Facilitating evidence‐based librarianship: a UK experience

The impetus for a journal club for Nottingham health librarians came from informal discussions between colleagues attending the first-ever Evidence-based Librarianship (EBL) conference, organized by the School of Health and Related Research (ScHARR) in Sheffield in September 2001. Enthused by the idea of evidence-based librarianship, Nottingham delegates decided to adopt some of the principles to develop local practice. An Internet search produced useful general information on how a journal club might be organized. Specific guidance on how to run a journal club for librarians was found on the Medical Library Association's website.1 Further advice was gained from colleagues already involved with clinical journal clubs. A lisa search identified an article describing a journal club at the Tompkinson-McCaw Library at the Medical College of Virginia/Virginia Commonwealth University.2 An initial meeting was arranged to discuss with interested colleagues how the club would work. An invitation was sent to approximately 59 health librarians and information specialists in the former Trent NHS region via the regional electronic discussion list, lis-health-trent. Fourteen people, approximately a quarter of those invited, attended this meeting and the following ground rules were set: Meetings would be held bi-monthly and over lunchtime. Members would take it in turns to chair the meetings. Meetings would take place at the Greenfield Medical Library at the Queen's Medical Centre, Nottingham. Any literature that was current and relevant to health libraries would be considered for discussion at meetings. Action and learning points from each meeting would be recorded to avoid the danger of the meetings becoming talking shops. Details of upcoming meetings would be disseminated via a local health librarians e-mail list. The Information and Libraries Development Service (formerly the Regional Library Unit) supported the initiative, offering to post notes and action points from the meetings on the Trent electronic Library for Health (TeLH) website.3 The first meeting was used to brainstorm possible topics for future meetings. Suggestions included library and information services to primary care, problem-based learning, implementing evidence-based practice, knowledge management, information literacy skills training for library users, and evaluating the impact of, and costing, library services. As well as establishing the practical side of running a journal club, the first meeting was used to examine the Department of Health document Working together learning together, a framework for lifelong learning for the NHS.4 An informal discussion about the document took place and points relevant to libraries were raised. The group found many useful references to support the case for health libraries in this document and, to ensure that best use was made of these references, these were captured in a Word document and then made available on the TeLH website.5 This allows members to extract key quotes when writing strategy documents, bidding for funding or materials, or generally raising the profile of their library. This idea proved timely, as a similar service has since been independently developed on the Librarians Portal on the National electronic Library for Health (NeLH) website.6 The ‘Find that quote’ service brings together quotes relevant to health libraries from many sources. The references extracted from Working together learning together have been made available there. At subsequent meetings, members have discussed articles on knowledge management, critical appraisal, accreditation of health libraries, evidence-based librarianship; and other Department of Health documents. The group generally takes two articles on a topic and compares them, with the Chairperson overseeing a loose structure for the discussion and highlighting key points. Journal club members bring suggestions for articles for consideration at future meetings, with the group reaching a consensus on what is to be read for the next meeting. Individuals are normally responsible for obtaining their own copies of articles for discussion, thereby reducing the administrative burden on those organizing the meetings. A reciprocal scheme for obtaining journal articles (HIFULOP) exists between Nottingham health libraries, and members make use of this where necessary. Publications appraised so far are listed in Table 1. Benefits of a journal club, identified by attendees, include: A supportive environment in which to examine current practice, and consider changes to that practice in the light of the evidence. Networking opportunities. The journal club is a cross-sectoral forum including colleagues from health libraries in the higher education sector, primary and secondary care, the Health Authority and the Workforce Confederation. The wide range of backgrounds makes the club an excellent networking forum, and gives plenty of opportunities for sharing experience and knowledge. A forum to develop critical appraisal skills. The journal club has been a useful experience for those wanting to practice looking critically at the literature. One journal club member has reported that they have found the club ‘very useful, it made me realise I needed some further training in Critical Appraisal and I have since attended a one-day (training) course. I now feel a little more confident in judging the usefulness of papers and have been spurred on to make the time to do some further reading’. An incentive to keep up to date with the literature. A chance to contribute to personal lifelong learning and continuing professional development. The existence of an EBL journal club in Nottingham has also been mentioned in the literature, helping to raise the profile of Trent librarians with colleagues and peers.7 One of the challenges faced by the journal club has been to sustain a level of commitment among attendees who have many calls upon their time. For the first two meetings, colleagues came from across the Trent region, but at later meetings attendees have been Nottingham based. It has not been practical to get people who are geographically distant together for 1–2 hours at a time. Nevertheless, the journal club has met five times at bi-monthly intervals, with a core group of around 5–8 regular attendees. The main challenge has been to integrate evidence into day-to-day decision-making and practice. The journal club meetings have not yet resulted in any wholesale changes in practice. Indeed it has been difficult to find sufficient evidence on which to base practice changes in topics that the members have examined. Members have been able to access lisa, the ovid Biomed databases, and have scanned some journals, but not everyone has access to other resources, for example the HMIC databases which cover health management topics. The cross-sectoral nature of the journal club is a clear strength in terms of benefits from networking. However, this has also made it more difficult to take joint decisions about changes to practice, as our client groups are varied and have different needs and expectations. Despite these challenges, the meetings have been valuable in sparking debate and questions. This in turn has encouraged closer examination of current practice, and produced suggestions for ways of doing things differently. Suggested ways of taking the journal club forward include the possibility of holding occasional joint meetings with clinical or management colleagues. Benefits of joint meetings might include networking, improved profile and status of library and information services (LIS) with non-LIS colleagues, and a useful additional perspective on the articles discussed. Widening the scope of the meetings to include evaluations of software, or sharing examples of good practice, has also been suggested. Although the focus of the journal club needs to be maintained, this kind of activity could be included in an extended session, making best use of the time colleagues spend together. Nottingham librarians have become increasingly involved in encouraging evidence-based practice among their clients, teaching information retrieval skills, working in partnership with systematic reviewers, and beginning to participate in the teaching of critical appraisal skills. In this climate, it has become increasingly pertinent to question the use of evidence in our own practice. The journal club has provided an opportunity to begin to bring evidence-based principles into our daily work.

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