Background questions usually concern conditions, and consist of two parts:
Early in training, a medical student on seeing a patient with newly diagnosed diabetes mellitus, may ask questions such as:
These background questions address normal human physiology and the pathophysiology associated with a medical condition.
Most background questions can be answered by standard textbooks, such as Harrison's Principles of Internal Medicine (Harrison's Online), Rudolph's Pediatrics, Williams Gynecology, Williams Obstetrics, and Current Diagnosis & Treatment: Surgery or Pathophysiology of Disease: an Introduction to Clinical Medicine.
Innovative evidence-based resources, such as UptoDate or First Consult (log on to ClinicalKey, search for a term or disease.eg diabetes, then select First Consult [FC] articles) also provide answers to some background questions. To provide faster searching, various publishers may group collections of textbooks together to be searched at the same time. Major collections of such textbooks at WHSL are found at ClinicalKey, Stat!Ref and AccessMedicine. These collections can also include various other resources besides textbooks.
Such e-textbooks are usually easy to search. A single term (such as a disease) can be searched and will lead to further categories or chapters.
The Internet can also be used to find background question information. However, caution should be exercised in using unreliable sources for clinical information (see WHSL Evaluating Web Sites for Health Information).
Note: it is advisable to register for ClinicalKey - therafter login using your personal ID and password. For full access to all features you will need to register from a Wits (on campus) computer using your Wits email details and activate the remote access option for 90 days. A link is then sent to your Wits email address which needs to be activated within 60 minutes of your registration. Thereafter you will be able to login remotely using your own ID and password. You will be required to reactivate remote access at a Wits networked computer after every 90 days using your Wits email details.
McKibbon A, Wyer P, Jaeschke R, Hunt D. Finding the evidence. Ch. 4. In: Guyatt G, Rennie D, Meade MO, Cook DJ, eds. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. 2nd ed. New York: McGraw-Hill, 2008. Available:
http://0-www.jamaevidence.com.innopac.wits.ac.za/content/3348229. [Accessed 25.07.2012]
Foreground questions usually concern choices, are specific to decision-making, and are asked by more experienced clinicians who are able to use the specialised knowledge typical of experts in the subject field. Different resources to those used to answer background questions are often used to answer such foreground questions.
You can search for synopses of the literature in evidence-based resources such as EssentialEvidencePlus (EE+). EE+ carries both evidence summaries (POEMs) as well as research summaries, and can also be searched under broad subject "topics", such as Infectious Diseases or Pregnancy and Childbirth. First Consult (a database within in ClinicalKey) also offers evidence-based literature. Additionally, Best Practice offers synopses of various conditions, and is useful for evidence-based practice.
PubMed can be searched for summaries and the primary literature, and use of the Clinical Queries option in PubMed can be helpful, as it offers the ability to search using evidence-based filters such as diagnosis or prognosis (see Clinical Queries on PubMed in the WHSL Clinical Queries using PubMed guide).
McKibbon A, Wyer P, Jaeschke R, Hunt D. Finding the evidence. Ch. 4. In: Guyatt G, Rennie D, Meade MO, Cook DJ, eds. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. 2nd ed. New York: McGraw-Hill; 2008. Available:
http://0-www.jamaevidence.com.innopac.wits.ac.za/content/3348229. [Accessed 26.07.2012]