Health care librarians and information literacy: an investigation

Dissertations into practice

Abstract

Until relatively recently, the concept of informa-tion literacy, and teaching the skills to enable it,was mainly a concern of academic libraries. Now,it is also seen to be of high importance within thecontext of health care libraries. Health carelibraries and librarians can provide crucial supporttowards the implementation of evidence-basedpractice in patient care through both informationliteracy skills training and by conducting mediatedsearches on behalf of health care practitioners.This article reports the findings from an investiga-tion conducted by Charlotte Kelham as part of herMA in Librarianship from the University of Shef-field. Her dissertation investigated how health carelibrarians understand the concept of informationliteracy, the implications of this for their role andtheir perceptions around how their role is valued.Charlotte graduated from Sheffield in 2013 and iscurrently job hunting.

AM

Keywords: health care, information literacy; libraries,library and information professionals; qualitative research

Health care librarians and information literacy:

an investigation

Charlotte KelhamUniversity of Wales, Trinity St David, Carmarthen,[email protected]

Background and context

Until relatively recently, the concept of informationliteracy, and teaching the skills to enable it, wasmainly a concern of academic libraries, but it isnow seen to be of high importance within thecontext of health care libraries.1 Being informationliterate is an essential skill for health care practitio-

ners, as it supports evidence-based practice andthus enables best patient care.2 Health care practi-tioners need to have quick access to informationand the skills to use it appropriately. A lack ofinformation literacy skills means that users canbecome quickly overwhelmed by irrelevant orunreliable information. Health care libraries andlibrarians can provide crucial roles in supportingthe implementation of evidence-based practice inpatient care through both information literacy skillstraining and by conducting mediated searches onbehalf of health care practitioners.The aims of the original dissertation were three-

fold, namely to establish what the healthcarelibrarian’s understanding of information literacywas, to explore the role of the health care librarianand the services offered in the library to see howthey facilitate the implementation of evidence-based practice, and finally to investigate howhealth care librarians feel their role is valued bytheir users.

Literature review

The literature review examined the concept ofinformation literacy and looked at the SCONULseven pillars model,3 as developed for academiclibraries, as well as frameworks developedspecifically within health care information.4,5 Theliterature review also identified a large amount ofexisting research examining the role of healthcare librarians, identifying them as facilitatorsand educators.6 It discussed methods used inlibraries to support evidence-based practice, suchas information skills training and offering medi-ated searches.7,8 Central to the literature reviewwas the EMPIRIC project – Effective Methodsof Providing Information for Patient Care –which was carried out in 2004–2005. This studyexplored the views of library staff and healthprofessionals on the effectiveness of information

© 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Journal

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DOI: 10.1111/hir.12071

skills training and librarian-mediated searching, asmethods of providing information for patientcare.9,10 The results were significant:• Both mediated searches and information skillstraining are effective

• Cost-effectiveness is dependent on whethercosts are viewed from a library or NHS Trustpoint of view

• Providing information skills training does notreduce the volume of mediated searchrequests

• Both information skills training and mediatedsearches were perceived by both library staffand health professionals to be effective.

• There is strong support both for mediatedsearches carried out on behalf of the healthprofessional and for information skills trainingto enable them to carry out their own searches

The literature review also identified existingresearch into perceptions of value and theeffectiveness of the health care library service.The consensus was that health care libraries andtheir staff are valued by those who used theservice.11,12

Methodology

The data were collected solely through semi-struc-tured interviews. There were ten participants in theinterviews, and their roles and experience in healthcare librarianship varied:• Participants A and H were outreach librarians• Participant B was a medical librarian• Participants C and I were assistant clinicallibrarians

• Participant E was a clinical librarian• Participant D was an assistant librarianinvolved in a clinical librarian project thatentailed going on ward rounds in the intensivecare unit

• Participant F was a public health andcommissioning librarian

• Participant G was a library operationsmanager

• Participant J was an evidence specialistThe participants were each asked the same

questions about their role, their understanding ofthe term information literacy, the information

services they offered in their library, and whetherthey felt they were valued.The interviews were subsequently transcribed,

coded, and given a thematic analysis. Findingsfrom the interviews were compared with thosefrom previous research, particularly relating to theEMPIRIC project,10 which evaluated informationskills training in health care libraries.

Findings

Understandings of information literacy: ‘getting

people to the information’

The participants’ responses to the question ‘whatdo you understand by the term informationliteracy’ tended not to be expansive. One notedthat information literacy is ‘not something we[do]’. This could possibly indicate a relative unfa-miliarity with the term and may explain why anumber of participants were initially hesitant anddid not give elaborate responses. Later in the inter-views, however, the participants gave responses toquestions that indicated that they did all have anunderstanding of information literacy and alludedto skills that occur in formal models. Most of theparticipants understood information literacy to be aset of abilities and defined it in terms of how itcould be used by health care practitioners, with theability to find and then use information beingprominent. Some viewed it from the perspectiveof the librarian and one understood the terminformation literacy to be supporting the patient infinding information about their health. Thereappeared to be five main categories relating tothe understanding of information literacy, namelysupporting patient health literacy, supportingdecision-making in evidence-based practice, deliv-ering information to the user, the ability to findinformation to meet a need and acquiring the abil-ity to gather and implement information effectively.

Role: ‘our remit[. . .]is actually putting users in

touch with the information they need to

function in their role’

In their replies to the question about their role in thelibrary, the participants tended to give their job title


Health Information & Libraries Journal, 31, pp. 235–238

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and a brief outline of their main responsibilities.These included providing information skillstraining, conducting literature searches on behalf ofhealth care practitioners and procuring resources.All those offering training provided group sessions,and they all offered training in conducting literaturesearches. The second most common training sessionwas an introduction to online resources. This differsfrom the findings of the EMPIRIC project,9,10

which found that the most commonly taught topicwas using databases – although it is possible thatusing databases is an alternative term for learninghow to conduct a literature search. However, all theparticipants used the terms ‘literature searching’ or‘literature searches’ and did not themselves connectit with teaching proficient database searching. Italso found that the most common format used bylibrary staff to conduct training was a one-to-onesession, as opposed to a larger group.10 Otherelements of their roles included marketing andpublicity, creating current awareness bulletins,accompanying health care practitioners on wardrounds and managing the institutional repository.In addition to providing information skills sup-

port, or directly providing the evidence needed,the majority of the participants took an active rolein trying to increase the perceived value of thelibrary and library services. Participant D felt thatthey should break down the stereotypes thatsurrounded the library – people who ‘think it isjust books and does not have any relevance tothem’ – and ‘try to market ourselves better’.

Perceptions of value: ‘the hurdle is to try and

get the value to the service to the wider people

of the trust who are the non-users’

There was a consensus amongst the participantsthat by and large they were valued, at leastamongst their users. The participants did vary intheir assertion of how they felt they, and theirlibrary services, were valued. This supportsfindings from previous research12 that noted thatthe clinical librarian service is ‘well used andliked’ by health care practitioners.There were a number of reasons given by

participants as to why they felt they were valued,namely the ability to save users time, it beingmore cost-effective for the librarian to search for

evidence, the participants’ involvement inoutreach, the services provided being tailored tothe users’ wants, direct support for evidence-basedpractice, the librarians’ specific skills, the usage ofthe service and receiving positive feedback fromthe library users. Some of the participants, mostnotably B and I, did not specify reasons at all asto why they felt they were valued. Instead, theytended to draw attention to the issue of non-usersnot deeming the library to be of any relevance.Other participants also paid attention to non-usersand touched upon how the problem might be com-batted.

Implications for practice

When examined in relation to the SCONUL3

model of the seven pillars of information literacy,the participants appeared to have had a limitedunderstanding of the term ‘information literacy’.They chiefly associated the concept of informationliteracy with the ability to find information. Oneimplication for practice therefore is the need toextend health care librarians’ understanding ofinformation literacy itself, so that it is notassociated solely with effective informationretrieval.A second implication for practice is that many

of the information skills training sessions wereconducted in groups. However, users appear toprefer one-to-one sessions. The study participantsfelt that it was important to tailor the services theyprovided to their users.However, the largest implication for practice

surrounds the perception of the value of the libraryservice to health care. The participants noted thatthe biggest challenge they faced was attractingusers. They felt that those who were unaware ofwhat the library and information service couldoffer health care practitioners were unaware of itsworth and that this therefore jeopardises theirposition within the organisation. The lack ofawareness can be combated with outreach andpublicity, and, indeed, a number of the participantswere already engaging in these activities.Some provided current awareness bulletins, and

some were also involved in providing outreachservices, taking the library directly into the



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organisation and answering questions at the pointof need.

Conclusion

The study demonstrated that the main roles of thehealth care librarians are conducting literaturesearches on behalf of health care practitionersand providing information skills training, particu-larly in how to conduct a literature search. Theparticipants felt that they were valued by themembers of their organisations who used them.The reasons for this were that they could savetheir users time and that it was more cost-effec-tive. Furthermore, they had highly specific skills,which tied into their perceived roles as informa-tion facilitators. A recurring observation was thatthey were regarded as irrelevant by non-users andwere therefore not valued by the organisation asa whole. A number of participants were workingto combat this, by publicising what the libraryhad to offer in the way of supporting evidence-based practice.The most commonly held the understanding of

the term ‘information literacy’ was that it wasacquiring the abilities to find, appraise andimplement information to meet a need. It may behelpful to increase health care librarians’ under-standing of information literacy itself, so that it isnot associated solely with effective informationretrieval. This will ultimately help supportevidence-based practice.

References

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Health care librarians and information literacy: an investigation