Designing and delivering reflective reading groups

When you’ve put a lot of work into something, it’s sometimes hard to accept when it’s not the runaway success you hoped. My reflective reading groups for nurses have been hit and miss. When they go well, it’s elating, and everyone agrees it’s a great thing to pursue. When no one turns up despite six bookings, it is disheartening to have put in hours of preparation for nothing.

However… Overall? It’s been a valuable learning experience, and I am glad I have stuck with it. As I said before, when it goes well, I feel over the moon. And even if people book but no one comes, they at least know the library exists when they might not have before.

So what are reflective reading groups?

As of April 2016, nurses and midwives undertake revalidation to maintain their registration with the Nursing and Midwifery Council (NMC). One criteria of the revalidation portfolio is evidence of 35 hours of continuing professional development (CPD), of which 20 hours must be participatory. To support this, I introduced reflective reading groups for nurses; roughly one-hour guided discussion to reflect on an article with other nurses.

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There’s a lot of preparation involved. I use the SRLA Tool in Collins et al (2015) Using reflection on your reading for revalidation, which I discovered from LIS-MEDICAL, to structure the discussion questions. The article is emailed in advance along with some questions to prompt reflection. I try to pick articles that can apply to a range of nursing areas; such as telehealth, apps or compassionate care.

Although I send the article in advance, not everyone will have read it or read it in full, so the first ten minutes or so are spent running over the key points. This works as an icebreaker too, since those who are more reluctant have some time while I’m talking. The discussion is more about the themes of the article and how it might apply to nursing practice, rather than a critical appraisal of the paper.

lightbulbs

My role is a facilitator, so I encouraged the discussion to be led by the nurses, but guided by myself with prompt questions or follow-up. Sometimes the conversation dies down, especially if it’s a small group, so having a facilitator is valuable here.

The groups have been a lot of mental effort, not just in the group itself but with the preparation of articles and reflection. As a non-expert, reading articles on nursing and thinking of discussion points has been challenging and interesting. I haven’t read articles with such scrutiny since my Masters degree, so although it’s sometimes demanding, it’s a good brain workout.

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Of the six groups I’ve scheduled, five have gone ahead, but two of those had only one person turn up. More people were booked to come but didn’t show on the day, so it’s difficult to rearrange in that circumstance. It can be disheartening when so much preparation and time has gone into it, but it’s important not to take it personally – nurses are incredibly busy people, and the feedback for the groups that have gone ahead is positive, so it’s not me!

The hope is that we’ll attract new people to the library, who may not have used the service before, by aligning with a national change.

Personally, I have learnt a lot about developing a program from scratch, promoting it, and evaluating it. I’ve had to tweak things, and deal with the unexpected, but I’m proud despite it occasionally not quite working.

Searching and Beyond: The Librarian’s role in systematic reviews

This a day-long course on the systematic review (SR) process and the role/opportunities for librarians and information professionals was just what I was looking for. Knowledge of SRs is something I’d recognised as a skills gap, so I jumped at the chance to attend this course in Winchester last month.

There was a surprising amount of interaction considering this wasn’t a hands-on workshop, and the time passed quickly – it never felt like a lecture. Four members of ESMI (Evidence Synthesis & Modelling for Health Improvement) based at the University of Exeter took us through an overview of how SRs are undertaken and how info skills fit into a SR, including searching, reference management and screening.

What are SRs?

“A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making.” This definition is taken from the Cochrane Library website, an organisation which produces SRs and which I regularly refer to when searching for evidence.

SRs are at the top of the traditional hierarchy of evidence. Although the hierarchy is not a perfect measure, the idea is that SRs limit bias, aim for high reliability (replicable with the same results) and carry more weight.

Systematic review vs Literature review?

Both provide summaries of the literature, but there are important differences. The question, protocol, and process of selecting and evaluating studies, among other things, should be stated clearly in an SR, whereas a literature review has less emphasis on transparency and reliability.

The role of the info pro

Looking back over my information pack from the day, I see that two of the objectives were “confidence in your existing skills” and “Learn new skills”. On reflection, I am surprised how unintimidating the speakers made the whole thing. Yes, SRs are a huge undertaking, but I do have confidence in my skills and can see myself adapting to the SR process.

Understandably, searching is the primary way information professionals are involved in SRs. I know I have definitely done scoping searches for our staff in the past. But we can be involved in other less obvious parts of the process, such as screening results for inclusion/exclusion. The speakers showed how they use reference management software to screen, which is something I’d never considered. For a large scale literature search, I might now use free software like Mendeley or Zotero.

A lot of the attendees were healthcare librarians like myself – involved in literature searching for clinicians and researchers, but not currently involved in SRs, and possibly not in a position to be. SRs can take 12 months at least for a good one (roughly) so not something to get involved in lightly, but a lot of the methodology and processes are applicable on a smaller scale.

The course really clarified SRs and our role within them, I highly recommend it (and in fact there is another one running in Exeter in January!)

Research in the NHS & the NIHR

Wellcome Library, London A young man conducting an experiment in a chemical laboratory.

Wellcome Library, London
A young man conducting an experiment in a chemical laboratory.

Every month my organisation hosts a Research Club – a chance to hear about research relevant to our work NHS Trust, or current research going on in the organisation. The November Research Club was on the National Institute for Health Research (NIHR) – the “NHS of research”.

I wasn’t aware of the NIHR before, so it was a useful introduction, as well as a compelling appeal for closer working between NIHR and NHS Trusts.

Why do research?

  • To improve the experience of care. This is particularly important in mental health because unlike most physical health we generally want people to come back
  • Patients like it. A study by the speaker showed that mental health patients were really keen to get involved in research. And, those involved in research live longer
  • It enriches the intellectual environment, and in psychiatry it’s quite stale

The NIHR is the “NHS of research”. It is made up of 15 regions and 30 specialities, of which we come under mental health. It funds research through grants, for which there are competitive bids, and it puts funding into Trusts to support local research activity. The NIHR also funds the Research Design Service (RDS), which offers support for designing research. It’s a rigorous process, such as picking apart your methodology, but if the RDS has been used, it scores a point for a proposal for funding.

It was inspiring to hear NIHR call for research embedded into mental health clinical practice, in a similar way as in oncology where research is so prominent.

I hadn’t known about NIHR before the Research Club, so I’m really glad I attended. It is a major institution intertwined with the research done in my organisation – of which I am involved in part, as I often carry out literature searches for researchers or advise in how to find evidence.