The informationist: building evidence for an emerging health profession

Perceptions, experiences, and attitudes of health care professionals regarding the role of librarians in fostering evidence-based health practice: a systematic review protocol

OBJECTIVE

The objective of this systematic review is to explore perceptions, experiences, and attitudes of health care professionals in teaching hospitals, academic health science centers, and health care professional colleges regarding the role of librarians in fostering the production of evidence-based research.

INTRODUCTION

Evidence-based health practice entails the use of the best research evidence, combined with knowledge and information gained through professional expertise as a practicing clinician, and consideration of patients' concerns and preferences to make the best possible decision for the care provided to those patients. With their extensive skills in literature searching, librarians and other information professionals contribute to the process of evidence-based health practice by locating and retrieving the most relevant information for clinical practice. Despite the importance of librarians in evidence-based health practice, little attention has been paid to the perceptions and attitudes of health care professionals toward the involvement of librarians in fostering evidence-based research and their participation in other evidence-based health practice activities.

INCLUSION CRITERIA

The population of interest is health care professionals working in teaching hospitals, academic health science centers, and health care professional colleges who make clinical decisions based on evidence, clinical judgments, and patient values.

METHODS

The following databases will be searched from database inception till June 2021 for published and unpublished studies: CINAHL, PsycINFO, AMED, Academic Search Premier, Scopus, LISTA, MEDLINE, POPLINE, and Open Grey. Studies published in English will be considered for review. The selected studies will be critically assessed for methodological quality by two independent reviewers.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019136749.

A core competency model for clinical informationists

Objectives:

Access to high-quality information improves the quality of patient care, but lack of time and sufficient skills in information seeking can prevent access to information by clinicians. To solve this problem, clinical informationists can provide high-quality, filtered information for clinical team members. This study identified the core competencies that clinical informationists need to effectively fulfill their roles on clinical teams.

Methods:

Participants were selected purposefully from clinicians and medical librarians. Data were collected through semi-structured interviews and analyzed using qualitative content analysis.

Results:

The authors identified six competencies—communication, research, education and training, domain knowledge, information services, and technology—which together were used to develop a “CREDIT” model of core competencies for clinical informationists.

Conclusions:

The CREDIT model can be used as criteria for evaluating the performance of clinical informationists as well as for developing and assessing clinical informationist educational programs and curriculums.

Clinical informationist educational needs and goals: A scoping review

Clinical informationist (CI) is one of the current trends in the field of medical librarianship and information science. CIs are members of clinical care teams, and their main duty is to fill the gap in the information needs of health-care workers and patients using information sources. They need an official and standard education. This study aims to identify the educational goals and needs of CIs. To this end, a scoping review was conducted using the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The ISI Web of Science, Scopus, Proquest (MEDLINE), Science Direct, Emerald, ERIC, Cochrane, and Library, Information Science and Technology Abstracts were searched. The Journal of the European Association for Health Information and Libraries was hand searched for relevant studies. A total of 1026 studies were extracted, and 38 studies were selected for the final review. The review resulted in identifying 18 goals in cognitive, emotional, and psychomotor areas. Furthermore, the educational needs were identified in eight educational needs including research method and statistics, education, medical knowledge, information and librarianship science, clinical environment knowledge, evidence-based knowledge, information technologies and systems, management, and leadership. Although part of these educational needs can be met through general medical librarianship and information science education, further specialized education for CIs requires specific aims and curriculum. Thus, the results of this study can be the basis for future studies regarding the competencies of CI in order to provide a more precise and detailed curriculum based on these educational needs.

The educational role of clinical informationist on improving clinical education among medical students: Based on Kirkpatrick model

INTRODUCTION

Due to time constraints and a significant increase in medical information, one of the ways to keep physicians and medical teams up to date is to use evidence-based medicine. The current research focused on the effects of the educational role of clinical informationist (CI) on improving clinical education among medical students based on the Kirkpatrick (KP) model.

METHODS

The method was semiexperimental research in two group designed with pretest and posttest. The research population included thirty medical students for each group that was selected by the convenience time-based sequential sampling method. The study data were collected using a researcher-made two questionnaires and a checklist. Data were analyzed by the descriptive statistics and inferential statistics using SPSS version 20 software.

RESULTS

Based on the first level of the KP model, the total mean of medical students' satisfaction in the experimental group was 4.06 from 5. Based on the second, third, and fourth levels of the model, the independent t-test showed that before the intervention, the mean scores of attitude, knowledge, information-seeking skills and behaviors, and also clinical skills were not significantly different in both the intervention and control groups (P > 0.05). After the intervention, the results of covariance test showed that attitude, knowledge, information-seeking skills and behaviors, and also clinical skills of the intervention group are significantly better than that of the control group (P < 0.001).

CONCLUSION

Training and the presence of the CIs in the clinical round had resulted in the improved satisfaction, attitude, knowledge, and information-seeking skills while also improving information-seeking behaviors and clinical skills of medical students.

Evaluating the impact of clinical librarians on clinical questions during inpatient rounds

Objective

The investigation sought to determine the effects of a clinical librarian (CL) on inpatient team clinical questioning quality and quantity, learner self-reported literature searching skills, and use of evidence-based medicine (EBM).

Methods

Clinical questioning was observed over 50 days of inpatient pediatric and internal medicine attending rounds. A CL was present for 25 days and absent for 25 days. Questioning was compared between groups. Question quality was assessed by a blinded evaluator, who used a rubric adapted from the Fresno Test of Competence in Evidence-Based Medicine. Team members were surveyed to assess perceived impacts of the CL on rounds.

Results

Rounds with a CL (CLR) were associated with significantly increased median number of questions asked (5 questions CLR vs. 3 NCLR; p<0.01) and answered (3 CLR vs. 2 NCLR; p<0.01) compared to rounds without a CL (NCLR). CLR were also associated with increased mean time spent asking (1.39 minutes CLR vs. 0.52 NCLR; p<0.01) and answering (2.15 minutes CLR vs. 1.05 NCLR; p=0.02) questions. Rounding time per patient was not significantly different between CLR and NCLR. Questions during CLR were 2 times higher in adapted Fresno Test quality than during NCLR (p<0.01). Select participants described how the CL's presence improved their EBM skills and care decisions.

Conclusions

Inpatient CLR were associated with more and improved clinical questioning and subjectively perceived to improve clinicians' EBM skills. CLs may directly affect patient care; further study is required to assess this. CLs on inpatient rounds may be an effective means for clinicians to learn and use EBM skills.

Social networks and relational capital in library service assessment

Purpose

– Researchers and administrators have struggled to fully understand the value of library human resources for decades. There are many approaches to counting the activities of library staffs, but less is understood about the value of developing and maintaining relationships. Given the growing importance of engagement-focussed, expertise-based service models in research libraries, the failure of library assessment models to account for the relational value of librarian activities is problematic in justifying and incentivizing new strategic activities and understanding the importance of libraries’ relationships with users and other stakeholders. The social network perspectives now commonplace in organizational studies to provide relational and contextual understandings of organizational behavior could be applied to library performance measurement and evaluation, providing a fuller picture of library impact. The purpose of this paper is to address this conceptual gap in the evaluation of library services.

Design/methodology/approach

– The first part of the paper will present a content analysis of recent literature on emerging service models in academic libraries to identify relational aspects of the models. The relational elements will then be mapped to major concepts and methods from the social network analysis literature. This will include, as appropriate, basic network properties such as transactional content (e.g. exchange of power, services, etc.) of the relationship, nature (e.g. intensity, reciprocity, embeddedness) of the relationship, and structural characteristics of library networks. It will also identify more advanced areas of analysis such as the development of social capital, diffusion of innovations and contagion, and the role of networks in providing access to organizational resources. After mapping relational elements of emerging library service models to social network theory, a research agenda for better understanding library social networks and their value will be proposed.

Findings

– Social network theory offers a rich conceptual and methodological framework for understanding the relational value of library services, particularly in emerging engagement-centered views of librarianship. Although activity- and outcome-based models of assessment are still important in the assessment of library activities, a social network view of library relationships is an essential complement in providing a more complete view of library value and will complement other work in this area such as human capital valuation and the relational capital components of the values scorecard.

Originality/value

– This paper presents a unique theoretical and methodological viewpoint on the assessment of library services. This will contribute to the understanding of a vexing problem in library assessment, the value of library human resources, by providing a framework for the measurement and evaluation of relational aspects of librarianship that are often viewed as intangible and unmeasurable.

Neuropathologic Characterization of Pontocerebellar Hypoplasia Type 6 Associated With Cardiomyopathy and Hydrops Fetalis and Severe Multisystem Respiratory Chain Deficiency due to Novel RARS2 Mutations

Autosomal recessive mutations in the RARS2 gene encoding the mitochondrial arginyl-transfer RNA synthetase cause infantile-onset myoencephalopathy pontocerebellar hypoplasia type 6 (PCH6). We describe 2 sisters with novel compound heterozygous RARS2 mutations who presented perinatally with neurologic features typical of PCH6 but with additional features including cardiomyopathy, hydrops, and pulmonary hypoplasia and who died at 1 day and 14 days of age. Magnetic resonance imaging findings included marked cerebellar hypoplasia, gyral immaturity, punctate lesions in cerebral white matter, and unfused deep cerebral grey matter. Enzyme histochemistry of postmortem tissues revealed a near-global cytochrome c oxidase-deficiency; assessment of respiratory chain enzyme activities confirmed severe deficiencies involving complexes I, III, and IV. Molecular genetic studies revealed 2 RARS2 gene mutations: a c.1A>G, p.? variant predicted to abolish the initiator methionine, and a deep intronic c.613-3927C>T variant causing skipping of exons 6-8 in the mature RARS2 transcript. Neuropathologic investigation included low brain weights, small brainstem and cerebellum, deep cerebral white matter pathology, pontine nucleus neuron loss (in 1 sibling), and peripheral nerve pathology. Mitochondrial respiratory chain immunohistochemistry in brain tissues confirmed an absence of complexes I and IV immunoreactivity with sparing of mitochondrial numbers. These cases expand the clinical spectrum of RARS2 mutations, including antenatal features and widespread mitochondrial respiratory chain deficiencies in postmortem brain tissues.

The status of health librarianship and libraries in the Republic of Ireland (SHELLI): a mixed methods review to inform future strategy and sustainability

BACKGROUND

This paper summarises the main points of a review of the Status of Health Librarianship & Libraries in Ireland (SHELLI). The review was commissioned to gain a broad understanding of what was happening in practice in Ireland; acquire knowledge about international best practice, and to inform strategic plans to develop and sustain health libraries and librarianship in Ireland.

METHODS

A Mixed Methods approach was used: a literature review; an online survey distributed to health librarians; Semi structured interviews with key stakeholders; a focus group drawing participants from the survey. All evidence was triangulated.

RESULTS

New roles for health librarians needed development and the changing educational needs of health librarians warranted attention. Increased collaboration across institutional boundaries needed more consideration, especially in relation to access to e-resources. Marketing of library services was crucial. Irish health library standards, needed to be updated and enforced and a proper evidence base established. The literature provided a number of examples of potentially useful initiatives.

CONCLUSIONS

A strategic plan of action was drawn up in three areas: (i) to identify champions and promote visibility of health service libraries, (ii) to establish a body of evidence and (iii) to support service development and staff mentoring.

"You're just one of the group when you're embedded": report from a mixed-method investigation of the research-embedded health librarian experience

OBJECTIVE

Embedded librarianship has received much attention in recent years. A model of embeddedness rarely discussed to date is that of research-embedded health librarians (REHLs). This study explores the characteristics of Canadian REHLs and the situations in which they are employed.

METHODS

The authors employed a sequential, mixed-method design. An online survey provided descriptive statistics about REHLs' positions and work experiences. This informed a series of focus group interviews that expanded upon the survey. Through constant comparison, we conducted qualitative descriptive analysis of the interviews.

RESULTS

Based on twenty-nine survey responses and four group interviews, we created a portrait of a "typical" REHL and discovered themes relevant to REHL work. REHLs may identify more strongly as researchers than as librarians, with corresponding professional needs and rewards. REHLs value "belonging" to the research team, involvement in full project lifecycles, and in-depth relationships with nonlibrarian colleagues. Despite widely expressed job satisfaction, many REHLs struggle with isolation from library and information science peers and relative lack of job security.

CONCLUSIONS

REHLs differ from non-embedded health librarians, as well as from other types of embedded librarians. REHLs' work also differs from just a decade or two ago, prior to widespread Internet access to digital resources.

IMPLICATIONS

Given that research-embedded librarianship appears to be a distinct and growing subset of health librarianship, libraries, master's of library and information science programs, and professional associations will need to respond to the support and education needs of REHLs or risk losing them to the health research field.

Involving clinical librarians at the point of care: results of a controlled intervention

PURPOSE

To measure the effect of including a clinical librarian in the health care team on medical residents and clinical clerks.

METHOD

In 2009, medical residents and clinical clerks were preassigned to one of two patient care teams (intervention and control). Each team had a month-long rotation on the general medicine teaching unit. The clinical librarian joined the intervention team for morning intake, clinical rounding, or an afternoon patient list review, providing immediate literature searches, formal group instruction, informal bedside teaching, and/or individual mentoring for use of preappraised resources and evidence-based medicine search techniques. Both intervention and control teams completed pre and post surveys comparing their confidence levels and awareness of resources as well as their self-reported use of evidence for making patient care decisions. The nonintervention team was surveyed as the control group.

RESULTS

The clinical librarian intervention had a significant positive effect on medical trainees' self-reported ability to independently locate and evaluate evidence resources to support patient care decisions. Notably, 30 of 34 (88%) reported having changed a treatment plan based on skills taught by the clinical librarian, and 27 of 34 (79%) changed a treatment plan based on the librarian's mediated search support.

CONCLUSIONS

Clinical librarians on the care team led to positive effects on self-reported provider attitudes, provider information retrieval tendencies, and, notably, clinical decision making. Future research should evaluate economic effects of widespread implementation of on-site clinical librarians.