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1.

Background

Published research evidence is typically not readily applicable to practice but needs to be actively mobilised.

Objectives

This paper explores the mechanisms used by information professionals with a specific knowledge mobilisation role to make evidence useful for local decision making and planning of public health interventions.

Methods

Data are drawn from a NIHR project that studied how, when, where and by whom published research evidence is used in commissioning and planning across two sites (one in England and one in Scotland). Data included 11 in‐depth interviews with information professionals, observations at meetings and documentary analysis.

Results

Published research evidence is made fit for local commissioning and planning purposes by information professionals through two mechanisms. They localise evidence (relate evidence to local context and needs) and tailor it (present actionable messages).

Discussion

Knowledge mobilisation roles of information professionals are not recognised and researched. Information professionals contribute to the ‘inform’ and ‘relational’ functions of knowledge mobilisation; however, they are less involved in improving the institutional environment for sustainable knowledge sharing.

Conclusion

Information professionals are instrumental in shaping what evidence enters local decision making processes. Identifying and supporting knowledge mobilisation roles within health libraries should be the focus of future research and training.
  相似文献   

2.

Background

The integration of evidence‐based practice (EBP) into speech and language therapy (SLT) curricula has been increasingly encouraged in recent years.

Objectives

The study aimed to evaluate whether an educational module on EBP for undergraduate SLT students can improve their EBP competencies.

Methods

The EBP module, taught by a SLT faculty member and a librarian, was delivered over 2 months. All fourth year SLT students (trained group) and all fourth year psychology students (control group) of the University of Liège (Belgium) were asked to participate in the study. Their performance on an adapted Fresno test was measured before and after the module. In addition, the SLT students took a computer‐based searching task. They were also asked to share their perceptions towards the module.

Results

All the 47 SLT students and 57/108 psychology students took the pre‐ and post‐tests. Although both groups performed similarly at the baseline, only the trained students gained new skills and knowledge. Furthermore, 36 SLT students shared their perceptions on the module and offered suggestions on ways to improve it.

Discussion‐Conclusion

Trained students improved their EBP competencies. Nevertheless, the module could be strengthened along with better integration of EBP into clinical modules and across the curriculum.
  相似文献   

3.

Purpose:

This lecture discusses a philosophy of educating health information professionals in a rapidly changing health care and information environment.

Discussion:

Education for health information professionals must be based upon a solid foundation of the changing paradigms and trends in health care and health information, as well as technological advances, to produce a well-prepared information workforce to meet the demands of health-related environments. Educational programs should begin with the core principles of library and information sciences and expand in interdisciplinary collaborations. A model of the health care environment is presented to serve as a framework for developing educational programs for health information professionals.

Conclusion:

Interdisciplinary and collaborative relationships—which merge health care, library and information sciences, and other information-related disciplines—should form the basis of education for health information professionals.

Highlights

  • Educational pathways for the creation of future health information professionals are charted through the discussion of four major roads.
  • A model of the health care environment sets the framework for building educational programs for health information professionals.

Implications

  • The presented pathways can inform educational decision making at all levels, including the need to revisit the accreditation bodies of programs educating health information professionals.
  • The National Library of Medicine is encouraged to create a workforce center to identify the needs of the profession.
  • Interdisciplinary and collaborative partnerships are vital to produce quality graduates who are prepared to handle the complexities of the health care and information environment.
  相似文献   

4.
5.

Objectives:

This research studied hospital administrators'' and hospital-based health care providers'' (collectively, the target group) perceived value of consumer health information resources and of librarians'' roles in promoting health information literacy in their institutions.

Methods:

A web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group.

Results:

A majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions'' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support.

Conclusions:

It is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources.

Highlights

  • Health care providers responded positively to a health information literacy curriculum offered by librarians and to related resources and services, namely MedlinePlus and the information referral system known as Information Rx.
  • Participation in a curriculum increased health care providers'' knowledge of health information literacy, awareness of available consumer health information, and referral of patients to the library for additional assistance.
  • Librarian involvement in health information literacy increased the profession''s visibility and perceived value.

Implications

  • Consumer health information services and resources offered by librarians can improve the health information literacy skills of health care providers and their patients.
  • Training by librarians can increase knowledge of the importance of health information literacy and usage of MedlinePlus and Information Rxs.
  • Hospital-based administrators and health care providers can be champions in support of health information literacy and consumer health information services offered by libraries.
  相似文献   

6.
7.
8.

Objective

The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.

Methods

In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants'' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen''s d statistic to compare pre- and post-study effects sizes.

Results

Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen''s d increase of +1.50 compared to AccessMedicine users'' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen''s d.

Conclusion

Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.Keywords and Medical Subject Headings (MeSH) Clinical Decision Support Systems, Computer-Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide, Information-Seeking Behavior, Medically Underserved Area, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Public Health Nurses, Randomized Controlled Trial as Topic, Service Learning, Vulnerable PopulationsHealth care practitioners regularly seek to incorporate valid information into their evidence-based decisions. Electronic information resources now provide easy access to current health information and summarized forms of evidence to support clinical decision making.

Access effects on health care

Health care providers who are affiliated with well-funded institutions benefit from access to a variety of high-quality information resources to support their evidence-based practices. Practitioners who are not affiliated with academic health sciences centers rarely have access to these same resources due to prohibitively high licensing costs. Ely et al. report that not having access to easy-to-use, high-quality, current information can negatively affect sound clinical decision making. [1].Patients in Isaac et al.''s study who were admitted to hospitals that had access to an electronic evidence-based resource experienced reduced length of stay and lower risk-adjusted mortality rates for prespecified conditions [2]. That study was validated on a broader scale by a multicenter investigation on the utilization of information resources by practitioners [3].Primary health care practitioners who are not affiliated with academic health sciences centers, particularly those who practice in rural or remote areas, often articulate the need for increased access to health information resources. The authors'' literature search and review of 114 of the most relevant research articles about the information needs and information-seeking behavior of health care practitioners suggested that these professionals most value speed and accuracy. For example, they likely would prefer to use point-of-care (PoC) resources for quickly and accurately answering their clinical questions.

Desirability of point of care

PoC resources quickly guide physicians through the diagnosis, treatment, and management of commonly encountered clinical conditions. PoC resources can present compilations of highly authoritative, often evidence-based, information. Physicians can answer more questions and revise clinical decisions more often using these PoC resources [4]. Meanwhile, many health care practitioners still rely on textbooks familiar to them from their professional training programs, despite their potentially dated contents [514].

Limited access in rural New Mexico

A randomized controlled trial involving public health practitioners across the rural state of New Mexico reported many barriers in accessing valued information resources [15, 16]. In another study, researchers in New Mexico set out to determine and analyze information needs of health care practitioners who were not affiliated with an academic center. Fifty-one interviews of rural physicians, nurses, physician assistants, and nurse practitioners showed both a need and desire for access to information resources [17].

Goals and hypothesis

This study sought to determine which rural health care providers found more useful in answering everyday clinical questions: electronic PoC DynaMed, which is more clinically oriented, or electronic PoC AccessMedicine, which consists primarily of a health sciences textbook collection. We hypothesized that free access to the explicitly clinical format of the PoC resource DynaMed would result in more extensive use than a baseline of zero over a six-month period than the electronic PoC textbook collection AccessMedicine. We felt this would be due to greater utility of DynaMed in clinical practice. We also predicted that clinicians using the clinically oriented PoC would express higher levels of satisfaction than those using the textbook-based PoC and that clinicians using these PoC resources would prefer using them over other information resources.  相似文献   

9.

Objective:

The research identified the skills, if any, that health preprofessional students wished to develop after receiving feedback on skill gaps as well as any strategies they intended to use to address these gaps.

Methods:

A qualitative approach was used to elicit students'' reflections on building health information literacy skills. First, the students took the Research Readiness Self-Assessment instrument, which measured their health information literacy, and then they received individually tailored feedback about their scores and skill gaps. Second, students completed a post-assessment survey asking how they intended to close identified gaps in their skills on these. Three trained coders analyzed qualitative comments by 181 students and grouped them into themes relating to “what skills to improve” and “how to improve them.”

Results:

Students intended to develop library skills (64% of respondents), Internet skills (63%), and information evaluation skills (63%). Most students reported that they would use library staff members'' assistance (55%), but even more respondents (82%) planned to learn the skills by practicing on their own. Getting help from librarians was a much more popular learning strategy than getting assistance from peers (20%) or professors (17%).

Conclusions:

The study highlighted the importance of providing health preprofessional students with resources to improve skills on their own, remote access to library staff members, and instruction on the complexity of building health literacy skills, while also building relationships among students, librarians, and faculty.

Highlights

  • After receiving feedback on skill gaps, most preprofessional health students intend to develop their information literacy skills.
  • Some students report that a trip to the library is a barrier to using library resources.
  • Students see the need to build their information evaluation skills, knowledge of citations and plagiarism, and library skills, which they differentiate from Internet skills.
  • Students are more likely to identify librarians as sources for assistance in finding information than faculty or peers after receiving individual feedback explaining the role of libraries and library staff members.

Implications

  • Students'' health information competencies can be built through assessment and feedback that reveals skill gaps, highlights misconceptions, and offers ideas on how to improve.
  • Access to professionally designed self-study resources is needed for students who intend to develop health information competencies on their own.
  相似文献   

10.

Objective:

The research conducted a large-scale, multisite study on the value and impact of library and information services on patient care.

Methods:

The study used: (1) 2 initial focus groups of librarians; (2) a web-based survey of physicians, residents, and nurses at 56 library sites serving 118 hospitals; and (3) 24 follow-up telephone interviews. Survey respondents were asked to base their responses on a recent incident in which they had sought information for patient care.

Results:

Of the 16,122 survey respondents, 3/4 said that they had definitely or probably handled aspects of the patient care situation differently as a result of the information. Among the reported changes were advice given to the patient (48%), diagnosis (25%), and choice of drugs (33%), other treatment (31%), and tests (23%). Almost all of the respondents (95%) said the information resulted in a better informed clinical decision. Respondents reported that the information allowed them to avoid the following adverse events: patient misunderstanding of the disease (23%), additional tests (19%), misdiagnosis (13%), adverse drug reactions (13%), medication errors (12%), and patient mortality (6%).

Conclusions:

Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.

Highlights

  • Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.
  • Electronic access to information resources from multiple locations has increased the ability of health professionals to use these resources for improved patient care.
  • The roles of librarians are diversifying to include management of electronic resources, user instruction and support, specialized research and clinical information search services, and involvement in institution-level quality improvement.
  • It is possible to conduct a large-scale, multisite study on the value and impact of library services on patient care.

Implications

  • Ongoing studies of the value and impact of library and information resources will be important for advocacy and quality improvement.
  • Community-Based Participative Research methods hold promise as a way of ensuring the relevance of future research.
  相似文献   

11.

Objectives:

The Medical Library Association (MLA)/National Library of Medicine (NLM) Joint Electronic Personal Health Record Task Force examined the current state of personal health records (PHRs).

Methods:

A working definition of PHRs was formulated, and a database was built with fields for specified PHR characteristics. PHRs were identified and listed. Each task force member was assigned a portion of the list for data gathering. Findings were recorded in the database.

Results:

Of the 117 PHRs identified, 91 were viable. Almost half were standalone products. A number used national standards for nomenclature and/or record structure. Less than half were mobile device enabled. Some were publicly available, and others were offered only to enrollees of particular health plans or employees at particular institutions. A few were targeted to special health conditions.

Conclusions:

The PHR field is very dynamic. While most PHR products have some common elements, their features can vary. PHRs can link their users with librarians and information resources. MLA and NLM have taken an active role in making this connection and in encouraging librarians to assume this assistance role with PHRs.

Highlights

  • A variety of personal health records (PHRs) exist with some tied to medical health records and others offered as standalone products.
  • Librarians can be connected to PHR users through inclusion of an assistance statement in PHRs.
  • PHRs offer librarians another means of providing consumers with quality health information.

Implications

  • PHR user support is a new role for medical librarians.
  • Medical librarians need to be proactive in their communities to educate consumers about PHRs.
  • Given the dynamic nature of this market, medical librarians should make a concerted effort to stay abreast of trends in this area.
  相似文献   

12.
13.
14.

Objective:

A survey was conducted of health sciences libraries to obtain information about newer buildings, additions, remodeling, and renovations.

Method:

An online survey was developed, and announcements of survey availability posted to three major email discussion lists: Medical Library Association (MLA), Association of Academic Health Sciences Libraries (AAHSL), and MEDLIB-L. Previous discussions of library building projects on email discussion lists, a literature review, personal communications, and the author''s consulting experiences identified additional projects.

Results:

Seventy-eight health sciences library building projects at seventy-three institutions are reported. Twenty-two are newer facilities built within the last ten years; two are space expansions; forty-five are renovation projects; and nine are combinations of new and renovated space. Six institutions report multiple or ongoing renovation projects during the last ten years.

Conclusions:

The survey results confirm a continuing migration from print-based to digitally based collections and reveal trends in library space design. Some health sciences libraries report loss of space as they move toward creating space for “community” building. Libraries are becoming more proactive in using or retooling space for concentration, collaboration, contemplation, communication, and socialization. All are moving toward a clearer operational vision of the library as the institution''s information nexus and not merely as a physical location with print collections.

Highlights

  • Seventy-eight health sciences library building projects at seventy-three institutions were reported as completed in the last ten years.
  • Five health sciences library projects illustrate the diversity of projects reported.
  • Eleven trends in health sciences library buildings are identified.
  • Numerous challenges are briefly discussed.

Implications

  • Changing services and usage patterns demand innovative ways to use library space.
  • Libraries are making more proactive efforts to retool library physical space.
  • Migration from print to digital collections is continuing at an accelerated pace.
  • More library space is now dedicated for “community” building.
  相似文献   

15.
16.

Objective

This study sought to determine whether a flipped classroom that facilitated peer learning would improve undergraduate health sciences students'' abilities to find, evaluate, and use appropriate evidence for research assignments.

Methods

Students completed online modules in a learning management system, with librarians facilitating subsequent student-directed, in-person sessions. Mixed methods assessment was used to evaluate program outcomes.

Results

Students learned information literacy concepts but did not consistently apply them in research assignments. Faculty interviews revealed strengthened partnerships between librarians and teaching faculty.

Conclusion

This pedagogy shows promise for implementing and evaluating a successful flipped information literacy program.Keywords (Medical Subject Headings) Information Literacy, Educational Technology, Education, Distance/Methods, Teaching/Methods, Evidence-Based Practice/Education, Learning, Group Processes, Program Development, Humans, Libraries, Medical/EducationIn the short term, health sciences students utilize the information resources that librarians highlight during instruction. In the years after graduation, students demonstrate low levels of information literacy skills [13]. These low levels of retention likely result from the limited amount of time dedicated to guided practice during library sessions, which has been shown to be critical to learning [4]. In addition, few undergraduate curricula feature scaffolded instruction on evidence-based practice, where guidance of student learning is deployed progressively to promote stronger understanding of concepts. This raises the concern that many students may be unprepared for the rigors and expectations of graduate-level research. Consequently, health sciences librarians and educators have tested numerous methods for improving the effectiveness of information literacy and evidence-based practice instruction [57].Higher education has also seen a rise in the use of instructional technologies, such as increased use of video tutorials, web-conferencing tools, and learning management systems (LMSs). Such tools can enhance the effectiveness of face-to-face teaching by delivering time-of-need instruction that is available for future reference during the entire semester [811]. LMSs, such as Canvas or Blackboard, provide a virtual space where students take ownership of the learning process and create meaningful learning experiences for themselves and their peer learners [12]. Educators increasingly use these technologies to enable a flipped classroom model of instruction, in which the lecture and homework are reversed [1315]. In older teaching models, a lecture occurs in the classroom, followed by exercises and applications of the information by students as homework. In the flipped model, students get the lecture-type information at home, then do exercises and applications in the classroom. This model allows instructors to move away from the traditional one-time lecture-based instruction and to incorporate active learning, which leads to better student performance for science, technology, engineering, and mathematics (STEM) undergraduate students [1618]. The flipped classroom model also accommodates the needs of diverse populations of learners by integrating peer learning and assessment [19, 20]. In contrast, traditional lecture-based approaches to information literacy have been shown to have limited effectiveness for promoting skill development and retention, and often rely on shallow, quantitative assessments to measure student learning [21]. Integrating library instruction strategically into the curriculum and using the flipped classroom model creates opportunities to use a greater variety of assessment tools at various points throughout the semester in order to conduct more meaningful assessment of student learning.Flipped classroom models have not been widely studied for health sciences students. This study aimed to determine whether a flipped classroom approach for upper-level undergraduate students in the health sciences would improve their abilities to find, evaluate, and utilize appropriate evidence for research assignments.  相似文献   

17.
18.

Objective:

A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.

Methods:

Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors'' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.

Results:

When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.

Conclusions:

Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers'' advisory practices, are suggested.

Highlights

  • Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.

Implications

  • Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
  • Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
  • An understanding of the patient''s potential epistemological community can make the librarian''s recommendations more appropriate for the individual user.
  相似文献   

19.

Purpose:

A systematic literature review was conducted to synthesize what is known about informationists, highlight program models, and suggest areas for future research.

Methods:

Articles retrieved through database searching were reviewed for relevance. Informationist case reports were identified and coded according to an attributes checklist. Data from other retained publications were synthesized under broad themes. The few research studies found were reviewed for level of evidence.

Results:

Of 113 papers reviewed, the study identified 7 classic and 8 emerging informationist programs. Two major models are apparent, clinical and research, with priorities differing according to program maturity. The literature synthesis also brought together current thinking about informationist qualifications; practice roles; setting characteristics; education and training; organizational, programmatic, and service provider success factors; and challenges and barriers. Program outcomes to date are reported, and future research topics suggested. Specific findings will assist informationist program planners.

Conclusions:

While the informationist concept remains in the early adopter stage, it appears that domain knowledge, continuous learning, and embedding (working in context) are essential to success. The need for librarians to transition to greater specialization and libraries to emphasize customized service was underscored. A research agenda focused on information management, dissemination, behaviors, and economics is proposed.

Highlights

  • After years of emphasizing the generalist librarian, health sciences librarians must become more specialized, paralleling the health care environment in which they work.
  • An embedded informationist is more likely to achieve credibility, acceptance, and sustainability than an impersonal information service provided at a distance.
  • Subject expertise is essential for the informationist.
  • Model informationist programs with the greatest stability are library funded.
  • Because informationist programs are inherently targeted to small groups, multisite studies are necessary to achieve robust evaluation.

Implications

  • A library starting an informationist program should review existing models, identify local needs, set program objectives, and then select the most appropriate approaches for its users.
  • Programmatic emphasis should be placed on both technical and service excellence.
  • Organizational commitment is needed for knowledge integration into practice and for the informationists'' lifelong learning.
  相似文献   

20.

Objectives:

The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs.

Methods:

A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008.

Results:

Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access).

Conclusions:

When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.

Highlights

  • Medical textbooks were the most popular information source for family physicians'' (FPs'') clinical decision-making purposes, and medical journals were the most popular information source for the purpose of updating FPs'' general medical knowledge.
  • FPs considered medical textbooks to be the most reliable (trustworthy) source, colleagues the most physically accessible, and continuing medical education the most relevant and intellectually accessible.
  • The lowest ranked information sources across all four attributes were personal digital assistants, mental health professionals, pharmaceutical sales representatives, and other decision aids.

Implications

  • The most popular information sources for clinical decision-making purposes among FPs were sources characterized as reliable and generally physically accessible.
  • This study suggests the need for further research into interventions that target information access barriers in FPs'' practice settings and the promotion of reliable evidence for FPs'' clinical decision-making purposes.
  相似文献   

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