GOING TO THE
NEXT LEVEL
How Health Librarians are
Engaging with Critical Appraisal
Martin Morris, MSc • Genevieve Gore, ML...
2
First:
Why the
honey bee?
Introduction
ASK the
question
ACQUIRE
the
evidence
APPRAISE
the
evidence
APPLY the
Evidence
ASSESS
4
The EBM Cycle
Our Research Questions
• Health librarians are taking part in
courses on evidence appraisal
• We are also constantly seeki...
6
Our Research
Questions
To what degree are health
sciences librarians engaging
in critical appraisal of the
medical evide...
7
Methodology
The study is a scoping
review conducted
according to
Arksey & O’Malley’s
guidelines (2005).
Methodology #1
8
What is a
scoping review?
Search
Strategy
Scoping reviews are a type of
literature review that aims to pr...
9
Search
Strategy
(LISTA)
S1 SU librarians
S2 SU information
S3 TX librarian#
S4 TX informationist#
S5 SU occupational rol...
10
Inclusion/
Exclusion
Criteria
Methodology #3
Inclusion:
Health Librarianship
Stage 3 of the EBM cycle (APPRAISE)
Langua...
Findings
Database searching (n = 4223)
Embase on Ovid: 846
Ovid MEDLINE: 792
PubMed (not Medline): 64
LISTA (ProQuest): 1138 / LISA...
Emerging
Themes
14
Emerging
Themes
1. How does the
literature define
Critical Appraisal?
There is a lack of rigour in the literature
regarding the meaning of CA, from:
–General checks of quality from an info
lit...
• The concept of CA is referred to in many
ways in the literature and it is frequently
unclear which level of CA is intend...
17
18
Emerging
Themes
2. What attitudes do
librarians have
towards Critical
Appraisal?
• We tallied positive and negative librarian
attitudes towards CA
– We noticed that more librarians reported positive
atti...
• Maden-Jenkins summarises attitude barriers
to librarian involvement in CA teaching
which we also saw reflected in the li...
• She also reports perceived skills/knowledge
barriers to librarian involvement:
– Lack of knowledge, not sure what it is
...
22
Emerging
Themes
3. What real-world
examples are there of
librarians getting
involved in Critical
Appraisal?
23
CA in context #1
• Clinical Librarians
• Informationist trends
• We spotted many types of librarian
engagement with CA:
– Librarians taking part in training, learning how to
conduct CA ...
25
CA in context #3
• Vanderbilt: From Clinical Librarians to
Informationists to Information Specialists:
The Clinical Inf...
26
Emerging
Themes
4. If we ignore Critical
Appraisal, will we
become irrelevant?
• CA appears to be expected more and more in
certain contexts.
• Do health librarians need to routinely learn
this in orde...
28
Emerging
Themes
5. Is there really a lack of
relevant literature and
a need for further
research in this area?
(Clue:Ye...
• There is no seminal article on this subject
• Maden-Jenkins conducted research into
librarians and CA (as quoted earlier...
Limitations
• During screening, particularly FT screening,
we found other terms for CA which were not
used in the original search stra...
Next Steps
• We need more evidence to find out what
health librarians really think about CA
– Diffusion of Innovation approach
– What...
34
References
Listing of the 105 articles we selected for data
extraction: http://bit.ly/1mWvC2x
Arksey, H., & O'Malley, L...
35
Thank you
for listening!
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Going to the Next Level / Presentation at IFLA 2014, Lyon

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Presentation given at IFLA 2014 in Lyon, to the Biomedical Libraries section.

Published in: Health & Medicine
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  • LIGHT INTRODUCTION: Explain how honeybees conduct a form of critical appraisal
  • In this slide, will talk about the five steps for those possibly unfamiliar, and how librarians typically only get involved in stages 1 or 2. Particularly in SRs.

    STAGE 3: “Critical appraisal is the systematic evaluation of clinical research papers in order to establish:
    Does this study address a clearly focused question?
    Did the study use valid methods to address this question?
    Are the valid results of this study important?
    Are these valid, important results applicable to my patient or population?”
  • “Critical appraisal is the systematic evaluation of clinical research papers in order to establish:
    Does this study address a clearly focused question?
    Did the study use valid methods to address this question?
    Are the valid results of this study important?
    Are these valid, important results applicable to my patient or population?”
  • “Critical appraisal is the systematic evaluation of clinical research papers in order to establish:
    Does this study address a clearly focused question?
    Did the study use valid methods to address this question?
    Are the valid results of this study important?
    Are these valid, important results applicable to my patient or population?”
  • Collaborators: we noticed health professionals have different expectations and varying degrees of flexibility; nurses and less academic areas seem more flexible
  • …although most were also involved in CA teaching anyway
  • …although most were also involved in CA teaching anyway
  • Hill erport: mention Harrison, J. and Beraquet, V. (2010), Clinical librarians, a new tribe in the UK: roles and responsibilities. Health Information & Libraries Journal, 27: 123–132. doi: 10.1111/j.1471-1842.2009.00862.x
  • Transcript of "Going to the Next Level / Presentation at IFLA 2014, Lyon"

    1. 1. GOING TO THE NEXT LEVEL How Health Librarians are Engaging with Critical Appraisal Martin Morris, MSc • Genevieve Gore, MLIS martin.morris@mcgill.ca • genevieve.gore@mcgill.ca McGill University, Montreal, Canada
    2. 2. 2 First: Why the honey bee?
    3. 3. Introduction
    4. 4. ASK the question ACQUIRE the evidence APPRAISE the evidence APPLY the Evidence ASSESS 4 The EBM Cycle
    5. 5. Our Research Questions • Health librarians are taking part in courses on evidence appraisal • We are also constantly seeking ways to develop collaboration with our health professional colleagues • Is critical appraisal (stage 3 of EBM) the next big opportunity for health librarians? • Are health librarians genuinely engaging with this opportunity? • We thought there was little literature on the subject 5 Why are we asking this question?
    6. 6. 6 Our Research Questions To what degree are health sciences librarians engaging in critical appraisal of the medical evidence? What attitudes do health sciences librarians display to this engagement?
    7. 7. 7 Methodology The study is a scoping review conducted according to Arksey & O’Malley’s guidelines (2005).
    8. 8. Methodology #1 8 What is a scoping review? Search Strategy Scoping reviews are a type of literature review that aims to provide an overview of the type, extent and quantity of research available on a given topic Two concepts: LIBRARIAN + CRITICAL APPRAISAL/EBM/EBHC
    9. 9. 9 Search Strategy (LISTA) S1 SU librarians S2 SU information S3 TX librarian# S4 TX informationist# S5 SU occupational roles S6 SU medical librarianship S7 TX information professional* S8 SU knowledge workers S9 SU librarians attitudes S10 TX information specialist# S11 TX information provider# S12 TX medical librarian* S13 TX hospital librarian* S14 TX informaticist# S15 TX knowledge worker# S16 SU medical libraries S17 OR/S1-S16 S18 SU evidence-based medicine S19 TX critical* apprais* S20 TX critical* think* S21 TX evidence-based S22 TX systematic* review* S23 TX evaluat* evidence S24 TX EBM S25 TX EBMP S26 TX EBHC S27 TX evidence N3 apprais* S28 TX quality N3 assess* S29 TX quality N3 apprais* S30 OR/S18-S29 S31 S17 AND S30 Methodology #2 Searches executed 31 March 2014.
    10. 10. 10 Inclusion/ Exclusion Criteria Methodology #3 Inclusion: Health Librarianship Stage 3 of the EBM cycle (APPRAISE) Language: • English, French, German, Spanish, Italian Exclusion: Research synthesis not librarianship Not health librarianship (including EBL not EBM) Only stage 1,2 of EBM (ASK, ACQUIRE) Full text not available Abstract only
    11. 11. Findings
    12. 12. Database searching (n = 4223) Embase on Ovid: 846 Ovid MEDLINE: 792 PubMed (not Medline): 64 LISTA (ProQuest): 1138 / LISA (ProQuest): 1383 Identified through other sources (to come) After duplicates removed (n=2275) Records screened (n=2275) Full text assessed for eligibility (n=363) Included in qualitative analysis (n=105) Records excluded (n=1912) FT excluded (n = 258) Duplicate: 2 / Language: 31 Research synthesis not lib’ship: 13 / Not health lib’ship: 69 / Only stage 1,2 of EBM: 91 / FT not available: 2 / Abstract: 3 / Other: 47 12
    13. 13. Emerging Themes
    14. 14. 14 Emerging Themes 1. How does the literature define Critical Appraisal?
    15. 15. There is a lack of rigour in the literature regarding the meaning of CA, from: –General checks of quality from an info lit point of view, to –Biostatistical appraisal of study quality –And various other levels in between 15 CA in the literature
    16. 16. • The concept of CA is referred to in many ways in the literature and it is frequently unclear which level of CA is intended • The term CA predates the term EBM. • Some of our 105 studies may include a lower level of CA 16 CA in the literature
    17. 17. 17
    18. 18. 18 Emerging Themes 2. What attitudes do librarians have towards Critical Appraisal?
    19. 19. • We tallied positive and negative librarian attitudes towards CA – We noticed that more librarians reported positive attitudes than negative. But the reports are highly self-selecting • We did the same, where possible, for collaborator attitudes – We saw no clear picture. However, collaborators regularly develop positive attitudes after working with a librarian who conducts CA 19 Attitudes to CA
    20. 20. • Maden-Jenkins summarises attitude barriers to librarian involvement in CA teaching which we also saw reflected in the literature: – “Lack of confidence” – “Lack of willing”, not wanting to take the lead – Perceived attitude of others • Concern about resistance from medical staff – Fear • Of the unknown, of statistics 20 Attitudes to CA #2
    21. 21. • She also reports perceived skills/knowledge barriers to librarian involvement: – Lack of knowledge, not sure what it is • Resulting in perceived lack of facilitation/teaching skills – Lack of specific statistical, mathematical knowledge – Difficulty of understanding or “getting your head around it” – Few opportunities to practice 21 Attitudes to CA #3
    22. 22. 22 Emerging Themes 3. What real-world examples are there of librarians getting involved in Critical Appraisal?
    23. 23. 23 CA in context #1 • Clinical Librarians • Informationist trends
    24. 24. • We spotted many types of librarian engagement with CA: – Librarians taking part in training, learning how to conduct CA at various levels – Librarians conducting training • Librarians conducting CA in various contexts – Filtering/evaluating the literature (rarely clear what this means) – Biostatistics, medical statistics, etc. 24 CA in context #2
    25. 25. 25 CA in context #3 • Vanderbilt: From Clinical Librarians to Informationists to Information Specialists: The Clinical Informatics Consult Service (CICS) – “Information specialists” synthesise the literature, analyse study methodology.
    26. 26. 26 Emerging Themes 4. If we ignore Critical Appraisal, will we become irrelevant?
    27. 27. • CA appears to be expected more and more in certain contexts. • Do health librarians need to routinely learn this in order to stay relevant? • Non-librarian, medical info specialists:We noticed various non-librarian informaticists and knowledge brokers conducting CA. 27 Staying Relevant
    28. 28. 28 Emerging Themes 5. Is there really a lack of relevant literature and a need for further research in this area? (Clue:Yes)
    29. 29. • There is no seminal article on this subject • Maden-Jenkins conducted research into librarians and CA (as quoted earlier). But she limited her research to training and her work is now 5 years old. • Research is needed into the broader field, and with a consistent definition of CA. 29 Lack of literature
    30. 30. Limitations
    31. 31. • During screening, particularly FT screening, we found other terms for CA which were not used in the original search strategies • The grey lit search was not completed in time for this presentation (of NHS, Canadian provincial health authorities, etc.) • Snowball searching also not complete 31 Limitations
    32. 32. Next Steps
    33. 33. • We need more evidence to find out what health librarians really think about CA – Diffusion of Innovation approach – What about collaborators? – Do collaborators really want librarian involvement? 33 What next?
    34. 34. 34 References Listing of the 105 articles we selected for data extraction: http://bit.ly/1mWvC2x Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. Maden-Jenkins, M. (2010). Healthcare librarians and the delivery of critical appraisal training: Attitudes, level of involvement and support. Health Information and Libraries Journal, 27(4), 304-315. Maden-Jenkins, M. (2011). Healthcare librarians and the delivery of critical appraisal training: Barriers to involvement. Health Information and Libraries Journal, 28(1), 33-40.
    35. 35. 35 Thank you for listening!

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