Medical Library Education: Critical Appraisal: An Evolving Topic in Health Sciences

Saturating a broad swath of current literature surrounding medical library education today—at least at the academic level—are the similar principles of evidence-based medicine (EBM) and evidence-based practice (EBP). A leading proponent of EBM and one of its chief devotees and practitioners of modern times is David Sackett. Sackett was particularly concerned, it seems, with the need for colleagues and other professionals to carefully scrutinize information quality, especially information supplied in the confines of science and medicine [1]. This appraisal process is, in fact, a major component of EBM and calls for a well-developed—read “critical”—assessment strategy.

Adding immeasurably to the consequence of critical assessment skills in medicine and the health sciences is the very real possibility that human lives can be significantly impacted or altered by professionals who base important decisions on “evidence” that may or may not be sound. Thus, assessment is quite possibly the most weighty phase of the entire EBM process, making learning it and teaching it vital to the primary constituents of health sciences libraries throughout the United States and beyond. It must be said, however, that EBM covers additional foundational territory, including the construction of a population, intervention, comparison, outcome (PICO) question and a subsequent clinical query.

Many, many are the webinars, online courses, tutorials, and more that have been (and continue to be) devoted to teaching librarians how to teach every aspect of EBM to medical students, nurses, and other students and professionals. Consequently, it does sometimes appear as though critical appraisal training directed at health sciences librarians in the United States is often folded into the broader topic of EBM. Nonetheless, the effort to facilitate, let us say, an optimal level of assessment awareness in the health sciences has seen the creation and the utilization of such instruments as critical appraisal tools (CATs) to guide the process. Journal clubs at academic health sciences institutions also have somewhat of a reputation for championing critiquing processes among members [2], and “across the pond” in the United Kingdom, critical appraisal skills programmes (CASPs) are commonly used to cultivate assessment as an activity and worthwhile pursuit in and of itself.

Joseph Costello, an informationist associated with Western Michigan University’s Homer Stryker M.D. School of Medicine, perceives a very real need in the health sciences for librarians to offer critical appraisal instruction that goes beyond differences in study designs and study methods, though a solid understanding of both concepts is essential. However, Costello takes things a step further, outlining a multipronged approach to library instruction that is aimed at equipping medical and health care professionals with the necessary information-seeking savvy to not only make wise decisions based on relevant information, but also to aid in discerning fake journals (i.e., predatory journals or publishers) from the genuine article—no pun intended [3]. Costello embraces an overarching holistic understanding of the sometimes shifting environment that underpins and shapes the health care landscape as a whole [3].

The reality is that support for such empowerment would need to come from within the library profession via structured educational opportunities proffered through professional associations and through academia itself. In the meantime, New York Medical College has established a “Critical Appraisal Institute” to support librarians in this area. The institute is receiving funding in the form of a grant from National Network of Libraries of Medicine’s Middle Atlantic Region.* What will carry the day will be, of course, attitudes in the library profession. That is as it should be: that librarians working in the health sciences weigh in and mold the future of library instruction on this topic. Is enough being done to promote critical appraisal training for librarians in the health sciences at the present time? What should the parameters of future critical appraisal training be: what is and what is not realistic?

References

1. Mellis C. Evidence-based medicine: what has happened in the past 50 years? J Paediatr Child Health. 2015 Jan;51(1):65–8. DOI: http://dx.doi.org/10.1111/jpc.12800.
2. Fitzgibbons M, Kloda L, Miller-Nesbitt A. Exploring the value of academic librarians’ participation in journal clubs. Coll Res Libr. 2017 Sep;78(6):774–88. DOI: http://dx.doi.org/10.5860/crl.78.6.774.
3. Costello J. Updating professional development for medical librarians to improve our evidence-based medicine and information literacy instruction. J Med Libr Assoc. 2018 Jul;106(3):383–6. DOI: http://dx.doi.org/10.5195/jmla.2018.386.

* Editor’s Note: This information has been corrected from stating that MLA had established the Critical Appraisal Institute.