The Research Imperative: Creating the Health Information Knowledgebase

Health sciences librarians have a long history of supporting health professionals engaged in evidence-based practice. Building on the foundation provided by EBM, many practitioners in other fields such as nursing, education, social work, health policy, and health care management are also taking an evidence-based approach to their work. While providing information support to all types of evidence-based practitioners continues to be an essential component of health sciences librarianship, especially for those working directly with users, some of the same principles—basing decisions on the best available evidence—apply to the practice of librarianship. Although the types of questions, decisions, and research methods may be different for EBLIP compared to EBM, the rationale for health practitioners and health sciences librarians to use the best available evidence is similar [1].

Recent years have seen major milestones in the evolution and dissemination of the evidence-based practice concept. Booth, Brice, Eldredge, and others have developed the intellectual underpinnings for the field. Events such as the biennial “International Conference in Evidence-based Library and Information Practice” and the publication of the open access journal, Evidence Based Library and Information Practice, signal the growing awareness of and interest in this concept. As a result of NLM's initiatives, evaluation of resources and services to assess their impact and value are also more common. These initiatives include the establishment of the National Network of Libraries of Medicine (NN/LM) Outreach Evaluation Resource Center at the University of Washington, a seminal publication on planning and evaluating health information outreach [2], and NN/LM’s emphasis on evaluating its consumer and public health outreach efforts.

Despite these advances, the profession of librarianship has not yet developed a culture of research and assessment [3]. And as librarians look to the literature for evidence they find little on which to draw. As the editor of Evidence Based Library and Information Practice noted, "rather than being able to find, appraise, and implement existing research, practitioners are finding themselves in the position where they have to design and carry out original research in order to obtain applicable evidence" [4]. And, as Plutchak noted,"we … need to spend time testing what we think we know and validating what we think we have proved. Single studies do not accomplish that. We have come a long way, as a profession, in improving our research skills and our understanding of the importance of research. But we still have considerable work to do in shaping our projects so that they contribute to building a body of evidence" [5]. However, many librarians do not have the requisite skills or support to do so.

At present, much of the library literature is of little use to anyone wishing to engage in evidence-based practice. The research done in the area of informatics or information science as well as the research conducted by library educators and doctoral candidates is rigorous and well designed, but findings often are not readily applicable in practice settings such as hospitals or even academic libraries. Few academic medical librarians apply for and receive research grants or contracts [6]. Those who do, may report findings with greater relevance to their cohorts as they plan for the future, but their findings are rarely applicable to immediate questions that arise in practice and are almost never replicated. For the most part, even articles that do address the real questions of practicing librarians produce the lowest level of evidence, the descriptive case study. These case studies seldom build on earlier similar studies or use existing methodologies, all of which makes them difficult to compare. Few if any cohort studies or randomized controlled trials are reported. A handful of meta-analyses and systematic reviews, the highest levels of evidence, have been published [7].

Given this picture, it is imperative for librarians, and health sciences librarians in particular, to recognize that the knowledge, skills, and personal attributes they employ in the service to their users have equal relevance in their own professional practice. Just as health practitioners have come to acknowledge the importance of identifying, understanding, and using the best available evidence for questions related to diagnosis, therapy, and prognosis, so librarians must adopt a similar perspective when questions related to intervention, prediction, and exploration arise in their practice. All library professionals in all roles and settings need to identify, understand, and use the research of others and whenever possible share the findings of their own local studies. To make them worth sharing, they must apply rigor in framing an answerable question, selecting and implementing the most appropriate methods, collecting data, analyzing the results, drawing conclusions, and communicating their findings.

On their own, individual librarians cannot create a culture where using and or conducting research is common professional practice. They will need the support of their professional colleagues, facilitated by MLA; the administrators for whom they work; their home institutions; library educators willing to amend curricula; and funding agents that recognize the importance of sponsoring applied research. These efforts in aggregate are needed to encourage a culture where reliance on research for decision making is the norm. Such a culture has the potential to benefit them all, not the least of which is the individual librarian. As Lindsay Glynn noted in her editorial, "The application of EBL can not only save time and money, but can also position information professionals as the highly competent researchers and prolific writers that we are" [4].

References

1. Eldredge J. Levels of evidence in librarianship. Hypothesis 2002 Fall;16(3):10–3.

2. Burroughs CM, Wood FB. Measuring the difference: guide to planning and evaluating health information outreach. [Web document]. Seattle, WA: National Network of Libraries of Medicine, Pacific Northwest Region, 2000. [cited 16 Apr 2007]. <http://nnlm.gov/evaluation/guides.html#A1>.

3. Lakos A, Phipps S. Creating a culture of assessment; a catalyst for organizational change. Portal: Libraries and the Academy [serial online]. 2004 Jul;4(3):345–61. (Johns Hopkins University Press Project Muse.)

4. Glynn L. The current state of EBL. Evidence Based Libr Inf Pract 2006;1(2):1–2.

5. Plutchak TS. Building a body of evidence. J Med Libr Assoc 2005 Apr;93(2):193–5.

6. Medical Library Association Task Force on Research Policy Statement Revision. Key informant interview with: representative of funding agency. 2005.

7. Eldredge J. Evidence-based information practice: a pre-history. In Booth A, Brice A, eds. Evidence-based practice for information professionals: a handbook. London, UK: Facet Publishing, 2004:24–35.