 $0.00 $1,999.95 Galaxy Tab protective Silicon Case 5 X $6.97 $34.85 $0.00 $34.85 iPad Air protective Silicon Case 5 X $14.95 $74.75 $0.00 $74.75 Galaxy HDMI adapter 1 X $39.99 $39.99 $0.00 $39.99 Apple lightning to VGA adapter 1 x $49.99 $49.99 $0.00 $49.99 Protective Travel Case 1 x $34.23 $34.23 $0.00 $48.95 Radiology Toolbox Pro 10 X $3.99 $39.90 $0.00 $39.90 Medrills Obstetrical Emergencies 5 X $3.99 $19.95 $0.00 $19.95 SUBTOTAL $4,822.72 $0.00 $4,822.72 3. Supplies

Item Quantity times Cost Grant Funds Cost Share Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 SUBTOTAL $0.00 $0.00 $0.00 4. Travel

From/To # of people/# of days Grant Funds Cost Share Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 SUBTOTAL $0.00 $0.00 $0.00 5. Other (Vendor costs, etc. Provide detail in Budget Narrative section.)

Item Quantity times cost Grant Funds Cost

Share Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 SUBTOTAL $0.00 $0.00 $0.00

Grant Funds Cost

Share Total Total Direct Costs (add subtotals of items 1-5) $4,822.72 $8,143.00 $12,965.72