"We Don't Like Unanswered Questions”: Information Practices of Students Transitioning to Clinical Education
DOI:
https://doi.org/10.18438/eblip30714Abstract
Objective – Health professions students are awash in large quantities of information, often conflicting, as they learn their professions. In order to navigate this information, librarians often engage with these students, usually in their didactic phase of education; however, the way students use information clinically may not be the same as the way they learn to do so in the classroom. This study investigated the information practices and experiences of health professions students early in the clinical phase of their education, in order to answer the following research questions: What are the information practices of health professions students at the transition to clinical education? How do these students understand how their practices have developed over their education?
Methods – A purposive sample of learners from six health-focused professional programs participated in individual in-depth interviews, created timelines, and completed follow-up diary entries. The data were analyzed using inductive thematic analysis.
Results – Students’ information practices are characterized by three themes. They are motivated to build competency to provide patient care; they operate in dual roles as student and clinician; and they navigate ambiguity, uncertainty, and doubt. They were able to describe the way they experienced information, problems they solved, and the development over time. Taken as a whole, this describes student experience with information as a method of making meaning from previous experience and learning with a focus on applying what they know and learn to improve patients’ lives and health.
Conclusion – Insight into these students’ practices, including affective and social domains of practice, can inform librarian-led instruction and outreach within health professions and other professional programs. Linking education about information to students’ motivations to provide excellent patient care and their desire to operate scientifically in a world of doubt may provide more relevant instruction, leading to transference of learning to new environments.
Downloads
References
Adams, N. E. (2014). A comparison of evidence-based practice and the ACRL information literacy standards: Implications for information literacy practice. College & Research Libraries, 75(2), 232–248. https://doi.org/10.5860/crl12-417
Association of American Medical Colleges. (2024). Total physicians in all specialties – 2023. U.S. Physician Workforce Data Dashboard. https://www.aamc.org/data-reports/report/us-physician-workforce-data-dashboard.
Atherley, A., Dolmans, D., Hu, W., Hegazi, I., Alexander, S., & Teunissen, P. W. (2019). Beyond the struggles: A scoping review on the transition to undergraduate clinical training. Medical Education, 53(6), 559–570. https://doi.org/10.1111/medu.13883
Bazrafkan, L., Hayat, A. A., Abbasi, K., Bazrafkan, A., Rohalamini, A., & Fardid, M. (2017). Evaluation of information literacy status among medical students at Shiraz University of Medical Sciences. Journal of Advances in Medical Education & Professionalism, 5(1), 42–48.
Biemans, B. L. H., Koenders, N., de Bie, R. A., Sieben, J. M., & Hoogeboom, T. J. (2024). The struggle of dealing with uncertainty: A qualitative, phenomenological study about how Dutch novice physical therapists experience their transition from student to professional. Annals of Medicine, 56(1), Article 2399755. https://doi.org/10.1080/07853890.2024.2399755
Boruff, J. T., & Harrison, P. (2018). Assessment of knowledge and skills in information literacy instruction for rehabilitation sciences students: A scoping review. Journal of the Medical Library Association, 106(1), 15–37. https://doi.org/10.5195/jmla.2018.227
Brennan, E. A., Ogawa, R. S., Thormodson, K., & von Isenburg, M. (2020). Introducing a health information literacy competencies map: Connecting the Association of American Medical Colleges Core Entrustable Professional Activities and Accreditation Council for Graduate Medical Education Common Program Requirements to the Association of College & Research Libraries Framework. Journal of the Medical Library Association, 108(3), 420–427. https://doi.org/10.5195/jmla.2020.645
Brennan, N., Edwards, S., Kelly, N., Miller, A., Harrower, L., & Mattick, K. (2014). Qualified doctor and medical students’ use of resources for accessing information: What is used and why? Health Information and Libraries Journal, 31(3), 204–214. https://doi.org/10.1111/hir.12072
Chi, S.-Y., Tsai, Y.-S., Fang, T.-P., Tung, T.-H., & Chi, C.-C. (2021). Evidence‐searching capability among health care professionals: A comparative study. BMC Medical Education, 21, Article 134. https://doi.org/10.1186/s12909-021-02565-3
Clark, S. (2014). Exploring the lived information seeking experiences of mature students. Journal of Information Literacy, 8(1), 58–84. https://doi.org/10.11645/8.1.1846
Conlogue, B. C. (2019). Information literacy instruction for pharmacy students: A pharmacy librarian reflects on a year of teaching. Journal of the Medical Library Association, 107(1), 98–102. https://doi.org/10.5195/jmla.2019.522
Daei, A., Soleymani, M. R., Ashrafi‐rizi, H., Kelishadi, R., & ZarghamBoroujeni, A. (2021). Personal, technical and organisational factors affect whether physicians seek answers to clinical questions during patient care: A literature review. Health Information and Libraries Journal, 38(2), 81–96. https://doi.org/10.1111/hir.12323
Dervin, B., & Naumer, C. M. (2018). Sense-making. In J. D. McDonald & M. Levine-Clark (Eds.), Encyclopedia of library and information sciences: Vol. 6. (4th edition, pp. 4113–4124). CRC Press.
Giesen, J., Bakker-Jacobs, A., van Vught, A., Berings, M., Vermeulen, H., & Huisman-de Waal, G. (2024). What is needed for nurses to work with evidence-based practice? A qualitative study. Contemporary Nurse, 60(6), 659–672. https://doi.org/10.1080/10376178.2024.2369660
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822X05279903
Heer, B. R., Gillette, C., Geary, A., & McDaniel, M. J. (2024). Clinical physician assistant students’ perceptions of evidence-based medicine resources: A cross-sectional examination. Medical Reference Services Quarterly, 43(2), 119–129. https://doi.org/10.1080/02763869.2024.2329012
Ilic, D., & Forbes, K. (2010). Undergraduate medical student perceptions and use of evidence based medicine: A qualitative study. BMC Medical Education, 10, Article 58. https://doi.org/10.1186/1472-6920-10-58
Kennie-Kaulbach, N., Cameron, K., Humphrey, M., Donovan, C., Isenor, J. E., Toombs, K., & Fernandes, O. A. (2023). Pharmacy student contribution to direct patient care during inpatient hospital experiential rotations: A scoping review. International Journal of Pharmacy Practice, 31(6), 585–593. https://doi.org/10.1093/ijpp/riad057
Kocevar-Weidinger, E., Cox, E., Lenker, M., Pashkova-Balkenhol, T., & Kinman, V. (2019). On their own terms: First-year student interviews about everyday life research can help librarians flip the deficit script. Reference Services Review, 47(2), 169–192. https://doi.org/10.1108/RSR-02-2019-0007
Laera, E., Gutzman, K., Spencer, A., Beyer, C., Bolore, S., Gallagher, J., Pidgeon, S., & Rodriguez, R. (2021). Why are they not accessing it? User barriers to clinical information access. Journal of the Medical Library Association, 109(1), 126–132. https://doi.org/10.5195/jmla.2021.1051
Lowe, M. S., Stone, S. M., Maxson, B. K., Snajdr, E., & Miller, W. (2020). Boolean redux: Performance of advanced versus simple Boolean searches and implications for upper-level instruction. The Journal of Academic Librarianship, 46(6), Article 102234. https://doi.org/10.1016/j.acalib.2020.102234
Mishra, M., Ramesh, D. B., Nanda, S., Jena, S., & Khuntia, S. K. (2015). Study on information need and seeking behavior of the health science students of an Indian deemed university. Library Philosophy and Practice, Article 1318. https://digitalcommons.unl.edu/libphilprac/1318/
Moffett, J., Hammond, J., Murphy, P., & Pawlikowska, T. (2021). The ubiquity of uncertainty: A scoping review on how undergraduate health professions’ students engage with uncertainty. Advances in Health Sciences Education, 26(3), 913–958. https://doi.org/10.1007/s10459-021-10028-z
National Center for Health Workforce Analysis. (2024). State of the U.S. health care workforce, 2024. Health Resources & Services Administration. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/state-of-the-health-workforce-report-2024.pdf
Nicholson, J., Kalet, A., van der Vleuten, C., & de Bruin, A. (2020). Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation. Journal of the Medical Library Association, 108(2), 219–228. https://doi.org/10.5195/jmla.2020.875
Olsen, N. R., Bradley, P., Lomborg, K., & Nortvedt, M. W. (2013). Evidence based practice in clinical physiotherapy education: A qualitative interpretive description. BMC Medical Education, 13, Article 52. https://doi.org/10.1186/1472-6920-13-52
Open AI. (2022, November 30). Introducing ChatGPT. https://openai.com/index/chatgpt/
Savolainen, R. (2007). Information behavior and information practice: Reviewing the “umbrella concepts” of information‐seeking studies. The Library Quarterly, 77(2), 109–132. https://doi.org/10.1086/517840
Savolainen, R. (2020). Elaborating the sensory and cognitive-affective aspects of information experience. Journal of Librarianship and Information Science, 52(3), 671–684. https://doi.org/10.1177/0961000619871595
Schvaneveldt, N., Stone, S. M., Brody, E. R., Clairoux, N., Lubker, I. M., Nevius, A. M., Porcello, L., & Bissram, J. S. (2021). Aligning information literacy and evidence-based dentistry concepts in a rubric to improve dental education. Medical Reference Services Quarterly, 40(2), 236–248. https://doi.org/10.1080/02763869.2021.1912580
Schweikhard, A. J., Hoberecht, T., Peterson, A., & Randall, K. (2018). The impact of library tutorials on the information literacy skills of occupational therapy and physical therapy students in an evidence-based practice course: A rubric assessment. Medical Reference Services Quarterly, 37(1), 43–59. https://doi.org/10.1080/02763869.2018.1404388
Sharun, S. (2021). Practicing information literacy: Practicum students negotiating information practice in workplace settings. The Journal of Academic Librarianship, 47(1), Article 102267. https://doi.org/10.1016/j.acalib.2020.102267
Silva, A. M. da, Valentim, D. P., Martins, A. L., & Padula, R. S. (2024). Instruments to assess evidence-based practice among health care professionals: A systematic review. Health Education & Behavior, 51(3), 467–476. https://doi.org/10.1177/10901981231170154
Smith, R. (2003). Thoughts for new medical students at a new medical school. BMJ, 327(7429), 1430–1433. https://doi.org/10.1136/bmj.327.7429.1430
SocioCultural Research Consultants. (2024). Dedoose (Version 9.2.22) [Computer software]. https://www.dedoose.com/
Straub-Morarend, C. L., Wankiiri-Hale, C. R., Blanchette, D. R., Lanning, S. K., Bekhuis, T., Smith, B. M., Brodie, A. J., Oliveira, D. C., Handysides, R. A., Dawson, D. V., & Spallek, H. (2016). Evidence-based practice knowledge, perceptions, and behavior: A multi-institutional, cross-sectional study of a population of U.S. dental students. Journal of Dental Education, 80(4), 430–438. https://doi.org/10.1002/j.0022-0337.2016.80.4.tb06101.x
Suarez-Lledo, V., & Alvarez-Galvez, J. (2021). Prevalence of health misinformation on social media: Systematic review. Journal of Medical Internet Research, 23(1), Article e17187. https://doi.org/10.2196/17187
Swanberg, S. M., Dennison, C. C., Farrell, A., Machel, V., Marton, C., O’Brien, K. K., Pannabecker, V., Thuna, M., & Holyoke, A. N. (2016). Instructional methods used by health sciences librarians to teach evidence-based practice (EBP): A systematic review. Journal of the Medical Library Association, 104(3), 197–208. https://doi.org/10.3163/1536-5050.104.3.004
U.S. Bureau of Labor Statistics. (2025, April 18). Occupational outlook handbook. U.S. Department of Labor. https://www.bls.gov/ooh/
Vijn, T. W., Fluit, C. R. M. G., Kremer, J. A. M., Beune, T., Faber, M. J., & Wollersheim, H. (2017). Involving medical students in providing patient education for real patients: A scoping review. Journal of General Internal Medicine, 32(9), 1031–1043. https://doi.org/10.1007/s11606-017-4065-3
Wahoush, O., & Banfield, L. (2014). Information literacy during entry to practice: Information-seeking behaviors in student nurses and recent nurse graduates. Nurse Education Today, 34(2), 208–213. https://doi.org/10.1016/j.nedt.2013.04.009
Waltz, M. J., Moberly, H. K., & Carrigan, E. E. (2020). Identifying information literacy skills and behaviors in the curricular competencies of health professions. Journal of the Medical Library Association, 108(3), 463–479. https://doi.org/10.5195/jmla.2020.833
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nena Schvaneveldt

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Creative Commons-Attribution-Noncommercial-Share Alike License 4.0 International applies to all works published by Evidence Based Library and Information Practice. Authors will retain copyright of the work.