Saturday, December 20, 2008

Teaching EBL, part 2

I begin where I left off, and will hopefully move forward. I ended my last posting by asking whether we even understand librarians' information behavior, and that this question has led me to a reworking of the syllabus and my own dissertation research question.

In syllabus creation I find it best to recursively echo objectives, in a progressive, perhaps kaleidoscopic way: how does this look from here? - does this aspect of the model appear to jibe with this new perspective? If a key part of the course objective is "to reflect on the experience and model for EBLIP as a way to bridge the gap between research and practice," assignments and discussions must continually encourage reflection, rather than compliance with the model for practice.

I am thinking this through as I write. With so little known about our practices, does in-class reflection truly serve the purpose of evaluating the model? Or rather, doesn't it ask for individual (or at best, small group) reactions - rather than a more structured approach that also incorporates what is known about the larger population? But if the purpose of EBP is to support the practitioner, and if I am trying to teach individual practitioners (as opposed to teaching researchers who wish to advance their research agendas), perhaps it is the individual and their reflective discourse that is key, so that the objective is bridging the research-practice gap as an individual practitioner.

If this is the case, then the intended take-away for the class might be an individualized toolbox, suited to each participant's area of practice, together with an appreciation for the translational issues within and across areas of practice.

Now, back to a consideration of whether the current syllabus moves us toward that goal. You know what I love? - that in teaching about EBL, I cannot myself avoid the model for its practice. It seems to me that the base and framework and process, the research support and evaluation, also need to be constructed using the best evidence, following the very model I am attempting to disseminate.

Sunday, December 14, 2008

Teaching EBL

I'm working now on the syllabus for the spring's class, offered through WISE, co-taught with Joanne Gard Marshall. Once again it will be completely revised, and this process is one I find so valuable - as a new university-level instructor, as a new researcher myself, and as a librarian.

The first course was a tutorial, with 6 modules. It was begun as the final project for the EBM course taught by Connie Schardt, further refined during a (wonderful, superb) college teaching course I took, and then trialed with a full-semester, Master's level class where the tutorial provided a framework. In the years between my time at the hospital library and now, I had been able to step away from the practice environment, where my focus was wholly on patrons, and toward a deeper understanding of my own long-simmering questions about the what and wherefore and why of LIS practice itself.

So, I stepped away, and began to think about those questions, simultaneously acquiring the critical mindset of a graduate student. I could make jokes here about book learnin'. I looked back, though, with a critical eye, remembering years of practicing by the seat of my pants.

I had to figure out, for example, how to find AV materials for physician CE on the pre-subject searchable OCLC by instinct and practice, or figure out which bindery (and bindery method - fan binding? new glues?) was best and most economical. No guides, no real mentorship early on (I had a director who was scared of computers, and was using the OCLC M300 with one 5 1/4" floppy drive - if I say PC File, do you shudder?), but at the same time, I had an incredible amount of freedom to err and earn my expertise.

I looked back and was shocked at the sheer amount of time wasted, at the slips I made. There is a better way, I became convinced, to do this. Here, from perspective, I wonder if I could have the same perceptions if I had not had such freedom to err. The mentorship that has benefited me so much from the start might have been more akin to Six Sigma training, all focused on the outcomes analysis, with 10% slashed from the top. Would I have felt the same about my work..? I can't tell, any more than I can tell from the inside out what it's like to come to medical librarianship now.

In a way my journey so far has been akin to the confusion many librarians had (myself included) when EBL began to emerge. We felt that EBL must be a way for us to find better information for our patrons. We had (have) trouble distinguishing our more management-oriented practices from those we have worked to perfect in serving our various populations. But of course, EBL is more than that. It is an opportunity to consider our own practices and profession, a way to insert confidence in our decision making through a stepwise approach: ask, search, evaluate, integrate, assess, disseminate - a traceable path to action that can support decisions and provide as near a stable base as possible to our knowledge management for the future.

The tutorial I built early on (I do hopefully return to my point!) reflected my own early understanding of EBL and LIS in general. I had begun with a somewhat unidimensional perception: we don't do enough, don't do what we do, well enough, and we'd best get with the program or we risk losing our professional shirts in the eyes of (more professional) colleagues in other fields, such as healthcare. Tsk tsk. After all, there is the example of EBM to follow, right? I had Olli Miettinen's severe philosophical writings to guide my understanding of the need for a more rigorous practice orientation (1).

And so, my tutorial began with a quick overview of EBM, presenting the shocking idea that in the field of medicine, all that came before is questionable, and only what transpires after the judicious application of the model and methods espoused by EBM has validity. I know, I know - I'm being simplistic here. But this was my springboard to the next module, and the ones that followed, leading participants through a mix of hands-on exercises and theoretical considerations to a more holistic comprehension of the model for LIS.

I still like the progression from concept to application I think I built in, but I also think I knew at the time that it was full of holes. One of them was right in the toe of the sock... I mean, at the business end. Right exactly where you are meant to take the step from question building, searching, evaluating... and then a miracle occurs.
As I began to focus more on EBL as my own research topic, I began to wonder if the gap was not only in my own naive approach, but in the model itself, and in the literature around it. Translation to practice is a ragged hole where the wind blows in. It's not news for social work, and is a concern even for EBM, where recent studies have showed that despite Cochrane, filters, integration into education, the practicing physician continues not to have time to search, is not skilled in the practice of searching, and prefers peer consultation (the 'expert' model EBM was intended to improve upon) as a method of decision support. So now, medicine and other disciplines proceed to focusing on translational research, finding ways to assist the practitioner to apply the findings of rigorous research in practice.

Next, I thought about LIS and how our model emulates EBM. Could we also fall in the same hole? Do we even have an understanding of our own decision making practices, or did we skip over that part? And this sequence of thoughts led to my reworking of the class, which was just taught for the second time as an online course. It also led to my reconsideration of my research question, but that's also a question for another day.

Sidebar thought: Could I have followed the EBL model, back when I conducted a study of bindery methods? Anyway - that's a question for a different day, implicating the then-status of LIS indexing availability, etc.

to be continued

(1) Miettinen OS. (2001, Aug 21). The modern scientific physician: 1. Can practice be science? CMAJ, 165(4):441-2. This is just the first part of an excellent series.