Clinical Problem and Electronic Index

The clinical problem investigated was: "What is a medical home, and what impact might a medical homes have on the management of chronic disease?" Since it is a broad medical model concept, I decided to stay within the PubMed electronic index believing it to be the most powerful for such a wide survey issues. PubMed provided 25,000 citations. An "also try" feature on the right of the screen suggested adding medical home model to filter the search and reduced the number to 1537 citations. Adding a five year limit reduced the number to 604 publications and the Boolean tool of "AND cost" dropped the number to 94 citations. I ran this search alone and with help a number of times to better grasp how to navigate and narrow the number for more relevant publications. Each time the process grew smoother, and I soon realized that it doesn't matter which steps one takes first or second which reduced my fear of the process considerably. There isn't a substitute for practice. Barriers were mainly my lack of use of the system, my fear of getting totally lost in the steps, and the tutorials along the pathway that were time consuming and a blur as they appear in so many windows. I had to create another log in for utilization of the library and free resources and need an index to keep up with all of the log ins now created over the last few months. As for barriers at work, the clinical I have been working has access to six central shared computers and a number in private side offices allowing on-line searches. No matter where one is in the world, these eresources are available to faculty and providers within our system. One must simply have the knowledge and take the time to look for them.