Clinical Practice Guidelines
Clinical practice guidelines are recommendations developed to educate clinicians on the current standard of care. Clinical guidelines can be useful, but may not apply to every patient and should not be considered a substitute for care from a knowledgeable health care professional.
When looking for clinical guidelines, look for the standards of the preeminent accreditation body in the field. For example, there are standards on treating anorexia nervosa from the American Psychiatric Association. You can also use the results below.
Run your search. On the results screen, choose Practice Guidelines from Article types in the upper left corner. For nonclinical guidelines related to health care administration, choose the broader term Guidelines.
Under the Quick Reference tab, choose Guidelines—Primary Care or Guidelines—Inpatient Medicine
Use the Advanced Search screen. Under Publication Type, choose Practice Guidelines
To browse guidelines, choose Guidelines under the search box. To search for a guideline, enter your search term, and from the results page, select Guidelines from the Filter By column on the left.
Browse by general topics, clinical specialties, care settings, or roles. You can refine results for free content under content types. ECRI is free to use but requires registration
Epistemonikos is a multi-lingual database of systematic review abstracts relevant for health decision making.
Health Systems Evidence
Contains evidence briefs for policy, overviews of systematic reviews, systematic reviews, systematic reviews in progress (i.e., protocols for systematic reviews), and systematic reviews being planned (i.e., registered titles for systematic reviews).
Institute for Healthcare Improvement
IHI contains recommended resources on topics like sedation, delirium, and mobility in ICU patients or managing chronic care. It also has a model for improvement, such as how to set realistic aims and test changes.
Pretty Darn Quick Evidence contains primary studies, systematic reviews, and broad overviews of systematic reviews. PDQ-Evidence shows which primary studies are included in systematic reviews, and which systematic reviews are in overviews. PDQ-Evidence is drawn from Epistemonikos.
Run your search. Then choose Guidelines under Evidence Type on the right side of the screen.
U.S. Preventive Services
Browse published recommendations on screening, counseling, and prevention from the U.S. Preventive Services Task Force.
Clinical Resources Guide
A guide to our most popular library resources to support third- and fourth-year medical students during clinical rotations.
(require PNWU network login)
- Which database should I use? (PDF)
- Accessing Resources on Rotations Powerpoint
- Basics of PubMed
- How to order articles from PubMed
- PubMed@PNWU – Clinical queries, link out to full text, single citation matcher
- AccessMedicine – Includes textbooks, customizable self-assessments, Quick Dx and Tx, ClinicalPrep, Case Files
- ClinicalKey – Full-text journals, textbooks, procedural videos, image bank, and patient handouts
- DynaMed – An evidence-based, point-of-care resource for clinicians (mobile)
- UpToDate – A clinical decision support tool for physicians (mobile)
- PNWU Library Subject Guides (resources for EBP, drug info, heart and lung sounds, EKG, and other topics)
- Need to borrow books while on rotation? Contact firstname.lastname@example.org
- Your eTextbooks in the Library
- Search our online catalog for print and eBooks for UMSLE and COMLEX (Levels 1 and 2)
AccessMedicine - McGraw-Hill Drug Monographs
ClinicalKey - Drug information is from Gold Standard.
DynaMed - Drug information is from Micromedex .
The Medical Letter on Drugs & Therapeutics - Critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases. Includes Handbook of Antimicrobial Therapy and Drugs for Parasitic Infections.
UpToDate - Drug information is from LexiComp.
NLM Drug Information Portal - Covers over 60,000 drugs from clinical trial stage onward. Information is from a variety of sources.
Drugs.com - Includes A-Z drug index, pill identifier, drug interactions, directory of pharmaceutical companies.
LactMed - Information on drugs and other chemicals to which breastfeeding mothers may be exposed.
Medscape Drugs & Diseases (user registration may be required)
National Center for Complementary and Integrative Health - Information about complementary health products and practices, including herbs and supplements.
ECG Learning Center - An introduction to clinical electrocardiography
ECG Wave-Maven - Sponsored by the Carl J. Shapiro Institute for Education and Research at Harvard Medical School and Beth Israel Deaconess Medical Center
Electrocardiogram (ECG, EKG) library - Cases and examples of normal and irregular cardiac rhythms
Practical Clinical Skills - Overview of EKG Interpretation
Easy EKG: Interpreting Rhythms - YouTube
In Our Collection
Additional resources can be found in the WG 1-9999 section in the library.
12-Lead ECG:The Art of Interpretation, 2e. Garcia T., Jones & Bartlett, 2015.
Call number: WG 18.2 G216t 2015
12-Lead ECG for Acute and Critical Care Providers. Page B., Brady/Prentice Hall, 2005
Call number: WG 140 P133z 2005
Introduction to Basic Cardiac Dysrhythmias, 4e (book and CD). Atwood S., Mosby, 2009.
Call number: WG 330 A887i 2009
Rapid Interpretation of EKGs, 6e. Dubin D., Cover Publishing, 2000.
Call number: WG 18.2 D814r 2000
What is evidence-based practice?
Evidence-based practice is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients .” Evidence-based practice does not mean applying interventions regardless of circumstance, but rather integrating clinician expertise, knowledge of the patient’s situation and preferences, and the best available research.
How is evidence-based practice different?
Evidence-based practice requires that clinical decisions be based on the best available scientific evidence rather than habits or protocols, and that scientific evidence is frequently examined and evaluated . Because of the sheer volume of medical literature that is produced, it is important to have access to good evidence-based practice resources that can summarize study results for clinicians.
Introduction to Evidence-Based Practice
- Duke’s Introduction to Evidence-Based Practice tutorial
- Greenhalgh, Trisha. "How to read a paper." Pts. 1 through 10. BMJ: British Medical Journal 315, no. 7109 (1997): 672.
- Cardarelli, Robert and Brent Sanderline. “Evidence-Based Medicine.” In Foundations of Osteopathic Medicine, edited by Anthony Chila. Baltimore: Lippincott Williams & Wilkins, 2011.
- Guyatt, Gordon H., Drummond Rennie, Maureen O. Meade, and Deborah J. Cook, eds. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed. New York: McGraw Hill Education, 2015. Call number WB 39 U845 2015.
Evidence-Based Practice Resources
Not all evidence-based practice resources are created equal. You can use the Centre for Evidence-Based Medicine Critical Appraisal Worksheets to assess the validity of a resource.
- Cochrane Library – The Cochrane Library contains independent high-quality evidence for health care decision making, as well as the Cochrane Database of Systematic Reviews.
- Trip Pro – Trip Pro is a clinical search engine designed to allow users to quickly and easily answer clinical questions with high quality research. Trip Pro searches a wide variety of publication types, so be sure to check the validity of any resource.
- PubMed Clinical Queries –From the PubMed homepage, choose Clinical Queries from PubMed Tools. PubMed Clinical Queries is an evidence-based practice filter that searches the available literature to answer clinical questions.
- DynaMed – DynaMed is an evidence-based point-of-care resource for clinicians that is also available for iOS and Android.
- CINAHL Evidence-Based Care Sheets – From the CINAHL homepage, click on evidence-based care sheets in the top bar. CINAHL offers short summaries on specific key topics. The references are ranked, using a coding matrix, according to the type of literature they represent (systematic reviews, meta-analysis, etc).
- UpToDate – UpToDate is a clinical decision support tool for physicians that is also available for iOS and Android. While UpToDate is primarily background information and expert opinion, recent updates have focused on more high quality evidence.
- You can also search the library catalog for evidence* to pull up subspecialties, such as evidence-based anesthesiology or evidence-based orthopedics.
- Sackett, David L., William MC Rosenberg, JA Muir Gray, R. Brian Haynes, and W. Scott Richardson. "Evidence based medicine: what it is and what it isn't." (1996): 71-72, url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2349778/pdf/bmj00524-0009.pdf.
- Davidoff, Frank, Brian Haynes, Dave Sackett, and Richard Smith. "Evidence based medicine." BMJ: British Medical Journal 310, no. 6987 (1995): 1085, url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2549494/pdf/bmj00590-0009.pdf.
Exam and Board Prep
Practice Questions & Exams
AccessMedicine - Under study tools, you can find review questions, Showdown (Jeopardy) and online flashcards. Requires a free MyAccess account.
BRS series includes case questions at the end of each chapter. Subjects include behavioral science, biochemistry & molecular biology, gross anatomy, microbiology & immunology, pharmacology, pathology, and more.
First Aid for the USMLE Step 1 (W 18.2 T222 2020) & Step 2
Rapid Review series
- Biochemistry (QU 18.2 P389r 2011)
- Gross & Developmental Anatomy
- Pathology (QZ 18.2 G626 2018)
- Physiology (QT 18.2 B881 2012)
Lippincott Illustrated Reviews
Blueprints series subjects include surgery, family medicine, neurology, OB-GYN, pediatrics, psychiatry, and radiology.
Clinical & Ethical Cases
OB-GYN Clinical Cases - created by Dr. Anita Showalter & Chelan Shepherd
American Society of Hematology Teaching Cases – Requires a free account.
Case Files series - Please note online Case Files do not have full text. Print, full-text copies of Case Files are available in the Library.
First Aid Cases for the USMLE Step 1 (W 18.2 F514 2012)
Practical Clinical Skills - Heart Sounds Murmurs
In Our Collection
Additional resources can be found in the WG 1-9999 section in the library.
The Art and Science of Cardiac Physical Examination, 2e (book with interactive CD-ROM). Ranganathan N., Jaypee, 2016.
Call number: WG 141 R196a 2016
Heart Songs 2 (CD). American College of Cardiology, 2009.
Available for 24-hour checkout. Please read accompanying copyright notice regarding unauthorized duplication.
Call number: WG 141.5.A9 H4 2009
Heart Sounds Made Incredibly Easy (book with CD). Lippincott, 2005.
Call number: WG 39 H4348 2005
Pediatric Heart Sounds (book with CD). McConnell M., Springer, 2009.
Call number: WS 290 M478p 2008
Heart Murmur Pro by Hipposoft, LLC (iOS only) - Includes 23 heart sounds with clinically relevant information. (Cost: $2.99)
What is open access?
Open access is defined by the Budapest Open Access Initiative as "free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself." 
In the traditional publishing model, an author submits a paper to a publisher, who then makes the paper available to researchers for a fee. In an open access model, the author submits an article along with a processing fee, and the paper is made available to all readers for free. Open access can also refer to articles published through traditional models but also made available for free through sources like institutional repositories or PubMed Central.
Some of the benefits of open access include making research available to those who may not be able to afford journal subscription fees, and potentially increasing citations since more researchers can view the article.
Predatory open access
Since open access shifts the burden of cost to authors or an author’s institution, some unethical open access journals have begun accepting as many papers as possible to maximize profits. These journals only exist to extract fees from authors, and have been observed accepting poorly vetted papers or appointing fraudulent reviewers . Some of the signs that a journal is predatory include:
- Accepting papers unnaturally quickly, often within a day—or even hours—of submission
- A publisher's page claiming to be based in one country, but email originating from another country
- Claiming to be free, but requesting a fee or sending an invoice once an article is accepted
- Reviewers or an editorial board with few or no relevant credentials
- Other articles in the journal feature unsubstantiated claims or appear poorly written
You can learn more about the difference between open access and predatory publishing on our Moodle page.
Open access journal resources
- Budapest Open Access Initiative. "Read the Budapest open access initiative." Budapest Open Access Initiative (2002).
- Bohannon, John. "Who’s afraid of peer review." Science 342, no. 6154 (2013).
Patient Education/Consumer Health Information
Patient education (also known as consumer health information) is intended to address the health information needs of the patient to aid in health care decision making . Patient education is typically written in a more conversational style then clinical information.
Websites for Patients
These websites are free to access and are designed to help the general public learn more about conditions and care.
These resources contain patient handouts on basic health information in multiple languages. Most of the following resources are subscription based, and can be accessed by PNWU faculty, staff, and students.
AccessMedicine Patient Education - AccessMedicine divides patient education handouts into four categories: Acute, Adult, Medicines, and Pediatric. You can switch between the categories using the sidebar on the left.
ClinicalKey Patient Education - ClinicalKey has a section on Patient Education that contains many handouts on various tests, drugs, and common problems. Handouts can be customized with special instructions for your patients. Resources are typically available in English and Spanish, but may also be available in languages such as Korean, Haitian Creole, Polish, Tagalog, Chinese (Mandarin/Traditional) and Vietnamese.
Consumer Health Information in Many Languages - The National Network of Libraries of Medicine has collected health resources with multiple translations as well as health information resources devoted to specific languages like ASL, Spanish, Laotian, Thai, German, and French.
DynaMed - Clinical topics in DynaMed typically contain a Patient Information section just above References with external links to patient resources from other sites.
EthnoMed - EthnoMed is a free resource that has patient education handouts on common topics like diabetes and smoking in Amharic, Chinese, Hmong, Somali, Spanish, Tigrinya, Vietnamese, and more. EthnoMed also includes narrated presentations and YouTube videos.
HealthReach - HealthReach is a free resource that has patient education materials in a wide variety of languages, such as multiple dialects of Arabic, Hindi, French, and Korean, as well as less common languages like Serbo-Croatian, Marshallese, and Ilocano. HealthReach also includes materials in audio and video formats.
UpToDate Patient Education - UpToDate offers patient education in two levels called The Basics, which focuses on the four or five most important topics, and Beyond the Basics, which are longer, more detailed reviews for patients who want more information. Available in English and Spanish.
- Flaherty, David, Laurie Hoffman-Goetz, and Jose F. Arocha. "What is consumer health informatics? A systematic review of published definitions." Informatics for Health and Social Care 40, no. 2 (2015): 91-112.
ACR Case in Point– Daily case studies from the American College of Radiology
LearningRadiology - Radiology modules divided by system and case studies
MedPix – Medical images from the National Library of Medicine
RSNA TFS – Teaching images from the Radiological Society of North America
In Our Collection
Basic radiology. Chen, Michael, Thomas Pope, and David Ott. McGraw Hill Professional, 2011. (AccessMedicine)
Blueprints radiology. Uzelac, Alina, and Ryan Davis. Lippincott Williams & Wilkins, 2006.
Call number: WN 18.2 U99b 2006.
Clinical radiology made ridiculously simple. Ouellette, Hugue, and Patrice Tétreault. MedMaster, 2015.
Call number: WN 100 O933c 2015.
Clinical radiology: the essentials. Daffner, Richard H., and Matthew Hartman. Lippincott Williams & Wilkins, 2013.
Call number: WN 17 D124 2013.
Fundamentals of diagnostic radiology. Brant, William E., and Clyde A. Helms, eds. Lippincott Williams & Wilkins, 2012.
Call number: WN 180 F981 2012.
Grainger & Allison's diagnostic radiology: a textbook of medical imaging. Grainger, Ronald G., and David J. Allison, eds. Elsevier Health Sciences, 2015. (ClinicalKey)
Introduction to diagnostic radiology. Elsayes, Khaled, and Sandra Oldham. McGraw Hill Professional, 2014. (AccessMedicine)
Learning Radiology: Recognizing the Basics. Herring, William. Elsevier Health Sciences, 2016.
Pediatric Radiology: The Requisites. Walters, Michele, and Richard L. Robertson. Elsevier Health Sciences, 2017. (ClinicalKey)
Primer of diagnostic imaging. Harisinghani, M. G., Chen, J. W., and Weissleder, Ralph. Elsevier, 2019. (ClinicalKey)
Surgical Radiology (iOS only) – Radiology trivia games. (Free)
UBC Radiology (Android only) – Includes preclinical anatomy images and clinical cases based on the curriculum of the University of British Columbia. (Free)
Vulnerable and Underserved Populations
Vulnerable populations, also known as underserved or at-risk populations, are defined as populations that are at a greater risk for poorer health status and lower health care access . Examples of vulnerable groups include (but are not limited to) racial or ethnic minorities, the LGBTQ+ community, patients in medically underserved areas, patients with a low socioeconomic status, patients who speak a primary language different than their provider, patients suffering from a chronic illness or disability, and legally vulnerable patients such as children, undocumented immigrants or human trafficking victims.
Kaiser Family Foundation Disparities Policy
Society, Health, and Vulnerability
Diversity and Quality in Health and Care
Medical Management of Vulnerable and Underserved Patients: Principles, Practice, and Populations. McGraw-Hill Medical Pub, 2007. Call number: W 84 AA1 M545 2007
Essentials of Health, Culture, and Diversity: Understanding People, Reducing Disparities. Edberg, M., Jones & Bartlett Publishers, 2013. Call number: WA 395 E123 2013
Cultural Competency Resources
- EthnoMed - Clinical Topics & Patient Education
- MedlinePlus American Indian and Alaska Native Health
- Journal of Cultural Diversity
- Cultural Competency for the Health Professional. Rose P., Jones & Bartlett Publishers, 2012. Call number: W 21 R797 2012
- JAMA Ethics: Western Diagnostic Labels Are Not Universal
Resources to Address Language Barriers
- Onlingo Spanish Level 1 (CD). Onlingo, 2006. Call number: PC 4112.5 O58 2006
- Medical Spanish Made Incredibly Quick!. Wolters Kluwer Health, 2008. Call number: W 15 M489 2008
- Spanish and the Medical Interview: A Textbook for Clinically Relevant Medical Spanish. Pilar Ortega Hernandez M., Elsevier, 2007. Call number: W 15 P637s 2007
- Random House Webster’s Pocket American Sign Language. Costello E., New York Random House, 1999. Call number: Reference HV 2475 .C663 1999
- MediBabble by NiteFloat (iOS only) – Free medical translation app for Spanish, Mandarin Chinese, Cantonese, Russian, and Haitian Creole.
- Consumer Health Information in Many Languages - The National Network of Libraries of Medicine has collected resources with multiple translations as well as health information resources devoted to specific languages like ASL, Spanish, Laotian, Thai, German, and French.
- JAMA Ethics: Language Barriers in the Emergency Room
Legally Vulnerable Populations Resources
- Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States. Holmes S., Univ of California Press, 2013. Call number: HD 1525.H685 2013
- Renting Lacy: A story of America's Prostituted Children. Coloma C., BookBaby, 2013. Call number: WA 325 S654 2009
- Child Abuse and Neglect: Diagnosis, Treatment, and Evidence. Jenny C., Elsevier Health Sciences, 2010.
- JAMA Ethics: Should An Undocumented Immigrant Receive A Heart Transplant?
- JAMA Ethics: Human Trafficking, Mental Illness, and Addiction
Chronic Conditions & Disabilities Resources
- Disability and Health Journal
- Chronic Illness
- Nass, Ruth, Reet Sidhu, and Gail Ross, "Autism & Other Developmental Disabilities," in Bradley's Neurology in Clinical Practice, ed. Daroff, Robert B., Joseph Jankovic, John C. Mazziotta, and Scott L. Pomeroy. Elsevier Health Sciences, 2015.
- Rondinelli, Robert D., and Mohammed Ranavaya, "Disability Assessment," in Practical Management of Pain, ed. Benzon, Honorio, James P. Rathmell, Christopher L. Wu, Dennis C. Turk, Charles E. Argoff, and Robert W. Hurley. Elsevier Health Sciences, 2013.
- "Chronic Disease Management," in Essentials of Clinical Geriatrics, ed. Kane, Robert, Joseph G. Ouslander, Itamar B. Abrass, Barbara Resnick. McGraw-Hill Education LLC, 2013.
Rural Healthcare Resources
- Agricultural Medicine: Occupational & Environmental Health for the Health Professions. Donham K., Blackwell Pub, 2006. Call number: WA 400 D682a 2006
- Journal of Rural Health
- Rural and Remote Health: North America
- Rural Public Health: Best Practices and Preventive Models. Warren J. & Smalley B., Springer Publishing Company, 2014.
- JAMA Ethics: Rural Primary Care - Working Outside the Comfort Zone
- Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health. Makadon H., American College of Physicians, 2008. Call number: W 84 AA1 F343 2008
- Comprehensive Care of the Transgender Patient. Ferrando A., Elsevier, 2020.
- National LGBT Health Education Center
- Lesbian, Gay, Bisexual, and Transgender Healthcare. Eckstrand K. & Ehrenfeld J., Springer, 2016.
- Gen Silent. Directed by Stu Maddux and Joseph Applebaum. Kanopy Videostreaming. 2016.
- JAMA Ethics: Should A Gay Physician in a Small Community Disclose His Orientation?
- JAMA Ethics: How Should Physicians Refer When Referral Options Are Limited for Transgender Patients?
- Shi, Leiyu, and Gregory D. Stevens. "Vulnerability and unmet health care needs." Journal of general internal medicine 20, no. 2 (2005): 148-154.