Do Clinical Librarians Matter? The First Randomized Controlled Trial in Librarianship

Abstract

A review of:
Marshall, Joanne Gard, and Victor R. Neufeld. “A Randomized Controlled Trial of Librarian Educational Participation in Clinical Settings.” Journal of Medical Education 56.5 (1981): 409-16.

Objectives – To determine whether clinical librarian services cause healthcare providers to change their information seeking behaviors. To evaluate librarians’ educational roles for clinicians, patients, and patients’ families.

Design – Randomized controlled trial.

Setting – An academic, health-sciences-center, teaching hospital in Canada.

Subjects – A total of eight teams, each consisting of at least eight members who represented at least three different types of health professionals. Four teams (rheumatology, obstetrics, neurology, and pediatrics) were randomized into the intervention group to receive clinical librarian services for a six-month period, and four teams (hematology, diabetic day care, pain clinic, and community psychiatry) were randomized into the control group that did not receive clinical librarian services.

Methods – Two half-time clinical librarians attended the intervention groups’ rounds, clinics, and conferences identified as having educational components or where questions would likely arise related to patient care. The two clinical librarians handled 600 perceived or actual information requests, delivered 1,200 documents, and provided over 3,000 references during the twelve-month study period of September 1978 to August 1979. The typical service consisted of the clinical librarian securing one or two articles relevant to the question raised along with pertinent references placed in a “hot topics” ring binder located in the clinical wards. Healthcare providers were alerted to or reminded about the clinical librarian service through a brochure and an exhibit. The brochure also advertised the clinical librarian service to patients or their families. Approximately 24% of all information requests fielded by the clinical librarians originated from patients or their families. The remaining information requests originated from physicians (40%), allied health professionals (21%), and nurses (15%) belonging to these interdisciplinary intervention group teams.

Main Results – Trained impartial interviewers conducted in-depth interviews with members of both the intervention group teams and the control group teams immediately following the first six-month study period and then again three months after the end of the study period. Following the initial six months of the study period, 67% of the members of the intervention group compared to 37% of the members of the study group used the library’s reference services. Three months after the study period had ended, 76% of the members of the intervention group compared to 49% of the members of the study group had used the reference services. The authors reported in a one-sentence page note that these findings were statistically significant beyond the .05 level as measured by chi-square and analysis of variance tests. Three months after the study period had ended, 60% of the members of the intervention group compared to 38% of the members of the study group reported rating highly the use of library resources. In addition, three months after the study period had ended, 36% of the members of the intervention group compared to 27% of the members of the study group reported rating highly the use of reference librarians. Although patients or their families were generally positive in rating the clinical librarians’ services, they proved to be a difficult population upon which to conduct a comprehensive follow-up evaluation study once patients had left the hospital.

Conclusion – The authors conclude that the clinical librarian services to the four intervention groups had changed the group members’ information seeking behavior.