Defending the Indefensible (Future HILJ Column)

Have recently had discussions with a senior EBM figure who asked the question "where is the robust (key word) evidence that librarians are effective"? Studies focusing on their specialist role as searchers are inconclusive in proving their unique value. Arguments I used with increasing desperation:
1. Cost-effectiveness/opportunity cost - librarians are cheaper and can therefore do it for cheaper/longer
2. Most librarians don't now do the volume of searching to justify a specialist role (Volume-outcome)
3.  The technology (i.e. electronic databases) is a limited one therefore librarians results are not much better than clinicians.
4. Most librarians are generalists not specialists. Therefore they will not perfom better than clinician searchers.
5. Perhaps this is a case mix issue. Perhaps librarians get the tricky, in someway untypical questions , and are therefore not able to demonstrate success as conclusively as for more straightforward questions.
6. Absence of evidence is not evidence of absence. Therefore it may just be that we haven't done the rigorous studies to prove this yet. Our over-reliance on known flawed designs e.g. critical incident technique (recall  bias) means we haven't conducted more rigorous studies.
7. Our managers haven't required us to demonstrate our justifcation for existence other than in the form of soundbites. So the one consolation is that managers are relatively less evidence based when compared to librarians.
8. Where is the justification that GPs are effective? Perhaps, like librarians, this comes in the category of "self evident"? !

I shall now try to assemble support for the above arguments - perhaps for a future HILJ Column.

Comments

[Stephen Due]

Sorry but I have no idea how to use this facility! The question of whether librarians are "effective" is irrelevant to the real debate. The real debate with senior EBM figures is the tedious old one of whether librarians "add anything" to the searching process. It is a bit like asking whether doctors add anything to the healing process. How would you know? Are you going to run a trial? In the case of librarians, the answer of course, from the very robust evidence of experience and common sense, is that it will depend on the relative level of expertise of the end-user (clinician) and the librarian. You need to raise the debate to a higher intellectual level than that exhibited so far. In this library, we find that very many of our end-users are poor searchers and need librarians to help them, sometimes to begin with, sometimes always. That is robust evidence. You can hardly get more robust than actual reported facts. My advice is not to waste your time with senior EBM figures, who really are not interested in evidence when it comes to librarians - they just do not like them.

[Sarah Sutton]

Dear All

I think Librarians can search better than clinicians on the whole. I am referring to librarians who conduct searches regularly and have been trained in this. My own experience shows that we can do better than all but the most experienced/interested clinician searchers. I think the only clinician advantage is that they know what sort of information they are looking for - so if they have framed their question poorly and then find the articles they want by some luck they can then follow them up - whereas the librarian if working on their own would just investigate the original question. However, assuming an accurately framed question and an experienced librarian I would back the librarian. Clinicians are quite busy enough looking after patients they dont have time to develop high level searching skills or keep abreast with database developments - librarians do and of course they are waaaaaaaaaaaaaaaaaaaaaaaay cheaper. I am devoted to my clinician colleagues and I couldnt do their job - they could do mine but they honestly dont have the time to do the searching itself or keep up the database knowledge neccessary for it.

[Imeri Waibuca]

Our effectiveness as Librarians is demonstrated in:
1) The level of knowledge base, understanding & skills we've acquired as information specialists for various information sources.
2) On the question of our database searching skills vs that of clinicians:
Our task as information professionals is to increase the success rate of retrieving the desired or useful information from a database. As librarians, we are duty-bound to ensure that these desired outcomes are realised through one-to-one training or group training.
3) Evidence of our effectiveness?
3.1 The impact of our service is our ability to provide clinicians with the right information at the right time.

[Gillian Wood]

Our "effectiveness" changes over time. When medline was hosted on remote servers, and searching was done using elhill software, of course we were more effective - we were the only ones who knew how to search! We proabably still are better searchers in a lot of cases, but we're also a lot more skilled at actually finding the articles at the end of a search. Or providing an appropriate suite of resources to search in the first place. Or undertaking training so people can do their own searches. Our skills aren't only measured by our searching prowess - it is (as Imeri says above) "providing people with the right information at the right time" in whatever format the client wants.