The value and impact of information provided through library services for patient care: a systematic review

OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.     

Preschoolers' Attention to Print During Shared Book Reading

Seventy-six children ages 3 to 5 were individually read two storybooks that had been specially formatted to contain salient printed words within the text, and illustrations and text on left or right-facing pages. The reader pointed to each word while reading to half of the children. After each book, children were asked to recognize elements of the illustrations and the specially formatted text elements from among a set of foils. Videotaped sessions were coded for the time children spent looking toward the pages with print versus illustrations. Analyses showed that the percentage of time looking at print was less than 2% in the no-pointing condition but increased with age. Pointing to the words increased print-looking time for all age groups and print target recognition for 4-year-olds. After controlling for receptive vocabulary, visual memory, and maturation associated with these scores, emergent orthography and letter-word identification predicted time looking at print and recognition of the print elements.     

Equity and Inclusion in Practice: Administrative Responsibility for Fostering Undocumented Students' Learning

Cassie Barnhardt, Marisol Ramos, and Kimberly Reyes share a case study of an undocumented student's academic success to demonstrate the importance of administrative commitment, clarity, and consistency in supporting such students in the unique challenges they face.     

Learning,Testing, and the Evaluation of Learning Environments in Medicine: Global Performance Assessment in Medical Education

Changes in the profession of medicine are creating the demand for a substantive reexamination of current practices in medical education. Many of the major issues in addressing this challenge are structural and political rather than scientific; here we address one critical scientific issue that will be important to (though not by itself adequate for) guiding such changes. The factor we address is the development of a global performance assessment: a standardized mechanism to assess individual skills and abilities that can be used to evaluate alternative educational interventions. We discuss the issues involved in developing such a system, and describe a set of principles for defining desired outcomes and developing assessment tools, including (a) wide clinical scope, (b) direct relationship to actual clinical performance, (c) reliability and repeatability, and (d) non-longitudinal measurement. We discuss the role of simulation, reflective practice, and portfolios of work in developing such a system, and argue that whatever form such metrics take, a system of global performance assessment will develop from close collaboration between clinicians and educators with innovative ways of thinking about performance and expertise.