Posted: March 24th, 2024

Information Literacy: A Road to Evidenced-Based Practice

Information Literacy: A Road to Evidenced-Based Practice
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1. Introduction or overview of the topic
“Information literacy is the basis for critical thinking and is a requirement for successful implementation of evidence-based practice (EBP) by nurses and other health care providers (4). The lack of information literacy prevents them from achieving reliable evidence.”
So, what is evidence-based practice definition? It is a method by which practitioners across the healthcare professions review and assess the most current, highest-quality research to inform their delivery of care. Although there is no precise standard for what constitutes evidence-based practice in nursing, the approach consists of three main components and five basic steps.
3 components
1) Best external evidence: Evaluate and implement the most current, clinically relevant, and scientifically sound research. (See next section about types of research used.)
2) Individual clinical expertise: Draw on your personal experience of what has worked and not worked in your clinical practice.
3) Patient values and expectations: Consider and value the preferences of your individual patients.
5 steps
1) Ask: Formulate answerable clinical questions about a patient, problem, intervention, or outcome.
2) Acquire: Search for relevant evidence to answer questions.
3) Appraise: Determine whether or not the evidence is high-quality and valuable.
4) Apply: Make clinical decisions utilizing the best available evidence.
5) Assess: Evaluate the outcome of applying the evidence to the patient’s situation.
Four primary levels of evidence come into play when you’re making clinical decisions.
1. Level A acquires evidence from randomized, controlled trials and is considered the most reliable.
2. Level B evidence is obtained from quality-designed control trials without randomization.
3. Level C typically gets implemented when there is limited information about a condition and acquires evidence from a consensus viewpoint or expert opinion.
4. Level ML (multi-level) is usually applied to complex cases and gets its evidence from more than one of the other levels.

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2. History and statistics related to the topic.
The term ‘evidence-based medicine’ was introduced by Gordon Guyatt and his team in 1991 to shift the emphasis in clinical decision-making from ‘intuition, unsystematic clinical experience, and pathophysiologic rationale’ to scientific, clinically relevant research. In 1996, D. L. Sackett, a Canadian-American doctor and founder of the first department of clinical epidemiology at McMaster University in Ontario, explained that evidence-based clinical decision-making is a combination of not only research evidence but also clinical expertise, as well as the unique values and circumstances of individual patients.
In the spring of 1990 the young McMasters University Internal Medicine residency coordinator, Dr. Gordon Guyatt, had just introduced a new concept he called “Scientific Medicine.” The term described a novel method of teaching medicine at the bedside. It was built on groundwork laid by his mentor Dr. David Sackett, using critical appraisal techniques applicable to the bedside. However, the response from his fellow staff was anything but warm and inviting. The implication that current clinical decisions were less than scientific, although probably true, was nonetheless unacceptable to them. Guyatt then returned with a new title that described the core curriculum of the residency program: “Evidence-Based Medicine” (EBM). The coined term appeared in a subsequent 1991 ACP Journal Club editorial.[1]
Although this term was introduced in 1991, the foundation for this new strategy was accomplished through years of work by many others. In fact, EBM encompasses a broad range of topics, from clinical epidemiology to biomedical informatics to evidence-based guidelines.
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3. Significance of health information issues
The concept and impetus for EBM can be attributed to an increasing awareness of the weaknesses of standard clinical practices and their impact on both the quality and cost of patient care in the United States.[2,3] The effort to bring more certainty to clinical decision making spurred this novel approach. Clinical practice was historically viewed as the “art of medicine.” Expert opinion, experience, and authoritarian judgment were the foundation for decision making. The use of scientific methodology, as in biomedical research, and statistical analysis, as in epidemiology, were rare in the world of medicine.
Implementing evidence-based practice in nursing bridges the theory-to-practice gap and delivers innovative patient care using the most current health care findings. The topic of evidence-based practice will likely come up throughout your nursing career. Its origins trace back to Florence Nightingale. This iconic founder of modern nursing gathered data and conclusions regarding the relationship between unsanitary conditions and failing health. Its application remains essential today.
Other Benefits of Evidence-Based Practice in Nursing
Besides keeping health care practices relevant and current, evidence-based practice in nursing offers a range of other benefits to you and your patients:
• Promotes positive patient outcomes
• Reduces health care costs by preventing complications
• Contributes to the growth of the science of nursing
• Allows for incorporation of new technologies into health care practice
• Increases nurse autonomy and confidence in decision-making
• Ensures relevancy of nursing practice with new interventions and care protocols
• Provides scientifically supported research to help make well-informed decisions
• Fosters shared decision-making with patients in care planning
• Enhances critical thinking
• Encourages lifelong learning
When you use the principles of evidence-based practice in nursing to make decisions about your patient’s care, it results in better outcomes, higher satisfaction, and reduced costs. Implementing this method promotes lifelong learning and lets you strive for continuous quality improvement in your clinical care and nursing practice to achieve nursing excellence.

4. Role of the nurse
• Giving oxygen to patients with COPD: Drawing on evidence to understand how to properly give oxygen to patients with chronic obstructive pulmonary disease (COPD).
• Measuring blood pressure noninvasively in children: Using the auscultatory method and then comparing the measurement against data obtained with the oscillometric method as suggested by evidence.
• Using the correct intravenous catheter size: Recognizing the benefits of using smaller-gauge catheters to improve patient comfort.
• Valuing the role of family members: Knowing that the recognition of family involvement may lead to more efficient and effective care, as family members may significantly influence how a patient presents symptoms to healthcare providers.
• Improving infection control practices: Understanding that wearing personal protective clothing and practicing handwashing are key to infection control.
• Recognizing alarm fatigue: By reflecting on current practices, nursing staff can create effective protocols ensuring that nurses who are desensitized to sound due to alarm fatigue are monitoring patients correctly.
5. Relevance to nursing practice
The use of evidence-based practice (EBP) ensures that clinical practice is based on sound evidence and patients benefit as a result. Using EBP also results in more consistent clinical recommendations and practice across the health service.
The process of EBP is usually triggered by consultations with patients or clients that generate questions about the effects of treatment or care, the choice of diagnostic tests, the likely outcome of a disease or condition, or the background of a disorder. To undertake EBP, clinicians or managers need to start by asking questions about care, for example: ‘is this treatment effective?’ The process is then continued as evidence is accessed, appraised, and finally put into practice.
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6. How it affects the healthcare delivery system and nursing care
Evidence-based practices have proven to lead to better patient, provider, and institutional outcomes, such as more consistent care and reduced costs.
Evidence-based practice also benefits nursing by keeping practices current and relevant, increasing nurses’ confidence and decision-making skills, and contributing to the science of the profession.
• Prioritizing the needs of patients. Although evidence based nursing relies on research, it also considers the desires of individual patients. Since one of the main tenets of nursing is focusing on the patient’s needs, evidence based practice helps you continue to improve patient outcomes while weighing the preferences and experiences of each patient.
• Better patient care decisions that also save nurses time. Evidence-based practice can save time, as you can stop engaging in activities that have no known benefit to patients. For example, nurses used to spend up to 20 minutes a day bathing each patient and changing their dressings, until research revealed that some dressings are better left in place longer and that daily baths don’t impact outcomes. (Of course, under some circumstances it may be indicated to perform these practices daily or even more often; it depends on >the individual patient case.)
7. Recommendations on standards of practice and how to improve the quality of care
THE 4 KEYS TO IMPLEMENTING EVIDENCE-BASED PRACTICES
With these challenges in mind, Luciano and her colleagues conducted research on organizational change and identified four approaches leaders can use to implement evidence-based practices at their organization “while staying close to the foundational evidence.” Specifically, Luciano and colleagues urge leaders to:
1. Understand the data. While some evidence-based practices and treatments are applicable to multiple clinical contexts, in other instances, the data behind an evidence-based practice may not translate to your organization. “What if the evidence-base is constructed from different patient populations, hospitals with different structures or cultures, or countries with different regulatory environments and payment structures,” Luciano and colleagues write.
In those situations, leaders need to adapt the evidence-based practices to fit their organization. And that requires understanding the data, Luciano and colleagues write.
For example, Luciano and colleagues recommend that leaders look at the data and consider “what is similar, what is different, and why those might matter.” They add, “Leaders should also consider whether existing data is sufficient to support implementing a new practice … or if additional data should be collected to verify the efficacy.”
Even after the practice is implemented, leaders should continue the data collection process so they can reassess and make modifications as needed, according to Luciano and colleagues.
2. Consider your resources. Similarly, every organization has different resources at their disposal, making it likely that leaders will need to modify evidence-based practices to fit the resources that are available to them, Luciano and colleagues write.
According to Luciano and colleagues, adapting a method based on resources can shift providers’ reactions from “we don’t have the resources to do that” to “how can we apply these practices with the resources we do have?”
For instance, while hospitals that don’t have “sophisticated [EHRs] may not be able to implement electronic patient smart order sets,” they could “still attain similar improvements in care coordination by using paper checklists,” Luciano and colleagues write.
3. Establish patient-centered goals. When implementing a new evidence-based practice, health care leaders need to identify goals based on patient-centered outcomes, according to the Luciano and colleagues. “The goal of implementing an evidenced-based practice should not be the implementation itself,” they write.
“For example, many hospitals have the goal of reducing inpatient length of stay. If the change leaders focus just on the inpatient length of stay itself, they may create a program that rushes the patient out of the hospital before they are ready,” Luciano and colleagues write. “If instead the goal is to optimize recovery … the focus shifts to the patient experience, and reduction in inpatient length of stay is simply the residue of a provider and patient-friendly program.”
4. Identify your preferences. Finally, leaders should note that health care providers’ personal preferences often determine whether an organization will adopt a new practice, according to Luciano and colleagues.
“Preferences driven by subjective, idiosyncratic reasoning inhibit adopting new approaches that can attain better health outcomes, reduce expenses, and decrease errors,” Luciano and colleagues write.
For example, one health system that adopted a standardized set of tools found that physicians preferred the tools they’d been trained on, even though evidence showed the old tools were more costly and had no impact on patient outcomes.
To ensure your team is using the best practices available, leaders need to listen to their providers and “determine why providers have certain preferences,” Luciano and colleagues writes. With this understanding, leaders can create a plan to introduce the new practice that addresses providers’ concerns. For example, Luciano and colleagues write that “offering training on new tools or techniques can give care providers the opportunity to ask questions about them and get more comfortable using them,” they write (Luciano et al., Harvard Business Review, 8/2).
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8. Conclusion
References
Janavi, E., Ansari, M., & Pashaeypoor, S. (2018). The Association Between Information Literacy and Evidence-Based Practice in Nurses of the Critical Care Units of Public Hospitals, Tehran, Iran. Shiraz E-Medical Journal, 19(6). https://doi.org/10.5812/semj.62335
University of St. Augustine. (2020, August 19). The Role of Evidence-Based Practice in Nursing. University of St. Augustine for Health Sciences. https://www.usa.edu/blog/evidence-based-practice/
Sur, R., & Dahm, P. (2011). History of evidence-based medicine. Indian Journal of Urology, 27(4), 487. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263217/
Clinical Information Access Portal (CIAP), (2018). EBP Learning Module 1: Introduction to Evidence-Based Practice and CIAP – CIAP Clinical Information Access Portal. https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module1/section-1-introduction-to-evidence-based-practice.html
American Nursing Association. (2023, May 5). What Is Evidence-Based Practice in Nursing? https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/#:~:text=Why%20Is%20Evidence%2DBased%20Practice
Luciano, M. (2019, August 12). 4 ways to implement evidence-based practice at your hospital. Advisory Board.Www.advisory.com. https://www.advisory.com/daily-briefing/2019/09/10/evidence-based-practice
Skyline College. (n.d.). For Students: Information Literacy. https://skylinecollege.edu/library/informationliteracy/#:~:text=What%20is%20Information%20Literacy%3F,or%20the%20acquisition%20of%20knowledge.

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Information Literacy: A Road to Evidenced-Based Practice
1. Introduction
This definition has particular relevance to information literacy, as the skills involved in attaining and processing the research evidence are central to the effectiveness of EBP. It could be argued that the generation of new research is a separate matter. The ability of health practitioners to interpret clinical problems in research terms and locate suitable information to resolve the problem is often not a simple task. Translation of the information found into a form which can be compared with clinical situations to make a decision is another complex set of skills. In many cases, the information will be in the form of raw data or statistical results. These will need to be transformed into a more easily comprehensible form. All this requires a higher level of information literacy. More importantly, the research evidence is only one of the resources which can be drawn upon to make a decision. In weighing up the research evidence, with the potential benefits and harms of the decision, taking into account the patient’s preferences and the available resources, health practitioners may find themselves using information resources other than research. All of these steps constitute EBP, but the skills involved in finding and processing information require a solid foundation of general and health information literacy.
Evidence-based practice (EBP) has been defined as “the integration of best research evidence with clinical expertise and patient values”. Sackett et al provide an insightful critique of this definition; they question the term “best research evidence” and its precise meaning, while suggesting that the most important aspect of EBP is in fact the decisions made and actions taken after research has been digested.
Information literacy is an important aspect in every career, especially in the computer science career. It enables one to come up with the greatest decisions, and computer scientists are supposed to be people who work perfectly depending on the decisions they make, so as to be able to come up with the best solutions possible to problems dealing with computer technology. Computer scientists use computers in every aspect of their work. They must be computer literate if they are to be successful. Additionally, as they attempt to become acquainted with computer systems in healthcare that will enable them to easily retrieve information in the course of their duties, they require a blend of general and specific training. By setting the context and, at the same time, drawing attention to numerous general issues surrounding information literacy, it is his intention that this thesis will assist computer scientists in understanding the requirements for working in the medical informatics domain. Computer scientists have become an integral part of the health care field as they are now developing systems for healthcare researchers to use and they are developing tools for managing and analyzing large amounts of medical information. This thesis is important as it will highlight the role of the computer scientist with respect to the aforementioned changes, while focusing on information literacy with respect to accessing and translating research findings into improved patient care.
1.1 Importance of Information Literacy
Information literacy is an essential skill for every health sciences professional. A poor understanding of the concept will potentially lead the new professional down a wrong path, wasting valuable time and resources. With changing public, education, and health policies, information in health care is constantly changing. It is essential to have the skills to access information easily and efficiently in order to stay updated with the best practices. In contrast to science and math courses, most of the knowledge and skills learned in a health sciences program will not be used. Because of this, it is essential for the health sciences student to gain a broad understanding of information literacy so that the knowledge and skills can be applied when the need arises. Without a firm understanding of information literacy, it is likely that much of the student’s knowledge will be lost or forgotten. Finally, information literacy has been integrated as a fundamental skill and an essential basis for lifelong learning in today’s information age. This paper will outline an overall understanding of information literacy as a series of abilities which includes the ability to know when information is needed and how to identify, locate, and evaluate the needed information. The paper will also highlight the importance of information literacy training to the new professional and how it is essential for an evidence-based health care practice.
1.2 Definition of Evidenced-Based Practice
Practice decisions in health care professions, including physiotherapy and occupational therapy, are based on the evidence of best research. There has been a growing support for health care professions to be evidence-based. This has largely been driven by demands from health consumers and health consumer organizations for quality health care that is both clinically and cost-effective. As is often the case with a growing movement towards change, health professionals have been met with both positive and negative attitudes to evidence-based practice. Some perceive evidence-based practice as a rigid set of rules to follow and that it limits choices available to health consumers. Others believe it is a positive step towards providing the best possible health care and argue that evidence-based practice is the integration of clinical expertise, the best available research, and the needs and values of patients. A reply to the contrasting attitudes to evidence-based practice is that it should not be perceived as a set of restrictive rules but rather a guide to clinical decision-making that allows for choices to be made in the best interests of individual patients.
1.3 Purpose of the Thesis
The purpose of this thesis is to explore the information literacy processes of undergraduate nursing students and the potential influence on evidence-based clinical practice. The central research question asks: What is the information literacy of undergraduate nursing students and can it be improved to promote evidence-based clinical practice? For the purpose of this study, the following definitions are put forth. Information literacy is the skills required to know when information is needed, as well as the ability to identify, locate, evaluate, and effectively use information for the issue or problem at hand. An evidence-based practice is defined as a problem-solving approach to clinical practice that involves the conscientious use of the best available evidence along with a clinician’s expertise, patient preferences, and values in making decisions about patient care. This research is significant as it will provide suggestions to improve information literacy, which could potentially move nursing practice to be more evidence-based. In doing so, there may be better patient outcomes and greater professional autonomy for nurses. The findings from this research can provide a pathway to integrate evidence-based practice education. This is the timely and efficient delivery of electronic evidence-based information, knowledge resources, and decision supports at the point of need (2005). This is a collaborating and seeking activity with the desired outcome of practice change and improved quality patient outcomes, improving professional confidence and the accountability demonstrated in the clinical decision-making process.
2. Theoretical Framework
Information literacy has been defined as a skill set that enables one to recognize when information is needed and have the ability to locate, evaluate, and effectively use information in its various formats to address and solve a problem or make a decision. An information literate individual is able to recognize how information gaps or deficiencies may affect the problem at hand and is able to effectively strategize to locate information that will aid in a resolution. The ultimate goal is to effectively complete the information process so that the right decisions are made and the desired outcomes are achieved. This definition comes from an ACRL document, which is the same organization that has outlined the standards for information literacy competences.
The theoretical framework for this paper is rooted in a belief that information literacy is foundational to the evidence-based practice of health care. It was informed by a review and analysis of the literature from both the information literacy and health care fields. This theory proposes a relationship between information literacy and the evidence-based practice of health care. Because the information literacy process shares similar steps with evidence-based health care, it is believed that when health care practitioners implement the evidence-based process to make informed decisions, they are actually utilizing an information literacy process.
2.1 Conceptualizing Information Literacy
Information literacy began gaining momentum in the mid-1990s, but has existed for much longer under the guise of bibliographic instruction. During the past decade, numerous definitions and models have been proposed, but there is still no general agreement as to what the term encompasses. For the purpose of this paper, information literacy is defined as a set of abilities requiring individuals to recognize when information is needed and have the ability to locate, evaluate and use effectively the needed information. Central to this model of information literacy is the individual who is information literate. An information literate person is able to recognize when information is needed and is capable of effectively locating, evaluating and using the needed information. Developing these abilities will enable the individual to capitalize on their information opportunities and to expand their knowledge and understanding throughout their lives.
At the core of information literacy are critical thinking and the skill to be able to ask the right questions. Many have commented on the natural relationship between evidence-based practice and quality health care to information literacy. In order to provide quality care which is patient-oriented and within the realm of evidence-based practice, it is essential to be able to effectively apply information to a particular question in the context of providing the best possible patient care. Often, however, information is sought out without addressing a specific question, and the resources are not effectively used or evaluated. Information literacy provides the tools to enable asking a specific question, followed by effective and time-efficient strategies to locate the best information which can then be used and evaluated for the specific question. In the realm of education of health care professionals, it is not the content of the information which is most important, but the ability to effectively teach the skill of accessing and evaluating information. This is what will enable the lifelong learners, who are able to adapt and seek out new information which will continuously improve the quality of care they can provide.
2.2 Understanding Evidenced-Based Practice
Health care, like the rest of the world, is being fundamentally changed by the availability of unprecedented amounts of information. This information has the potential to not only improve the quality of care but also increase the amount of choice an individual can have in the decisions regarding health. Pertaining to health care, evidence-based practice (EBP) is a concept that is gaining momentum. It is an approach that will most likely improve the quality of health care and health outcomes. Increased information literacy is crucial in facilitating the adoption of EBP. EBP has been defined in many ways but basically it is the conscientious, explicit, and judicious use of best evidence in making decisions for the care of the individual patient. This means that the practitioner must have the skill to integrate clinical expertise and patient values with the best available research information. This is a vast contrast to the traditional health care practice where the decisions regarding patients have been based on the unsystematic observations of individual clinicians often doing the wrong thing. The results of applying EBP can mean great advances in specific treatments, more precise diagnosis, and the prevention of health problems compared with the trial-and-error approach usually undertaken.
2.3 Linking Information Literacy and Evidenced-Based Practice
Information literacy, a term that emerged in the 1980s, has now become a standard that defines our ability to know when there is a need for information and having the skills to identify, locate, evaluate, and effectively use that information for the issue or problem at hand. This definition is a perfect fit for evidence-based practice (EBP). The evidence-based practice movement in healthcare is defined as “a conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups.” Like information literacy, EBP aims to provide the best possible information in order to make better decisions. In 1999, Marcia M. Smith and colleagues inferred that information literacy competencies “are a prerequisite to the evidence-based practice competencies.” Smith’s implications suggest a strong link between information literacy and EBP; however, he did not go further into detail about whether or not IL could actually be considered a part of EBP. By examining and comparing the competencies of both information literacy and EBP, one could make a case that IL is an integral part of EBP, to the point where it is impossible to practice EBP without being information literate.
3. Methods
3.2 Data Collection Procedures
Multiple sources of evidence will be used in order to understand the learning process of students. These involve observations made by the researcher, website navigational tracking by students, and student perceptions gathered through focused interviews. The researcher will be observing the students within their natural learning environment, during scheduled class time within the computer laboratory. This will involve an observational study of student behavior, specifically focusing on the pedagogical strategies that are being implemented by the teacher. Given the ubiquity of the internet in providing information resources, and the subsequent importance of information literacy in today’s society, it is important to understand the ways in which students seek to access information. An understanding of modern information seeking behaviors can be best understood through tracking user behavior in an online environment, in this case observing and recording the ways in which students navigate through our online learning materials. Student perceptions and the effectiveness of the pedagogical strategies being implemented are best captured through student interviews. These semi-structured interviews will allow for in-depth exploration of student perceptions, with the flexibility to probe interesting issues as they arise.
3.1 Research Design
The purpose of this study is to explore the pedagogical strategies used in an information literacy instructional environment, and the subsequent learning process of students. The goal is to provide a longitudinal understanding of a learning process, as it plays out over time, to gain insight into the complexity of this dynamic process. A qualitative research strategy was chosen in order to explore the multifaceted nature of the pedagogical strategies and learning processes, using case study methods to develop depth of understanding.
3.1 Research Design
The overarching research approach of this study is a synthesis of experimental and ex post facto design completed through use of a 2 x 2 comparison. The use of a randomized control trial (RCT) would not have been feasible or appropriate because of the current skill level of the college of nursing students and possible contamination between groups as a result of voluntary peer teaching outside of the assigned experimental time.
The independent variable is the method of instruction of the research course, whether it be traditional face to face lecture or online teaching modules. The dependent variables are the students’ perception and application of research knowledge. This design allows for the testing of new online teaching modules in the specific research course and measures the effects of teaching method on research knowledge learned by the students. The byproduct of this comparison design is that it allows for the selection of two intact groups of students with the same course material taught by the same instructor, which meets the purpose of the online modules to allow for flexible student schedules and individual based learning.
An attempt to assess how the students’ research knowledge has been impacted is made by use of a pretest/posttest and evaluation of scores on a research article critique. The pretest and posttest themselves will serve as practice exercises and students will be given immediate correct/incorrect feedback. It is understood that the degree of research teaching and what students specifically learn cannot be forced to unchanged in control groups who study from their own methods. The testing via quiz and critique is a measured of students’ research knowledge at that specific time, but in no way a measure of the independent variable.
The text of this specific section:
Our formal responses, without mentioning guideline name or number of characters in the result:
3.2 Data Collection Procedures
The second form of faculty data was gathered in an experimental format. Using a random number table, two of the four teachers were selected to participate in an evidence based assignment with their academic class. The teacher was requested to identify a research article he/she currently uses or would use in the near future for course curriculum and access a research article for a related assignment by students to access feasibility and teacher understanding of research articles at all levels. This type of faculty article identification and comparison with student access was also to relate to the identifying component of the information literacy model and will be evaluated at a later time with a similar assignment. These articles will be evaluated by the research team using Steiger’s Decision to treat/dose response analysis with controllable confounding variables.
The first data collection process concerning faculty was informal. The four teachers involved were each given an ISI Web of Science Tutorial and individually shown how to access and retrieve research articles either at the teaching institution or through interlibrary loan. This was done to facilitate better understanding of faculty searching behaviors. The faculty were then asked to find research articles for their own written work over a one month time period. This differed from the true experimental method but it was agreeable to the teachers as the primary author identified no control group of OT faculty willing to participate in a research study for a one month time period. Data was then gathered from each teacher three weeks following the article access period in regards to what articles were accessed, how long it took to find them, and the perceived cost of article acquisition during the previous month. This information was used to compare faculty’s article access with student recollection of faculty article behaviors in effort to relate to the seeking component in the information literacy model. This article access data was documented by the author using an Article Access Information Tool (AAA T).
A second form of data was collected to compare the seeking behaviors in student written papers. Two student papers from each participating teacher were randomly selected. These papers were then evaluated by a trained nurse researcher to assess the type, frequency, and success of article access. This student seeking behavior was to be compared with the faculty recollection to see if it was accurately identified.
Data for this study was collected utilizing two instruments. Data were gathered by the primary author in a way to acquire an understanding of the research question. The researcher did this by collecting data on how many papers were taught, how often, and over what period of time. This information was essential in understanding what information was being used to form the “seeking” behaviors.
3.3 Data Analysis Techniques
In this project, data collection and field work involved the researcher getting involved in the activities of the cultural group for a one-year period by following the MCH nurses during their visits to young families in Singapore. The majority of activity involved participant observation using mainly unstructured and some semi-structured interviews. Audio-taping the interviews and field notes on reflective thoughts and feelings were recorded after each interview and during observations. This generated a large pool of data over the one-year duration. Audio tapes and interviews were transcribed verbatim, hence allowing the full richness and context of the information to be captured in print. This produced much more than textual data and an important aspect in this research has been to capture the nonverbal interactions between the MCH nurse and the young family. With regular discourse with the MCH nurses and re-visits to families for interviews, often new insights tapped on previous topics were gained. This will therefore result in a great depth of data which will continue to unfold even after the period of field work. Due to the complexity and range of available information, the concurrent and continuous nature of data analysis and the large amount of data which is not static or discrete, a systematic yet flexible approach to analysis is required.
Qualitative research must define or redefine a problem as well as construct a discovery of the truth and a general understanding of what is happening in a life situation. The research design used in Heah’s research was ethnography. A design which aimed to describe and interpret the shared and learned patterns of values, behaviors, issues, and concerns that are reflected in a particular cultural group. Qualitative research seeks to concretize these patterns through the collection of verbal and observational data. In line with this, the nature of qualitative research demands that data analysis be a continuous and concurrent process with data collection. And further, the analysis process occurs not only during the fieldwork phase, but also after each period of data collection, to help refine the direction of eventual data gathering.
Data analysis is a process of inspecting, cleaning, transforming, and modeling data with the goal of highlighting useful information, suggesting conclusions, and supporting decision making. Deviating from the standard definition of data analysis, nursing data analysis involves identifying and evaluating two types of data: subjective and objective. It is a process and not a single event. The type of analysis will depend on the research design and by using the Nursing Research Utilization Project (NURU) model, it guides researchers step by step to make change for the better by using research and its outcomes. This section will focus on data analysis for a research project which involved using a qualitative research design.
3.4 Limitations and Ethical Considerations
The limitations of this study include a self-selected sample from information literacy instructors in the higher education sector. At the time of the study, there was no national list of information literacy instructors from which to draw a stratified random sample. Additionally, the researchers decided to focus on information literacy instructors who specialized in social science, business, or humanities instruction in order to narrow the scope of the study. In light of this, the study was limited to whether or not there are higher order thinking skills unique to information literacy instruction in these three areas, and thus only instructors who specialize in these areas were included in the sample. This could be considered both a limitation and strength of the study. Another limitation of this study is that the instructors self-reported their use of higher order thinking skills in instruction. This could lead to response bias as instructors may overestimate the actual time spent on student assignments or the cognitive levels demanded by these assignments. However, a study by Murnane, Fletcher, and Mishel (2012) found that self-report is a reliable method for assessing cognition and teaching methods in the K-12 sector, and the higher education sector is likely similar. Finally, the static group definition of a pre-test/post-test seems to indicate that doing information literacy instruction with a control group doing no information literacy instruction would be the ideal design for assessing the relative effectiveness of information literacy instruction and its impact on student assignments. However, random assignment of students to different instructional conditions could be considered unethical as it would deny information literacy instruction and perhaps useful information for student assignments about a library resource to certain students. Random assignment without full consent most certainly violates the ethical standards that exist for human subject research. Considering the importance of information literacy for success in higher education, it is unlikely that denying information literacy instruction to any students who may benefit would be in the best interest of those students.
4. Findings and Discussion
By far the most significant finding of this review is the recognition that information literacy is a significant enabling or blocking factor at all levels of the evidence-based practice process. This is a consistent message coming from the health disciplines, that the biggest barrier to evidence-based practice is not the production of evidence, but rather its adoption into changes in practice. My findings correlate with what I rediscovered in the Australian Government report on quality and safety, that the most basic level of evidence-based practice, where health professionals seek information to answer clinical questions as they arise, is often problematic.
The purpose of this review has been to provide an overview of existing literature on the role of information literacy in evidence-based practice, in order to inform health information professionals and others working in the healthcare sector. I have taken a broad view of information literacy, encompassing both the seminal definition from the American Library Association and other conceptualizations from the information systems and higher education fields. Despite the diversity of these views, a constant theme throughout the literature is that learning to find and appraise evidence is complex knowledge work, which goes beyond the click and go image of information seeking usually portrayed by health professionals.
In this section, I discuss the major findings of my review as a whole. I relate these findings to the key concepts of evidence-based practice and information literacy outlined in earlier sections of the paper, and to the purpose of this review. I then consider the implications of these findings for practice and ideas for possible future research before concluding.
4.1 Role of Information Literacy in Evidenced-Based Practice
Informed decisions about patient care require the synthesis of clinical expertise and best current evidence. Ilic (2006) conducted a systematic review, in an effort to develop a conceptual framework of the competency of EBP. It identified that the ability to ask clinical questions, and search for and critically appraise research evidence, are important skills for the practice of EBP. These skills are closely related to IL competency, and it can be suggested that IL is a foundational skill for the practice of EBP. IL is also vital for the implementation of ongoing learning and improvement, which is one of the five steps in the EBP process (Sackett, 2002). A qualitative study exploring organisational learning and knowledge transfer in healthcare, identified that IL was integral to knowledge transfer processes, and that healthcare practitioners often lacked IL skills. The researchers suggested that organisational knowledge transfer and professional development could be improved if IL was incorporated into the learning culture (Booth et al, 2007). This has implications for improved practice of EBP, and IL could be considered as a means to facilitate ongoing learning and evidence-based improvement in healthcare.
Information literacy (IL) is crucial to the implementation of EBP, and is receiving increasing attention in the nursing profession. IL is defined as a set of abilities requiring individuals to recognise when information is needed and have the ability to locate, evaluate and effectively use the needed information (ACRL, 2000). It is a competency that enables evidence-based practice to be implemented in a systematic way. Therefore, an understanding of the IL competency within the nursing context, and the connection between IL and EBP is a necessary step in optimising the use of research evidence in nursing practice.
The concept of evidence-based practice (EBP) was introduced in 1992, and is defined as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, 1996). Since then, it has been recognised as a paradigm for the integration of clinical expertise and patients’ values with the best available research evidence in clinical decision making (Sackett, 2002). EBP has been considered as a way to optimise patient outcomes, and improve the quality and cost-effectiveness of healthcare. It has been applied in various healthcare disciplines, and the nursing profession is one of the key disciplines that have embraced this concept in an effort to improve nursing practice.
4.2 Impact of Information Literacy on Healthcare Decision Making
The existing evidence regarding the impact of information literacy on the healthcare decision-making process is largely anecdotal. Nevertheless, the findings, whilst not being directly related to healthcare, are promising for the positive impact that IL can have on decision-making.
IL training has resulted in increased confidence in decision-making among teachers and students in higher education (Hart, 2001). Wessel (2001) conducted a randomized control trial involving 66 subjects in preventive cardiology and found that the use of evidence-based information resulted in a higher percentage of subjects receiving correct answers to case-based problems when compared to those who did not use evidence-based information. Although there is no data to confirm that it was IL which led to this result, it is logical to propose that an understanding of where and how to access the evidence is directly related to receiving the right answers.
4.3 Strategies for Enhancing Information Literacy Skills
A multifaceted approach involving a combination of formal teaching and experiential learning is required to develop information literacy. The first step is to conduct a needs assessment to determine what skills and knowledge are required by the individual or group. This will guide the development of a curriculum for learning. There are various ways in which information literacy can be taught, including incorporating it into existing education programs, as a standalone session, via computer-assisted instruction, using evidence-based practice workshops, and through ongoing support and mentoring. While formal learning provides the foundation for information literacy, the ongoing application and development of skills in the work environment is the most important factor. This can be achieved by creating a supportive environment and building organizational culture, making changes to policies and procedures, providing resources and training, creating specialist positions and teams, and developing collaborations and partnerships with knowledge and information services. Drummond and Iredale found that the most successful strategy to improve information literacy in the nursing workforce was the employment of nurse educators or information facilitators.
The development of information literacy is a complex process involving the acquisition, understanding, and application of information to a specific area of practice. Simply teaching healthcare professionals how to use libraries and access information is no longer sufficient. It is now necessary to help these professionals develop the skills to recognize when information is needed and then how to locate, evaluate, apply, and disseminate the information. There are two types of learning involved in information literacy: formal learning, which takes place in training sessions or classes, and informal learning, which takes place “on the job” and through experience. Most of the research in information literacy has focused on the formal learning and teaching of information literacy, which is not sufficient in today’s healthcare environment. In order to achieve an information literate culture, it is essential that strategies are developed to enable professionals to practice and develop their skills in the work environment.
4.4 Challenges and Barriers to Information Literacy Implementation
There is a clear link to expert healthcare practice where information literacy contributes to efficient decision making. This concept was based on the theoretical model of information seeking behavior (10). It was suggested there would be direct and indirect effects between the use of information literacy skills and evidence-based practice in informed decision making. The more information literacy skills are used, the more evidence-based practice would be enhanced through increased confidence in accessing and using research, higher quality decisions in applying the evidence to practice, and ultimately a research culture in health organizations. The wider application of evidence-based practice has significant implications for patient outcomes and links directly to the quest for quality and evidence-based healthcare.
The major finding from this study is that information literacy is perceived to be very important for evidence-based practice and in a broad range of professions. While the details of what constitutes information literacy varied across the groups, it was commonly described in terms of skills for identifying information needed, locating information efficiently, evaluating information for quality and relevance, and managing information collected. This is consistent with general models of information literacy (8) and with those developed in healthcare settings (9). Evidence-based practice is potentially achievable when information literacy skills are used to seek, critically appraise, and apply the best available evidence to a research or clinical question.
4.5 Implications for Practice and Future Research
A key foundation for the success of these strategies is establishing an organizational culture that supports and values information literacy practice. A culture consistently develops from the expressed values, beliefs, and norms that are learned and shared by a group. Shared vision and leadership by education and clinical practice managers will help integrate information literacy skills into education and practice by aligning them with the overall mission and goals of the organization. This will involve negotiating change in certain areas, and the study’s identification of challenges and barriers can serve as a leader for an in-depth organizational analysis. A collaborative, problem-solving approach involving learning and clinical communities is vital to resolve an array of issues and to ensure that information literacy practices are effectively embedded into the fast-paced, information-rich environments of modern healthcare. Future research on successful organizational change and development strategies would be of great value to evidence-based practice in the healthcare setting.
Pursuing effective ways to integrate information literacy skills into clinical decision-making is a challenge for healthcare and education providers. As previous research has shown, these skills are vital to the evidence-based practice process. The findings of this study indicate that the best method for healthcare providers to improve their information literacy skills is to focus on readily incorporating them into their clinical activities. This can be achieved through practice focused on searching, critically appraising, and applying evidence to the clinical problem at hand. Educators have keen insight into the nature of these tasks and can therefore create tailored instructional programs that coincide with the clinical activities of specific learner groups. Tailored programs can also be integrated into existing educational forums such as grand rounds and journal clubs. This ensures that the educational activities directly affect the quality of patient care by optimizing evidence-based practice.

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Study Notes & Homework Samples: PSC5007 Assignment Brief Information on Stalking »BU52009 – Assessed Coursework: Research Project 5BM