Linking research to practice: the rise of evidence-based health sciences librarianship

Purpose:

The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work.

Methods:

Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement.

Results:

These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice.

Implications:

Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.     

The road not taken

The annual Janet Doe Lecture was established in l966 to honor Janet Doe, emerita librarian of the New York Academy of Medicine. The lecture focuses on either the history or philosophy of health sciences librarianship. This lecture addresses three fundamental values of the field, highlighting basic beliefs of the profession that are at risk: privacy, intellectual property rights, and access to quality information. It calls upon readers to make the everyday choices required to keep the value system of health sciences librarianship in place. Robert Frost''s poignant poem ”The Road Not Taken” provides the metaphor for examining choices in an information economy.

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,
And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
Robert Frost [1]

These charming pastoral words evoke a not so subtle hint at the importance of choices made and opportunities unexplored. When Frost wrote these words in Vermont more than a century ago, he had no intimation of the myriad choices that overwhelm our senses today. The rhythm of the crafted stone fences of New England marked the boundaries of the land. The disruption of the interstate highway with its unrelenting straight lines had not yet cleaved the fences one from another. The stillness of the woods was not yet pierced by jet-propelled aircraft and, yet, Robert Frost knew then of roads not taken.

“And I shall be telling this with a sigh
Somewhere ages and ages hence”

We, too, know of choices forced upon us with dizzying pace, choices made with adrenaline and exhilaration, agonizingly belabored, or often ignored. Choices surrounding our fundamental beliefs in an age of disruptive technologies and value-changing economies are the theme of this paper. Walk down a path with me that examines choices around privacy, intellectual property rights, and access to quality information, core values that medical librarians support and rely upon every day of the year.     

Our words,our story: a textual analysis of articles published in the Bulletin of the Medical Library Association/Journal of the Medical Library Association from 1961 to 2010

Purpose:

This lecture explores changes in the medical library profession over the last fifty years, as revealed by individual word usage in a body of literature.

Methods:

I downloaded articles published in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2000 to create an electronic corpus and tracked annual frequency of individual word usage. I used frequency sparklines of words, matching one of four archetypal shapes (level, rise, fall, and rise-and-fall) to identify significant words.

Results:

Most significant words fell into the categories of environment, management, technology, and research. Based on word usage changes, the following trends are revealed: Compared to 1961, today''s medical librarians are more concerned with digital information, not physical packages. We prefer information to be evidence-based. We focus more on health than medicine. We are reaching out to new constituents, sometimes leaving our building to do so. Teaching has become important for us. We run our libraries more like businesses, using constantly changing technology. We are publishing more research articles.

Conclusions:

Although these words were chosen by individual authors to tell their particular stories, in the aggregate, our words reveal our story of change in our profession.The Janet Doe Lecture on the history or philosophy of medical librarianship: I will warn you right now that you will get very little philosophy out of me today, for two reasons. First, my predecessor T. Scott Plutchak, AHIP, was a philosophy major, and I knew that a zoology major like myself could not compete with that. Second, “philosophy” in many Janet Doe lectures is actually a strong personal viewpoint of medical librarianship—what it is or what it should be. I do collection development, where things change so much and so rapidly that I have not had time to develop a strong viewpoint like many of my Doe predecessors. Like most of my collection development colleagues, I''m just trying to survive day to day. That tends to create a very pragmatic attitude. If I believe in anything strongly, it is that I believe I''ll have another cookie.Without philosophy, I am left with history. And here I will echo the complaint of many Doe lecturers by stating that I have a severe lack of historical research skills. I became painfully aware of this lack as I read previous Doe Lectures, such as David Kronick''s 1980 lecture 1. Kronick was a true scholar, with a doctorate in librarianship. We honor him to this day with the Medical Library Association''s (MLA''s) David A. Kronick Traveling Fellowship. In his Doe Lecture, Kronick quoted H. Curtis Wright''s “The Oral Antecedents of Greek Librarianship,” Francis Bacon, and the fifteenth-century Abbot Johannes Trimethius. In contrast, later in this speech, I will quote the Talking Heads.While I am totally unqualified for traditional historical research, that still leaves informal, or personal, history. Although I am old enough to be in my anecdotage, I just do not have many interesting stories to tell. And as Thomas Basler, FMLA, told us in his 2008 Doe Lecture, there are no more giants. While I met some of those giants, I did not know them, and I certainly do not have any stories to tell about them. I suppose I could tell stories about some of the taller than average individuals I have met in my career, but that does not sound very exciting.     

A current perspective on medical informatics and health sciences librarianship.

OBJECTIVE: The article offers a current perspective on medical informatics and health sciences librarianship. NARRATIVE: The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. SUMMARY: Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as "boundary spanners," incorporating human factors that unite technology with health care delivery.     

That vision thing.

The 1991 Janet Doe lecturer describes the vision held by the founders of the Medical Library Association of medical information being readily accessible to health professionals no matter how far they were located from major medical centers, and traces the pursuit of this vision to current outreach activities.     

The Medical Library Association in retrospect, 1937-1967

The medical librarian of 1967 lives in a period of changing concepts, dramatic new methods, everwidening scientific horizons. In looking toward the immediate past he may think of the medical librarian of thirty years ago as a complacent follower of accepted procedures, not as a pioneer in a brave new world. Yet the corps of trained medical librarians today and the resources of our collections and their management are dependent upon the efforts of those who were then pioneers in medical librarianship. Training, standards, recruitment, literature control, international relations, all had continuing attention at a time when financial assistance through government funds, support by administrators, concern by scientists was almost nonexistent. In these years the day of the devoted amateur passed; the trained medical librarian came into being and matured.This, the first Janet Doe Lecture, is named for one who illustrates the best in medical librarianship, serving with scholarly distinction. It is a brief survey pointing to some of the Association's significant achievements during the years of Miss Doe's greatest activity when she and her colleagues met their "Challenge of Change."     

Appraising the Community of Practice at a Hospital Library System Using a Critical Librarianship Lens

Abstract

The Kaiser Permanente health sciences librarians created inter-regional policies to standardize and guide the work of all librarians across regions. In response to the larger organization’s emphasis on promoting diversity and equity in healthcare and the workplace, the library policies have evolved over time to include aspects of critical librarianship in the information services that the Kaiser Permanente librarians provide to their organization. The article describes how the inter-regional group of hospital librarians provide information services through a critical librarianship lens and provides examples of how other health sciences librarians can incorporate these principles to expand their services.     

New to health sciences librarianship: strategies,tips, and tricks

Three new librarians highlight their varied pathways into health sciences librarianship and offer insight into how they are navigating the challenges and successes of being new to the profession. The authors define a new health sciences librarian as a person who has fewer than five years of experience in health sciences librarianship specifically, having either recently graduated from library school or entered the health sciences from another type of librarianship. Jamia Williams speaks about her journey from new MLS graduate to health science librarian; Kelsa Bartley details her transition from library professional to health science librarian; and Jahala Simuel shares her experiences moving from academic librarian to health science librarian. This commentary provides strategies, tips, and tricks that new health sciences librarians may use to hone their craft and explore opportunities for professional development.     

Learning Instruction: How an Academic Librarian Transitioned to a Health Sciences Environment

This guest column details the experience of an early career academic librarian learning how to instruct and assist students in health sciences programs. It includes information on mentoring, peer coaching, formal and informal trainings, and proficiencies needed for reference and instruction services. The author shares sources of specific knowledge and skills that empowered her to transition to health sciences librarianship.     

Examining care navigation: librarian participation in a team-based approach?

Objective

This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship.

Method

The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample''s responsibilities and skill sets.

Results

Coordination of patient care and a bachelor''s degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams.

Conclusion

Such overlap may provide an avenue for collaboration between navigators and health sciences librarians.     

The randomised controlled trial design: unrecognized opportunities for health sciences librarianship

Objectives: to describe the essential components of the Randomised Controlled Trial (RCT) and its major variations; to describe less conventional applications of the RCT design found in the health sciences literature with potential relevance to health sciences librarianship; to discuss the limited number of RCTs within health sciences librarianship. Methods: narrative review supported to a limited extent with PubMed and Library Literature database searches consistent with specific search parameters. In addition, more systematic methods, including handsearching of specific journals, to identify health sciences librarianship RCTs. Results: While many RCTs within the health sciences follow more conventional patterns, some RCTs assume certain unique features. Selected examples illustrate the adaptations of this experimental design to answering questions of possible relevance to health sciences librarians. The author offers several strategies for controlling bias in library and informatics applications of the RCT and acknowledges the potential of the electronic era in providing many opportunities to utilize the blinding aspects of RCTs. RCTs within health sciences librarianship inhabit a limited number of subject domains such as education. This limited scope offers both advantages and disadvantages for making Evidence‐Based Librarianship (EBL) a reality. Conclusion: The RCT design offers the potential to answer far more EBL questions than have been addressed by the design to date. Librarians need only extend their horizons through use of the versatile RCT design into new subject domains to facilitate making EBL a reality.     

The international scene in biological and medical libraries

This article introduces the Bulletin's special issue devoted to international health sciences librarianship with a discussion of the formal structures of international cooperation. The International Federation of Library Associations and Institutions' (IFLA) Biological and Medical Sciences Libraries Section conducts activities along four strands: world and regional health sciences library directories, mutually supportive regional groupings, a quarterly newsletter, and the quinquennial International Congress on Medical Librarianship. These activities, as well as those of other organizations, make up the formal international structure of health sciences librarianship.     

Complementary competencies: public health and health sciences librarianship.

OBJECTIVES: The authors sought to identify opportunities for partnership between the communities of public health workers and health sciences librarians. METHODS: The authors review competencies in public health and health sciences librarianship. They highlight previously identified public health informatics competencies and the Medical Library Association's essential areas of knowledge. Based on points of correspondence between the two domains, the authors identify specific opportunities for partnership. RESULTS: The points of correspondence between public health and health sciences librarianship are reflected in several past projects involving both communities. These previous collaborations and the services provided by health sciences librarians at many public health organizations suggest that some health sciences librarians may be considered full members of the public health workforce. Opportunities remain for productive collaboration between public health workers and health sciences librarians. CONCLUSIONS: Drawing on historical and contemporary experience, this paper presents an initial framework for forming collaborations between health sciences librarians and members of the public health workforce. This framework may stimulate thinking about how to form additional partnerships between members of these two communities.     

Authorship outlets of academic health sciences librarians.

Journal articles are the most common publication format for U.S. academic health sciences librarians. This is consistent with the findings of other researchers. Of the total publications in this study, 68% were in journals. Watson found that 69% of the academic librarians' publications were published in some type of journal [8]. Similarly, Yerkey and Glogowski found that 67% of the publications in their study were journal articles, although their population consisted of all types of authors of library/information science materials [9]. Both the present study and Watson found that monographs were the second most common publication outlet. Watson found that 16% of the total publications were monographs; the current study identified 14.8% of the total publications as monographs [10]. Although Watson's findings are similar to the newer results, it is important to note that Watson's study was conducted in a different manner and included book reviews, which were not counted in the present study. The health sciences librarians in the present study published more than two thirds of their articles in library/information science journals and 27% in health sciences journals. Similarly, in Yerkey and Glogowski's study, the second-largest number of library/information science articles appeared in medical and health sciences journals [11]. Fang also found that 22.57% of the journal articles on health sciences librarianship or by health sciences librarians were in medical journals [12. This seems to demonstrate the desire of health sciences librarians to communicate with the health professionals. Yerkey and Glogowski that library and information science is an interdisciplinary field, "borrowing and supplying information to and from other disciplines"[13].     

Evidence-based librarianship: searching for the needed EBL evidence

This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).     

Introducing health sciences librarians to the Internet

The Internet is no longer just for the adventurous explorers or the technical experts--it has found its way into the mainstream of librarianship. New users are coming onto "the net" in droves. A wealth of information is currently available dealing with the mechanics of the Internet and there are general guides to the available resources. More work needs to be done, however, in developing subject specific materials. This paper will report on the strategy that Scott Memorial Library, Thomas Jefferson University, has employed to develop staff skills and awareness and to take advantage of the resources and opportunities that the network provides for the health sciences community.