DESCRIPTION (provided by applicant):
The requirements of evidence-based practice increasingly pressure clinicians to obtain relevant biomedical information from a growing body of literature. Over the past six years, the Vanderbilt Eskind Biomedical Library (EBL) Clinical Informatics Consult Service (CICS) has developed and implemented a novel approach to address these needs. Librarians with specialized training in medical subject areas and in information retrieval ("clinical informationists") participate on clinical teams in intensive care settings. Acting as expert consultants, they analyze the biomedical literature to identify, filter, and present the best examples of each clinical viewpoint expressed about key problems. Working in cooperation with the world-renowned Learning Sciences Institute at Peabody College of Vanderbilt, the investigators propose to evaluate formally the role of CICS in improving clinician knowledge and evidence-seeking behavior. While past studies have evaluated clinical medical librarians' roles, few if any studies have examined the effectiveness and utility of the new clinical informationist approach in sites where informationists are well-established. The project will create reusable evaluation tools transferable across environments. Through a combination of observation, interviews, and focus groups, investigators will examine librarian involvement in three existing Vanderbilt CICS intensive care units. The project will collect detailed information about the ways in which clinicians incorporate CICS-provided information into their workflows. Next, investigators will conduct a randomized trial to evaluate the effect of CICS on clinician knowledge. When a CICS-related clinical decision-making issue arises, the project team will administer a pre-test to clinicians and randomize them into two groups. Both groups will repeat the test after an appropriate interval for "independent learning". The intervention group will have access to the result of the CICS consultation prior to the post-test; the control group will not. Finally, "virtual cases" developed from actual patient CICS-related scenarios in each clinical unit will be used to evaluate the effect of CICS information in altering clinical decision-making and evidence-seeking behavior in a controlled laboratory setting. Demonstration of the utility of the clinical informationist approach can foster widespread adoption nationally, and increase the degree to which clinical practice becomes evidence-based.