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By Andrew Booth, Reader in Evidence Based Information Practice, School of Health and Related Research (ScHARR), University of Sheffield
Every day practising librarians and library managers face decisions that impact upon the success of their services. Should they follow their instinct or should they meticulously plan every step of their response? This is where an evidence based approach ought to enter the picture but it often falls victim to its own mythology. Evidence Based Library and Information Practice (EBLIP) is typically portrayed as the triumph of scientific rationality over individual initiative and enthusiasm. Its adherents are misconceived as following an almost mechanical “cookbook” approach at the expense of the flair and creativity of the “masterchef”. In reality, both ingredients are equally important – the evidence based practitioner typically arranges a work surface of evidence based tools and techniques before bringing them to bear creatively upon a problem of pressing concern. Returning to LIANZA, the scene of the first international presentation on EBLIP over a decade ago, provides an opportunity for the author to describe how the fundamental model of evidence based practice has been developed, enhanced and improved to emerge fit for purpose in advancing our professional passions.
At first sight the combination of "passion" and "research", as encapsulated in the title of this article, may appear a strange juxtaposition. Evidence Based Practice, with its roots in scientific rationalism (Nolan & Bradley, 2008), is typically portrayed as the antithesis of "passion". Within this article I intend to outline why Evidence Based Library and Information Practice (EBLIP) may rightly be construed as a passion. I am then going to explore characteristics of the profession that require careful consideration within the context of EBLIP. I shall then conclude by summarising some current developments in the paradigm as well as speculating upon some future directions.
In our early years as a professional many of us may have rejoiced in the label "bibliophile" reflecting an initial passion for books. As we proceed through our professional "adolescence" we respond to the strictures of our leaders and educators in declaring our “passion” for people, even if the real intent of many of us is simply to spell "books" as p-e-o-p-l-e! In this connection it was gratifying to encounter the blog of a recent library school graduate, already practising their profession although not yet able to secure employment, who declares:
"[her] passion for sharing information and helping to connect people to the information that they need" (Jones, 2010)
This article will highlight a third, more mature passion, namely the passion for continually monitoring, evaluating and improving our practice and for engaging with research, as both a consumer and as a producer. In this regard I am very influenced by a schema of Mardis (2011), itself derived from the work of Stokes (2007), which depicts the relationship between research and practice within each of four quadrants; practice, research, practice-based research and research-based practice. When charting our own passions we need to re-orientate ourselves beyond the bottom left quadrant towards the two quadrants on the right hand side. It is noticeable that neither of these right-hand quadrants requires us to completely separate ourselves from our practice orientation. Neither, to the contrary, do we need to inhabit the quadrant completely associated with Research. In reinterpreting the original schema I have added the sense that as we become more mature practitioners we seek insights of greater generalizability that we can transfer throughout the rest of our professional lives to other contexts and other settings.
Figure 1 - Based on, and adapted from, an original idea by Mardis (2011) derived from Stokes (2007)
On Being Rational
However let us commence by dispelling our first myth, namely that "EBLIP is the Triumph of Scientific Rationality over Individual Initiative and Enthusiasm". We should perhaps start by acknowledging that passion itself holds hidden dangers for ourselves as a profession:
For many library staff, being "right" is a passion. On issues that seemingly should have any number of acceptable answers, pitched battles are waged to ensure that all are swayed to THE obvious correct answer (Busby, 2008)
Busby continues by acknowledging that although this passion may originate from the best of intentions this may result in unintended confusion for our user communities:
The motivations are the best! The banner of the user is waved high ‐‐ our users are always first and foremost in guiding our decisions! Yet our users’ perception of a Google searchable free web crash everyday into the library’s efforts to spread information literacy throughout the campus and the community (Busby, 2008)
Does the librarian know best?
This in turn leads to a second myth, what I facetiously term the "Divine Right of Librarians", namely that "The Librarian Always Knows Best". We should ask ourselves "Does our passion for our profession colour our view?", that is "Do we see our library world through rose-coloured, library-tinted glasses?"
The gap between what we as library staff observers perceive and the perceptions of our student users is well attested by research carried out by Sue McKnight (2009) at Nottingham Trent University. This research found that items perceived as irritants for users by library staff bore little if any correlation to the major irritants as perceived by the students themselves. Clearly so-called "user-oriented services" informed by such misperceptions are likely to fall considerably short of standards for high rates of user satisfaction.
Having flagged up the potential vision deficiencies that relate to our passion for our profession it is timely to consider some cognitive biases that may impair professional judgements and managerial decision-making. Generically, that is across multiple professions, the following types of bias have been identified (Eldredge, 2007):
We place disproportionate importance upon information initially provided in a sequence of far more information rather than giving equal consideration to all information.
We place disproportionate importance upon information provided at the end of a sequence of far more information rather than giving equal consideration of all information.
We form rigid perceptions based upon incomplete information about another individual or about a group.
Perseverance of Belief
We persist in believing previously acquired information even after it has been discredited.
- Prior expectations cause us to filter how we perceive a situation despite the existence of facts that should contradict these prior expectations.
Table 1 Some Common Cognitive Biases (from Eldredge, 2007)
And, of course, we all suffer from Question Framing Bias, don’t we?
What if we turn our attention specifically to ourselves as a profession? Before identifying such weaknesses it should be noted that the following list of biases does not represent the harsh judgements of an outsider looking in. In fact these cognitive biases are derived from those self-identified by a group of librarians themselves. Results, although preliminary, suggest that librarians have two primary cognitive biases in their practice (Eldredge, 2007):
Before automatically taking issue with such severe pronouncements, thereby demonstrating our vulnerability to déformation professionnelle!, we should consider just one example of a perspective that we might summarily dismiss as being merely perverse. In a study by Goodall & Brophy (1997) one interviewee described how "not having information skills training" can be:
good because you have to learn the hard way. You tend to have better skills if you have had to find your own way around - but it would've been nice to have been eased into it, in a bit more structured way as well
I am reminded of a distinction, first encountered when at library school in Aberystwyth, namely between dictionaries that are prescriptive, that is they spell out how a word should be used, and those that are descriptive, that is they outline how a word has been used (Morris, 1952). It seems to me that when we train others in information skills we tend to be prescriptive, suggesting that there is a single right way of searching. Would it not be preferable to be more descriptive, that is to find out how users are accustomed to searching, and then seek to harness these already-present skills within appropriate search strategies?
To extend my example, in my own field of health librarianship I frequently observe that librarians criticise the Google search as a means of locating reliable medical information. Yet, in my personal experience, I frequently find that a journal abstract from PubMed MEDLINE will almost invariably appear within the first ten results on a Google page. I hasten to add that I have no evidence base on which to centre the following observation – in fact this is a research question just crying out to be addressed. However might we just speculate whether using this particular search route, supplemented by such tools as algorithms to match Related Articles, might yield comparable results to a technically-precise Boolean constructed search strategy?
The brief consideration above serves to illustrate how Evidence Based Practice can be seen as an antidote to our misplaced professional passions and to our primary cognitive biases. However my primary objective is to demonstrate that it should be possible to harness both passion and evidence based library and information practice together in a fruitful alliance. In other words I wish to encourage ourselves, as librarians, to “back up our passion”. This rallying call derives from interviews conducted by Helen Partridge and colleagues (2007) from Queensland University of Technology when exploring librarians’ perceptions of the contribution of evidence based library and information practice. One interviewee described how:
I’m very passionate about things, so I made sure that I had something to back up my passion (Partridge et al, 2007)
while another reflected how so-called "hard" data can be used to reinforce professional passion and judgement:
being able to prove what we do in libraries or how it’s done in libraries, or why we do things or how we do things, but be able to prove that by either statistics or understanding of what’s been done before (Partridge et al, 2010)
Research, Reflection and the Library Profession
Does the library and information profession need research? This brings me to a third persistent myth, that is where colleagues conclude that "We Don’t Need to be a Research-Based Profession". Here I return to an analogy first explored at the European Association of Health Information Librarians in Krakow (Booth, 2007), that of the Barber versus the Surgeon. Of course "the barber’s art of shaving beards and cutting hair" dates from time immemorial. In fact "long before there was history, there were razor blades, found among the relics of the Bronze Age". [BBC Website]. In contrast the profession of surgery is of comparatively recent origin. Although both these professions share the similarity of taking a sharp knife and using it to achieve a predefined objective no doubt you all would state a preference as to which one you would most like operating upon you. Wherein lies the difference between these two activities? Well, whereas the art of the barber has remained essentially unchanged over many millennia, the profession of the surgeon continues to evolve, stimulated by technical improvements and technological innovation. In short the surgeon has the ability to utilise an embodied evidence base of professional knowledge populated by experience and reflective practice:
Is it not in the building up and transmission of an evolving body of knowledge? How is this corpus developed? – surely it is through reflective practice? As a professional surgeon performs a procedure he reflects on how it might be enhanced and improved. He may invent a new version of a procedure and is perhaps rewarded by having it henceforth attributed with his name! (Booth, 2007)
As librarians we therefore need to ask ourselves, will we….,
continue as barbers simply acquiring the same inventory of skills and repeating the same practices? Surely the challenge is to reflect on our practice, to build up a body of evidence based library and information practice and to communicate it to others (Booth, 2007)
In reaching such a conclusion I acknowledge the influence of other commentators (Partridge & Hallam, 2007), most noticeably Juznic & Ubanija (2003) who state that:
If research is absent, non existent or even scarce, there is no profession, but only an occupation grounded in techniques, routine and common sense
Not that evidence based practice simply constitutes an attempt to put retreads or remoulds on the well-worn tracks of research utilization. Instead, evidence-based practice is "founded on the premise that professional practice should be based on up-to-date, valid and reliable research" (Brice & Hill, 2004). In short it seeks to use research in an attempt to identify best practice and combine this with the best (i.e. most efficient, most effective and most appropriate) use of resources. As Williamson (2002) observes:
Research allows professionals to add value to their work practices and…the use of research in practice clearly differentiates between [those] professionals who maintain the status quo without question and those who strive to develop their work practices through continual evaluation and investigation (Williamson, 2002).
It is in this attempt to provide added value to our services that we must seek a context in which:
Research and professional practice are inextricably linked and, consequently, research skills are a prerequisite [italics added] for those who want to work successfully in information environments (Harvey, 2002).
Again the prominence of this particular skill sets stems from a recognition that the ‘work of professionals is being transformed’ - professionals cannot be effective unless they have a working knowledge of research and its many tools and techniques. Indeed Marshall (2003) goes further in pronouncing that:
The health and future of any profession depends on the members’ ability to evaluate both themselves and their professional practice (Marshall, 2003)
The Power of Research
Is all the above to overclaim on behalf of the merits of research? No, because the impact of research can be felt at so many important levels. For example at a professional level research can:
We should add to this the benefits to be realised at a personal level by involvement in research. In this context research is able to:
Such manifold benefits from pursuing a profession based on judicious use of evidence, including that derived from research lead McNicol & Nankivell (2001) to conclude that.
“Research should be promoted as a valuable professional activity for practitioners to engage in”
Alternatives to Evidence Based Practice?
Unsurprisingly there are those, myself included, who resist an attempt to impose a homogenous "vanilla" flavour of decision-making over the top of all contexts for library practice. However espousal of evidence based practice need not necessarily come from an uncritical acceptance of the paradigm. It simply comes from a recognition that evidence based practice may not be the best way of making decisions, it is simply the best available at this particular point in time. In seeking to dispel a fourth myth, namely, "There are Better Alternatives to Evidence Based Practice", we are reminded of a facetious article in the British Medical Journal which identified seven alternatives to evidence based practice (Isaacs & Fitzgerald, 1999). Table X reproduces these alternatives. However, lest we should be misunderstood we should acknowledge that the Armani suit, while prevalent within the discipline of surgery, is more likely to be replaced by the "No money" suit in a librarian context :
Eminence based LIP — More senior the colleague, less importance placed on anything as mundane as evidence. Experience worth any amount of evidence.
Vehemence based LIP—Substitution of volume for evidence for brow beating your more timorous colleagues.
Eloquence based LIP —Suntan, carnation in button hole, silk tie, Armani suit, and tongue - all equally smooth. Sartorial elegance and verbal eloquence powerful substitutes for evidence.
Providence based LIP—If practitioner has no idea what to do, decision best left in hands of the Almighty.
Diffidence based LIP —Some see a problem and look for an answer. Others merely see a problem. Diffident [practitioner] does nothing from sense of despair.
Nervousness based LIP —Fear of litigation (or the sack)
Confidence based LIP – You definitely believe that you already know what this is!
Table 2 Alternatives to Evidence Based Practice (Adapted from Isaacs & Fitzgerald, 1999)
To this long-established list of dangerous professional passions we should perhaps add an eighth alternative, Propaganda based library and information practice whereby practitioners simply select that element of the evidence they believe most likely to drive forward the innovation or practice for which they have a passion!
In contrast, my argument very much focuses on the need to align Evidence, the values of our Profession and our Passion. Such an alignment is alluded to in the Journal of the Medical Library Association:
My hospital is on a path to excellence in patient service…..based on the knowledge that all of us in health care believe in our purpose, in our worthwhile work, and in making a difference. The…flywheel of change and improvement turns ever faster when all of us align our principles [Profession], our passion, and our results [Evidence] (Quoted in Hill, 2007, Italic parentheses added)
So What Exactly is EBLIP?
The distinction between research and evidence based practice is not an immediate one to grasp. This is attested to by the experience of a participant on one of our EBLIP courses, fortunately only an experience limited to the beginning of the course:
Meanwhile, I struggled a bit with the EBLIP course as I didn’t quite understand at the beginning the difference between research and using evidence based practice to make workplace decisions. Much of what was outlined in the EBLIP literature was to do with evaluating previous research (or actually, previous ‘what we did in our library’) to build a business case or plan for proceeding with something in the workplace. The whole point was to avoid re-inventing the wheel.
Such a distinction becomes clearer when we examine an authoritative definition for evidence based library and information practice (Booth, 2006):
Evidence Based Library and Information Practice (EBLIP) seeks to improve library and information services and practice by bringing together the best available evidence and insights derived from working experience, moderated by user needs and preferences.
The EBLIP process involves:
asking answerable questions, finding, critically appraising and then utilising research evidence from relevant disciplines in daily practice. It thus attempts to integrate user-reported, practitioner-observed and research-derived evidence as an explicit basis for decision-making (Booth, 2006)
I have previously conceived the vital interdependence of these three dimensions, i.e. user-reported, practitioner-observed and research-derived, as three cogs. The point of this analogy is that, although EBLIP has apparently focused on research, some would say to the neglect of the other dimensions, all three are required to align and interact. This is particularly the case if we are to advance library decision-making and move ourselves from ineffective, or at least non-demonstrably-effective practice, towards effective practice.
The process by which this is to be achieved has been commonly described as the 5A process – in essence a model that, as I have remarked elsewhere (Booth, 2011), bears great similarities to that required for effective information management:
Ask a focused question
Acquire the evidence
Appraise the studies
Apply the findings
Assess the impact…on your own service and on your own personal development (Booth, 2009)
ADAPT not ADOPT
Myth No 5 is that "We Must Adopt Evidence Based Practice Exactly as it is", an off-the-peg solution with its origins in the autonomy of the medical practitioner. In fact one of the refreshing characteristics of the Evidence Based Practice movement is that every profession that has sought to engage with it has ended up adapting or reinventing it. One need only think of the configuration of evidence based social care, with its emphasis on the involvement of the client, to illustrate that the priority is to adapt, not adopt. What are the characteristics of our profession that seek to reshape EBP into EBLIP? Initially we sought to translate concepts, such as the focused question, directly into our own domain. However following a very stimulating 5th EBLIP conference in Stockholm my colleagues and I identified two main problems with uncritical adoption of the EBP Model (Booth, 2009).
Firstly EBP "is conceived and expounded around the concept of the individual self- directed practitioner" (Booth, 2009). In the reality of our library setting our route to evidence based practice comes via the involvement of the team, not through individual autonomy. This model also carries the associated implication "founded on assumptions of rational decision-making, that it involves a logical and sequential procession through five tasks and their subsequent resolution"(Booth, 2009). Again the reality is that we may progress more iteratively, consulting, responding to feedback, taking a step backwards to re-examine a course of action through a refreshingly different perspective. As a research nurse had previously observed: "The 5 stage model of the evidence-based practice process is a deliberate simplification of a complex iterative process" (Newman, 2006). For this reason I have proposed that EBLIP is characterised by a different variant of the EBP process (what I have labelled EBLIP 5.0, after the 5th EBLIP Conference), namely:
Articulating the Problem
Assembling the Evidence Base
Assessing the Evidence
Agreeing the Actions
Adapting the Implementation (Booth, 2009)
Of course even recognising that the path to individual instances of evidence based practice can be iterative, recursive or even regressive is not to ignore that some systemic barriers will also exist. This is why we could say that our own evidence based practice is in the hand of the FATES, an acronym for the following barriers (Koufogiannakis & Crumley, 2006):
Focusing more at an individual practitioner level, Pfeffer & Sutton (2006) (cited in Hiller et al, 2008), in an influential article in Harvard Business Review, seek to address the question: "What makes it hard to be evidence-based?" and arrive at the following diagnosis
It is interesting in this context to see that, beside the often reported effect of the bias and opinion of others (People are trying to Mislead you), there is recognition of a less-explicit factor, our own passions and cognitive biases (You are trying to mislead you) – which is, of course, where we came in!
The Future of EBLIP
Our sixth and final myth is that advocates of EBLIP are simply jumping on the nearest propitious vehicle, whether that variously proves to be a bandwagon or a gravy train. Of course it is difficult to counter such an accusation when my own involvement in the movement brings me a sponsored place to such a beautiful and stimulating location as New Zealand! However EBLIP is a movement that, by its very nature, seeks to counter the uncritical acceptance of any unbridled passion. In 2003, almost a decade ago, I sought to locate the novelty of the EBLIP movement within a more sustainable approach to critical inquiry, via reflective practice:
the long-term future of evidence based [library and] information practice probably lies not in a single-minded focus on research-derived evidence but in a more encompassing approach that embodies reflective practice….the ability to critically analyse, make informed judgements and direct actions can be triggered by any number of catalysts, of which research evidence may be just one…. (Booth, 2003)
Indeed I followed this up several years later by developing a model (the Five Mirrors of EBLIP) that links reflective practice to the contribution of evidence based practice (Booth, 2010). In my 2003 paper I continued by making the apparently gloomy pronouncement of the demise of the movement under the heading “EBLIP RIP!” stating that:
ultimately evidence based practice will contribute to a toolbox from which the reflective practitioner will occasionally draw. The ultimate objective of evidence based information practice is thus to write itself out of existence! (Booth, 2003)
Undoubtedly those who heard my original pronouncement that evidence based practice would write itself out of existence will express surprise that this remains my verdict. While I draw tremendous optimism from the isolated instances of excellent evidence based practice that pepper our profession this is tempered by a realism that progress has been slower than anticipated, and has been unconcerted. In more recent offerings I have chosen to look for another driver that may yield further momentum to the adoption of evidence in our day-to-day practice. Instead of pinning hopes to the professional characteristics of reflective practice, such momentum may, instead, derive from a drive towards knowledge translation. I conclude with the delicious irony that EBLIP may itself need to be "translated" if it is to succeed in becoming a fundamental ingredient of our professional passion!
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 Causing a decision to be directed by the way that “the question” has been phrased, the range of those alternatives considered, or the permitted outcomes.