Academic journal article Journal of the Medical Library Association

Evaluating the Effectiveness of Clinical Medical Librarian Programs: A Systematic Review of the Literature*

Academic journal article Journal of the Medical Library Association

Evaluating the Effectiveness of Clinical Medical Librarian Programs: A Systematic Review of the Literature*

Article excerpt

Objective: This study was undertaken to determine if a systematic review of the evidence from thirty years of literature evaluating clinical medical librarian (CML) programs could help clarify the effectiveness of this outreach service model.

Methods: A descriptive review of the CML literature describes the general characteristics of these services as they have been implemented, primarily in teaching-hospital settings. Comprehensive searches for CML studies using quantitative or qualitative evaluation methods were conducted in the medical, allied health, librarianship, and social sciences literature.

Findings: Thirty-five studies published between 1974 and 2001 met the review criteria. Most (30) evaluated single, active programs and used descriptive research methods (e.g., use statistics or surveys/ questionnaires). A weighted average of 89% of users in twelve studies found CML services useful and of high quality, and 65% of users in another overlapping, but not identical, twelve studies said these services contributed to improved patient care.

Conclusions: The total amount of research evidence for CML program effectiveness is not great and most of it is descriptive rather than comparative or analytically qualitative. Standards are needed to consistently evaluate CML or informationist programs in the future. A carefully structured multiprogram study including three to five of the best current programs is needed to define the true value of these services.

INTRODUCTION

Clinical medical librarian (CML) services have been implemented in dozens of different clinical health care settings since the first program started with grant funding from the National Library of Medicine in 1971 at the University of Missouri-Kansas City School of Medicine [I7 2]. Descriptions and evaluative discussions of these programs have been published with considerable regularity in the library and health sciences literature over the past three decades. However, a 1985 review by Cimpl (the former name of the first author of this review) of the first fifteen years of this literature found only eight published studies that used a survey or questionnaire to assess the value or cost-effectiveness of those early programs, and these studies provided very limited data to support their generally positive assessments [3]. Since then, many more descriptive papers have been written as well as a number of additional studies incorporating at least some evaluative methodology. As a result, clinical librarianship has become a widely recognized, but still relatively infrequently used, model for extending library and information services into the clinical health care environment.

The current study was undertaken to determine if a systematic review of the cumulative, thirty years of evidence from the literature evaluating CML programs could help provide a more definitive determination of the potential effectiveness of this model of outreach service and also help inform the current debate on the potential for developing CML-like "informationist" roles in health care settings [4, 5]. However, we were not optimistic and hypothesized that the published literature would provide little additional strong evidence showing how or if CML services contribute to improved patient care or better performance of health professionals in clinical health care settings.

The paper that follows first provides a descriptive review of the entire CML literature to show the general characteristics of these services as they have been implemented, primarily in teaching-hospital settings. This review also includes other related research studies in clinical health care settings about the impact of information services on education and patient care as well as more recent articles suggesting that health sciences librarians can play a significant role in evidencebased medicine and knowledge management. The next section of the paper describes the criteria and methods used to screen the CML literature for evaluative studies along with the characteristics and measures used to categorize and analyze the thirty-five evaluative studies of CML programs identified from this systematic review. …

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