Journal club, tool of change asted at 32_2_nov2012final


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Presentation ASTED 2012, Lessons learned from Nursing Journal Club, survey and change of educational tool.

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  • “Goal (Vision) Empower nurses with knowledge, skills and attitudes to create a supportive community of reflective learners that will benefit psychiatry patients at the Jewish General Hospital”
  • Access and resource discovery
  • Example of questions asked: - What is nurse’s role in decreasing stigma in mental health? - Mental disorder and substance use: what are the street drugs?
  • Journal club, tool of change asted at 32_2_nov2012final

    1. 1. The Journal Club: A Tool of Change?Le Club de lecture: Un outil de changement ? Teodora Constantinescu, MLIS & Renée Lavoie, RN, BSc Colloque ASTED Montreal, le 2 Novembre 2012
    2. 2. OUTLINE• Background• Objective• Methods • Survey• Results• Discussion
    3. 3. BACKGROUND
    4. 4. IN THE BEGINNING…• Serendipity and opportunity …• Nurse-librarian conversation (spring 2011)
    5. 5. ACTORS• Nurses• Librarians• Organization (Institution)
    6. 6. NEEDS AND OBJECTIVESOF PSYCHIATRY NURSES AT JGH• Forum to meet regularly• Discuss literature on issues of interest• Keep up to date• Learn together (knowledge, skills)• Nurses in control of process• Improve patient outcome EMPOWERMENT
    7. 7. JOURNAL CLUBS• “The most compelling reason to start a journal club is to keep abreast of the latest nursing research”• “A way of improving practice by ensuring patient care is based on most accurate and current information” (Luby, 2006)• Increase research utilization1875 - Sir William Osler: first formal medical journal club in North AmericaHLWiki: Journal Clubs :
    8. 8. EVIDENCE BASED PRACTICE (EBP) PROCESS Library training (ACRL Information Literacy) PATIEN T CENTEREDOrganizational Journal Club Procedures
    9. 9. EBP LIMITATIONS• Evidence – Body of research varies in quantity and quality• Implementation – Time – Lack of knowledge and skills – Lack of incentives – Organizational culture• Measurement of outcomes
    10. 10. OUTLINE• Background• Methods • Survey• Results• Discussion
    11. 11. METHODSThe Journal ClubObservationRe-evaluationThe Survey
    12. 12. JGH Psychiatry Nurses Journal Club• Monthly meetings• Over 60% participation rate• 2 nurse coordinators / club facilitators• Topics chosen by the group• Presenter: volunteer basis• Article selected by presenter with nurse coordinator
    13. 13. LIBRARIAN’S ROLE• Collaborator• Search the literature• Present “vignettes”• Reflective Observer• No influence on choice of topic or choice of article to discussed
    14. 14. OBSERVATIONS• Nurses driven process• Questions asked: general not specific• Information chosen : reviews, reference• Preference: summarized and concrete applications• Some difficulty with computer and searching skills• Some difficulty: research methodologies and critical appraisalEnthusiasm for learningEngaged in discussions
    15. 15. REFLECTION• Evaluate the gap• Is the group ready for searching , critically assessing and integrating the research into practice? – Knowledge, skills, values• Re-evaluate the pertinence of journal club as a learning tool (blind spot)
    16. 16. LITERATURE SEARCH : NURSES AND INFORMATION SEEKING• Information seeking behavior, O’Leary (2011) – Routine vs non-routine – Colleagues rather than searching literature for answers – Prepackaged information• Low research uptake Estabrooks (2003), Squires (2011) - Contextual factors significant - No clear interventions to increase research utilization• Readiness of nurses for EBP: Pravikoff, Tanner, Pierce, (2005) – Low use of bibliographic databases and hospital libraries – Greatest barrier to using evidence is “lack of value for research in practice”
    17. 17. METHODS: SURVEYModeled on Pravikoff (2005) (93 points)8 questions with sub-questions (39 points)1. Knowledge of EBP and attitudes (values)2. Information needs and Information Sources3. Perceived Top Three Barriers and Facilitators for EBP 20 participants 65% response rate
    18. 18. OUTLINE• Background• Methods • Survey• Results• Discussion
    19. 19. RESULTS
    21. 21. RESULTS: PERCEIVED KNOWLEDGE RELATIVE TO RESEARCH 70% never involved in research 67 % somewhat knowledgeable of EBP and processes 50% somewhat knowledgeable ininterpreting research results and assessing quality 23% evaluated research reports
    23. 23. RESULTS: USE OF RESOURCES Internet (Google) 83% Daily/Weekly Colleagues 76% Daily/Weekly Textbooks 53% WeeklyPractice Guidelines 41% Monthly Medline/PubMed 41% Monthly CINAHL 63% Never PsycINFO 50% Never Librarian: 41 % yearly, 25% monthly, 25% never
    24. 24. RESULTS: TOP BARRIERS TO EBP(OTHER THAN TIME) Correction: Lack of literature searching skills
    26. 26. OUTLINE• Background• Methods • Survey• Results• Discussion
    27. 27. DISCUSSION
    28. 28. DISCUSSION: Findings• Findings reflect those of larger studies: – Low use of resources – Preference for summarized information• Readiness for Evidence Based Practice? – Lack of value for research – Need for information skills – Need for a role model and mentor • nurse educator trained in EBP – Need for organizational support
    29. 29. DISCUSSION: Limitations• Survey limitations • Survey tool • Small data set • Correlation • Limited access to original research questionnaires • Blindspot: assessing journal club as a method
    30. 30. LESSONS LEARNED• Librarian – Nurse Collaboration: “merging silos”*
    31. 31. Way forward:• Re-evaluate educational objectives and methods• Curriculum for information literacy• Content drives the format:• Journal club format – at a later stage• Immediate relevance of teaching
    32. 32. CONCLUSION: Journal Club, Tool of Change ?• Readiness for journal club at your institution?• Facilitating factors ?• Limiting factors?• What will be your role?
    33. 33. REFERENCES• Miller LC, Jones BB, Graves RS, Sievert MC. Merging silos: collaborating for information literacy. J Contin Educ Nurs. 2010 Jun;41(6):267-72. PubMed PMID: 20411879.• Oleary DF, Mhaolrúnaigh SN. Information-seeking behaviour of nurses: where is information sought and what processes are followed? J Adv Nurs. 2012 Feb;68(2):379-90.• Pravikoff DS, Tanner AB, Pierce ST. Readiness of U.S. nurses for evidence- based practice. Am J Nurs. 2005 Sep;105(9):40-51• Squires JE, Estabrooks CA, Gustavsson P, Wallin L. Individual determinants of research utilization by nurses: a systematic review update. Implement Sci. 2011 Jan 5;6:1.• HLWiki: Journal Clubs :
    34. 34. CONTACTTeodora Constantinescu, MLIStconstantinescu@jgh.mcgill.caRenée Lavoie, RN,