Information Literacy for Speech-Language Pathologists: A Key to Evidence-Based Practice

Information literacy skills and training of licensed practical nurses in Alberta, Canada: results of a survey

BACKGROUND

Although information literacy skills are recognized as important to the curriculum and professional outcomes of two-year nursing programs, there is a lack of research on the information literacy skills and support needed by graduates.

OBJECTIVE

To identify the information literacy skills and consequent training and support required of Licensed Practical Nurses (LPNs) in Alberta, Canada.

METHOD

An online survey using a random sample of new graduates (graduated within 5 years) from the registration database of the College of Practical Nurses of Alberta (CLPNA).

RESULTS

There was a 43% response rate. Approximately 25-38% of LPNs felt they were only moderately or to a small extent prepared to use evidence effectively in their professional practice. LPNs use the internet and websites most frequently, in contrast to library resources that are used least frequently. Developing lifelong learning skills, using information collaboratively, and locating and retrieving information are areas where LPNs desire more effective or increased training.

CONCLUSION

The results suggest there are significant gaps in the preparedness and ability of LPNs to access and apply research evidence effectively in the workplace. There are several areas in which the training provided by Librarians appears either misaligned or ineffective.

Awareness, adoption, and application of the Association of College & Research Libraries (ACRL) Framework for Information Literacy in health sciences libraries. J Med Libr Assoc 2017;105:347-354. [PMID: 28983198 PMCID: PMC5624424 DOI: 10.5195/jmla.2017.131]

OBJECTIVE

In early 2016, the Association of College & Research Libraries (ACRL) officially adopted a conceptual Framework for Information Literacy (Framework) that was a significant shift away from the previous standards-based approach. This study sought to determine (1) if health sciences librarians are aware of the recent Framework for Information Literacy; (2) if they have used the Framework to change their instruction or communication with faculty, and if so, what changes have taken place; and (3) if certain librarian characteristics are associated with the likelihood of adopting the Framework.

METHODS

This study utilized a descriptive electronic survey.

RESULTS

Half of all respondents were aware of and were using or had plans to use the Framework. Academic health sciences librarians and general academic librarians were more likely than hospital librarians to be aware of the Framework. Those using the Framework were mostly revising and creating content, revising their teaching approach, and learning more about the Framework. Framework users commented that it was influencing how they thought about and discussed information literacy with faculty and students. Most hospital librarians and half the academic health sciences librarians were not using and had no plans to use the Framework. Librarians with more than twenty years of experience were less likely to be aware of the Framework and more likely to have no plans to use it. Common reasons for not using the Framework were lack of awareness of a new version and lack of involvement in formal instruction.

CONCLUSION

The results suggest that there is room to improve awareness and application of the Framework among health sciences librarians.

Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information

While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low ( n = 13) and adequate ( n = 14) health literacy patients, and health professionals ( n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.

Developing an Information Literacy Workshop to Foster Evidence-Based Practice Among Nurse Practitioner Students

The increased autonomy and responsibility associated with the nurse practitioner (NP) role compounded with the plethora of electronic health information requires advanced practice registered nursing (APRN) students to possess information literacy (IL) skills associated with identifying, locating, and evaluating the quality of health-related literature (Majid, Chaudhry, & Xue, 2008). Without the proper IL skills needed to select high-quality clinical practice guidelines (CPGs) for decision making when developing treatment plans, NP students will be ill-equipped to perform evidence-based practice (EBP) during their clinical practicum experiences. The incorporation of IL skills training in NP educational programs is paramount for the actualization of EBP in clinical nursing (Majid et al., 2008). However, few studies have discussed IL skills and EBP as they relate to NP students' abilities to critically appraise CPGs and make EBP clinical decisions. This article discusses the development of a 4-hr IL workshop to enhance NP students' abilities to effectively search and critically appraise evidence-based research to make well-informed clinical decisions as advanced practice nurses.

Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability

BACKGROUND

People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic.

AIMS

To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values.

METHODS & PROCEDURES

A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making.

OUTCOMES & RESULTS

Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD.

CONCLUSIONS & IMPLICATIONS

Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches.

Evidence-Based Speech-Language Pathology Practices in Schools: Findings From a National Survey

Purpose

This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010–2011.

Method

Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP activities, as well as their resource needs and future training format preferences.

Results

A total of 2,762 SLPs in 28 states participated in the online survey, 85% of whom reported holding the Certificate of Clinical Competence in Speech-Language Pathology credential. Results revealed that one quarter of survey respondents had no formal training in EBP, 11% of SLPs worked in school districts with official EBP procedural guidelines, and 91% had no scheduled time to support EBP activities. The majority of SLPs posed and researched 0 to 2 EBP questions per year and read 0 to 4 American Speech-Language-Hearing Association (ASHA) journal articles per year on either assessment or intervention topics.

Conclusion

Use of ASHA online resources and engagement in EBP activities were documented to be low. However, results also revealed that school-based SLPs have high interest in additional training and resources to support scientifically based practices. Suggestions for enhancing EBP support in public schools and augmenting knowledge transfer are provided.

Occupational therapy master-level students' evidence-based practice knowledge and skills before and after fieldwork

ABSTRACT Evidence-based practice (EBP) has become a universal standard for practice among healthcare professions, but due to barriers to EBP, the most effective ways of teaching EBP are not well understood. The purpose of this study was to report students' EBP knowledge and skill gained from an entry-level Master's of Science in Occupational Therapy course in EBP. The Adapted Fresno Test of EBP was administered at the beginning and end of the course and after fieldwork experience. Results indicated that EBP knowledge and skills increased between the precourse and postcourse measurements (t = -7.98; p < 0.001), but declined between postcourse and postfieldwork measurements (t = 6.65; p < 0.001) indicating that the course improved basic EBP skills and knowledge, but was ineffective in giving the students the strategies to retain and use those skills beyond the classroom. Suggestions are made to strengthen the student retention and use of EBP skills and knowledge after graduation.

Some Pragmatic Tips for Dealing With Clinical Uncertainty

Purpose

This article proposes some recommendations to enable clinicians to balance certainty and uncertainty when evaluating the currency and effectiveness of their treatment approaches.

Method

I offer the following advice: (a) Question the authority of the information previously learned in one’s career; (b) be cognizant of what we do not yet know about best clinical practice; (c) understand that knowledge of “best practices” is both temporary and relative; (d) enable access to new information by the use of electronic alerts; (e) be flexible in reading new clinical reports, keeping an open mind as to their value; (f) get the clinically relevant details of new approaches by reading the full reports; and (g) employ, and then evaluate the outcomes of, new approaches used in treating individuals on our caseload.

Results

Examples are provided to show that proactive participation in research-alert programs can enable clinicians to access emerging, clinically relevant information, some of which is controversial. Staying abreast of such information is more efficient than performing guided searches for information as challenging cases arise.

Conclusions

Applications of these recommendations should enable practicing clinicians to entertain new, clinically useful concepts while not taxing the limited time that clinicians typically have to engage in continuing education.

Learning centred approach for developing the electronic information search processes of students

BACKGROUND

Undergraduate students of the twenty-first century are widely regarded as 'technologically savvy' and have embraced the electronic information world. The literature, however, describes undergraduate students as using a limited range of electronic information sources and not critically evaluating the information they retrieve from internet searches.

AIMS

The aim was to evaluate a purposefully designed intervention that sought to expand the information search and evaluation practices of undergraduate students. The intervention scaffolded an independent learning activity in the form of a group-based project.

METHODS

Survey methodology was used to collect data from student pre- and post-intervention for two cohorts of students who undertook the intervention in 2005 and 2006 involving a total of 71 students. Percentages were used to describe survey findings and chi-square analysis and Fisher's exact test examined differences between groups.

RESULTS

Questionnaires were completed by 59 students (response rate 83%) pre-intervention and 49 students (response rate 69%) post-intervention. Post-intervention there were positive and statistically significant differences in database searching behaviour (p = 0.000), use of Google Scholar (p = 0.035) and number of criteria used to evaluate information retrieved from the internet (p = 0.000) by students.

CONCLUSION

By positively reshaping the electronic information search and evaluation practices of students we are helping students to find informed information sources as they engage in independent learning activities at university and as future health professionals.

Radiation therapists and the Internet: a perspective from Australia

The Internet is an important information source for health practitioners; yet little is known of how radiation therapists (RTs) are currently using this vast information resource for their professional learning. In 2007, a four-page postal survey was sent to a random sample of 1,142 Medical Radiation Science practitioners with a response rate of 32.8%, which included 76 RTs. This paper reports and analyses the questionnaire responses from RTs on the use of the Internet to update their professional knowledge and issues affecting accessibility to the Internet in the workplace. This research provides an initial data set on the professional use of Internet-based tools and resources by Australian RTs. It has been shown that the Internet is an important information source widely used by RTs as they search the Internet (89%), access specific web pages (85%), use e-mail (84%) and listservs (49%) to update their professional knowledge. Although all RTs reported Internet access within their workplace, a number of factors have been identified which at present limit accessibility of current quality health and medical information through the Internet to RTs. A large number of RTs were unaware of Internet-based resources, such as Cochrane Library (48%) and GoogleScholar (42%), which support evidence-based practice (EBP) and research. RTs in teaching environments had greater access to computers with Internet access than their colleagues in non-teaching environments (p = 0.044). More RTs in the private sector (22%) reported they had ‘no’ access to the Internet in their workplace than their public sector colleagues (4%, p = 0.037). In addition, RTs in metropolitan workplaces had greater access to protected time during work hours for professional reading or study than their non-metropolitan colleagues (p = 0.000). These issues of non-uniformity of resources across workplaces and knowledge gaps within the profession must be addressed so that all RTs can avail themselves of high quality resources available through the Internet that support them in implementing EBP and meeting the mandatory requirement of updating their professional knowledge.

Using family paradigms to improve evidence-based practice

PURPOSE

Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP.

METHOD

This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples.

RESULTS

A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions.

CONCLUSIONS

Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.

Introducing information literacy into anesthesia curricula

PURPOSE

This review examines the topic of information literacy (IL) and its importance as a component of competency-based education in the health professions, and shares the process and outcome of a collaborative effort between The University of Manitoba Department of Anesthesia and Health Sciences Libraries to create, to introduce and integrate IL training into a new anesthesia curriculum.

PRINCIPLE FINDINGS

Nine IL modules were developed according to standards set by the Association of College and Research Libraries (ACRL) and aligned with the Royal College of Physicians and Surgeons CanMEDS competencies. Taken collectively, they explore modern tools used to approach the medical literature in an organized, efficient manner, and to locate, evaluate and use information effectively to accomplish a specific purpose. Each module forms the basis of one IL session that combines self-study and group projects with librarian-led, computer-based training, designed to build competency in information need awareness, retrieval skills and resource appraisal. Facility with the concepts taught was evaluated though examples relevant to the anesthesia practice environment. The entire collection is available at http://wiki.lib.umanitoba.ca/tiki-index.php?page=Anesthesia+Clinical+Assistants+Programme. While the original impetus for this project was to prepare Anesthesia Clinical Assistants for self-directed, life-long, active learning, what emerged was a curriculum in IL germane to medical specialties and flexible enough to be used by healthcare professions generally.

CONCLUSION

An IL program, directly relevant to current expectations of competent practice, education and lifelong learning, has been created and is discussed within the larger context of curriculum-integrated IL for the health professions.

Evidence-Based Practice and Speech-Language Pathology: Strengths, Weaknesses, Opportunities and Threats

Speech-language pathologists are increasingly required to demonstrate that their practice is based on evidence. While the concept of evidence-based practice has strengths, there have been some weaknesses in its application in speech-language pathology. Nevertheless, since current health care demands compliance, the profession must consider the opportunities and threats that evidence-based practice poses. This paper reviews the literature to provide an understanding of the relevance of evidence-based practice for speech-language pathology. It considers the assumptions on which definitions of evidenced-based practice rely and reviews the ways in which clinicians might base their practice on evidence. While the medical model of evidence-based practice research is controversial even in the medical field, the concept provides opportunities for the profession of speech-language pathology. Evidence-based practice has the potential to improve intervention for people with communication disorders, increase resources for services and enhance perception of the profession.

An assessment of the information-seeking abilities and needs of practicing speech-language pathologists

OBJECTIVES

This study assessed the information-seeking practices and needs of speech-language pathologists (SLPs). Improved understanding of these needs can inform librarians and educators to better prepare students in principles and methods of evidence-based practice (EBP) and, through continuing education (CE), promote the integration of EBP into clinical practice of SLPs.

METHODS

A 16-question survey was mailed to 1,000 certified speech-language pathologists in the United States.

RESULTS

Two hundred and eight usable surveys were returned for a response rate of 21%. For clinical questions, SLPs most often consulted with a colleague, participated in CE activities, and searched the open Internet. Few respondents relied on scholarly journal articles for assistance with clinical cases. The most prominent barriers to finding appropriate information were time and knowledge of where and how to find relevant information. Few reported having information literacy instruction by a librarian.

DISCUSSION

If EBP is to become a viable practice in clinical decision making, there appears to be a tremendous need for information literacy instruction in the university curriculum, as well as through CE activities for currently practicing SLPs. Given respondents' reported lack of time and limited access to full-text journals containing evidence relevant to clinical practice, the field of speech-language pathology will need to generate readily accessible clinical summaries of research evidence through meta-analyses, systematic reviews, and clinical practice guidelines.

Evidence-based practice: an examination of its ramifications for the practice of speech-language pathology

PURPOSE

The purpose of this article is to consider some of the ramifications that arise when a discipline newly endorses evidence-based practice (EBP) as a primary guiding principle. Although EBP may appear straightforward, events experienced by peer disciplines that have preceded us in the implementation of EBP raise questions about defining acceptable forms of evidence for treatment effectiveness and efficacy, the potential roles of nonspecific or common factors, therapist quality in achieving therapy outcomes, and eventual applications of EBP that may overly confine which treatments are considered acceptable and reimbursable.

METHOD

Through narrative review of the literature, the article examines valuable as well as controversial features of EBP in addition to obstacles that may impede the transition of evidence (research findings) to clinical practice.

CONCLUSION

EBP is a valuable construct in ensuring quality of care. However, bridging between research evidence and clinical practice may require us to confront potentially difficult issues and establish thoughtful dialogue about best practices in fostering EBP itself.