journal club, tool of change asted at 32_2_nov2012final
DESCRIPTION
Presentation ASTED 2012, Lessons learned from Nursing Journal Club, survey and change of educational tool.TRANSCRIPT
The Journal Club: A Tool of Change? Le Club de lecture: Un outil de changement ?
Teodora Constantinescu, MLIS & Renée Lavoie, RN, BSc
Colloque ASTED Montreal, le 2 Novembre 2012
OUTLINE
• Background
• Objective
• Methods• Survey
• Results
• Discussion
BACKGROUND
IN THE BEGINNING…
• Serendipity and opportunity …
• Nurse-librarian conversation (spring 2011)
ACTORS
• Nurses
• Librarians
• Organization (Institution)
NEEDS AND OBJECTIVES OF PSYCHIATRY NURSES AT JGH
• Forum to meet regularly
• Discuss literature on issues of interest
• Keep up to date
• Learn together (knowledge, skills)
• Nurses in control of process
• Improve patient outcome
EMPOWERMENT
JOURNAL CLUBS
• “The most compelling reason to start a journal club is to keep abreast of the latest nursing research”
• “A way of improving practice by ensuring patient care is based on most accurate and current information” (Luby, 2006)
• Increase research utilization1875 - Sir William Osler: first formal medical journal club in North America
HLWiki: Journal Clubs : http://hlwiki.slais.ubc.ca/index.php/Journal_clubs
EVIDENCE BASED PRACTICE (EBP) PROCESS
PATIENT
CENTERED
Journal Club
Library training (ACRL Information
Literacy)
Organizational Procedures
EBP LIMITATIONS
• Evidence
–Body of research varies in quantity and quality
• Implementation
– Time
– Lack of knowledge and skills
– Lack of incentives
– Organizational culture
• Measurement of outcomes
OUTLINE
• Background
• Methods• Survey
• Results
• Discussion
METHODSThe Journal Club ObservationRe-evaluation The Survey
JGH Psychiatry Nurses Journal Club
• Monthly meetings
• Over 60% participation rate
• 2 nurse coordinators / club facilitators
• Topics chosen by the group
• Presenter: volunteer basis
• Article selected by presenter with nurse coordinator
LIBRARIAN’S ROLE
• Collaborator
• Search the literature
• Present “vignettes”
• Reflective Observer
• No influence on choice of topic or choice of article to discussed
OBSERVATIONS • Nurses driven process
• Questions asked: general not specific
• Information chosen : reviews, reference
• Preference: summarized and concrete applications
• Some difficulty with computer and searching skills
• Some difficulty: research methodologies and critical appraisal
Enthusiasm for learning
Engaged in discussions
REFLECTION
• Evaluate the gap
• Is the group ready for searching , critically assessing and integrating the research into practice? – Knowledge, skills, values
• Re-evaluate the pertinence of journal club as a learning tool (blind spot)
LITERATURE SEARCH : NURSES AND INFORMATION SEEKING
• Information seeking behavior, O’Leary (2011)– Routine vs non-routine – Colleagues rather than searching literature for answers – Prepackaged information
• Low research uptake Estabrooks (2003), Squires (2011)
- Contextual factors significant
- No clear interventions to increase research utilization
• Readiness of nurses for EBP: Pravikoff, Tanner, Pierce, (2005)– Low use of bibliographic databases and hospital libraries – Greatest barrier to using evidence is “lack of value for
research in practice”
20participants65%response rate
METHODS: SURVEY
Modeled on Pravikoff (2005) (93 points) 8 questions with sub-questions (39 points) 1. Knowledge of EBP and attitudes (values) 2. Information needs and Information Sources3. Perceived Top Three Barriers and Facilitators for EBP
OUTLINE
• Background
• Methods• Survey
• Results
• Discussion
RESULTS
RESULTS: JGH PSYCHIATRY NURSE DEMOGRAPHICS
RESULTS: PERCEIVED KNOWLEDGE RELATIVE TO RESEARCH
23%evaluated research reports
67 %somewhat knowledgeable
of EBP and processes
70% never involved in research
50% somewhat knowledgeable in
interpreting research results and assessing quality
RESULTS: USE OF INFORMATION RESOURCES
RESULTS: USE OF RESOURCES
Internet (Google) 83% Daily/Weekly
Colleagues 76% Daily/Weekly
Textbooks 53% Weekly
Practice Guidelines 41% Monthly
Medline/PubMed 41% Monthly
CINAHL 63% Never
PsycINFO 50% Never
Librarian: 41 % yearly, 25% monthly, 25% never
RESULTS: TOP BARRIERS TO EBP (OTHER THAN TIME)
Correction: Lack of literature searching skills
RESULTS : FACILITATORS OF EBP
OUTLINE
• Background
• Methods• Survey
• Results
• Discussion
DISCUSSION
DISCUSSION: Findings
• Findings reflect those of larger studies:
–Low use of resources
–Preference for summarized information
• Readiness for Evidence Based Practice?
–Lack of value for research
–Need for information skills
–Need for a role model and mentor
• nurse educator trained in EBP – Need for organizational support
• Survey limitations
• Survey tool • Small data set• Correlation • Limited access to original research
questionnaires • Blindspot: assessing journal club as a method
DISCUSSION: Limitations
LESSONS LEARNED
• Librarian – Nurse Collaboration: “merging silos”*
- Refining the question
• Librarians: help with resources, methods and tools
• User owns the question and answer (content)
• Content drives the method
• Practice evidence based librarianship
• Implementing a quality library service :
- Conditions : personal, organizational
- Tools
*“Merging Silos: Collaborating for Information Literacy” (Miller, 2010)
Way forward:
• Re-evaluate educational objectives and methods
• Curriculum for information literacy
• Content drives the format:
• Journal club format – at a later stage
• Immediate relevance of teaching
CONCLUSION: Journal Club, Tool of Change ?
• Readiness for journal club at your institution?
• Facilitating factors ?
• Limiting factors?
• What will be your role?
REFERENCES
• Miller LC, Jones BB, Graves RS, Sievert MC. Merging silos: collaborating for information literacy. J Contin Educ Nurs. 2010 Jun;41(6):267-72. PubMed PMID: 20411879.
• O'leary DF, Mhaolrúnaigh SN. Information-seeking behaviour of nurses: where is information sought and what processes are followed? J Adv Nurs. 2012 Feb;68(2):379-90.
• Pravikoff DS, Tanner AB, Pierce ST. Readiness of U.S. nurses for evidence-based practice. Am J Nurs. 2005 Sep;105(9):40-51
• Squires JE, Estabrooks CA, Gustavsson P, Wallin L. Individual determinants of research utilization by nurses: a systematic review update. Implement Sci. 2011 Jan 5;6:1.
• HLWiki: Journal Clubs : http://hlwiki.slais.ubc.ca/index.php/Journal_clubs
