Factors that impact on recruitment to randomised trials in health care : a qualitative evidence synthesis (Review)

Peer reviewedPublisher PD

Summary of findings tables for communicating key findings of systematic reviews

Peer reviewedPublisher PD

Factors that impact on recruitment to randomised trials in health care : a qualitative evidence synthesis (Protocol)

Peer reviewedPublisher PD

Methods of disseminating and translating research findings to health care professionals and other stakeholders

There are many barriers to the uptake of research findings including information overload, a lack of health literacy skills, a lack of access to research resources. Knowledge translation and dissemination and implementation research attempt to addresses the gap between evidence and decision-making, policy-making or practice. Derivative summarisation products and multi-component programmes can be used as tools in the knowledge translation process. My objectives were to: • assess studies of the effects of ‘Summary of findings’ (SoF) tables for communicating key findings of systematic reviews; • plan, design and implement an evidence-informed, theory-driven initiative for health care professionals, called Evidence Rounds, which disseminates evidence, and promotes implementation and evidence-informed practice; • describe the processes, mechanisms and contextual factors involved in the implementation of Evidence Rounds; • report follow up data regarding the impact of Evidence Rounds on clinical practice and local guidance; and • explore the perspectives of the key stakeholder group (HCPs) who attended or participated in Evidence Rounds, and identify their preferences to inform the development of future initiatives. Paper one is a Cochrane systematic review assessing studies of the effects of ‘Summary of findings’ tables on communicating key findings of systematic reviews of healthcare interventions to any potential user e.g. patients and their families or carers, health care professionals, policy makers, health systems managers, systematic review authors or other stakeholders. This is followed by a two-part series presenting the original research findings from the Evidence Rounds study conducted in collaboration with staff at University Hospital Galway. Paper two describes the complex process of planning, designing and implementing Evidence Rounds. I identify core components and adaptations undertaken throughout the duration of implementation. I report attendance figures at group sessions and web analytics from the dedicated website as well as follow up data regarding implementation of evidence. Collaboration was a key feature of the initiative and this paper is co-authored by five HCPs who were members of the implementation team. I used the Template for Intervention Description and Replication (TIDieR) checklist to describe the initiative. I detail the implementation process by applying Lavis’s (2003) organising framework for knowledge transfer. In Paper three, I report the findings of focus groups and interviews with HCPs who attended or presented at Evidence Rounds. I ask them to identify barriers and facilitators to attending and presenting at the initiative, the usefulness of modes of delivery used in our implementation strategy, and how the initiative could be improved and made more sustainable. I employed the framework approach by Ritchie and Spencer (1994) to analyse the data. This PhD research indicates that single and multi-component knowledge translation innovations have potential to improve evidence use and uptake by clinicians and other stakeholders as methods and tools to summarise and synthesise findings. This thesis contributes to the field of knowledge translation by presenting the first systematic review assessing studies of the effectiveness of ‘Summary of findings’ tables. Paper 2 introduces and describes the implementation process of a novel and complex initiative that led to changes in clinical guidance and practice. The findings reported in Paper 3 contribute to the understanding of individual and organisational-level contextual factors relating to multicomponent knowledge translation strategies experienced by health care professionals. This thesis strengthens the need for future research to further explore both approaches, particularly around the issues of design, development and tailoring to target audiences, to increase the likelihood of adoption and evidence use

One-shot library instruction sessions may not increase student use of academic journals or diversity of sources

Objective - To assess the effect of one-shot library research workshops focused on database searching on student coursework bibliographies. Design - Comparative bibliometric analysis of student bibliographies. Setting - Career and Transfer Program at a community college in Illinois, United States of America. Subjects - Students taking an English 101 course. Methods - During the study, 39 sections of English 101 occurred. An optional library instruction session was offered to faculty and as a result students from 18 sections participated. Each session consisted of a 45-minute lecture and 30 minutes of independent research time. The librarian delivering the session introduced students to keyword searching and demonstrated the online library catalogue and two core electronic databases; Academic Search Complete, and Opposing Viewpoints in Context (OVC), and other databases of their choosing. Students in each session were required to submit a variety of assignments in an exit portfolio at the end of the semester. Sections of students were excluded if the instructors did not submit the students' portfolios and they no longer taught at the community college, making it impossible to track down the portfolios. Exclusion also occurred in cases where sections were taught by the researchers. Seventeen sections who had attended library instruction group and 14 sections who had not attended the library instruction group were included in the study and randomised. Researchers evaluated portfolios according to the following criteria: whether the student who submitted the portfolio attended library instruction; whether their portfolio earned a pass or fail mark; total number of citations in bibliographies; number of each type of source (e.g., book, journal, Internet resource, or other; and dates of sources). Main Results - Data were collected from 115 portfolios submitted by students who had attended a library session and 92 portfolios from students who had not attended a library session. Student pass or fail status was not reported. Attending library instruction did not have a significant effect on the mean number of total citations: 5.513 for attendees vs. 6.076 for non-attendees. Of 205 student portfolios evaluated, there was no difference in the number of types of resources used by students who had library instruction (2.3 +/- 0.1) and those who had none (2.2 +/- 0.1; p > 0.05). Conclusion - The library instruction sessions did not increase the use of academic journals or the diversity of sources used. However, students were more likely to use library sources if they attended training. The authors recommend that demonstrating multiple databases should be covered in later sessions and more conceptual information literacy instruction should be the first step. Librarians could teach the value of different types of sources; connect the sources to the tools needed to locate and access them; and demonstrate how to effectively evaluate sources. The authors recommend further research to evaluate objectives, content and outcomes of this type of library instruction

Methods of disseminating and translating research findings to health care professionals and other stakeholders

There are many barriers to the uptake of research findings including information overload, a lack of health literacy skills, a lack of access to research resources. Knowledge translation and dissemination and implementation research attempt to addresses the gap between evidence and decision-making, policy-making or practice. Derivative summarisation products and multi-component programmes can be used as tools in the knowledge translation process. My objectives were to: • assess studies of the effects of ‘Summary of findings’ (SoF) tables for communicating key findings of systematic reviews; • plan, design and implement an evidence-informed, theory-driven initiative for health care professionals, called Evidence Rounds, which disseminates evidence, and promotes implementation and evidence-informed practice; • describe the processes, mechanisms and contextual factors involved in the implementation of Evidence Rounds; • report follow up data regarding the impact of Evidence Rounds on clinical practice and local guidance; and • explore the perspectives of the key stakeholder group (HCPs) who attended or participated in Evidence Rounds, and identify their preferences to inform the development of future initiatives. Paper one is a Cochrane systematic review assessing studies of the effects of ‘Summary of findings’ tables on communicating key findings of systematic reviews of healthcare interventions to any potential user e.g. patients and their families or carers, health care professionals, policy makers, health systems managers, systematic review authors or other stakeholders. This is followed by a two-part series presenting the original research findings from the Evidence Rounds study conducted in collaboration with staff at University Hospital Galway. Paper two describes the complex process of planning, designing and implementing Evidence Rounds. I identify core components and adaptations undertaken throughout the duration of implementation. I report attendance figures at group sessions and web analytics from the dedicated website as well as follow up data regarding implementation of evidence. Collaboration was a key feature of the initiative and this paper is co-authored by five HCPs who were members of the implementation team. I used the Template for Intervention Description and Replication (TIDieR) checklist to describe the initiative. I detail the implementation process by applying Lavis’s (2003) organising framework for knowledge transfer. In Paper three, I report the findings of focus groups and interviews with HCPs who attended or presented at Evidence Rounds. I ask them to identify barriers and facilitators to attending and presenting at the initiative, the usefulness of modes of delivery used in our implementation strategy, and how the initiative could be improved and made more sustainable. I employed the framework approach by Ritchie and Spencer (1994) to analyse the data. This PhD research indicates that single and multi-component knowledge translation innovations have potential to improve evidence use and uptake by clinicians and other stakeholders as methods and tools to summarise and synthesise findings. This thesis contributes to the field of knowledge translation by presenting the first systematic review assessing studies of the effectiveness of ‘Summary of findings’ tables. Paper 2 introduces and describes the implementation process of a novel and complex initiative that led to changes in clinical guidance and practice. The findings reported in Paper 3 contribute to the understanding of individual and organisational-level contextual factors relating to multicomponent knowledge translation strategies experienced by health care professionals. This thesis strengthens the need for future research to further explore both approaches, particularly around the issues of design, development and tailoring to target audiences, to increase the likelihood of adoption and evidence use

Medical school librarians need more training to support their involvement in evidence based medicine curricula

Objective To describe the self-perceived role of librarians in developing evidence based medicine (EBM) curricula and identify their current and desired level of training to support these activities. Design Multi-institutional qualitative study. Setting Nine medical schools in Canada and the United States of America. Subjects Nine librarians identified by medical school faculty as central to the provision of EBM training for medical students at their institution. Methods The researchers designed a semi structured interview schedule based on a review of the literature and their own experiences as librarians teaching EBM. The topics covered were; librarians' perceptions of their roles in relation to the curriculum, the training required to enable them to undertake these roles, and their professional development needs. The interviews were conducted by telephone and then audio recorded and transcribed verbatim. The authors present five main themes; curricular design, curricular deployment, curricular assessment, educational training, and professional development. Profiles were developed for each participant based on the latter two themes and from this information common characteristics were identified. Main Results The participants described the importance of collaboration with faculty and student bodies when designing a curriculum. Information literacy instruction and specifically literature searching and forming a research question were taught by all of the participants to facilitate curricular deployment. Some of the librarians were involved or partly involved in curricular assessment activities such as formulating exam questions or providing feedback on assignments. Educational training of participants varied from informal observation to formal workshops offered by higher education institutions. All librarians indicated a willingness to partake in professional development focused on teaching and EBM. The subjects' perceptions of their roles are supported by Dorsch and Perry's themes of the librarian's role in curricular design, deployment, and assessment. The educational training received by participants included formal training and experiential and self directed learning activities. Finally, the librarians identified their professional development needs going forward. The majority of participants indicated that they would like to attend workshops run by universities or the Medical Library Association. Others wanted to invite and host guest speakers at their own institutions. Librarians identified financial restraints and geographic location as barriers to attending professional development events. Conclusion Librarians can be actively involved in the delivery of EBM instruction in medical schools. However, they require additional educational opportunities to enable them to develop in this role. Online training could be a viable option for self-directed learning to overcome financial and geographic constraints

Medical Students in the United States Reveal Their Ideal Expectations to Help Planners of a New Library

A Review of: Aronoff, N. (2016). Surveying medical students to gauge library use and plan for a new medical library. Medical Reference Services Quarterly, 35(2), 187-203. http://dx.doi.org/10.1080/02763869.2016.1152144 Abstract Objective – To help plan for a new library by exploring student use of existing library services and identifying their priorities for the new space. Design – Online survey, sent via email. Setting – Medical school at a university in New York. Subjects – 585 medical students. Methods – The researchers emailed a 45-item online survey to all medical students enrolled at the school. Responses were anonymised and all questions were non-mandatory. Main results – 27% of students (157 out of 585) took part in the survey by answering at least one question. The questions were categorised into the following six topic areas: 1. Use of space and expectations for the new library space: More than half of the participants (67%) indicated that they rarely or never came to the library during the academic year in question. Of the students who reported frequenting the library on a daily, weekly, or monthly basis, the majority indicated that they preferred independent study to group study. The following resources were ranked as very important for an ideal library space: sufficient electrical outlets, strong wireless connectivity, printing facilities, individual and quiet study spaces, comfortable seating, online resources, computers, windows/natural light, and group study spaces. Open-ended responses indicated that students desire close proximity to food and beverage services, large study tables to accommodate reading materials and technology, improved opening hours, and satisfactory bathroom facilities. 2. Where medical students study: Of the participants, one third of students reported studying at home, 21% chose to describe the physical characteristics of their place of study rather than name a place, 18% of students studied in multiple places, and 16% studied in the library. The remainder studied in another library, cafés, or other locations on campus. Online resource use was much higher than borrowing figures with the majority of students indicating that they had never borrowed a print book (77%), a reserve book (90%), or a DVD (96%). In addition, 92% indicated never consulting a print reference book. Online resources were used at least once a semester by 90% of students. 3. Resource use and expectations: Most students used lecture notes, presentations, websites, personal copies of books, clinical decision support tools, online tutorials or video content, electronic journal articles, recorded video or audio lectures, medical apps, electronic books, clinical practice guidelines, or pocket manuals or pocket guides. Print books from the library were the least exploited resources with only 13% of students reporting their use. 83% of students ranked online resources as the most important feature of an ideal library. 4. Equipment use and expectations for equipment and technology: In terms of equipment required for an ideal library space, 88% of students indicated printers, 78% computers, and 69% scanners. Therefore, easy access to electrical outlets and strong wireless connections were hugely important. 5. Services: Book or article requests were only sought monthly or once per semester by 18% and 7% of students respectively. More than half of students (54%) felt that assistance from a librarian was a very important or important feature of an ideal library space. However, 68% never consulted a librarian in the past and of those who did they did not do so frequently. In-person or email contact with a librarian was preferred over other methods of communication. 52% of respondents were not interested in training provided by the library. Of those who were, online and virtual training was preferred by 51% when compared to face to face instruction. 6. Additional Feedback: The vast majority of students (90%) indicated that they would be interested in using the library outside of the existing opening hours of 9:00a.m. to 5:00p.m., Monday to Friday. Regarding the overall library service, 53% of students were satisfied or very satisfied, 26% were neither satisfied nor unsatisfied, and 21% were unsatisfied or very unsatisfied. Lighting, electrical outlets, and having a place to get food and drink were also prioritized by students in this section of the survey. Conclusion – The author concluded that since convenience was considered an important factor by students when choosing their place of study, the increased proximity of the new library should attract more students. In accordance with student preferences, both individual and group study spaces are planned for the new library. Sufficient electrical outlets and a glass façade increasing the amount of natural light will feature in the building. Core textbooks and reference books will be made available in a small area onsite despite the fact that this did not feature in the original plan. Computers and printers will also feature in the new library for students who require equipment to facilitate their study activities. A computer lab to accommodate 30 students will enable face to face instruction on library resources. A professional librarian will not be based at the new library. In-person services will be available at another library with sufficient staffing

Medical school librarians need more training to support their involvement in evidence based medicine curricula

Objective To describe the self-perceived role of librarians in developing evidence based medicine (EBM) curricula and identify their current and desired level of training to support these activities. Design Multi-institutional qualitative study. Setting Nine medical schools in Canada and the United States of America. Subjects Nine librarians identified by medical school faculty as central to the provision of EBM training for medical students at their institution. Methods The researchers designed a semi structured interview schedule based on a review of the literature and their own experiences as librarians teaching EBM. The topics covered were; librarians\u27 perceptions of their roles in relation to the curriculum, the training required to enable them to undertake these roles, and their professional development needs. The interviews were conducted by telephone and then audio recorded and transcribed verbatim. The authors present five main themes; curricular design, curricular deployment, curricular assessment, educational training, and professional development. Profiles were developed for each participant based on the latter two themes and from this information common characteristics were identified. Main Results The participants described the importance of collaboration with faculty and student bodies when designing a curriculum. Information literacy instruction and specifically literature searching and forming a research question were taught by all of the participants to facilitate curricular deployment. Some of the librarians were involved or partly involved in curricular assessment activities such as formulating exam questions or providing feedback on assignments. Educational training of participants varied from informal observation to formal workshops offered by higher education institutions. All librarians indicated a willingness to partake in professional development focused on teaching and EBM. The subjects\u27 perceptions of their roles are supported by Dorsch and Perry\u27s themes of the librarian\u27s role in curricular design, deployment, and assessment. The educational training received by participants included formal training and experiential and self directed learning activities. Finally, the librarians identified their professional development needs going forward. The majority of participants indicated that they would like to attend workshops run by universities or the Medical Library Association. Others wanted to invite and host guest speakers at their own institutions. Librarians identified financial restraints and geographic location as barriers to attending professional development events. Conclusion Librarians can be actively involved in the delivery of EBM instruction in medical schools. However, they require additional educational opportunities to enable them to develop in this role. Online training could be a viable option for self-directed learning to overcome financial and geographic constraints