Flipped/Split Critical Appraisal – a means of getting users to come to library training

HLG Nursing Bulletin Vol 38 (1)

Phillip Barlow
NHS Support Librarian
Chelsea and Westminster campus library
Imperial College London
p.barlow@imperial.ac.uk
Twitter: @hammerslibrary

We’re all aware of the difficulties that can arise in persuading users to come to training sessions provided by the library service. The fact that people employed in healthcare are extremely busy, and have to deal with all sorts of situations involving people that need their help, means that invariably things will fall by the wayside, and attending that library training session that they signed up to with the best of intentions will often be one of them. Even the prospect of adding to their CPD requirement for revalidation is not always enough. Which is where a team’s own training time can be useful. An hour a week set aside for the team to undertake some form of training activity, which everyone (or almost everyone) is guaranteed to attend, can be a godsend to the NHS Support Librarian in getting the time with users to pass on the things that we know, and which they appreciate, are important.

Imperial College’s library service provides a fairly comprehensive package of training sessions to our NHS users, with critical appraisal being a major element. Not only is it the longest duration of the sessions that we provide, but we also do separate ones for quantitative and qualitative article types. The format for these is the same; we send out an article to all attendees (or at least all those that have signed up) before the session that, along with the appropriate CASP checklist, they are expected to read beforehand. In the two-hour session, the first half is dedicated to a teaching presentation, going over the principles of critical appraisal, with the second half serving as a group discussion of the paper. This method though does have some faults:

• The attendees will be of many different job types and specialties
• The paper will be a general one chosen by the librarians, and therefore may not be of particular interest, beyond as a teaching exercise
• The attendees may not have done much in the way of critical appraisal, and thus when reading the article before the session, without the benefit of knowing the basics first, may miss or not understand vital elements of it

Despite these issues however, with the format of our training package, it is hard for us to find an alternative.

In the spring of 2018, a specialist women’s physiotherapist attended one of the training sessions (specifically current awareness) at Chelsea and Westminster, and enquired about the possibility of having a dedicated critical appraisal sessions for members of her team. While I was more than happy to accommodate them, it was clear that the timing would be an issue. As they only had the hour of their regular weekly training period, it would be difficult to shoehorn a two-hour session into 60 minutes. So, I suggested that they might like two sessions – one with the teaching, wherein they could learn about the principles, which they would then apply in the second session, which, having had time to read the article thoroughly, they would have an hour-long discussion about. They were also offered the choice of my finding an article for them, or selecting their own. The latter option was chosen, and dates were set up. Almost immediately, a second team, this time specialist paediatric dietitians, contacted the library with a view to having some critical appraisal training in their team training period, which led to the same offer of a pair of sessions being made to them.

Since the first session in April 2018, critical appraisal session have been held with groups of six different job types, with a total of 14 individual sessions. The majority have been the split, teaching/discussion sessions with a single group, but a group of assistant psychologists requested both quantitative and qualitative articles to discuss, which led to them having a total of three sessions. Table 1 shows the total number of attendees for each session by job role, while Table 2 is a comparison of attendances at regular critical appraisal sessions as part of our standard training compared to split sessions as part of the individual team training during 2018.

Job Role	Session 1 Attendees	Session 2 Attendees	Article
Hand Therapist	11	8	https://doi.org/10.1177/1758998314533306
Paediatric Dietitians	7	7	https://doi.org/10.3945/ajcn.115.125138
Paediatric Doctors	21	11	https://doi.org/10.1016/S0140-6736(16)00340-8
	4
Women’s Physios	4	3	https://bradscholars.brad.ac.uk/handle/10454/12129
Pre-Registration Pharmacists	8	8	https://doi.org/10.1177/1060028018778045
Assistant Psychologists	4	4	https://doi.org/10.1016/j.brat.2012.03.001
		31	https://doi.org/10.1080/17482631.2017.1325673

1: Additional session to look at qualitative article

	No of sessions held	Attendees
Regular sessions	52	9
Split sessions	14	103

2: This is out of a total of 12 sessions scheduled

Undertaking these sessions, with different articles for each different group, has also enabled me to improve my own skills, as it is necessary to read each one beforehand to help guide the participants as required. Running critical appraisal sessions this way, as part of their own training time, split into two with enough time to properly read the article with the benefit of having already learned about the basics, seems to have been successful; feedback has been uniformly good, with users commenting that the sessions, as scheduled, have been

“a good overview…a good reminder from university days”,

and that they

“feel much more confident in deciding whether a study is good enough in order to change practice”,

with one user stating

“I wish I had been told this information so clearly before my dissertation! I might have understood what I was doing”.

Undertaking these sessions as part of their own training time appears to make users motivated both to take in the training, and to be more vocal in the discussion with an article that they have a professional interest in.