Research in the Library: An Evidence-based Approach for Making Informed Decisions

NIH Library April 2, 2010

Research in the Library: An
Evidence-based Approach for
Making Informed Decisions
Library Research Seminar-V
Session 3B, Room 1105
Thursday, October 7, 2010

Framing the questions…
…continuing the conversation

Twitter
#lrsv20103B
SlideShare
http://www.slideshare.net/doujou.DC
Wiki
http://evidence4lib.pbworks.com/

1


The Research Imperative: The
Research Policy Statement of the
Medical Library Association

Culture of Research

Research Skills Set

Domains of Research

In memory of Jocelyn Rankin PhD, librarian & mentor

Creating a Culture of Research: the
Vision

One important factor is having a leader at your library that is

interested in research and helping others in the
library become engaged in doing research.

Betsy L. Humphreys, AHIP

2


Creating the Health Information
Knowledgebase: The Challenge

The comment we sometimes hear is that I don’t have
enough time to do research. “There is always time, it is the

question of priorities.”

Wayne J. Peay

Domains of Research

We need to be more active in publishing our

research. “If it is interesting and valuable to you, you can
almost guarantee that it will be interesting and valuable to
someone else.”

Ann McKibbon

3


Research Skills Set

Collaboration, research almost always involves other
people.

Claire J. Twose

Start by collaborating with someone who has done
research, start with a poster presentation, brief
communication

Deborah D. Blecic, AHIP

The process of implementing a
federated search system at the
National Institutes of Health Library

Anne White-Olson, Information & Education Services Branch
Ben Hope, NIHL Information Architecture Branch
Douglas Joubert, NIHL Information Architecture Branch

DIVISION OF LIBRARY SERVICES
OFFICE OF RESEARCH SERVICES
NATIONAL INSTITUTES OF HEALTH
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

4


Project Goals and Objectives

 Find a meta-search product that would allow NIH staff to
simultaneously search multiple resources
 Establish a search interface that integrates library
resources into the NIH Clinical Research Information
Systems (CRIS)
 Ascertain the needs and preferences of NIH staff in terms
of searching for information online
 Identify core functionality and ideal user interface design
for the NIHL meta-search tool

One search system deployed on 2
unique platforms

NIH Library Clinical Center*

The Clinical Center search interfaces exposes patient data; therefore,
we are not able to show search results

5


About the search prototype

 Developed by Tamas Doszkocs, Senior Computer
Scientist at NLM.
 Searches multiple, independent databases and clusters
retrieval into subject categories.
 Utilizes natural language process tools to access
heterogeneous information sources on the open and deep
web.
 Includes spellchecker, automatic mapping to thesauri,
concept clusters for focused drill down and query
refinement.

The Environment - NIH Library 2006

Two things were happening
1. Professional staff was taking a Qualitative
Research Course
2. Staff was looking into implementing a Federated
Search System
Outcomes
1. Combined the two to develop a class project on
looking at systems using qualitative research
methods learned in class.
2. In 2009 completing the process implementing
First Search at the NIHL

6


Project Phases

Phase 1

A qualitative approach using focus groups with six nurse
specialists from the Department of Clinical Research
Informatics was used.

Phase2

The NIHL contracted with UserWorks, Inc. to conduct a
usability study.

Grounded Theory

 Inductively build theories through successive levels of data
analysis and conceptual development.
 The theory evolves and changes as the researcher
interacts with the data.
 Methodology is inductive rather than deductive due to the
“interplay with the data collected in actual research”.
 Interplay is continuous and evolving

Berg, B. L. (2007). Qualitative research methods for the social sciences (6th ed.). Boston:
Pearson/Allyn & Bacon.

7


Our Focus Group

CRIS Nurse Informaticians who provide user support,
training and documentation for the NIH Clinical Research
Information System

Focus Group Methods (1)

Participants were asked the following
questions
1. What is your favorite web site and why?
2. When you search for information on the web,
where do you go?
3. What resources do you use at the library?

8



The contents of interviews were transcribed and analyzed in
ATLAS.ti according to the principles of grounded theory.

Focus group activities included a discussion of meta-
searching and a demonstration of the meta-search
prototype.

Additional discussion to elicit feedback from the participants
concerning the preferred design and features of a meta-
search search system.


 Focus group transcripts
were loaded into
ATLAS.ti v5.2.12 for
analysis.
 Content analysis is the
systematic examination
and interpretation of a
primary document to
identify themes and
meanings.

9



 Independent group also
developed codes using
index cards.
 After the first and second
stages of organizing the
codes into themes, a third
researcher was brought in
to resolve differences in
organizing the codes into
groups.

Usability Methods (1)

 The usability study compared the prototype to a number of
meta-search platforms in an attempt to understand user
performance, needs, and preferences of the proposed
meta-search platform.
 The usability study had 14 participants (4 male and 10
female), which included researchers, administrators, and
NIHL staff.

10


Usability Methods (2)

 Each subject participated in a one-on-one interview and
three user-performed tasks:
 Find information on a specific topic
 Locate a specific article
 If time allowed, conduct a user-defined search

Results – Focus Group

88 codes were generated from 114 quotations using
the open coding technique, in which research team
members grouped each line of discreet and
meaningful text from the focus group transcript into
conceptual units.

The “Features” theme focused on the manipulation of
search results and saving searches

“Types of Resources” theme focused on the resources
commonly used by these focus group participants,
namely PubMed and CINAHL

11


16 themes generated from the
codes

Usability Grouped Categories

Advanced search

Search terms

Search status and results

Refining results
Clustering
Search Results Display

Other Key Findings

12


Advanced search

 It was important to have an advanced search option to
accommodate different users
 Labels need to be clearly identified and use intuitive
nomenclature (no library jargon)
 Help needs be context-specific.

Search terms

 Increase the prominence of the “did you mean” spell check
 Employ commonly used search inputs, such as quotation
marks, the word “and,” semi-colons, and the plus sign

13


Search status and results

 Wanted a status bar to help them understand when the
search was complete.
 Preferred to wait and see all the results at once, rather
than seeing the results by source.

Refining results

 Used and liked the refine results option
 Function of “refine results” was not consistent across all
platforms

14


Search results display

 Participants expected and wanted a summary abstract for
journal articles
 Participants wanted keywords in titles and abstract to be
highlighted to determine whether a result was relevant

Clustering

 Participants thought that clustering was important;
however, it needed to be refined:
 Offer many layers to the clustering
 Show consistent clusters
 Show full subcategory cluster headings
 Provide a means for narrowing by clustering without
losing the primary cluster

15


Other Key Findings

 Right-handed content had limited use and interest
 Several features were not heavily utilized
 Category links
 MeSH capability
 Publication links
 Sort and limit options

OK, What Next?

 Based on the findings from the usability study, the team
developed a list of priorities for the developer
 The list was further refined for both products

16


Contact Us
 Douglas J. Joubert, MS, MLIS
Phone: 301-594-6282
E-mail: joubertd@mail.nih.gov
LinkedIn: http://www.linkedin.com/in/douglasjoubert
Twitter: http://twitter.com/doujouDC

 Anne White-Olson, MLS
Phone: 301-451-5863
E-mail: whiteols@mail.nih.gov

Visualize the Activity in the Library
with Data

Bradley Otterson, NIHL Information Architecture Branch
Ben Hope, NIHL Information Architecture Branch


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Case Study

 The NIHL was redesigned to make the facility
reconfigurable and flexible.
 To find the best way to use and arrange the space, we
wanted to look at data based on usage and activity, but we
didn’t know how to get it.
 This case study explores the way we approached and
solved this problem.

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Computer Zone
• Study Carrels
• Raised counter
with stools
• Laptop Chairs

Visual Display with Numbers
Numbers represent the times a chair or workstation was occupied during an
observation period. A total of 71 observations took place during a single week.
Each observation took about 10 minutes.

Computer Window
Zone Zone
Media
Zone

Spine Zone
Collaboration
Zone
Carrel Training
Zone Zone
Standing Computer Zone

IESB Chair Zone

Visual Display of Activity Zones
Each color represents a distinct activity area of the library.

19


Computer Zone Window Zone
• Study Carrels with • Lounge Chairs
PCs • Tables with Chairs
• Raised counter • Browsing of New
and stools with PCs Journals,
• Laptop Chairs Newspapers, and
Media Zone
•Tables and
Books
•Chairs
•Area for Receptions
•TV with News
Spine Zone
•Tables with chairs
•Browsing of New Books Training
Room
Collaboration •Tables and
Zone Carrel Zone Chairs
•Lounge Chairs •Study Carrels

Standing Computer
Zone
•Stand-up Stations

IESB Chair Zone
•Lounge Chairs

Visual Display of Activity Zones with Furniture Options
Darker variations of red indicate higher levels of activity. Furniture within the
zones range from lounge chairs to study carrels.

Case Study
 Background Information
 Problem
 Solution
 Pilot Study
 Study
 Results
 Analysis and Outcome
 Lessons Learned
 Next Steps

20


Background Information
 The library serves 18,000+ staff.
 The library is located in the largest building on campus,
and is the largest brick building in the world.
 3.3 million square feet and over nine miles of corridors.
 The library is in the hub of a large, sprawling campus.

The redesign turned a room full of study carrels into an inviting
space with a variety of moveable seating options and activity
zones.

Before After

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The redesign included transforming an outdoor slab of concrete into
an inviting green roof terrace.

Before After

Problem
How do we document the use of the library?
The first attempt was to develop a paper-based system using maps
of the library with activity zones. A team of nine library staff members
walked through the library at designated time intervals noting the
activity on the map. They put an X where people were sitting and a
note about the patron’s activity.

22


Problem
The paper-based system created additional problems:
 The data and notes from library staff were inconsistent. For
example, some library staff members made extensive notes
and other did not annotate anything.
 It was difficult to mark, score, and tabulate the results. The
error rate for entering the data from the printed maps into an
Excel spreadsheet was high and the work was tedious.

Solution (1)

 Create a paperless system based on three requirements:
 A touch screen laptop would allow library staff to easily
record their observations of patron activity.
 The laptop needed a map of the library with seating
options that let library staff touch the screen where clients
were sitting. A drop-down menu allowed for documenting
the activity (e.g., reading, using a laptop, collaborating).

23


Solution (2)

 The data from the observations should be automatically
captured and stored in a database. This would minimize
errors and allow us to easily create a variety of reports and
thematic maps to visualize the activity.
 Built a system based on our requirements

Finding the Right Software (1)

1. Checked for existing software or custom programming
solutions – too expensive and no products matched our
requirements
2. Found a form-creating software package that allowed
form fields to be placed over a background image. The
image was a map of the library with furniture and other
aspects of the room done in Visio. Each piece of
furniture was a field in the form.

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Finding the Right Software (2)

3. The software wasn’t designed for our purposes, but it
included the ability to:
 Create drop-down fields over furniture to record
different activities
 Integrate Visual Basic programming for customization
and scripting
 Directly export data to a SQL or Access database.
4. Used asp and a webpage to create a display of tallied
data based on SQL query.

This is a screenshot of the tool on the touch-screen laptop. The
drop-down menu has the options for recording the activities.

25


Pilot Study

We asked for volunteers from all branches of the library to form a
research team to conduct the study. A total of 27 (out of 47) staff
members volunteered. Members were trained on how to use the
laptop. They signed up for time slots for each hour the library was
open during the week. They walked through the library noting the
activity on the laptop. It took about 10 minutes for each scan.

Pilot Study

After the pilot study, the team met to discuss their experiences with
conducting the observations. They reported problems with the software
and gave suggestions for improving the outcome of study.
Software Problem Suggestions
 An error caused the last entry for  They wanted to clarify the drop-
a chair to replicate into the next down options for activity. The
time slot. This would have tainted final options were:
the data.
 Laptop
 Laptop and Paperwork
 Reading
 Collaborating
 Relaxing
 Training

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Study

 When the software problems were fixed and the suggestions
were implemented, the team conducted the final study with the
laptop for a one-week period.
 After conducting the observations, the data was tabulated. We
used Photoshop to create thematic maps and Excel to make
charts.

Results
We created a series of thematic maps that showed where people
were sitting. This is an example:
Usage

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Results
A series of charts showed what people were doing. Here’s an example:

Activities

Laptop 1,169 people observed
9%
Laptop +
Papers
9%

Library computers
43% Reading
14%

Paperwork
7%

Training
10% Collaboration Total 1,169
Relaxing 4%
4%

Analysis and Outcome

After analyzing the series of thematic maps and charts, the
research team made suggestions for changing the layout of
the room.
The room was changed based on their recommendations.
Here are two examples:
 More PCs and carrels were added to the Computer Zone
due to high usage. Laptop chairs were moved from the
Computer Zone to another level of the library due to low
usage.
 Lounge chairs near the information desk were moved due to
low usage. The unused chairs were moved to the entrance
and to another level of the library.

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Top 5 Things Learned from the Case
Study

1. Technology, innovation, and perseverance can help solve a
problem.
2. We found out where the high and low usage areas were.
3. After we rearranged the room based on the team’s suggestions, we
noticed that patrons are using the new arrangement more than the
previous one. We want to do another study to find out if our new
observations and changes are supported by the data.
4. The most-used chairs were the private study carrels.
5. It’s possible for a research team of 27 members not only to work
together to get something done but to remain on speaking terms
afterwards.

Next Steps (1)

 Add the terrace and downstairs to the maps for the next
studies.
 Do additional studies with the terrace, downstairs, and
new configurations of the room.
 Remove and/or purchase more furniture if future studies
warrant.
 Examine activity areas to make changes.

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Next Steps (2)

 Improve the software so that results are calculated and
displayed on the web in real-time.
 Configure the database so that we can run different
reports on activity in the entire library for comparative
future studies.
 Busiest times of day and week
 Most popular activity and where
 Most/least used options for chairs/workstations/areas

Contact Us
 Ben Hope
Phone: 301-594-6473
E-mail: TallGuy@nih.gov

 Bradley Otterson
Phone: 301-496-2258
E-mail: Bradley.Otterson@nih.gov

30


Disaster Information Needs:
A Medical Librarian Perspective

Alicia Livinski, Nancy Terry

Alison Rollins, Linda Spitzer
Learning Resource Center, Uniformed Services University


Background

 “Researchers learn their craft through a combination of
trial and error, and getting their hands dirty with data.”*
 Ours is a qualitative research project.
 Our introduction to qualitative research was a class on
Qualitative Research Methods in 2008.
 Our research began as a class assignment.

Berg, B. L. (2007). Qualitative research methods for the social sciences (6th ed.). Boston:
Pearson/Allyn & Bacon.

31


Rationale

 Collaborators in this study provide library services to
groups in the US Dept. of Health and Human Services
(HHS) and Department of Defense personnel (civilian and
military).
 People in these groups have previously deployed for a
disaster or humanitarian emergency.
 Idea for this research grew out of our work providing
library services for them.
 Small body of literature on information needs of disaster
responders.

Purpose

 To determine the information needs of disaster and
emergency response personnel within the Federal
Government.
 Identify information needs, formats, access challenges,
and barriers, technology capabilities.
 Learn how libraries can proactively provide information
needed by response personnel when deployed in a
disaster/emergency situation.

32


Hypothesis

 Information needs of disaster/emergency
professionals before, during and after a response
are significant and vary greatly in scope.

Focus

 What should librarians know to provide the best service to
emergency and disaster responders?
 About the user: Disaster responders
 The operational environment
“I don’t always have the cognitive
 Delivering information process it takes to tease out the
resources I have access to, or you
 Resources used
all have access to, so I am relying
 Other challenges on you all resource librarians to
help me find the information I need
 Resource design for background information and for
information support.”
recommendations

33


Methodology
 Interviewed 12 public health & military personnel
 Agencies represented by interviewees:
1 2 3 4

 Interviewees had world-wide responder experience:

1. Faculty, Uniformed Services University of the Health Sciences (USUHS)
2. Center for Disaster & Humanitarian Medicine (CDHAM), USUHS
3. HHS, Office of the Secretary, Assistant Secretary for Preparedness & Response (ASPR)
4. HHS, Office of the Secretary, Office of the Surgeon General, Office of Civilian Volunteer Medical Reserve Corps
(OCVMRC)

Methodology

 Interviewees were:
 public health officials,
 nurses,
 physicians,
 pharmacist,
 faculty, &
 government leaders

34


Methodology

 Semi- Structured Interviews
 9-question survey used to explore:
 Information used during response
 Information needed/desired
 Formats & delivery options
 Information sources need in an ideal resource
 Coded transcribed interviews
 Identified themes
 Categorized with a card sort

Methodology

 Limitations to our study:
 Federal uniformed responders only (DoD & DHHS)
 Recall bias of interviewees
 Small # of interviewees
 We also did not include responders to the January
2010 Haitian earthquake

35


Results

"It's not until you hit the ground that you
realize, 'What else do I need?”

FEMA

Wildfires

Results: The users

 Information needs differ during different stages:
 Pre-deployment
 Deployment
 Planning
 “Normal” duties & experience may not match crisis
assignments
 Personal & professional networks are essential

36


Results: Environment

"during a disaster and being in the
middle of it [...] being able to lay your
hands on information instantaneously is
usually what it is about."

PhotoShare
Flooding


 Librarians should always consider their disaster-responder
patrons’:
 Physical Environment
 Type of disaster/emergency
 Location of disaster/emergency
 Socio-Cultural Environment
 Type of response: International, federal, state, UN
 Players on the ground: NGOs, military, US, or other
foreign governments
It’s complicated!

37


 Challenges from their physical environment:
 Electricity to power/re-charge devices
 Unreliable & slow Internet service
 Bandwidth restrictions
 Not enough laptops for all
 Email account size limits
 Firewalls
 Insufficient time to research - ready answers are key
 Small screens (PDAs)
 Printing not always possible
 Weather


 The socio-cultural environment:
 Collaboration among all responding partners is key to
prevent duplication, sharing of resources, ensuring
coverage of affected populations
 Respect for capability and decision-making role of
“host” government
 All those responding also need food, clean water,
shelter, & security
 Different missions, goals & objectives of responding
partners
 Military/Government responders may be limited by
classified/non-classified sharing restrictions

38



"I think multiple means of
communication are absolutely
necessary, even when deploying down
on the Mall for the Reagan funeral, we
had to fall back on finding people's
personal telephone numbers, we'd use
walkie-talkies, we'd go into dead zones,
or something.

Leone, American Samoa – Tsunami (2009)

Results: Delivering information
 Formats:
 Electronic is favored for:
 Portability,
 Compatibility with multiple devices
 Transferability
 BUT, print is still important!

 Devices: http://nnlm.gov/webreports/ep/uploads/2009/07/one-shelf-0709.jpg

 Many types of devices are used
Redundant delivery methods are
important!

39


Results: Delivering information

Types of devices used:
• PDAs/SmartPhones
• CD-Roms
• Laptops
• Cell Phones
• Fax
• Cameras
• Satellite phones
• Thumb drives

Important: Internet is accessed via these devices!

Results: Resources required

"...the frustrating thing is, there's not a
good single book for all of this. For
instance, the Sphere Guidelines, [is]
just for displaced populations, and
it's great for that purpose. ...There's
not a really good textbook out there,
nor have I seen much in the way of
recent bibliographies out there."
Peter Allen (MA-1)

HHS/DMAT – MA-1: Haiti Earthquake (2010)

40


Information required by responders is
scattered:
 Across authoring groups  Across delivery formats
& organizations
 PDF vs. print vs. html
 Government
 Across types of
 NGOs resources
 International agencies  Journals
(e.g. UN, WHO, PAHO)
 Books
 Think tanks
 Reports, white papers,
 Professional manuals, & technical
associations reports
 Academic institutions


 Types of grey literature needed:
 Policy & legislative information
 Local, State, Federal disaster plans & policies
 Disaster/emergency specific information
 Surveys & assessment tools

41



 Cultural, socioeconomic, geographical, endemic health
information on affected area
 Clinical information
 Reporting forms
 Patient education materials


Examples of clinical care resources:
 Clinical care guidelines & standards
 Drug information (substitutions, interactions)
 Patient education materials
 Quick references (handbooks, downloadable software to
PDA/smartphone)

42


Specific resources mentioned in
interviews

"having these tools available in
one place as opposed to having to
recreate them or find them . . . “

(AP Photo/ U.S. Army)

Combat Support Hospital, Baghdad, Iraq (2003)

43


Recommendations
Some recommendations for delivery of info to
responders:
• Centralized access: provide one-stop searching
• Easy to navigate

• Searchable: users are "Googlers“
• Quick & easy to add information
• Robust tagging
• Redundancy
• Pre-loaded devices
• Be prepared to "push" info to users

Conclusions

"It would have been really nice to
have one Web portal where you
could go and get current updates
related to what was going on
within the mission, like how many
people had been treated and
seen..."
FEMA/Casey Deshong

DMAT - Pago Pago, American Samoa (2009)

44


Conclusion: Summary

Information needs depend upon:

 Deployment role
 Type of information needed
 When its needed
 Nature of disaster
 Knowledge of pre-existing resource
 Technology available
 Other physical constraints (e.g., electricity)

Unfortunately, when it comes to accessing information
during a disaster, much depends on the nature of the
disaster & who is responding.

There is no one-size fits all solution!

45


Lessons Learned

 Interview more non - DOD people for balance

 Conduct pre-interview informant screening – difficult to
find the right person

 Conduct study over shorter time period

 Use transcription software service

How Study Results Helped Us

 Inform/Improve disaster preparedness resource collection
development
 USUHS is developing a portal for disaster response
information resources
 Promote desired information resources to HHS
responders
 Results feed into work being done by the National Library
of Medicine (NLM)

46


Next Steps - Other Thoughts

 Future research projects:
 Questionnaire of USPHS personnel
 Additional questions:
 Will innovations in mobile devices eliminate
communication limitations?
 Assist with accessing information?
 More information:
 NLM Disaster Information Management Resource
Center (DIMRC)

Contact Us
 Nancy Terry
Phone: 301.594.6274
E-mail: terryn@mail.nih.gov

 Alicia Livinski
Phone: 301-594-6423
E-mail: livinska@od.nih.gov

47


The Research Imperative: The
Research Policy Statement of the
Medical Library Association

 Creating a Culture of Research: the Vision
 Creating the Health Information Knowledgebase: The
Challenge
 Domains of Research
 Research Skills Set
 MLA's Partners: Who Will Make It Happen
 Research Policy Statement Recommendations
http://www.mlanet.org/research/policy/policy-01_toc.html

Resources

 Bayley, L., & McKibbon, A. (2006). Evidence-based librarianship:a
personal perspective from the medical/nursing realm. Library Hi Tech,
24, 317-323.
 Booth, A. (2002). From EBM to EBL: two steps forward or one step
back? Med Ref Serv Q, 21(3), 51-64.
 Booth, A. (2003). Bridging the Research-Practice Gap? The Role of
Evidence Based Librarianship. New Review of Information and Library
Research, 9(1), 3 - 23.
 Booth, A. (2010). Upon reflection: five mirrors of evidence-based
practice. Health Info Libr J, 27(3), 253-256.

48


Resources

1. Bayley, L., & McKibbon, A. (2006). Evidence-based librarianship:a
personal perspective from the medical/nursing realm. Library Hi
Tech, 24, 317-323.
2. Booth, A. (2002). From EBM to EBL: two steps forward or one step
back? Med Ref Serv Q, 21(3), 51-64.
3. Booth, A. (2003). Bridging the Research-Practice Gap? The Role of
Evidence Based Librarianship. New Review of Information and
Library Research, 9(1), 3 - 23.
4. Booth, A. (2010). Upon reflection: five mirrors of evidence-based
practice. Health Info Libr J, 27(3), 253-256.

Resources

5. Booth, A. (nd). Critical Appraisal Checklists. from
http://nettingtheevidence.pbworks.com/Critical-Appraisal-Checklists
6. Booth, A., & Brice, A. (2004). Evidence-based practice for
information professionals : a handbook. London: Facet Pub.
7. Booth, A., Clarke, M., Ghersi, D., Moher, D., Petticrew, M., &
Stewart, L. An international registry of systematic-review protocols.
The Lancet, In Press, Corrected Proof
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