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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
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Journal club, tool of change asted at 32_2_nov2012final

Jul 04, 2015

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Presentation ASTED 2012, Lessons learned from Nursing Journal Club, survey and change of educational tool.
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Page 1: Journal club, tool of change asted at 32_2_nov2012final

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

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OUTLINE

• Background

• Objective

• Methods• Survey

• Results

• Discussion

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BACKGROUND

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IN THE BEGINNING…

• Serendipity and opportunity …

• Nurse-librarian conversation (spring 2011)

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ACTORS

• Nurses

• Librarians

• Organization (Institution)

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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

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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

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EVIDENCE BASED PRACTICE (EBP) PROCESS

PATIENT

CENTERED

Journal Club

Library training (ACRL Information

Literacy)

Organizational Procedures

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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

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OUTLINE

• Background

• Methods• Survey

• Results

• Discussion

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METHODSThe Journal Club ObservationRe-evaluation The Survey

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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

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LIBRARIAN’S ROLE

• Collaborator

• Search the literature

• Present “vignettes”

• Reflective Observer

• No influence on choice of topic or choice of article to discussed

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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

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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)

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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”

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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

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OUTLINE

• Background

• Methods• Survey

• Results

• Discussion

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RESULTS

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RESULTS: JGH PSYCHIATRY NURSE DEMOGRAPHICS

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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

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RESULTS: USE OF INFORMATION RESOURCES

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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

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RESULTS: TOP BARRIERS TO EBP (OTHER THAN TIME)

Correction: Lack of literature searching skills

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RESULTS : FACILITATORS OF EBP

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OUTLINE

• Background

• Methods• Survey

• Results

• Discussion

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DISCUSSION

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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

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• Survey limitations

• Survey tool • Small data set• Correlation • Limited access to original research

questionnaires • Blindspot: assessing journal club as a method

DISCUSSION: Limitations

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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)

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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

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CONCLUSION: Journal Club, Tool of Change ?

• Readiness for journal club at your institution?

• Facilitating factors ?

• Limiting factors?

• What will be your role?

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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

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CONTACT

Teodora Constantinescu, MLIS

[email protected]

Renée Lavoie, RN, BSc

[email protected]