The International Clinical Librarian Conference took place on the 3rd and 4th October at the Science and Industry Museum in Manchester. The event was a chance for clinical and outreach librarians from both the UK and abroad to network and share ideas and best practice. The LIHNN committee sponsored several people from across the region to attend. Patrick Glaister, Caitlin McCulloch, Jane Roberts and Caroline Timothy reflect on their experiences of the conference below.
Science and Industry Museum Sign is copyright Science Museum Group - used under a CC BY-SA 4.0 licence
The week before the conference I started at new job at East Lancashire Hospitals NHS Trust as a Clinical Librarian. At my previous trust Northern Care Alliance I did not have the title “Clinical Librarian” but did a lot of the work associated with it, from searching to training and appraising evidence. This conference gave me an excellent opportunity to learn from others and get some useful ideas to bring to my new role. The Science and Industry museum was a great setting for two days of learning, networking and eating (nice food by the way). Unlike other conferences this was a set programme affair apart from the afternoon workshops where we chose between two sessions. I got to catch up with some old friends and make some new ones, the lunch breaks are great times to learn and I talked to a number of more established librarians who gave me some great advice. Perhaps the best advice people gave me was not to try to do everything at once when you’re setting up a service.
Over the two days there were so many interesting talks. Helen Kiely (Mersey Care) did a very interesting talk on Library language: a barrier to service. Now I recall hearing one like this done by the University of Bradford at a previous CILIP conference and that really struck a chord with me. Often as librarians we think of terms that we understand and expect others to understand right away. But there is so much library language out there and it does cause a barrier to the service from what I have found. The research by Helen was very interesting. Terms like ‘critical appraisal,’ for instance can cause confusion, as appraisal is often the word used for staff PDR’s/Development meetings. Similarly terms such as ‘journal clubs,’ are often not well understood so it is important to make it as simple as possible for people to understand what terms mean. When I got back to East Lancs Hospitals NHS Trust I told people about this talk and it created an interesting discussion within the team. We now plan to look at the language within the library and create some plain language definitions of terms such as inter-library loans etc.
The conference seemed well-paced with lots of different speakers. I think it works well when you have shorter presentations as the message that the presenter gives hits home more when it is condensed. The second day had a number of useful talks on a variety of topics. I really enjoyed the workshop session put on by Siobhan Linsey (Taunton and Somerset) on Creative writing-based reflection to support professional development and staff wellbeing. A lot of staff need to do reflective writing as part of courses, revalidation and for other reasons too so this course was something I was interested in finding out more about. Reflection is not as easy as it seems and I think the format of this offering is certainly something that makes reflection much easier. I had not really even thought about how it helps in terms of health and wellbeing and - from taking part in the workshop - I can certainly see how it helps to clarify situations and learn from them. We were asked to close our eyes while Siobhan went through a script intended to get you to think and reflect on an incident at work. From this exercise I was able to write up something both relevant and useful that I could use. Although this is not something I would be confident to run myself yet it is certainly something I would like to explore more and perhaps help inform any reflective sessions I might create in the future. I think the demand for reflective practice is out there it’s just a case of finding a way of delivering it and this is a very interesting and effective way to do so.
There were a lot of highlights from the two days at the conference, particularly meeting with other colleagues. I enjoyed 'Alexa, are vaccines safe?’: evaluating voice assistant responses to consumer health questions by Emily Alagha, (Dahlgren Memorial Library, Georgetown University Medical Center). It was very interesting to hear how well different voice assistants responded to medical questions and where they drew their search information from. I also found the following presentations very useful: Embedded librarian in an Emergency Department Jennifer Moth, Isle of Wight NHS Trust and Clinical librarian in Norway Henriette Fretheim Viksløkken & Sonja May Amundsen, Sørlandet Hospital Trust. I left feeling very caffeinated but also like I had learnt a lot. The ideas and the information I have been exposed to over the two days will stand me in good stead for my new role and give me a good foundation to build the service up.
East Lancashire Hospitals NHS Trust
As a fairly new NHS librarian, I’d never been to a health library conference before. With its wide range of topics and speakers, the International Clinical Librarian Conference seemed like the perfect place to start. Although I’ve spoken to people on Twitter (where you can find all my musings about #ICLC19), I really appreciated the chance to put names to faces over the two days. One thing I’m always struck by during conferences is how friendly everyone is, and that was even more prevalent here – I could see that health librarianship is a close-knit community.
The presentation I’d been looking forward to most was delivered by Helen Kiely, now of Mersey Care NHS Foundation Trust. Helen focused on the language we use when communicating our services to people. To do this, she asked NHS librarians what vocabulary they used to describe their services – even after removing duplicates and spelling variants she came back with a staggering 386 different phrases. Alongside this, she asked her service users to define various library terms – inter-library loan was the most recognised term (amazingly!) but more than half of respondents didn’t recognise or incorrectly defined OpenAthens.
I’m not surprised that people struggle with the vocabulary we use – I previously worked in academia where jargon was rife, but the NHS is a different level. But what can we do about it? We’re limited in changing the language we use – like it or not, we’re stuck with phrases like ‘library management system’. One thing we can think about is context – to librarians the word ‘appraisal’ might mean critically evaluating the evidence, but it can also refer to staff evaluations. And do we aim to standardise our language across the sector or factor in local differences? There’s no easy answer to this, but clearly user education is key.
A key theme that cropped up across the conference was the importance of physically ‘being there’. Whether it’s working with the paediatrics department in Kettering, embedding an enquiry service into A&E on the Isle of Wight or updating clinical radiotherapy protocols in real time at Taunton and Somerset, having a member of library staff present inevitably drove up the number of enquiries and requests. It’s no longer enough for us to wait for our users in the library; we have to go to where they are. Feedback from users was unfailingly positive – but as Margaret Theaker pointed out, we need to be sharing these successes with other groups of NHS staff as well as other librarians.
ICLC was a very intense two days with a huge variety of topics, and I left with a lot to think about. Beforehand I didn’t have a clear idea of what a clinical librarian was, but now I see that the key to this role is being proactive and embedding library services - the real successes are where you’re simply ‘one of the team’ rather than ‘someone from the library’. Thanks again to LIHNN for giving me the opportunity to go – with any luck I’ll be attending more health conferences in the future!
Northern Care Alliance NHS Group
I have been to several health library conferences over the past few years and always found them to be of great benefit to both my personal and professional development. When I saw the International Clinical Librarian Conference was to be held in Manchester this year I jumped at the chance to go. I was particularly interested to find out how other libraries were supporting systematic reviews and journal clubs as we have recently seen an increase in demand for support in these areas across the Northern Care Alliance. I applied for – and got - a bursary from LIHNN and below is a summary of some of the sessions which stood out for me.
The first paper of the conference was delivered by Sarah Rudd and Samantha Harding from North Bristol NHS Trust and focused on a piece of research they had conducted looking at how library and knowledge service (LKS) staff viewed the role of the clinical librarian (CL). The purpose of the research was to look at the personal characteristics needed to be a successful CL (such as being approachable and a good listener) and the things they do. Interestingly non-CL LKS staff ranked attending ward rounds as a task performed more often than CLs reported. Overall their research concluded that non- CL colleagues have a much better idea of the tasks CLs undertake then we think.
The importance of being approachable when delivering a CL service was covered by Liz Hunwick (Basildon & Thurrock University Hospitals FT) and Rebecca Parrott (Princess Alexandra Trust) in their presentation ‘The clinical librarians guide to winning friends and influencing people’. They reported that their CL service model was moving more from a transactional model to a relationship model and highlighted the importance of embedding the library service within teams as a CL service can’t flourish within the walls of the library. The presenters went on to give examples of teams, such as critical care and vascular surgery, where they had successfully embedded the CL service. It was interesting that the presenters also focused on the personality traits of a CL linking their experiences to the Myers Briggs personality types.
Having been involved in supporting several systematic reviews recently I found numerous presentations on topics such as search filters and the PRISMA statement particularly useful. Lynda Ayiku from NICE delivered a presentation on geographic search filters. She went through how she had developed a validated search filter to pick up UK-based research in Ovid Medline. This was followed by practical tips on how to develop your own geographical search filter. Tips included using word-frequency analysis, starting broad and using additional search fields such as journal name or author address. Kirsty Rickett from University of Qld/Mater hospital presented It doesn’t reflect well: an audit of search-method-reporting compliance to PRISMA in a sample of published systematic reviews in Pubmed. Kirsty’s research focused on the quality of search reporting and the compliance of selected papers with the PRISMA statement. Out of a sample of 749 only 10 papers scored full compliance and the research suggests library involvement had a positive impact on increasing compliance. From now on I will be highlighting how the LKS at the Northern Care Alliance can support researchers with various reporting standards for research-including the PRISMA statement.
Patient information and health information literacy was another key area covered in several sessions throughout the conference. I went to a knowledge café – How can we influence patient information to be evidence based? - which was facilitated by Deena Maggs (The King’s Fund), Vicki Veness (Royal Surrey County Hospital NHS FT) and Emily Hopkins (Health Education England). The workshop provided an introduction to Health Education England’s project on evidence-based patient information and the importance of LKS involvement. I then took part in a knowledge café sharing ideas about how LKS staff can make patient information more evidence based. Ideas included liaising with public library colleagues to show them where to find high quality health information, and providing workshops to patients themselves to improve health information literacy. This is something that is already happening at the University Hospitals of Derby and Burton NHS FT. Suzanne Toft described how she provided some critical appraisal training to a haemodialysis patient who was involved in a systematic review. I found this approach really interesting as I had never really considered delivering critical appraisal training to patients’ before. I will be feeding back at our next team meeting and reviewing how the LKS currently supports patient information and health information literacy and explore how to take this further.
Rosy Bennett from Royal Surrey County Hospital presented on running a journal club on Twitter. The Macmillan education team approached the library service to arrange access to articles, Twitter and a blog. Rosy went on to discuss the challenges of setting up a journal club on Twitter which included buy-in from senior managers and identifying the most appropriate time for the journal club. I found this talk of particular interest as we are getting more requests from clinical teams wanting to set up journal clubs. Using Twitter may be a way of engaging more staff if a journal club be facilitated remotely.
My write up provides just a few highlights from an eventful two-day conference. It was extremely informative with lots of useful ideas which I have taken back and shared with the rest of the LKS team at the Northern Care Alliance. I would recommend going to any outreach or clinical librarian if they get a chance as it is also a great networking opportunity. Finally I would like to take the opportunity to thank the LIHNN committee for funding my place at the conference.
Library and Information Specialist-Outreach and Evidence Search
Northern Care Alliance NHS Group
One of the reasons that I wished to go to the International Clinical Librarian Conference (ICLC) was to hear a paper by Lynda Ayiku from NICE on Geographic search filters: retrieving context-specific research evidence to inform patient care decisions. I have often found it a bit tricky when searching just for UK evidence on the healthcare databases. I have found myself putting in as many different cities in the UK that I can think of to limit the search, but still probably miss out a lot of the places mentioned in papers containing UK evidence! NICE have produced UK geographical search filters. They have created filters for Medline and Embase (OVID). The filters include UK search terms on countries within the UK, nationalities, cities and the NHS. Lynda said that the only other validated geographic filters are for Africa and Spain. There are therefore only three validated geographic search filters in the world. Lynda said that to identify relevant terms you can use WriteWords (NICE use this), PubMed’s PubReMiner or other similar tools. Another useful point was to use the NOT Boolean operator, for example, York NOT “New York” to exclude irrelevant articles containing New York when you are just looking for UK material. As a result of this talk I will definitely be looking at the NICE UK filters when doing my next UK only evidence search.
For our team meeting in work I was asked to think about three takeaway messages from the conference. The messages were:
The Clinical Librarian’s (CL) guide to winning friends and influencing people – discussed how the old service was transactional, whereas the new service is based on relationships. We want to provide a relationship – a more satisfying exchange with our users. The CL’s personality can affect what we get out of the role. Positive attitudes increase good relationships and in turn increase connectivity. One of the clinical teams at Princess Alexandra Trust thinks that the most important aspects of CL are:
• Ability of CL
• Level of interest of the CL
• Personality of the CL
Sue Lacey-Bryant opened the second day of the conference with a talk on Implementing the Topol Review. Sue said that in England half of the workforce will still be slaving away in 2032 so it is the people working now that need to establish this, not the next generation. Sue said AI and machine reading will transform current awareness services and searches. What will we do to prepare and deal with this? Sue said evidence does not speak for itself; we are the voice, its speakers! In April 2020 there will be a CILIP review into the impact of AI/Technology on libraries and librarians. Sue said stop faffing about with ILLs and cataloguing! Leave this to technology and spend time on current awareness, searching, etc. Work smarter, but we also need more CLs!
Although there are some problems and we would like more staff, I realised during the conference that we are very lucky here in the UK to actually have clinical and outreach librarians! While networking I spoke to someone who told me that there is no such role as a CL in many European countries. Library managers have tried to set up services and one of the talks at the conference was about the attempts being made to try to establish a CL service in Norway and the difficulties being faced by the librarian. The man that I spoke to told me that it is in fact the pharmaceutical industry that often supplies ‘evidence’ to hospitals and healthcare staff! Imagine how completely biased a system of working that is. He said that until the system changes, there is no hope of establishing a similar pattern of working to what we have in the UK.
What stood out?
A paper by an American CL on voice assistants (Siri, Google Assistant and Alexa) showed that Alexa is most popular (in 2019) but is probably the worst! Most people use them to ask a question, but research showed the quality of answers given varies widely. When looking at how well voice assistants cover vaccination information, Siri and Google Assistant scored quite well – Alexa was much lower. Alexa did not understand the question a lot of the time and cited Wikipedia the most! For Siri and Google Assistant, CDC.gov was the most cited source.
Suzanne Toft talked about how she has provided critical appraising training to a haemodialysis patient involved in a systematic review at her Trust. She put the terms in plain English for the patient, e.g. what ‘lost to follow up’ means. Suzanne used A Rough Guide to Spotting Bad Science and “Information therapy” to look at points to consider when reading research articles. Could this be trialled in other trusts?
This is just a snapshot of some of the information that I gleaned over the two days of the conference. If you are thinking of going to the next ICLC I would definitely recommend it!
Warrington & Halton Hospitals NHS Foundation Trust
The conference programme and supporting materials can be found on the ICLC website
You can also follow them on Twitter: @ClinLib_Conf