Clinical Key Interface Update

Clinical Key UpdateAs previously announced, MD Consult has been replaced by Clinical Key.  Clinical Key has all the books and journals formerly in MD Consult, and much more, including over 1,000 books, over 20,000 videos, 2.5 million medical images, 600 journals, and a point-of-care resource called First Consult.

Clinical Key has released a new interface to make searching and browsing easier.

  • The search box on the opening page allows you to designate the type of resource to search: all, books, journals, First Consult, patient education.
  • The table of contents of individual books are presented more clearly with links to the chapters more apparent.
  • There are new “topic pages” with quick information on 1,400+ diseases.
  • Viewing the pdf of a book chapter still requires a personal account, one that you can create for yourself for free by clicking on “login” at the top righ of any screen.  Note that if you already have a login for Elsevier’s ScienceDirect journals you will already be registered and can use that same username and password.

Subscription to Clinical Key was made possible by the Geisel School of Medicine, the Department of Medicine, the Department of Surgery, the Department of Anesthesiology, the Patient Safety Training Center, and contributions from the Departments of Urology and Pediatrics.

Questions?  Contact, stop by, or call 603-650-7660.

MD Consult Now Clinical Key

MD Consult has been transitioned to a new product, Clinical Keyas of July 2014.  Elsevier no longer offers MD Consult.


 Clinical Key has all the books and journals formerly in MD Consult, and much more, including over 1,000 books, over 20,000 videos, 2.5 million medical images, 600 journals, and a point-of-care resource called First Consult.  Subscription to this enhanced database was made possible by the Geisel School of Medicine and contributions from several clinical departments.

Some navigation tips:

  • When browsing the contents of a particular book or journal, scroll down in the middle frame to see the chapters or articles.  Highlight one by clicking in the description (or by hovering and then clicking on the arrow that appears pointing right) and the contents of that chapter or articles will show in the right frame.  You can then click on a topic in the right frame to go directly to it.
  • Click on the title of a chapter or article to go to it. (Click on the words, not the pdf icon.)
  • At the chapter or article level, the contents jump over to the left frame, and additional navigation aids are in the right frame.
  • There is a search box at the top center of the page – the default is to search all content in Clinical Key, but you can also change it to search just the book you are looking at.
  • To browse books, click on “Books” in the top bar.  Similarly, you can browse other types of content by clicking on it in the top bar.
  • If you had personal bookmarks for MD Consult you will need to update them.

Tips for printing:

  • If you click on a pdf icon, you’ll get a notice that you must log in.  That means that you must create a personal login – one you can create one for yourself for free by clicking on “login” at the top right of any screen.  Note that if you already have a login for Elsevier’s ScienceDirect journals you will already be registered and can use that same username and password.
  • There is another way to print, without logging in. While looking at the content of a chapter, click on the little printer icon at the top of the center frame.  A new window with the content, stripped of extraneous material, will open, plus your browser’s print window.  Your browser’s print window may offer an option to “print” to pdf, if you would like to save the content in this format.

More help can be found here:

If you have questions, contact the Biomedical Libraries Reference staff – 650–7660 or

The Artwork of Ben Blais: New Exhibit at the Matthews-Fuller Library

artwork metastasisMetastasis by Ben Blais

Cancer. Hearing the word alone can produce powerful emotional responses. The disease starts infinitesimally small, but knowledge of its presence is capable of inspiring hope, despair, fear, triumph… a power which has always fascinated me. This series is a commentary on how cancer arises from the modest origins of the genetics/proteins of only one cell, and how this cell loses its identity to become an enemy to the host.

Cancer is a disease in which the cells of the body turn against their host. Every normal cell in the body has functions it performs for the good of the whole system, as well as rules it follows to keep it functioning healthily, which are written into the DNA code. Each cell faithfully follows this code its whole life, like a code of conduct to which it has sworn. Every attempt is made to protect this code, but it is at always at risk of being damaged, altered, or even faulty from the start. If this occurs, it begins at an unfathomably small scale: in a single, tiny cell, on average about one third the width of a human hair. This faithful cell continues to do what the broken code tells it to do and, in the process, becomes something else, committing acts of aggression and treason. It is greedy, intrusive, and forgets what it means to share. A newborn conquerer, its focus shifts to multiplication of its forces and invasion. These cells can’t be our own.

Following its Jekyll to Hyde transformation, an effort is made at containment. Natural barriers exist in the body to compartmentalize systems, with the hope that they will not be breached. Invasion beyond the contained space is known as “Metastasis”, and beyond the walls, there are roads to which the entire body may be accessed. This is territory that is our own, and these are unwelcome visitors. We don’t recognize these hands, forcing this Petri-dish-cell on us as a new responsibility.

In these images, the shape of the subject’s hands is meant to represent an organ, held over the site of cancer within the body. The human subject is presumed to be hidden behind the sterile background. The only indication of identity given is in the gesture and likeness of the hands. The cell represented on the culture dish in each drawing is recreated from research photographs taken in a cancer research lab at Vanderbilt University, with each color used representing a different cell component related to a cancer that our team at the time was investigating.

As has almost every person who sees these drawings, I have lost a friend to cancer. It happened a long time ago, in my childhood, but these drawings were an opportunity to revisit some of the feelings one may go through when their lives are affected by something so powerful. I have included his name, LANCE, on one of the plates, as I have also included important cancer researchers names on the others.

In honor of the fact that everyone has been touched in some way by this disease, an arm in each drawing has a single “mole”, a physical reminder that nearly everyone carries on their body of the potential of chaos. With every person who is forced to endure this chaos, our knowledge grows, our treatments improve, and support networks evolve. People have an incredible ability to adapt to and endure things they should never have to experience. I am hopeful the word “cancer” won’t always hold so much power.

Ben Blais – Artist Bio

I am a fourth year medical student at the Geisel School of Medicine at Dartmouth. I grew up in the Lakes region of New Hampshire, and spent the more recent part of my life in the small town of Eliot, Maine. In 2010, I graduated from Vanderbilt University with a combined degree in Studio Art and Cell and Molecular Biology, and have often found myself combining these two interests.

I’ve always been fascinated by realism and trompe l’oeil styles, with my preferred media being colored pencil and graphite. My art career has so far included a solo exhibition at Berwick Academy in Maine, and two combined exhibitions, one at AVA Art Gallery in Lebanon, NH, and another at Vanderbilt University in Nashville, TN. I have also done a number of private commission works.

A few of my greatest influences include M.C. Escher, since I have a similarly mathematical approach to the technical aspects of drawing, and a fascination with surprising the viewer with new perspectives, Anthony Waichulis, for his process and mastery of realism, and Norman Rockwell, for his ability to recreate people’s expressions and familiar moments in a way that has always made me smile. Of course, I cannot ignore the fact that medical school has given me a strong appreciation for Dr. Frank Netter as well.

I am interested in pursuing a career in pediatrics or combined medicine and pediatrics, and I am looking forward to continuing to draw.

Thank you for enjoying my work!


Yesterday we were giving a presentation to The Dartmouth Institute’s Health Professions Educators’ Summer Symposium on various plagues that are nicely documented here in Rauner. It was a room filled with death and despair: one section was devoted to a small pox outbreak that hit Hanover in 1777, another to the cholera pandemic of the 1830s, and another on the bubonic plague that devastated London in 1665. The London plague (alluded to in an earlier post) brings to mind Monty Python, of course, but also fleas. And fleas reminded us of one of our favorite books, Robert Hooke’s Micrographia (London: J. Martyn and J. Allestry, 1665).

Micrographia was the first detailed account of life under a microscope. Hooke’s meticulous descriptions and illustrations revealed a wondrous new world to behold. But it was the irony of the publication date that was a wonder yesterday. The book came out in September of 1665, right when London was in the throes of the Plague. Little did the original readers know that the marvelously illustrated creature made so utterly foreign by the microscope was the source of all of their current sufferings.

To see Micrographia, ask for Rare QH271.H79.

UpToDate Enhancements Coming

UpToDate banner UpToDate® introduces enhanced search results and an improved user interface Find answers faster than ever with links to the sections and graphics most likely to answer your clinical questions. UpToDate synthesizes data from over 21 million monthly topic views to analyze search terms and information viewed by clinicians. This analysis enables UpToDate to quickly and accurately display relevant sections and graphics for a given search. Navigating UpToDate is even more intuitive with a redesigned user interface that puts key features like Drug Interactions and Practice Changing UpDates on every page.

Enhancements that improve search and usability include:

  • Links to the sections and graphics within a topic that are most likely to answer your clinical question
  • Customizability allows you to collapse the search results to see more results per page; this setting will be saved if you are logged in
  • The topic outline continues to provide a comprehensive overview of all topic sections and graphics
  • Find in Topic now displays your search term immediately upon opening
  • Improved user interface facilitates navigation by grouping items together in sections in the header and footer

enhancement examples

Learn more about the enhanced search results and updated user interface:
Watch a brief video demonstrating the changes or view a full description.

New Resource: Access Medicine

The Biomedical Libraries has a new resource that allows you to access full text clinical books, watch procedural videos and animations, and take self-assessment exams.

Access Medicine

Access Medicine features:Learn

  • Full text of 85+ clinical textbooks including Harrison’s Online, CMDT, Schwartz’s Principles of Surgery, Tintinalli’s Emergency Medicine, Pharmacotherapy: A Pathophysiologic Approach, and more!
  • More than 250 examination and procedural videos, patient safety modules, audio files, and animations.
  • Extensive self-assessment with thousands of Q&As to prepare for exams.
  • Drug database to look up dosing, indications, and adverse reactions with thousands of generic and name-brand drugs.
  • Differential diagnosis tool that allows you to browse 1,000+ diagnoses by symptom, disease or organ system.
  • Concise evidence-based outlines of common medical conditions for the clinical setting.

Benefits of a MyAccess account:

  • No VPNs or extra logins required! Simply create a MyAccess account while authenticated on the Dartmouth or DHMC secure network. Your registration expires if you do not log in every 90 days from either your device or computer on the Dartmouth or DHMC secure network.
  • Access to the site on your mobile devices and from off-campus computers.
  • Access to the Q&A feature and prior quiz result scores.
  • Save and download image capability, including the ability to download images directly to PowerPoint.

To create a MyAccess account:

  • From the Biomedical Libraries web page, click on the “Access Medicine” link under resources, while authenticated on the Dartmouth or DHMC secure network.
  • Click on “Dartmouth College” at the top right of the screen.
  • Click on “Login or Create a Free Personal Account.”
  • Fill out the required fields, including a username and password then select “Create an Account.”

Create Account

  • Click on “Dartmouth College” at the top right of the screen.
  • Click on “Login or Create a Free Personal Account.”
  • Fill out the required fields, including a username and password then select “Create an Account.”


Faculty Insight: Creating iBooks for Medical Education

Guest post by Amanda Albright, Educational Technology Support Specialist at Geisel School of Medicine Computing Services


In the fall of 2012, each incoming student at the Geisel School of Medicine at Dartmouth received an iPad as well as a variety of productivity and content apps to aid learning. As part of the iPad initiative, faculty willing to investigate the educational value of the iPad also received a device. A number of faculty, after attending iBook Author workshops facilitated by Apple educators, decided to create iBooks.

The following are excerpts submitted by faculty describing the rational for creating iBooks, the experience of creating iBooks, and student reaction to the iBooks. For more information, please contact

SBM Cardiology (Yr2) – James Bell, M.D.Myocardial and Pericardial Diseases

I give approximately 20 hours of lecture in the 2nd year Fall SBM Cardiology curriculum.  These lectures are supplemented by a series of fairly extensive lecture notes and PowerPoint slides.

In the past, some students have been confused as to where they should spend their study time: the notes, the slides, or reviewing the lecture on video. In an attempt to resolve student confusion, I constructed a series of iBooks for each of my lectures to integrate the key aspects of both the lecture notes and the most important illustrations from the PowerPoint slides.

I’m a bit of a visual learner, so I put a lot of emphasis on the juxtaposition of text and graphics on each page.  I particularly appreciated the ability to use video (e.g., echocardiogram) and sound recordings (especially helpful in describing heart sounds and murmurs).  I tried to make each page a separate entity, to minimize page turning when trying to make a point.  I was on a pretty steep learning curve, but I really enjoyed learning to create what for me was a work of science and art.

There were, of course, some problems.  I think the biggest was that none of the other (SBM Cardiology) lectures had iBook counterparts, leaving students with the previous dilemma of how to distribute their study time.  Another was that, despite my hope that students could just use the iBook and not worry about the notes and slides, many of them saw the iBooks as just one more study object to occupy their time.

Still, I think the iBooks were generally well-received.  The student evaluations were quite positive (mostly excellent or very good) with a 4.55 out of 5 on the evaluation form.  We asked specifically for comments on the iBooks, which proved quite insightful:

“The iBooks were incredible. The integration of pictures and audio files for the heart murmurs made for an excellent studying resource. Couldn’t be happier with this use of the technology; it really made a difference.”

“They could be improved by incorporating “test your understanding” questions along the way. It would break them up a bit and help to reinforce important concepts.”

“The iBook is the perfect modality for presenting information, as it seamlessly blends notes and slides. I wish there was an iBook for every lecture.”

Medical Virology (Yr1) – Edward Usherwood, Ph.D.Enveloped Viruses

For the 2012 – 2013 academic year, I created two iBooks for the Medical Virology course for Year 1 medical students.  The books synthesized lecture notes and slides from the lecture, so they are together in one integrated document.

The ability to insert sets of sides as galleries in the iBook allowed students to review all the visual material together with the pertinent section of the text.  It also removed the inconvenience of switching between Word and Powerpoint files when reviewing notes and slides, respectively.

There was something of a learning curve when I began to create the iBooks, but the online tutorials on were an invaluable resource when learning the interface.

Student feedback was overwhelmingly positive, the most common comment being they liked the format as a single, integrated document containing all the relevant material in one place.  In response to this, for the 2013-2014 classes, we are converting all lecture notes in this class to the iBook format.  Currently, I am exploring inserting more video and internet-based content into the iBooks to enrich the experience for the students. The recent release of Apple’s OS X Mavericks will make iBooks even more accessible since they will run on a Mac laptop as well as an iPad.

Medical Physiology (Yr1)– Andy Daubenspeck Ph.D., Eugene Nattie M.D., Donald Bartlett M.D.Fick Principle and Mass Balance

The fall 2013 semester was the first year that the Medical Physiology 110 faculty were able to effectively prepare lecture notes (13 iBooks) and concept-specific materials (7 iBooks).

Lecturers were responsible for producing the lecture note iBook for their assigned topics. The responsibility for developing the concept iBooks that covered more basic material pertinent to multiple lectures was assumed by Andy Daubenspeck.

An essential aspect of the development of these lecture note iBooks was the summer assistance of Jason Laurita, a rising 2nd year medical student, who was able to massage the material from various lecturers into quite impressive iBooks. Hermes Yeh, chairman of Physiology and Neurobiology, was very supportive of this and found the funds for Jason’s efforts.

Based upon discussion with the Year 1 curriculum representatives, who gave us thoughtful insights about the effectiveness of the iBooks, we realize that preparing these materials is a process of continuing improvement. We may have unconsciously made the content of some iBooks unnecessarily difficult for first year students to follow and grasp. In addition, we may have underutilized linkages to available web-based resources that students found useful. We also have not fully responded to the difficulties facing incoming students for whom English is not their first language.

As a result, we anticipate substantial revisions to the iBooks for next fall to simplify the verbiage, to incorporate improved guidance as to the overall goals for each iBook and of each iBook within the overall course, and to incorporate more of the useful, web-based resources (e.g., Khan Academy offerings).

Human Anatomy and Embryology (Yr1) – Virginia Lyons, Ph.D.Human Anatomy and Embryology

Creating an iBook is not difficult, and you do not have to start from scratch as your existing notes and PowerPoint slides can easily be imported. The training videos on provide everything you need to get started with iBooks Author.

I think what I like best about presenting our course materials in this format is the ability to make the material interactive. In other words, as students are reading the content you can insert questions along the way or diagrams for them to label so they are not just passively reading. The students really love having all the material in one place, and especially seem to like review questions at the end of the chapters. A typical comment from our course evaluation reads:

“The presentation of material in iBook format was extremely helpful. I really liked the scrollable galleries and the end-of-chapter review questions.”

If you plan to incorporate iBooks into your course be forewarned: once you provide some of your content in iBook format, the students will want all of your content in this format. Creating iBooks takes time and we were fortunate to have the assistance of Aaron Steen, a medical student who had recently completed our course.  However, once you create your books, it would be naïve to assume that you are done; iBooks offer so much potential for creativity in content delivery, you will find yourself spending your evenings tweaking your iBooks…but you won’t mind because it is fun!

Red Book© Mobile Access

Article Katie DeFord, Rick Hansen, and Jeremy Klockars

You can now access the Red Book Online from the American Academy of Pediatrics on your Apple and Android smartphones and tablets. This important resource provides guidance on manifestations, etiology, epidemiology, diagnosis, and treatment of 200+ childhood conditions.



  • Complete Text of Online & Print Editions
  • Influenza Resource Page
  •  Special Vaccine Shortage Updates
  • Current Immunization Schedules
  •  News & Alerts Regarding Infectious Diseases

Search categories then toggle between text and images for full context:

redbook2    redbook3

To download, simply follow these instructions: 

NOTE: You have to be on the College or DHMC network, or VPN or Secure Access (if offsite).  Once there, you can sign up for an individual account, which then lets you use the app from offsite.

  1. From the Biomedical Libraries web page, Go to eBooks, scroll down to Titles by Subject. Under Infectious Disease, select Red Book Online.
  2. Click on “Sign-In via User Name/Password” (fine print) located on the top-left (under the red banner) and just to the right of “Institution: Dartmouth College Library.”
  3. Click the link “Sign In for Individuals.”
  4. For New Customers, select “New Customer Registration.”
  5. Type in your email.
  6. Create an Individual account.
  7. Fill out the registration form and click “Continue.”
  8. You will get an email shortly after registering. It will give you your AAP ID. Use your AAP ID and the password you created to login to the AAP web site in the future.
  9. From the App Store on your Apple device, or from Google Play on your Android device, you can download the Red Book app and login with the above information.

The system will ask you to access the site within your organization’s site license at least once during a 120-day span to validate that you are still eligible. A reminder will appear when you log in if you haven’t accessed within 120 days.

Please send questions or comments to:

UpToDate for Your Mobile Device

UpToDate is now available for your IOS, Android, or Windows 8 mobile device.

To take advantage of this new feature, you must register for a personal account.  Go to UpToDate while on a computer (not your mobile device) connected to the DH or Dartmouth network. Click on the red “Log In/Register” button on UpToDate’s home page:













Fill out the registration form for new users and submit. You’ll quickly receive a confirmation by email.

Go to the app store for your device and download the free UpToDate app. Log in with your newly created user name and password. You can have the app on up to 2 devices; your laptop or desktop computer does not count as a device. Please note: you must be connected to the internet via your device to access the content.

Your registration expires if you do not log in every 30 days from either your device or computer on the Dartmouth or DH network. You’ll get a reminder after 25 days of not logging in.

UpToDate is brought to you by a partnership of the Dartmouth Biomedical Libraries, Geisel School of Medicine, and Dartmouth-Hitchcock.

Questions?  Contact or 650-7660.

New Resource: Natural Standard, an Alternative Therapies Database

The Natural StandardNatural Standard, a database assessing herbal medicine, supplements, and other complementary and alternative therapies, is now available from the Biomedical Libraries. Connect to

Natural Standard describes itself as founded by healthcare providers and researchers to provide high-quality, evidence-based information about complementary and alternative medicine including dietary supplements and integrative therapies. Grades reflect the level of available scientific data for or against the use of each therapy for a specific medical condition.  It is impartial; not supported by any interest group, professional organization or product manufacturer.

The evidence grading system is explained at

Other sources of information about alternative therapies include free sites such as Medline Plus,, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements, as well as comprehensive drug information resources from the Biomedical Libraries such as UpToDate, Clinical Pharmacology Online, DynaMed, and Micromedex.

Questions? Contact Peggy Sleeth, Associate Director for Information Resources.