EBM-EBL Trends – DRAFT
Carol Perryman
Joanne Marshall
The roots of evidence-based library and information practice (EBLIP) may be found in
evidence-based medicine (EBM), which itself originated from the realization that most
medical decisions were not based upon generalizable research. Due to their involvement
in helping to find the best information to support patient care, medical librarians were
natural partners in EBM. Librarians’ work in developing evidence, and in training
healthcare professionals to retrieve ‘best evidence’ as technology made access to full-text
resources more available, has been crucial to the improvement of healthcare quality.
Such growth led directly to a realization on the part of EBL's pioneers that what we do
for our patrons, we can (and should) do for ourselves, and to the creation of a research
statement by the Medical Library Association in 1995 (Bradley & Marshall).
Although librarians have always conducted research to enhance their own library
practices, the use of more rigorous research methods such as those encouraged by EBL is
relatively recent. The search for a suitable model for EBL did not begin until 1997,
when MLA President Rachel Anderson spoke of the need to develop a model for
evidence-based practice for librarianship. An article published in Hypothesis speculated
about what such a model might look like (Eldredge, 1997), recognizing fundamental
differences between the contexts for practice for medicine and librarianship, the
realization that not all practitioners would need to conduct research, and the need for a
shift toward a culture that supported and valued research activities. Factors supporting
this trend have included an increased emphasis on evaluation, such as the successful
implementation of the LibQual tools and benchmarking activities between libraries.
These initiatives have increased the visibility of library administrative decision-making,
leading to the need for more rigorous, outcomes-focused practice methods.
Medical librarians’ involvement with research has evolved in what might be seen as two
separate, but complementary, pathways. First, our support of increased quality in patient
care has led to our enhanced understanding of EBM, as it has become more
sophisticated. We continue to move toward an increasingly collaborative model of
practice, acting as quality filters for healthcare practitioners. Second, the use of more
rigorous research methods to support our own practices began with just a scattering of
studies as far back as 1946 (Postell) and has slowly been building a base of research
knowledge for future growth.
Milestone studies include the first randomized clinical trial in librarianship (Marshall,
1981), and the Rochester study (Marshall, 1992), which helped to establish the value of
hospital libraries within their institutions. More recently, the requirement for structured
abstracts in papers and posters submitted to MLA meetings and to JMLA have begun to
improve our ability to find research articles from our own literature (Bayley & Eldredge,
2003). A hierarchy of evidence tailored to LIS practice was proposed in 2000
(Eldredge); domains for practice were established as the result of a study published in
2004 (Koufogiannakis & Slater); and the initial discussion of models and methods were
refined and summarized in the 2004 text, Evidence-based practice for information
professionals: a handbook (Booth & Brice). The handbook provides readers with
practical ways to apply EBL, including examples of its use in the six domains of
librarianship, first identified by Crumley and Koufogiannakis (2002) and discussion of
methods of question formulation, such as PICO1, SPICE2, and ECLIPSe3, all mnemonics
intended to focus on the most pertinent aspects of a question.
It is clear that evidence-based practice is finding its way into the profession’s
publications and standards, based upon this brief listing of progress, and by growing
attendance at a series of international conferences on the topic. Three conferences have
focused on EBL to date, in 2001, 2003, and 2005. The LINC Health Panel Research and
Horizon Scanning Task Group and the School of Health and Related Research
(ScHARR), University of Sheffield presented the first EBL conference, focusing on
definitions, models, the need for critical evaluation by librarians, describing and
educating participants about the CRISTAL model for evaluation (Brice, 2001); and
conducting a forum on Canada’s involvement in EBL initiatives (EBL Conference,
2001). Cited as background information was Goal 4 of the Strategic Plan of the Medical
Library Association 2000-2001, which made the recommendation to “foster evidencebased librarianship and the judicious application of research results as a hallmark of the
health information professional".
In 2003, the second international conference was hosted by the University of Alberta in
Edmonton, Canada, with the theme of Improving Practice Through Research: Current
Perspectives, Future Prospects. Chaired by Andrew Booth and co-chaired by Ellen
Crumley and Denise Koufogiannakis, the event showcased practical application of EBL
techniques, including a plea for the use of structured abstracts for all library journals;
considered issues of lifelong learning; the evaluation of qualitative evidence in EBL; and
a presentation by Prudence Dalrymple on educational preparation for EBL in practice.
The 2005 conference, entitled Global Perspectives on Linking Research with Practice,
was held in Brisbane, Queensland, Australia. Keynote speakers included Andrew Booth,
Anne Brice, who brought the attendants up to date about developments in EBL; J. Eric
Davies, on the topic of trends and goals in appraisal of library practices; Peter Macauley,
who spoke about librarian roles; and Joanne Gard Marshall, who discussed the North
American implementations of EBL. Papers read demonstrated the expansion of EBL
models into domains such as marketing, user perspectives, humanities education and
librarianship. The fourth conference, entitled Transforming the Profession, will be held
in North Carolina in 2007.
1
PICO is a mnemonic for Population, Intervention, Comparison, and Outcome.
SPICE is a mnemonic for Setting, Perspective, Intervention, Comparison, and Evaluation.
3
ECLIPSe is a mnemonic for Expectation, Client group, Location, Impact, Professionals, and Service.
2
1st EBL Conference, Sheffield, UK, 3-4 September 2001. Evidence-based librarianship.
Further information is available at http://www.eblib.net/ (accessed 8/9/2006).
2nd International EBL Conference, Edmonton, Canada, 4-6 June 2003. Improving
practice through research: current perspectives, future prospects.
3rd International EBL Conference, Brisbane, Australia, 16-19 October 2005. Evolution of
evidence: global perspectives on linking research with practice.
4th International EBL Conference, Chapel Hill, NC, United States, May 16-11 2007.
Transforming the profession.
Anderson RK. “Inaugural Address” in Proceedings of the Ninety-seventh Annual
Meeting, Medical Library Association , Seattle, WA, May 23-28, 1997. Bulletin of the
Medical Library Association 1998 Jan; 86(1): 117–143.
Bayley L & Eldredge J. (2003). The structured abstract: an essential tool for researchers.
Hypothesis, 17(1):1,11-13.
Booth A & Brice A. (2004). Evidence-based practice for information professionals: a
handbook. London, England: Facet Publications.
Brice A. Clear as CRISTAL? Equipping health librarians with the skills to appraise
health information research articles. Powerpoint presented at the first EBL Conference in
Sheffield, UK, 2001.
Crumley E. & Koufogiannakis D. (2002). Developing evidence based librarianship:
practical steps for implementation. Health Information and Libraries Journal, 19(2):6170.
Dalrymple PW, Bastille JD, Bradley J, et al. (1995). Research Policy Statement of the
Medical Library Association: Using Scientific Evidence to Improve Information Practice.
Retrieved from http://www.mlanet.org/research/science2.html 4/23/2006.
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Marshall JG. (1992, Apr). The impact of the hospital library on clinical decision making:
the Rochester study. Bulletin of the Medical Library Association, 80(2):169-78.
Medical Library Association. The Strategic Plan of the Medical Library Association,
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