This article is from the June 2004 issue of Update.
If you work in education or social services, government or healthcare, it is likely that you know about ‘evidence-based practice’. This is a model that originated within healthcare but is rapidly migrating to other fields. Increasingly information professionals are turning a critical eye towards examination of their own practice and the services they offer.
Is it possible to adapt the evidence-based practice model to librarianship and information work? To do so involves applying the results from rigorous research studies to professional practice to improve the quality of services to users. To what extent are its skills and techniques transferable to professional information practice? Is it desirable for information professionals to integrate research findings into their day-to-day decision-making? Such issues are considered in a new book from Facet Publishing, Evidence-based Practice for Information Professionals: a handbook.1
We contend (and many colleagues agree) that this model is equally valid for the sector within which you are working. It requires the application of tools and techniques to your specific area of practice, be it in libraries, museums or archives, and sensitive adaptation to your local culture and environment.
The beginnings
Our evidence-based trail started when we asked fellow professionals some basic questions, informed by our work in helping health professionals improve their practice. Ask yourselves these same questions:
- How many of the decisions that you make are based on sound research?
- Where do you go to find evidence to inform your decisions?
- Would you be able to assess whether a research study is valid, reliable and relevant in informing your practice?
Our early work in this area suggested that the same six barriers found in other disciplines are also present in our own professional practice, namely:
- lack of time and skills;
- information overload;
- access to resources;
- poor-quality indexing;
- poor quality of the evidence base itself;
- difficulties in finding information in a format suitable for decision making.
So what is evidence-based information practice?
Several definitions of evidence-based information practice (EBIP) have been attempted. Of these, one has the advantage of being derived from the writings of a librarian, Anne McKibbon from McMaster University, the spiritual home of evidence-based medicine:
‘Evidence-based librarianship (EBL) is an approach to information science that promotes the collection, interpretation and integration of valid, important and applicable user-reported, librarian-observed, and research-derived evidence. The best available evidence, moderated by user needs and preferences, is applied to improve the quality of professional judgements’.2
Evidence-based information practice is our preferred term for the approach championed within this work, as it encompasses a wider range of current roles and specialisms within the field.
Evidence-based practice is fundamentally a model of information management. It addresses two information ‘pathologies’3 namely ‘information overload’ and the slow dissemination of research findings into routine practice. Similarities with information management become even more apparent when we examine the five stages of evidence-based practice:4
- Identify a problem or question.
- Find, as efficiently as possible, the best evidence to answer the question.
- Appraise the evidence for validity and usefulness.
- Apply the results to a specific population.
- Evaluate the outcome of the intervention.
Although stages one and two are those most obviously associated with information practice, judging information quality (stage three), judging relevance (stage four) and evaluating the outcome of information provision (stage five) are all integral to good information management.
What knowledge, skills and attitudes does an evidence-based practitioner need, and how might such competencies be achieved? Inconsistent approaches to teaching research methods in library and information studies departments, and a lack of skills in implementing research findings, provide formidable obstacles to overcome if practitioners are to be aware of the importance of research from the onset of their librarianship career.
Skills needed
The book takes the evidence-based process outlined above, and provides a practical introduction to support the development of the necessary skills. For example, practitioners are encouraged to identify their information need and formulate a focused, structured question. Models for analysing the constituent parts of an information need, and examples of questions generated by information practitioners, are provided.5
Despite their skills in information retrieval, information professionals do not often systematically search their own knowledge base for evidence with which to support their decisions. Information practitioners therefore need to understand more about the types of information resources that are pertinent to evidence-based information practice, and to be familiar with the techniques required for searching them. A key skill is appraising the evidence retrieved. Purpose-designed tools and products are needed if practitioners are to find it easy to apply research findings on a day-to-day basis. For this reason we developed two critical appraisal checklists relevant to research papers most likely to appear in the library and information literature. Critical appraisal helps a reader of research to decide how trustworthy a piece of research is (validity), to determine what it is telling us (results), and to weigh up how useful the research will be (relevance).
These checklists, badged under the acronym CRiSTAL,6 provided a focus for the development and piloting of evidence-based information practice and research methods workshops, delivered as short and online courses. All of these have generated a very favourable reaction. Such learning opportunities, however, need to become more plentiful and have a wider coverage.
Using the evidence base
The last section of the book explores six domains of evidence-based librarianship identified in research, to demonstrate how evidence-based information practice can be applied. These chapters present concise summaries of evidence-based information practice within, for example, enquiry services and collection management. Accompanying each chapter are one or more special topics illustrating practical examples of how evidence-based principles and methods are applied to the common concerns of information professionals. Supporting material is drawn from a wide range of sectors, featuring contributions from leading professionals and covering a wide range of key issues.
Undoubtedly the most common of several objections to evidence-based practice is a perceived lack of time. If the alternative is to run the risk of wasting valuable time by persevering with an intervention that the evidence might show is ineffective, such reasoning is soon revealed as specious. A brief search of the relevant literature will find immediate examples of existing, under-utilised research that highlights ineffective practices that consume large amounts of information professionals’ time and resources.
Other objections, such as observations on the poor quality of currently available evidence, may have more validity but usually mean that such critics have not bothered to search and examine the evidence. A crucial point here is that the evidence base for information practice is not merely derived from library and information science databases but is found in management, computing, social science and education databases. Even if such evidence is not plentiful, a practitioner will usually find some item of research that may be used to address a specific focused question.
Evidence-based practice also generates many questions about the research process itself. Research topics should reflect priorities of importance to users of services, specifically focusing on questions identified by them or their representatives.7 Users should be involved in the conduct of the research and in the appropriate dissemination of its findings. Most importantly, in the context of the practitioner (as opposed to the more specialist ‘doer’ of research) the findings from any research study should be mediated and moderated by the views, preferences and values of the community within which the evidence is to be implemented.
Mechanisms to improve the production and dissemination of good-quality research might include:
- increasing the number of higher-level research evidence studies such as systematic reviews, randomised controlled trials and cohort studies;
- ensuring that important, answerable questions are addressed through effective research policies;
- disseminating EBIP speedily through conference proceedings;
- using the web as a short-term publishing medium.
Many information workers have developed new skills in supporting evidence-based practice for their users. The application of evidence-based approaches to our own professional practice is no less worthy an aspiration. Indeed, many of the models and tools you need are already available within the broader context of evidence-based practice and transfer easily to our profession.
Two successful Evidence-based Librarianship Conferences have now been held, the first in Sheffield in September 2001,8 and the second in Edmonton, Canada, in 2003, bringing together individuals from the UK, Canada, Australia and the US.9 These conferences provided an opportunity to share understanding of the potential activities and goals required by a global initiative, and to identify practical steps to be planned and taken forward internationally.
A discussion list (evidence-based-libraries) provides a forum for discussion and information sharing. It is complemented by a website (www.eblib.net) with initial content developed primarily from the two EBL Conferences. The EBL website and discussion list have helped to promote the movement internationally and to encourage librarians from all subject areas to learn more. However, limitations remain, and we need to engage more of the profession, as well as ensure that senior and high-profile librarians offer vital leadership and direction.
EBIP for all
A key challenge for all collaborating countries involves understanding the context for all sectors of the profession, and responding to their needs — getting the message out to all librarians, not just those in the health sciences.
A further challenge lies in spreading EBIP beyond keen enthusiasts in regional and national centres to the grassroots. Practitioners need to apply EBIP principles and research when they make decisions in their workplaces. If they are to do this they need to be convinced that EBIP matters to them — that it is not just a concept for academics.
Collaboration with international colleagues and librarians from many different backgrounds, through committees, conference planning and, indeed, the planning and production of this book, has revealed significant advantages in developing EBIP. The information community as a whole can look beyond current perspectives on international collaboration,10,11,12 which have already achieved much, to enticing future prospects that offer much, much more.
References
1 A. Booth and A. Brice. Evidence-based Practice for Information Professionals: a handbook. Facet Publishing, 2004.
2 A. Booth. ‘From EBM to EBL: two steps forward or one step back?’ Medical Reference Services Quarterly, 21 (3), 2002, pp. 51-64.
3 A. Booth and M. Haines. ‘Room for a review?’ Library Association Record, 100(8), 1998, pp. 411-2.
4 D. L. Sackett et al. Evidence-based Medicine: how to practise and teach EBM. Churchill Livingstone, 1997.
5 J. Eldredge (submitted on behalf of the Evidence-Based Librarianship Implementation Committee). ‘The most relevant and answerable research questions facing the practice of health sciences librarianship.’ Hypothesis 15 (1), 2001, pp. 9-17. Available from: http://gain.mercer.edu/mla/research/hypothesis.html
6 A. Booth and A. Brice. ‘Clear-cut? Facilitating health librarians to use information research in practice.’ Health Information and Libraries Journal, 20 (Suppl 1), 2003, pp. 45-52.
7 A. Booth. ‘Turning research priorities into answerable questions.’ Health Information and Libraries Journal, 18 (2), 2001, pp. 130-132.
8 J. Eldredge. ‘First Evidence-based Librarianship (EBL) Conference.’ Hypothesis, 15 (3), 2001, pp. 1,3, 8-11.
9 ‘Improving practice through research: current perspectives, future prospects.’ 2nd International Evidence-Based Librarianship Conference, 4-6 June 2003. University of Alberta, Edmonton, Canada.
10 J. Eldredge. International Research Reviews. ‘Evidence-based librarianship (EBL) needs international collaboration.’ Hypothesis, 13 (2), 1999, pp. 14-16.
11 D. Koufogiannakis and E. Crumley. ‘Evidence-based librarianship.’ Feliciter, 48 (3), 2002, pp. 16.
12 J. G. Marshall. ‘Influencing our professional practice by putting our knowledge to work.’ Information Outlook, 7(1), 2003, pp. 40-44.
Anne Brice (anne.brice@ihs.ox.ac.uk) is Head of Knowledge & Information Sciences at the Public Health Resource Unit, Oxford. She is seconded to the National Electronic Library for Health (NeLH).
Andrew Booth (a.booth@sheffield.ac.uk) is Director of Information Resources and Senior Lecturer in Evidence-based Healthcare at the School of Health & Related Research, University of Sheffield.