Information needs of health professionals (nursing, rehabilitation specialists, speech therapists, etc.)

Background and goal

Nothing is easier than searching information on Web. But, much time spent and any guarantee on sources. There are many information systems already available online in the field of health (BDSP – French public health database, Medline, Cairn, etc.), but few in the field of palliative care, death and bereavement, in particular for French-speaking people. Having a unique entry point which proposes selected and checked references, resources, tools, methods and advice, it’s a dream for any health professional…

To realize this dream, Information and Documentation Service of Centre National De Ressources Soins Palliatif (CNDR SP) is going to launch a documentary web portal on palliative care: VigiPallia. With its experience of over 10 years in management and dissemination of information in the field of caring, end of life, death and bereavement, it proposes reliable and easily available tool for professionals.

This article aims to introduce VigiPallia, its development methodology and the ensuing results.

Method and results

To develop this tool, Information and Documentation Service identified health professionals’ needs and expectancies faced with these issues.

Two surveys, conducted in 2009 and 2010 among French-speaking people, allowed to identify these needs. The first survey dealt with information use and practices of palliative care professionals; the second with the expectancies on documentary services and products (documentary synthesis, bibliographic fields, news, etc.). Based on this observation, Information and Documentation Service studied technologic solutions answering to this range of requests.

Thus, Information and Documentation Service thought and built VigiPallia related to its users and partners. Evolution of technology can offer today a precise, customizable and relevant tool: full text, synthesized information, unique search engine to several databases, methodological help… all within a few clicks!

Conclusion and future perspectives

Disseminating palliative care represents a daily challenge for each health professional. Implementation of VigiPallia can constitute a first answer to this challenge. More, this web portal is develop by documentalists team with savoir-faire for treating information and whose the main goal is innovation in response to changing needs.

Description and implementation of an information strategy to reach and activate the county employees in information retrieval, skills development and research.

Background

In order to establish a sustainable regional growth and stimulate the development of a high quality health care, an R & D Centre, was created in 2006 by the Sörmland County Council and Uppsala University, Sweden. To this organization the County’s four hospital libraries with 9 librarians were added and merged into a single activity. A new mission was formulated, which focused on the libraries role of being a resource for the 7 000 county employees in their search for information for clinical work, education and research.
The first years were spent developing procedures and a functional infrastructure for the libraries. The goal has been to offer a similar service to all county employees, regardless of where they are in the region.

Information strategy

A priority in the new library organization was to locate and reach the users who do not automatically use library services. People in the health sector do not have time and opportunity to physically visit the library - and has no reason for it either. It is our job to give them the opportunity needed to be able to operate and develop a good health care. The libraries therefore added a strategy for a two-year effort that would include targeted marketing, outreach and locally adapted training. The librarians understood that they must seek the employees where they were and when they had time and opportunity.

During 2009-2011 the library organization visited more than 60 staff-meetings with groups between 5-50 people. The meetings took place at any time, from early in the morning to late at night - all as desired. The premises were all from large lecture halls to small closets with no Internet. For each operation the library prepared unique search examples. The librarians wanted the presentations to be an experience, even for those who were not interested in the content. On one level, it was as much about building the library brand as providing information about the library service.

Each semester the library organization in addition to the outreach campaign also focused on specific professions or specialties, such as nurses and primary health care centers. During the second year the offer expanded with breakfast and lunch seminars at each library, where in addition to information also sandwiches were a part of the offer.

Evaluation

The outreach campaign is now closed. The hospital libraries information strategy will be evaluated during the spring 2012. The library organization want to see if it is right that in addition to good infrastructure and available e-resources, it is information, promotion and training that should be a hospital library priority. During these two years, the hospital libraries visited nearly 20% of the county employees in their workplaces. The response has been beyond expectations. The hope is that the activity can be made ​​permanent and the number of visitors will double within the next two years

Introduction

Two years ago, a course on Evidence-Based Practice (EBP) was integrated into the speech therapy curriculum at the University of Liège. We decided to carefully analyze speech therapists’ needs in order to adjust the preliminary educational program to fit with current working conditions and to address challenges faced by clinical practitioners.

Questions/Objectives

The aim was to address the following questions: 1) What actions do speech therapists take to solve a clinical problem? 2) Are they satisfied with their approach? 3) To what extent do they use scientific information and what are the possible barriers to accessing it? 4) Do they know the principles of EBP? 5) Do they feel comfortable with methods of information searching? 6) Are they interested in professional training?

Methods

An exploratory survey was launched with 2028 members of two Belgian associations of French speaking speech therapists: 256 of them belonged to the “Association scientifique et éthique des logopèdes francophones” (ASELF) and 1772 others were members of the “Union Professionnelle des Logopèdes Francophones” (UPLF). The survey was also sent to 40 practitioners working in collaboration with the University of Liège as supervisors to speech therapy students.

The survey contained three types of question: questions to gain general information about the participants, questions about the process they used to solve the last problem encountered in their clinical practice and questions about how they access relevant scientific information. Several questions were in a multiple choice format, while others were opened-ended. The questionnaire was designed so that some questions did not necessarily require a response.

The questionnaire was delivered online. Practitioners were invited to participate by either an ASELF or UPLF representative, and supervisors were contacted by a professor from the University of Liège.

Results

One month after launching the survey, 520 people connected to the questionnaire. 427 people gave their answers but only 410 of those had graduated in speech therapy. When the answers given by these 410 professionals were taken into account, the participation rate rose to 19.8%.

Of the respondents, 97% had undertaken one or several processes to solve the last clinical problem that they had faced:

• 81% of people had relied on personal experience (61% of them were satisfied with the solution they had found in this way);
• 77% had discussed the clinical problem with colleagues in the workplace (81% satisfied);
• 71% had consulted their personal library (84% satisfied);
• 50% had searched scientific articles on the internet through a general search engine (e.g. Google) (71% satisfied);
• 47% had discussed the clinical problem with an expert in the discipline (94% satisfied);
• 43% had searched the internet through a general search engine (e.g. Google) to find sources of information other than articles (74% satisfied);
• 33% had discussed the clinical problem with colleagues in a professional context but not in the workplace (e.g. through a forum on the internet) (78% satisfied);
• 5% had done a search in a specialized database (e.g. Medline/PubMed) (65% satisfied);
• 5% had contacted or been to an academic library (71% satisfied);
• 5% had delegated the information search to a third party (67% satisfied);
• 3% had contacted or been to a public library (78% satisfied);
• 19% had used another approach than those cited above (80% satisfied). The most frequent answers from these respondents included: referring the patient to another professional, undertaking training, or attending a conference.

Generally speaking, 14% of the speech therapists who participated in the survey said that they used scientific information at least once a week, 37% once a month, 33% once every 3 months and 16% said they never or only exceptionally used such information.

Reported barriers to accessing scientific information were: lack of time (54%), lack of competence in the English language (45%), lack of knowledge of available sources in the discipline (44%), difficulty in accessing specialized search tools (40%), cost of accessing information (40%), difficulty in selecting relevant documents (37%), difficulty in assessing the scientific quality of information (33%), lack of skills in using specialized search tools (28%), barriers other than those cited (2%).  
7% did not perceive any barrier to obtaining quality scientific information.

On a scale 1-10 (1 being the lowest level and 10 the highest level), average scores regarding perceived competence in accessing and using scientific information were as follows: searching scientific information (6.9), assessing information (6.7), using in their professional practice information obtained from the literature (7.3).

12.4% of the respondents had already heard about EBP. They rated the importance of the approach as follows: essential (15%), interesting (25%), interesting but not feasible (23%). 37% did not know enough about EBP to give an opinion.

The surveyed speech therapists indicated their training interests to be as follows: EBP training (69%), improving skills such as professional attitudes (66%), information retrieval (62%) and information on critical reading (47%).

Discussion

This preliminary analysis shows that the majority of speech therapy practitioners in our study had searched for a solution to the clinical problems they encounter.     
They referred mostly to 1) experience, 2) colleagues in the workplace and 3) documents available in their personal library. The highest satisfaction levels were experienced when 1) they discussed the problem with an expert, 2) they consulted their personal library, and 3) they discussed it with a colleague in the workplace.

When searching for a journal article, the practitioners seemed to prefer a general search engine rather than a specialized database. As already reported by Nail-Chiwetalu & Bernstein Ratner (1), the most cited barriers to accessing relevant information are lack of time and ignorance of available sources in the discipline.

Whatever usage the practitioners were making of scientific information in their daily practice and whatever their self perceived level of competence in information literacy, they expressed an interest in being trained. This can be interpreted as a willingness to improve their practice and their approach to the literature.

The survey gathered a large amount of additional data, which still need to be analyzed. Nevertheless, as recommended by Guo et al. (2) and by Nail-Chiwetalu & Bernstein Ratner (1), we can already conclude that efforts need to be made to help speech therapists to develop their skills in information literacy. On the one hand, educational programs should provide EBP courses in order to anticipate the challenges of professional life. On the other hand, continuing education activities should also be offered to professionals in order to support decision making and to transform them into models for the next generation.

Purpose and Setting

The Hospital de Torrejon library in Madrid and The Medical Sciences Library (MSL) at Texas A&M University share a common goal, to make information and resources accessible to users wherever they are, whenever they need it. This has led to an increased focus on effective distance communication and information sharing. Although there are several means of communicating over large distances, limited budgets and differing levels of librarian and user technological expertise, make it essential to identify effective and inexpensive sharing methods that provide a continuity of experience from academia to clinical settings.

Objective

To identify the similarities and differences in the communication and service methods of academic and hospital libraries as they relate to distant professional and student users with varying technology expertise. Initiate the planning, implement the support, and assess the viability of those communication methods to determine their effectiveness in both the clinical and academic settings in very different countries. Use the combination of the results to encourage a more effective and coordinated effort in providing services and resources to distant locations.

Methods/Process

As the medical community grows into new markets, this has a direct impact on the libraries that have been designated to serve those areas with resources and services.  Although the most common and preferred interface has generally been face-to-face, tighter budgets make personal support at various locations much more difficult to achieve.  As an alternative to in-person communication, the Hospital de Torrejon has looked to implement such tools as web pages, blogs, Google chat, E-mail, and twitter.  Likewise, the Medical Sciences Library has investigated changes in its own webpage, a chat service with texting capability, and Adobe Connect.  Beyond communication, there is also the aspect of providing actual resources.  To accomplish this, the library systems have each made use of E-mail, Google Docs, Specific Applications, and actual internal and external mailing services.  Each listed method was analyzed based on the level of expertise needed for use, the level of support required, any cost considerations, and the success achieved with each method. The methods used to measure the successfulness of each communication type included website hit statistics, attendance at announced events, and specific user comments.  Additionally, a survey was provided by the Medical Sciences Library to better gauge exactly what type of services and resources a newly acquired client group at a distant location would desire.  The population surveyed consisted of students and staff of a clinical/educational setting that had full access to an unmanned library space, but an extremely limited number of physical resources and instruction on accessing the electronic resources.  The survey was designed to discover if the respondents were from the College of Medicine, College of Nursing, or College of Pharmacy.  The survey also questioned when the library space was most often used, what people most often used from the library, and what they wish was provided.  To alert different and disparate populations to the services and resources that were at their disposal, a series of “Info-fairs” were hosted at each location so that resources could be further demonstrated, and relationships could be created to aid with future virtual correspondence.  At the Spain locations, periodic visits are made for training and instruction purposes, but in general, most support is given electronically.

Outcomes/Conclusions

In the survey given by the Medical Sciences Library concerning what resources are used the most in an onsite physical space, Twenty-eight out of Fifty-one respondents said that they used online resources.  Additionally, in the following question asking what was desired of the library to have available, only six of the fifty-one suggested electronic resources.  This indicates that a majority of the users were already quite comfortable with using electronic materials, and therefore would likely be comfortable with electronic communication methods.   In fact, one of the key noted requests revolved around searching for resources rather than the resources themselves.  One of the most difficult tasks in using different vehicles for distance support is actually educating the clientele on the existence of these communication methods, and identifying which ones are most effective for particular user groups on in specific situations(1).  The librarian for the Hospital de Torrejon travels to the other hospitals in that system approximately 3 times per year for teaching purposes.  Periodically, an email will be sent with the training needed which prompts the creation and scheduling of some workshops and/or classes.  These experiences have demonstrated that the younger doctors seem to be much more comfortable with using the electronic means of communication for library assistance (email, web forms, and chat).  The younger doctors also seemed to prefer the electronic interaction not just for convenience, but also because it saves them from the delays and interruptions that generally come with having to plan a trip to the library or arrange for a visit from the librarian.  The older or more experienced generation still seems to prefer face to face interaction if given a choice.  As one of the Spain libraries is to serve students (which closely resembles the Medical Sciences Library model, it too has demonstrated that students prefer the online services because they can access them from anywhere and at any time.  The recent popularity in smartphones and tablets has only added to the luxury that clients now have in accessing library resources.  This allows the clients to take the library with them in a sense, and have even faster access than simply using a computer.  The technology is however creating a double-edged sword in that the ease of accessing the library from anywhere also brings with it the problem that there is no excuse for not being able to work from wherever they may be.  Blogs and Facebook updates have proven effective for posting news and links as well as information about new services. Chat is extremely effective a means of addressing any immediate needs that a medical student or professional student may have as long as a librarian is present to be involved in the chat.  Likewise, these same systems generally support text capability which accepts questions from mobile devices.    Twitter seems to be best implemented when it is used to post information about the library for quick announcements or sudden changes, but still leaves somewhat of a gap even for the younger generation.  Google docs works really well when used for forms and for collecting information on scientific articles or books that have been published.  Additionally it is useful in saving congress presentations, posters, etc.  A comparative list of these different distance communication techniques used by both entities clearly illustrates many of the pros and cons of each method.