Presentation ASTED 2012, Lessons learned from Nursing Journal Club, survey and change of educational tool.

1. The Journal Club: A Tool of Change?
Le Club de lecture: Un outil de changement ?
Teodora Constantinescu, MLIS & Renée Lavoie, RN, BSc
Colloque ASTED
Montreal, le 2 Novembre 2012

2. OUTLINE
• Background
• Objective
• Methods
• Survey
• Results
• Discussion

3. BACKGROUND

4. IN THE BEGINNING…
• Serendipity and opportunity …
• Nurse-librarian conversation (spring 2011)

5. ACTORS
• Nurses
• Librarians
• Organization (Institution)

6. NEEDS AND OBJECTIVES
OF PSYCHIATRY NURSES AT JGH
• Forum to meet regularly
• Discuss literature on issues of interest
• Keep up to date
• Learn together (knowledge, skills)
• Nurses in control of process
• Improve patient outcome
EMPOWERMENT

7. JOURNAL CLUBS
• “The most compelling reason to start a journal club is to
keep abreast of the latest nursing research”
• “A way of improving practice by ensuring patient care is
based on most accurate and current information” (Luby,
2006)
• Increase research utilization
1875 - Sir William Osler: first formal medical journal club in North America
HLWiki: Journal Clubs : http://hlwiki.slais.ubc.ca/index.php/Journal_clubs

8. EVIDENCE BASED PRACTICE (EBP) PROCESS
Library training
(ACRL Information
Literacy)
PATIEN
T
CENTERED
Organizational Journal Club
Procedures

9. EBP LIMITATIONS
• Evidence
– Body of research varies in quantity and quality
• Implementation
– Time
– Lack of knowledge and skills
– Lack of incentives
– Organizational culture
• Measurement of outcomes

10. OUTLINE
• Background
• Methods
• Survey
• Results
• Discussion

11. METHODS
The Journal Club
Observation
Re-evaluation
The Survey

12. JGH Psychiatry Nurses Journal Club
• Monthly meetings
• Over 60% participation rate
• 2 nurse coordinators / club facilitators
• Topics chosen by the group
• Presenter: volunteer basis
• Article selected by presenter with nurse coordinator

13. LIBRARIAN’S ROLE
• Collaborator
• Search the literature
• Present “vignettes”
• Reflective Observer
• No influence on choice of topic or choice of article to
discussed

14. OBSERVATIONS
• Nurses driven process
• Questions asked: general not specific
• Information chosen : reviews, reference
• Preference: summarized and concrete applications
• Some difficulty with computer and searching skills
• Some difficulty: research methodologies and critical
appraisal
Enthusiasm for learning
Engaged in discussions

15. REFLECTION
• Evaluate the gap
• Is the group ready for searching , critically
assessing and integrating the research into
practice?
– Knowledge, skills, values
• Re-evaluate the pertinence of journal club as a
learning tool (blind spot)

16. LITERATURE SEARCH : NURSES AND
INFORMATION SEEKING
• Information seeking behavior, O’Leary (2011)
– Routine vs non-routine
– Colleagues rather than searching literature for answers
– Prepackaged information
• Low research uptake Estabrooks (2003), Squires (2011)
- Contextual factors significant
- No clear interventions to increase research utilization
• Readiness of nurses for EBP: Pravikoff, Tanner, Pierce,
(2005)
– Low use of bibliographic databases and hospital libraries
– Greatest barrier to using evidence is “lack of value for
research in practice”

17. METHODS: SURVEY
Modeled on Pravikoff (2005) (93 points)
8 questions with sub-questions (39 points)
1. Knowledge of EBP and attitudes (values)
2. Information needs and Information Sources
3. Perceived Top Three Barriers and Facilitators for EBP
20 participants 65% response rate

18. OUTLINE
• Background
• Methods
• Survey
• Results
• Discussion

19. RESULTS

20. RESULTS: JGH PSYCHIATRY NURSE
DEMOGRAPHICS

21. RESULTS: PERCEIVED KNOWLEDGE
RELATIVE TO RESEARCH
70%
never involved in research
67 %
somewhat knowledgeable
of EBP and processes
50%
somewhat knowledgeable in
interpreting research results and
assessing quality
23%
evaluated research reports

22. RESULTS: USE OF INFORMATION
RESOURCES

23. RESULTS: USE OF RESOURCES
Internet (Google)
83% Daily/Weekly
Colleagues 76% Daily/Weekly
Textbooks 53% Weekly
Practice Guidelines 41% Monthly
Medline/PubMed 41% Monthly
CINAHL 63% Never
PsycINFO 50% Never
Librarian: 41 % yearly, 25% monthly, 25% never

24. RESULTS: TOP BARRIERS TO EBP
(OTHER THAN TIME)
Correction: Lack of literature
searching skills

25. RESULTS : FACILITATORS OF EBP

26. OUTLINE
• Background
• Methods
• Survey
• Results
• Discussion

27. DISCUSSION

28. DISCUSSION: Findings
• Findings reflect those of larger studies:
– Low use of resources
– Preference for summarized information
• Readiness for Evidence Based Practice?
– Lack of value for research
– Need for information skills
– Need for a role model and mentor
• nurse educator trained in EBP
– Need for organizational support

29. DISCUSSION: Limitations
• Survey limitations
• Survey tool
• Small data set
• Correlation
• Limited access to original research
questionnaires
• Blindspot: assessing journal club as a method

30. LESSONS LEARNED
• Librarian – Nurse Collaboration: “merging silos”*

31. Way forward:
• Re-evaluate educational objectives and methods
• Curriculum for information literacy
• Content drives the format:
• Journal club format – at a later stage
• Immediate relevance of teaching

32. CONCLUSION: Journal Club, Tool of Change ?
• Readiness for journal club at your institution?
• Facilitating factors ?
• Limiting factors?
• What will be your role?

33. REFERENCES
• Miller LC, Jones BB, Graves RS, Sievert MC. Merging silos: collaborating for
information literacy. J Contin Educ Nurs. 2010 Jun;41(6):267-72. PubMed
PMID: 20411879.
• O'leary DF, Mhaolrúnaigh SN. Information-seeking behaviour of nurses:
where is information sought and what processes are followed? J Adv Nurs.
2012 Feb;68(2):379-90.
• Pravikoff DS, Tanner AB, Pierce ST. Readiness of U.S. nurses for evidence-
based practice. Am J Nurs. 2005 Sep;105(9):40-51
• Squires JE, Estabrooks CA, Gustavsson P, Wallin L. Individual determinants
of research utilization by nurses: a systematic review update. Implement
Sci. 2011 Jan 5;6:1.
• HLWiki: Journal Clubs : http://hlwiki.slais.ubc.ca/index.php/Journal_clubs

34. CONTACT
Teodora Constantinescu, MLIS
tconstantinescu@jgh.mcgill.ca
Renée Lavoie, RN, BSc
rlavoie@jgh.mcgill.ca