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MEDICAL LIBRARIANS IN THE QUEST FOR BEST EVIDENCE. J. Potomková Palacky University Faculty of Medicine, Olomouc H. Bouzková National Medical Library, Prague E.S. Lesenková Institute for Postgraduate Medical Education, Prague CZECH REPUBLIC. BACKGROUND.
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MEDICALLIBRARIANS IN THE QUEST FOR BEST EVIDENCE J. Potomková Palacky University Faculty of Medicine, Olomouc H. Bouzková National Medical Library, Prague E.S. Lesenková Institute for Postgraduate Medical Education, Prague CZECH REPUBLIC
BACKGROUND • Librarians’ role in evidence-based medicine • Waiting for „clientelle“? • Advocacy based on librarians’ knowledge and skills? • Czech experience • Active involvement since 1997 • International project supported by American International Health Alliance • Inter-professional approach
OBJECTIVES OF STUDY • Assees effectiveness of Ovid Collection usage • Evaluate quality of medical library services to search and offer best evidence • Estimate medical library users’ satisfaction
MATERIAL • Consortium of 28 Czech medical libraries • 6 geographical regions • Access to OVID Collection since 2001 • Managed by the National Medical Library in Prague
OVID COLLECTION • Ovid Medline (1966-present) • Ovid OldMedline (1951-1965) • Ovid Medline in Process • Ovid Medline Daily Update EBM RESOURCES • EBM Reviews Fulltext • Cochrane Database of Systematic Reviews • Cochrane Central Register of Controlled Trials • Database of Abstracts of Reviews of Effects • ACP Journal Club (1991-present)
OVID CONSORTIUMIN CZECH REPUBLIC Figures = number of libraries in geographical regions
METHODS • Survey by questionnaire • Section A for all users of Ovid databases (librarians, staff) • DB usage frequency grading scale: • weekly - monthly - infrequently -never • Section B • Specific questions for librarians and staff • Distribution of 500 questionnaires • Statistical evaluation: SPSS statistical package
RESULTS • 500 questionnaires distributed • 425completed and returned (85%) • 56 excluded (13.2%) • 369used for statistical analysis (86.8%) • 28 submitted by librarians (7.5%) • 341 received from database users (92.5%)
QUESTIONS FOR LIBRARIANS + STAFF Ovid Collection usage frequency DB preferences
Question for librarians:Do you use Ovid Collection regularly? NO 10.7 % 89.3 % YES
Question for staff:Do you search Ovid Collection on your own? No 46.3 % 51.2 % Yes Not specified 2.5 %
Usage FrequencyOVID MEDLINE (1966-present) 66.7 67.7 Percent of Responses 12.5 12.9 12.9 12.5 8.4 6.4
Usage FrequencyEBM REVIEWS FULLTEXT 67.7 45.9 Percent of Responses 25.0 20.8 17.7 11.3 8.3 3.2
Usage FrequencyCOCHRANE DATABASE OF SYSTEMATIC REVIEWS 64.5 37.5 37.5 Percent of Responses 17.7 16.7 16.1 8.3 1.6
DATABASES WITH LOWEST USAGE FREQUENCY Cochrane Central Register of ControlledTrials Database of Abstracts of Reviews of Effects ACP Journal Club
Usage frequencyCOCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS 67.7 54.1 37.5 Percent of Responses 25.7 4.2 4.2 3.2 3.2
Usage frequencyDATABASE OF ABSTRACTSOF REVIEWS OF EFFECTS 80.6 54.2 37.4 Percent of Responses 16.2 4.2 4.2 1.6 1.6
Usage frequencyACP JOURNAL CLUB 93,5 58.3 Percent of Responses 29.2 8.3 4.2 3.2 1.6 1.6
QUESTIONS FOR LIBRARIANS Consultation with end-users Purpose of DB searches Evaluation of retrieved documents Organization of training courses for staff Continuing education
Question for librarians:Do you discuss information requests with your clients? Sometimes 32 % 68 % Always
Question for librarians:Are you interested in the purpose of information requests? No 16 % 84 % Yes
Question for librarians:Are you able to evaluate retrieved documents by hierarchy of evidence? No 68 % 32% Yes
Question for librarians:Have you organized training courses for staff in the past 3 years? No 56 % 44 % Yes
Question for librarians:Have you participated in training courses for librarians in the past 3 years? No 28.6 % 67.9 % Yes Not specified 3.6 %
QUESTIONS FOR STAFF Purpose of searches (info requests) Search criteria, limits Participation in training courses Satisfaction with Ovid Collection and library services
Question for staff:What is main purpose of your searches (information requests)? 93.2 % Science, research 81.1 % Publications, presentations 64.9 % Clinical practice 58.1 % CME – self-study Teaching 40.5 % Health management,policy 9.5 % 1.4 % Other
Question for staff:How do you sort retrieved documents? Publication date 78.9 % Author(s) 56.3 % 56.3 % Publication type 32.4 % lmpact factor
Question for staff:Have you participated in training courses in the past 3 years? No 60.3 % 33.1 % Not specified 6.6 % Yes
EVALUATION OF OVID COLLECTION BY STAFF Good 69.4 % 28.2 % Excellent Unsuitable 2.4 %
SATISFACTION WITH LIBRARY SERVICES Acceptable 51.7 % 45.7 % Excellent Should improve 2.6 %
CONCLUSIONS „After survey“ steps • EBM seminar for postgraduate teachers organized by Institute for Postgraduate Medical Education • EBM Steering Committee • Invited speakers from academic institutions • Articles in Czech medical journals: • pediatrics • internal medicine • psychiatry • emergency meicine • health insurance
CONCLUSIONS Steps to be taken • Guideline for teaching and learning EBM • to assist and inspire Ovid Consortium libraries to advocate EBM principles in their organizations
Didactic setting for teaching and learning EBM Well-built clinical questions Instrumental skills, abilities, knowledge medical literature databases focused search info retrieval Critical appraisal hierarchy of evidence extraction of knowledge Evaluation of outcome pre- and post-tests GUIDELINE STRUCTURE Matzen et al., 2004 http://www.sund.ku.dk/.
Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? T. S. Eliot (1888-1965)
Usage frequencyOVID MEDLINE DAILY UPDATE 48.4 41.7 Percent of Responses 33.3 25.9 16.1 12.5 12.5 9.7
Usage frequencyOVID MEDLINE IN PROCESS 71.0 41.7 37.5 Percent of Responses 19.3 12.5 8.3 4.8 4.8
Usage frequencyOVID OLDMEDLINE 58.1 37.5 37.5 Percent of Responses 22.6 20.8 14.5 4.8 4.2