Evaluating the impact of clinical librarians on clinical questions during inpatient rounds
DOI:
https://doi.org/10.5195/jmla.2018.254Keywords:
Librarians, Library Services, Medical Informatics, Evidence-Based Medicine, Education, MedicalAbstract
Objective: The investigation sought to determine the effects of a clinical librarian (CL) on inpatient team clinical questioning quality and quantity, learner self-reported literature searching skills, and use of evidence-based medicine (EBM).
Methods: Clinical questioning was observed over 50 days of inpatient pediatric and internal medicine attending rounds. A CL was present for 25 days and absent for 25 days. Questioning was compared between groups. Question quality was assessed by a blinded evaluator, who used a rubric adapted from the Fresno Test of Competence in Evidence-Based Medicine. Team members were surveyed to assess perceived impacts of the CL on rounds.
Results: Rounds with a CL (CLR) were associated with significantly increased median number of questions asked (5 questions CLR vs. 3 NCLR; p<0.01) and answered (3 CLR vs. 2 NCLR; p<0.01) compared to rounds without a CL (NCLR). CLR were also associated with increased mean time spent asking (1.39 minutes CLR vs. 0.52 NCLR; p<0.01) and answering (2.15 minutes CLR vs. 1.05 NCLR; p=0.02) questions. Rounding time per patient was not significantly different between CLR and NCLR. Questions during CLR were 2 times higher in adapted Fresno Test quality than during NCLR (p<0.01). Select participants described how the CL’s presence improved their EBM skills and care decisions.
Conclusions: Inpatient CLR were associated with more and improved clinical questioning and subjectively perceived to improve clinicians’ EBM skills. CLs may directly affect patient care; further study is required to assess this. CLs on inpatient rounds may be an effective means for clinicians to learn and use EBM skills.References
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Additional Files
- Appendix A: Direct observation instrument
- Appendix D: Rounding schedule
- Appendix B: Population, intervention, comparison, outcome (PICO) question submission form
- Appendix C: Population, intervention, comparison, outcome (PICO) information card
- Appendix E: Adapted rubric from the Fresno Test of Competence in Evidence-Based Medicine
- Appendix F: Post-rotation survey
