Involving clinical librarians at the point of care: results of a controlled intervention.
OBJECTIVE
To measure the effect of including a clinical librarian in the health care team on medical residents and clinical clerks.


METHODS
In 2009, medical residents and clinical clerks were preassigned to one of two patient care teams (intervention and control). Each team had a month-long rotation on the general medicine teaching unit. The clinical librarian joined the intervention team for morning intake, clinical rounding, or an afternoon patient list review, providing immediate literature searches, formal group instruction, informal bedside teaching, and/or individual mentoring for use of preappraised resources and evidence-based medicine search techniques. Both intervention and control teams completed pre and post surveys comparing their confidence levels and awareness of resources as well as their self-reported use of evidence for making patient care decisions. The nonintervention team was surveyed as the control group.


RESULTS
The clinical librarian intervention had a significant positive effect on medical trainees' self-reported ability to independently locate and evaluate evidence resources to support patient care decisions. Notably, 30 of 34 (88%) reported having changed a treatment plan based on skills taught by the clinical librarian, and 27 of 34 (79%) changed a treatment plan based on the librarian's mediated search support.


CONCLUSIONS
Clinical librarians on the care team led to positive effects on self-reported provider attitudes, provider information retrieval tendencies, and, notably, clinical decision making. Future research should evaluate economic effects of widespread implementation of on-site clinical librarians.
Rockyview General Hospital Knowledge Centre, University of Calgary, Calgary, Alberta, Canada. eaitken@ucalgary.ca
Elizabeth M
EM
Aitken
Susan E
SE
Powelson
Renée D
RD
Reaume
William A
WA
Ghali
D000328:Adult; D000416:Alberta; D016022:Case-Control Studies; D002982:Clinical Clerkship; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000193:education; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D016247:Information Storage and Retrieval; D007396:Internship and Residency / Q000379:methods*; D016245:Librarians; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D019095:Point-of-Care Systems / Q000458:organization & administration*; D024382:Professional Role; D011786:Quality Control; D012016:Reference Values