A survey of the information management and technology training needs of doctors in an acute NHS trust in the United Kingdom

BACKGROUND: Doctors need information skills to deliver health care in the 21st century. There is concern that those who trained before the 'information age' will be inadequately equipped for their work. OBJECTIVES: To assess doctors' use of computers for clinical tasks, and their knowledge and skills in health information management and technology. DESIGN: Questionnaire survey. SETTING: An acute NHS trust in the UK. PARTICIPANTS: 96 (83%) of all doctors in the trust responded. MAIN OUTCOME MEASURES: Proportion of respondents reporting the following: use of computer-based systems for clinical tasks, knowledge in eight health informatics topics, skills in using specific hardware and software applications. Also comparison of reported skills between senior and junior staff; proportion of doctors identifying specific training needs. RESULTS: All but one (1%) of the responding doctors used a computer regularly. Over three quarters of respondents reported they were semi-skilled or fully skilled in basic office applications, though the juniors scored significantly more highly than the seniors for some applications. However, 44% of doctors reported no skills in database software, identifying this as a training need. Around half of the doctors were unaware of health informatics topics, including electronic patient records, the Caldicott report and data protection law. In each case the senior doctors were significantly more aware than the juniors of the topic in question. CONCLUSION: Both junior and senior doctors have basic computer literacy, but nearly half of this population identify the use of database software as a training need. In addition, there are several health informatics topics of which a large proportion of doctors, particularly the juniors, have little knowledge, but which have not been identified as training needs. Some recommendations are made for provision of in-house health informatics education for doctors.     

The information needs of doctors‐in‐training: case study from the Cairns Library,University of Oxford

The objective of this study was to find out more about the information needs of doctors‐in‐training and to identify their preferred sources of information. The methodology included interviews with consultants and administrators, a focus group discussion with library staff and a postal questionnaire sent to 347 doctors‐in‐training (there was a 43% return). The shortcomings of a questionnaire primarily composed of closed questions were addressed by the inclusion of one‐to‐one interviews which offered the opportunity for more in‐depth commentary on specific issues highlighted in the questionnaire. Results indicated the frequency with which various types of information sources were consulted and how this related to the ‘ease of access’ of each information source. There was also the opportunity to comment on future information needs. It was clear from the interviews as well as comments made on the questionnaire that the two most important requirements for doctors‐in‐training were ‘more time to find and obtain information’ and ‘better access to information sources when and where they are needed’. The results, although not surprising, included specific suggestions that have been used for the strategic planning of the library service to deliver the best possible support to users within the current framework of evidence‐based medicine.     

Clinical librarians,a new tribe in the UK: roles and responsibilities

Aims: The aims of this research were to determine the background, education, training experience, roles and responsibilities of practising Clinical Librarians (CL) in the UK. This paper reports the findings of a survey undertaken in 2007 at the third Clinical Librarian conference. This research builds on research undertaken by Harrison and Sargeant in 2002 and Ward in 2004, and can be considered as part of a longitudinal study of the role of the CL in the UK. Objectives: The objectives of the research were to define and gain a broad understanding of the role of the CL in the UK highlighting similarities and differences amongst the professionals and provide evidence for a baseline of skills and activities for the CL role. The type of sampling used was Judgemental. Results/analysis: Results/analysis detail the skills and activities undertaken by CLs. Searching for information for Clinicians was the activity most frequently undertaken. Developing good relationships with other healthcare professionals was considered essential. Two‐thirds of the respondents held a postgraduate library qualification. Conclusions: Crucially a new model for the UK CL role is derived drawing on the findings of this study and the existing literature.     

Effect of an evidence-based answering service on GPs and their patients: a pilot study

Objectives: For general practitioners (GPs), an important obstacle to practising evidence‐based medicine is lack of time. An evidence‐based answering service was developed that took over searching and appraisal of medical evidence from the GPs. GPs sent in questions, and the informationist formulated the answers. Our objectives were to find out if such an evidence‐based answering service was feasible, including assessing the effect of the answers on GPs and their patients, as reported by the GPs. Methods: After attending a workshop on building well‐formulated questions from daily practice, the GPs sent in questions to the informationist. The literature was searched, the relevant information was appraised, and the answers to the questions were formulated. With a questionnaire, the effect of the answers on the GP and the patient was assessed, as well as the perceived barriers to implementing the answers. Results: From 26 GPs, 61 questions were received. For 12% of questions, information was found with the highest evidence level, while for 36%, no information was found. However, for 89% of the questions for which no information could be found, the answer ‘no information found’ did have an effect on the GP concerned. In total, 81% of all the answers had an effect on the GP, and, according to the GP, 52% had an effect on the patient. Few barriers to implementing the evidence were perceived. Most of the answers were found in Pubmed/Medline, the Cochrane Library and Embase. Conclusions: This study indicates that an evidence‐based answering service can have an impact on GPs and their patients. Librarians can provide an evidence‐based answering service for GPs and their patients. The evidence‐based answering service for GPs in this study had an impact on 81% of the GPs and on 52% of their patients. Although for one‐third of the questions no evidence‐based answer was found, this message in itself had an impact on 89% of the GPs. An informationist as mediator between medical information and doctors can save doctors’ time.     

From UHSL to UHMLG: the evolution of a group for health librarians in higher education

Background: In 2007 the University Health Sciences Librarians Group (UHSL) merged with the University Medical Schools Librarians Group (UMSLG) to form the University Health and Medical Librarians Group (UHMLG). This paper traces the course of health librarianship in the UK which led to this event, from the perspective of the UHSL. Methods: The narrative has been developed from the Executive Committee minutes, newsletters and reports of events organized by the UHSL. Summary: The UHSL evolved from the Council of Polytechnic Librarians (COPOL) Health Sciences Group and the Standing Conference of National and University Librarians (SCONUL) Health Sciences Group. It sought to represent the views of health librarians working in the university sector. It also provided, through newsletters and study days, information, networking opportunities and professional development. UHSL collaborated with other relevant organizations to further its aims. Conclusion: The structure of professional support groups within health librarianship reflects the evolving nature of the health service, higher education and the social changes driven by technological developments.     

Using mobile technologies to give health students access to learning resources in the UK community setting

Objectives: This article describes a project which explored the potential for mobile technologies to give health students in the community access to learning resources. The purpose included the need to identify possible barriers students could face in using mobile technologies. Another focus was to assess the students perceptions of the importance of being able to access learning resources in the community. Methods: This 1‐year project used two main approaches for data collection. A review of the literature on mobile technologies in the health context was conducted. This was used in a systematic way to identify key issues and trends. The literature review was used to inform the design and production of a questionnaire. This was distributed to and completed by a group of community health students at Northumbria University, UK. The questionnaire was piloted and there was a 100% completion rate with 49 returned forms. Results: The literature review indicated that most mobile technology applications were occurring in the US. At the time of the review the most prevalent mobile technologies were PDAs, laptops, WAP phones and portable radios with use being concentrated around doctors in the acute sector. A range of advantages and disadvantages to the technology were discovered. Mobile technologies were mainly being used for clinical rather than learning applications. The students showed a low level of awareness of the technology but placed great importance to accessing learning resources from the community. Conclusions: Significant development and changes are taking place in mobile technologies. Since the data collection for this work was completed in 2004 podcasting and videocasting have become significant in mobile learning for health professionals. Librarians will need to address the relevance and implications of m‐learning for their practice. Care and consideration needs to be given on the time and resources librarians allocate for the necessary development work around mobile technologies. Collaboration and partnership working will be most effective approach for librarians wishing to integrate their services with m‐learning technologies.     

Geography,the Academy and Libraries

Geographic information sources have evolved at the same rate as the many other information sources in the last half a century. This article discusses geographic literacy and spatial thinking, and the questions that derive from geographic inquiry. Librarians in academic libraries are most often called on to meet the complex specialized geographic information needs that arise from study and practice in those areas. The sources we use and the ways we respond to these needs have evolved and expanded with the advent of various digital technologies. In order to be able to work with these new technologies, librarians can develop specialized competencies in geographic information systems (GIS) which allow them to go beyond print maps and atlases in the provision of geographic information.     

Partnering to Analyze Selection of Resources by Medical Students for Case-Based Small Group Learning: A Collaboration between Librarians and Medical Educators

Librarians and medical educators analyzed the quality of information resources used by first- and second-year medical students in their case-based small group learning summaries. Librarians provided instruction on using library resources and gave formal feedback to students about appropriate resources for basic science and clinical questions. The team found that students used a high number of clinical and basic science journal articles and textbooks with a number of factors influencing their resource choices. The study demonstrates numerous areas where librarians can play a key role in assisting students to find and assess information to answer clinical questions.     

A study of clinical questions posed by hospital clinicians.

OBJECTIVE: This article presents the results of complementary research studies on the behaviors of hospital clinicians in asking clinical questions and the relationship between asking of questions, outcome of information searches, and success in problem solving. METHODS: Triangulation in research methods--a combination of mailed questionnaires, interviews, and a randomized controlled study--was employed to provide complementary views of the research problems under study. RESULTS: The survey and interviews found that clinical problems (concerned mainly with therapy and equipment or technology) were expressed as statements rather than questions (average number of concepts = 1.7), that only slightly more than half (higher for doctors) of problems could be solved, and that the majority of clinical questions were not well formed. An educational workshop however improved clinicians' formulation of questions, but the use of structured prompting was found to improve building of hypotheses in the doctors' group without training. The workshop also improved satisfaction with the obtained information and success in problem solving. Nonetheless, for both the experimental and control groups, more structured and complete questions or statements did not mean higher success rates in problem solving or higher satisfaction with obtained information. CONCLUSION: The triangulation methods have gathered complementary evidence to reject the hypothesis that building well-structured clinical questions would mean higher satisfaction with obtained information and higher success in problem solving.     

Bibliotherapy for mental health service users Part 1: a systematic review

Aims and objectives: UK health policy advocates a patient‐centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio, or e‐learning materials to provide therapeutic support). Part 1 of a two part article describes a systematic review of the evidence for the effectiveness of bibliotherapy in mental health services. Methods: The systematic review of the literature used Cochrane guidelines, together with an overview of evaluations of bibliotherapy initiatives, and assessments of the needs of adult mental health service users for rehabilitation support. Results: The evidence strongly suggests that library‐based interventions and the provision of information could be beneficial for service users and economical for the health service in assisting treatment of a range of conditions. At present, public libraries in the UK are developing basic bibliotherapy services. Conclusions: Librarians, including librarians working for the health service, might provide more sophisticated bibliotherapy services, but the evidence to guide delivery is limited.     

Undertaking an information-needs analysis of the emergency-care physician to inform the role of the clinical librarian: a Greek perspective

AIM OF STUDY: The primary focus of this pilot study was to gain a better understanding of the information needs of emergency-care clinicians. The secondary focus was to compare the traditional current practice of information provision within other emergency departments in Greek hospitals, with the new model of clinical librarianship (CL). RATIONALE: Clinical staff in the emergency department deal with a variety of cases, they have no time to visit the library, but need information instantly in their place of work. Clinical decision making in the emergency department setting frequently requires the clinician to obtain additional sources of information and clinical librarians may facilitate this. STUDY DESIGN: The present study focused on two professional groups: medical librarians (group A) and clinicians (consultants, senior registrars, registrars, nurses (group B), working in the emergency departments of two Greek hospitals. The study was organized through a questionnaire survey and some in-depth interviews. RESULTS: This study showed that, for 100% of the clinicians in daily practice, the main information needs arise while treating patients, and that information would help in making patient-care decisions. Clinicians made little use of hospital libraries because they are usually under tremendous time pressure. The main outcome of the study was the use of a clinical librarian as an information provider. Clinical librarians supply information to assist decisions, based on this model. This extends the librarian's role in evidence-based medicine, giving much stronger attention to the relevant evidence in clinical practice. CONCLUSIONS: Nowadays, health services are facing organizational change. The introduction of new technology, and rapid growth of medical knowledge creates a demand for new ways of providing information. Clinical librarian programmes may deliver patients specific information in a timely manner. The mission of the clinical librarian is to facilitate access to quality information which is necessary for improving health, and to act as an informationist in the emergency department.     

Education for inpatients: working with nurses through the clinical information system

Librarians at the UMDNJ Cooper Library have been filling orders for patient education materials through Cooper University Hospital's Clinical Information System (CIS) since December 2000. This service was instituted in response to a JCAHO survey, which revealed that although patient education was being provided, it was not being routinely documented. Patient education orders fall into two categories: customized disease/procedure information and smoking cessation information. Nurses note the condition(s) and/or procedure(s) regarding which information is needed and indicate the education level of the material desired (basic, intermediate or advanced). Requests are received via a dedicated printer in the reference office. Librarians rely heavily upon a wide variety of Web-based consumer health resources, including proprietary resources such as MD Consult and Micromedex CareNotes. Patient Transport staff delivers two copies of all materials to nursing stations on patient care floors. One copy is for the patient to keep, while the other is attached to the patient's chart. To complete and document that patient education was provided, librarians record the order as filled in the CIS system.     

What Do Faculty Want?

The academic reference librarian needs to know what the college faculty expect from their library. These needs seem often to be idiosyncratic if they do not fit the librarian's conception of the generalized user, but these needs must be identified and met in order to serve the faculty appropriately. Librarians need to be as aware of information acquisition patterns as they are of information sources.     

The information-seeking behaviour of doctors: a review of the evidence

This paper provides a narrative review of the available literature from the past 10 years (1996-2006) that focus on the information seeking behaviour of doctors. The review considers the literature in three sub-themes: Theme 1, the Information Needs of Doctors includes information need, frequency of doctors' questions and types of information needs; Theme 2, Information Seeking by Doctors embraces pattern of information resource use, time spent searching, barriers to information searching and information searching skills; Theme 3, Information Sources Utilized by Doctors comprises the number of sources utilized, comparison of information sources consulted, computer usage, ranking of information resources, printed resource use, personal digital assistant (PDA) use, electronic database use and the Internet. The review is wide ranging. It would seem that the traditional methods of face-to-face communication and use of hard-copy evidence still prevail amongst qualified medical staff in the clinical setting. The use of new technologies embracing the new digital age in information provision may influence this in the future. However, for now, it would seem that there is still research to be undertaken to uncover the most effective methods of encouraging clinicians to use the best evidence in everyday practice.     

The information needs and behaviour of clinical researchers: a user-needs analysis

AIMS: As part of the strategy to set up a new information service, including a physical Resource Centre, the analysis of information needs of clinical research professionals involved with clinical research and development in the UK and Europe was required. It also aimed to identify differences in requirements between the various roles of professionals and establish what information resources are currently used. METHODS: A user-needs survey online of the members of The Institute. Group discussions with specialist subcommittees of members. RESULTS: Two hundred and ninety members responded to the online survey of 20 questions. This makes it a response rate of 7.9%. Members expressed a lack of information in their particular professional area, and lack the skills to retrieve and appraise information. DISCUSSION: The results of the survey are discussed in more detail, giving indications of what the information service should collect, what types of materials should be provided to members and what services should be on offer. RECOMMENDATION: These were developed from the results of the needs analysis and submitted to management for approval. Issues of concern, such as financial constraint and staff constraints are also discussed. CONCLUSIONS: There is an opportunity to build a unique collection of clinical research material, which will promote The Institute not only to members, but also to the wider health sector. Members stated that the most physical medical libraries don't provide what they need, but the main finding through the survey and discussions is that it's pointless to set up 'yet another medical library'.     

Information needs of specialist healthcare professionals: a preliminary study based on the West of Scotland Colorectal Cancer Managed Clinical Network

OBJECTIVES: Funded by Research in the Workplace Award (RIWA) 2001, the study investigated the information needs and use of NHS library services by members of the West of Scotland Colorectal Cancer Managed Clinical Network (MCN), a single subject, cross boundary, multi-professional organization. METHOD: A postal questionnaire sent out in October 2002 was returned by 100 members and follow-up interviews were held in March 2003 with 11 of the respondents. The questions related to access to resources, library services such as literature searches, current awareness and training. They also explored the use of electronic resources and the Internet. RESULTS: Respondents were mainly hospital doctors and a few nurses from across five health boards. Most had access to a library, although not all made use of it, possibly an indication of the need for improved communications between librarians and health-care staff. Generally, research and professional development were reported as reasons for needing cancer information, but on further investigation the motivation to conduct literature searches was more related to patient care. Examples included treatment of unusual cases, locating information for patients and identifying guidelines. There are indications of unmet needs for local contact information and evaluated patient information. CONCLUSION: Development of a cancer portal within the NHS Scotland e-Library available from May 2004 based on the Managed Knowledge Network (MKN) concept is attempting to address many of the issues raised in the survey, including inequities of access to services and signposting to a variety of types of information.     

Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK

Aims and objectives: UK health policy advocates a patient‐centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e‐learning materials to provide therapeutic support). Part 2 of this two‐part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. Methods: An e‐mail questionnaire survey of psychiatric library members of the psychiatric lending co‐operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. Results: At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. Conclusions: In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.