The Librarian’s Role in Evidence-Based Practice

Authors:

• Amanda Davis, MPH, RDN, CHES, Manager, Value Institute, MUSC Health, davisam@musc.edu
• Emily Brennan, MLIS, Research & Education Informationist, MUSC Libraries, brennane@musc.edu
• Debra Trogdon-Livingston, MLS, User Experience and Education Strategist, Region 2, NNLM, trogdonl@musc.edu

The COVID-19 pandemic thrust evidence-based practice (EBP) and the librarian’s role in identifying trustworthy sources of information into the public eye. Historically, the translation of research from bench to bedside has been 17 years [1]. The transmissibility and severity of the COVID-19 virus challenged traditional models of evidence translation to operate at a never-before-seen pace [2]. This forced health care and public health providers to make decisions based on limited and ever-changing evidence, which meant recommendations changed often. For example, CDC guidance for prevention and treatment of COVID-19 has been updated more than 40 times since the beginning of the pandemic [3]. As such, the pandemic has illustrated the importance of the practice and application of EBP in health care decision-making.

The librarian’s role has evolved over time, from merely supportive to a more collaborative role, and even leading the EBP charge in some cases. Within the five steps of the EBP process, librarians have expertise in forming clinical questions, searching the literature, identifying relevant evidence, and recommending critical appraisal tools. There are roles for librarians in EBP education, clinical work, and research and dissemination.

Academic librarians teach and assess the EBP skills of students, residents and fellows in undergraduate, graduate, and post-graduate education. Librarians are often embedded in curricular classes and serve on curriculum committees where they lend their expertise in education planning, assessment, and curriculum mapping. These curricula are often informed by association guidelines related to EBP expectations. For example, the Association of American Medical Colleges (AAMC) Core Entrustable Professional Activities (EPA) 7 indicates that all medical students, upon entering residency, should be able to “form clinical questions and retrieve evidence to advance patient care” [4]. The Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirement IV.A.5.c indicates that “residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning” [5]. Expertise in information literacy uniquely positions librarians to teach and assess EBP skills.

EBP activities with residents include retrieving literature during morning reports, teaching EBP concepts at noon conference or academic half day, teaching appraisal skills during journal clubs, and guiding residents through quality improvement projects. Librarians are equal partners on interprofessional teams, answering clinical questions at the point-of-care during rounds. Librarians serve on a wide variety of clinical committees including Shared Governance at Magnet hospitals, EBP Advisory Committees, and other committees related to quality, patient safety, and EBP. At Magnet hospitals, librarians guide nurses through EBP projects for Shared Governance and clinical ladder advancement. At all hospitals, there are opportunities for librarians to partner with clinicians to conduct literature reviews for the development of hospital guidelines, policies and procedures, clinical decision support tools, and evidence briefs. 

The EBP methodology relies on the steady publication of new and novel findings to promote innovation. Without the dissemination of results, new research cannot be implemented into practice at the bedside. As such, librarians have a role and responsibility to ensure that evidence-based work is properly documented and disseminated. Librarians educate faculty on scholarly communication, institutional repositories, and other issues. This includes registering evidence synthesis protocols, co-authoring guidelines, systematic reviews, and other publication types, and disseminating that work through professional conferences and publications.

Using evidence to inform decision-making has been an integral component of healthcare for decades. However, the way this methodology is implemented in practice is always evolving. This creates an opportunity for the librarian’s role in the EBP process to evolve in tandem.

Learn more about EBP in the Introduction to Evidence Based Practice Webinar Series hosted by the Network of the National Library of Medicine:  https://linktr.ee/nnlmregion2.

References

[1] Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011 Dec;104(12):510-20. doi: 10.1258/jrsm.2011.110180. PMID: 22179294; PMCID: PMC3241518.American Public Health Association & National Academies of Science.

[2] Hanney SR, Wooding S, Sussex J, Grant J. From COVID-19 research to vaccine application: why might it take 17 months not 17 years and what are the wider lessons? Health Res Policy Syst. 2020 Jun 8;18(1):61. doi: 10.1186/s12961-020-00571-3. PMID: 32513202; PMCID: PMC7276964.

[3] American Public Health Assocaiton and National Academy of Medicine (APHA & NAS). COVID-19 Conversations: Responding to COVID-19: A Science-Based Approach.<https://www.covid19conversations.org. Accessed 14 February 2022>.

[4] Association of American Medical Colleges (AAMC). Core entrustable professional activities for entering residency: EPA 7 toolkit: form clinical questions and Retrieve evidence to advance patient care. <https://www.aamc.org/media/20161/download?attachment>.

[5] Accreditation Council for Graduate Medical Education (ACGME). ACGME common program requirements.  <http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2017-07-01.pdf>.