Evaluating the impact of clinical librarians on clinical questions during inpatient rounds

Authors

  • Riley Brian Medical Student, University of Chicago Pritzker School of Medicine, Chicago, IL
  • Nicola Orlov Assistant Professor of Pediatrics, Department of Academic Pediatrics, University of Chicago, Chicago, IL
  • Debra Werner Librarian for Science Instruction and Outreach and Biomedical Reference, John Crerar Library, University of Chicago, Chicago, IL
  • Shannon K. Martin Assistant Professor of Medicine, Department of Medicine, University of Chicago, Chicago, IL
  • Vineet M. Arora Assistant Professor of Medicine, Department of Medicine, University of Chicago, Chicago, IL
  • Maria Alkureishi Assistant Professor of Pediatrics, Department of Academic Pediatrics, University of Chicago, Chicago, IL

DOI:

https://doi.org/10.5195/jmla.2018.254

Keywords:

Librarians, Library Services, Medical Informatics, Evidence-Based Medicine, Education, Medical

Abstract

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.

Author Biographies

Riley Brian, Medical Student, University of Chicago Pritzker School of Medicine, Chicago, IL

Riley Brian is a medical student at the University of Chicago Pritzker School of Medicine.

Nicola Orlov, Assistant Professor of Pediatrics, Department of Academic Pediatrics, University of Chicago, Chicago, IL

Nicola Orlov is an Assistant Professor of Pediatrics at the University of Chicago.

Debra Werner, Librarian for Science Instruction and Outreach and Biomedical Reference, John Crerar Library, University of Chicago, Chicago, IL

Debra Werner is the Librarian for Science Instruction & Outreach and Biomedical Reference at the John Crerar Library at the University of Chicago.

Shannon K. Martin, Assistant Professor of Medicine, Department of Medicine, University of Chicago, Chicago, IL

Shannon Martin is an Assistant Professor of Medicine at the University of Chicago.

Vineet M. Arora, Assistant Professor of Medicine, Department of Medicine, University of Chicago, Chicago, IL

Vineet Arora is an Associate Professor of Medicine at the University of Chicago.

Maria Alkureishi, Assistant Professor of Pediatrics, Department of Academic Pediatrics, University of Chicago, Chicago, IL

Maria Alkureishi is an Assistant Professor of Pediatrics at the University of Chicago.

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Published

2018-04-05

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Original Investigation