Focus on Assessment - Jul 11, 2011

The Harrell Health Sciences Library is one of 56 health libraries, from across the United States and Canada, who are participating in the Value of Library and Information Services in Patient Care Study (Value Study).1 The Value Study is a collaborative partnership of the National Networks of Libraries of Medicine, Middle Atlantic Region and the University
of North Carolina at Chapel Hill (UNC).

The purpose of the Value Study is to “understand the value of the health library, information services and the librarian in improving patient care.” This study builds on the earlier work of Joanne Gard Marshall, specifically the “Rochester
Study.”2 Using a critical incident approach, the study will investigate 1) “the use and value of the print and electronic
resources provided by the library” and 2) “the information services (mediated or assisted information requests/searches) provided by the librarian that aid in clinical decision-making.” The research consists of three components:
1) A survey of physicians, residents and nurses assessing the value of the library and information services in patient care.
2) Interviews with selected physicians, residents and nurses aimed at understanding the role of library resources
and the librarian in providing information related to patient care.
3) Focus groups with librarians to validate and confirm research findings.

The initial survey component of the Value Study was administered by the UNC Research Team in March and April
of 2011 using a web-based tool. Physicians, nurses, and residents were invited to participate via an e-mail invitation from the Harrell HSL Director along with several members of the Milton S. Hershey Medical Center Senior Leadership
Team, which included information about the study and a link to the survey site. The original invitation was followed
up with three additional e-mail reminders encouraging participation. As a participant in the study, the Harrell HSL will
receive our institutions Summary Report of Survey Results and our de-identified dataset with all the survey responses.

A second project currently underway is the assessment of fourth year medical students’ knowledge, skills, and attitudes related to the practice of evidence-based medicine (EBM). EBM is the integration of the best available clinical evidence with an individual clinician’s expertise and the patient’s values. The practice of EBM requires skills in formulating an answerable clinical question; identifying the best information sources to locate evidence; effectively searching those resources; critically appraising the results to select those results with the highest level of evidence;
and applying the evidence through the lens of clinical expertise and patient values. Academic librarians practicing in
other fields would recognize similarities between EBM skills and the performance indicators outlined in ACRL’s Information Literacy Competency Standards for Higher Education.3

In April 2011, all fourth year students were assessed using a published, validated instrument measuring their skills and
knowledge in EBM (the “Fresno” test4) along with a locally-developed survey to elicit attitudes towards the practice of EBM. The project team plans to continue yearly assessment through 2015, attempting to correlate assessment results against overall medical school GPA and scores in the two required EBM medical school courses. Results will be used to measure the impact of EBM-related curricular interventions. This project is being undertaken by the associate director and coordinator of education and instruction at the Harrell HSL, in conjunction with the associate dean of clinical curriculum, and the associate dean of preclinical curriculum at the Penn State College of Medicine.

The information obtained from these surveys will provide insight into the value and uses of e-resources and services, and the impact of our efforts to teach Evidence Based Practice. They will also help inform strategic planning as we envision the future.

1 This project has been funded in part with federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract #N01-LM-6-3501 from the New York University Middle Atlantic Regional Medical Library Program. Additional support is provided by from the Hospital Library Section of the Medical Library Association (MLA), the NY/NJ Chapter of MLA; the Philadelphia Chapter of MLA; the Upstate New York and Ontario Chapter of MLA; the New York State Reference and Research Library Resources Councils and the Donald Lindberg Research Fellowship from MLA.
2 Marshall, JG. “The Impact of the hospital library on clinical decision making: the Rochester Study.” Bulletin of the Medical Library Association. 1992 Apr; 80(2): 169-78.
3 Association of College and Research Libraries. “Information Literacy Standards for Higher Education. 2000.” Available at http://www.acrl.org/ala/mgrps/divs/acrl/standards/standards.pdf
4 Ramos, K. D. “Validation of the Fresno test of competence in evidence based medicine.” British Medical Journal. 2003; 326(7384): 319-321.