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BACKGROUND: Timely information provided by clinical librarians can contribute to outcomes such as improved patient care and time savings for hospital staff. What is unknown is the return on investment (ROI) of a clinical librarian on a critical care unit. OBJECTIVE: The aim of this study was to assess the ROI, from the employer perspective, of placing a clinical librarian in a critical care unit in a large UK acute hospital. METHODS: Using a mixed methods approach, ROI was estimated by comparing the total costs with the total monetised benefits of implementing the clinical librarian intervention. Total costs included salary and equipment costs. Total monetised benefits included time saving for hospital staff, support for professional development and improved patient care. RESULTS: When total monetised benefits were compared with total costs, the 15-month clinical librarian intervention generated a positive ROI of £1.18-£3.03 for every £1 invested. DISCUSSION: Using outcome measures derived from previous research, this novel study generated promising results indicative for commissioners seeking to improve patient care and deliver value for money. To improve generalisability, multisite studies using standardised ROI tools are recommended. CONCLUSION: Employing a clinical librarian in a critical care unit can generate a positive ROI.

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Increasingly, users of health and biomedical libraries need assistance with challenges they face in working with their own and others' data. Librarians have a unique opportunity to provide valuable support and assistance in data science and open science but may need to add to their expertise and skill set to have the most impact. This article describes the rationale for and development of the Medical Library Association Data Services Competency, which outlines a set of five key skills for data services and provides a course of study for gaining these skills.

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The article presents a mixed-methods evaluation of regional libraries in Namibia, which incorporates three perspectives: the patron perspective (library users), the library perspective (library staff, management, and related officials), and the external perspective (including evaluators and monitoring data). Seven data collection methods were used: patron surveys, patron panel studies, focus group discussions, key informant and staff interviews, secondary data analysis, media analysis, and observations. The goal of the evaluation was to assess library performance for both formative and summative purposes by addressing evaluation questions on areas such as library services, use, and operations. Building upon the literature review of how mixed-methods approaches can contribute to library evaluation, the aim of this article is to show how a mixed-methods evaluation can be designed to examine multi-faceted library performance and to illustrate how the evaluation design allows information complementarity and can be utilized to present diverse viewpoints of the above three perspectives. The evaluation design, analysis process, and lessons learned from this study may be useful to evaluators engaged in evaluation of public services or programs (including public libraries) that examine multiple aspects of service performance and involve a variety of stakeholders.

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OBJECTIVE: Reflective practice is common in nursing and other professions. In the published literature, there is very little about librarians' use of reflective practice and no studies of health librarians' use of reflective practice. This study examined the use of reflective practice among health sciences librarians, perceived benefits, and perceived barriers to use. METHODS: This cross-sectional study replicated the 2014 study by Greenall and Sen, using a version of their questionnaire. The research population in this study was health sciences librarians who were members of the MEDLIB-L email discussion list, Medical Library Association (MLA) chapter email discussion lists, and/or MLA section email discussion lists. RESULTS: There were 106 librarians who completed the questionnaire, ranging from those new to the profession through midcareer to longtime librarians. While a high percentage of respondents considered themselves to be reflective practitioners (77%), a larger percentage (87%) reported that they consciously spent time reflecting. Respondents selected a wide variety of benefits of reflective practice, while barriers tended to center on lack of time, knowledge, skills, or experience. CONCLUSION: The diversity of benefits that respondents selected suggests that reflective practice can play an important positive role in librarians' professional development. Reported barriers to reflective practice suggest that there is a need for educational opportunities to develop skills.

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The performance of librarians in the medical sciences is enhanced by identifying their training needs through the use of an information literacy tool. We performed this study between 2016 and 2017 with the staff of the medical libraries network at Artemisa province in Cuba. In the first stage of the study we assessed the initial state of the staff's information literacy, and in a second stage, we used empiri-cal and theoretical methods to propose an information literacy tool in digital format. The methodology used was based on educational software. The tool will contribute to enhancing the performance of librarians working in the network of medical libraries in the prov-ince of Artemisa, Cuba.

El logro de este proceso informacional en la salud se encuentra centrado en el personal bibliotecario, por lo que resulta necesario fortalecer su desempeño en correspondencia con la identificación de sus necesidades de aprendizaje mediante la aplicación de una herramienta de alfabetización informacional en la provincia de Artemisa, Cuba durante el curso del período 2016-2017. Se realizó una investigación organizada por dos momentos y, con el empleo de métodos empíricos y teóricos, se propuso una herramienta de alfabetización informacional en soporte digital. La metodología utilizada se basó en un medio de enseñanza-aprendizaje de tipo software educativo. La herramienta contribuirá a la calidad en el desempeño del personal que labora en la red de bibliotecas médicas de la provincia de Artemisa.

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Resumen El logro de este proceso informacional en la salud se encuentra centrado en el personal bibliotecario, por lo que resulta necesario fortalecer su desempeño en correspondencia con la identificación de sus necesidades de aprendizaje mediante la aplicación de una herramienta de alfabetización informacional en la provincia de Artemisa, Cuba durante el curso del período 2016-2017. Se realizó una investigación organizada por dos momentos y, con el empleo de métodos empíricos y teóricos, se propuso una herramienta de alfabetización informacional en soporte digital. La metodología utilizada se basó en un medio de enseñanza-aprendizaje de tipo software educativo. La herramienta contribuirá a la calidad en el desempeño del personal que labora en la red de bibliotecas médicas de la provincia de Artemisa.

Abstract The performance of librarians in the medical sciences is enhanced by identifying their training needs through the use of an information literacy tool. We performed this study between 2016 and 2017 with the staff of the medical libraries network at Artemisa province in Cuba. In the first stage of the study we assessed the initial state of the staff's information literacy, and in a second stage, we used empiri-cal and theoretical methods to propose an information literacy tool in digital format. The methodology used was based on educational software. The tool will contribute to enhancing the performance of librarians working in the network of medical libraries in the prov-ince of Artemisa, Cuba.

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OBJECTIVE: The research evaluated the perceived quality of librarian-mediated literature searching services at one of Canada's largest acute care teaching hospitals for the purpose of continuous quality improvement and investigation of relationships between variables that can impact user satisfaction. METHODS: An online survey was constructed using evidence-based methodologies. A systematic sample of staff and physicians requesting literature searches at London Health Sciences Centre were invited to participate in the study over a one-year period. Data analyses included descriptive statistics of closed-ended questions and coding of open-ended questions. RESULTS: A range of staff including clinicians, researchers, educators, leaders, and analysts submitted a total of 137 surveys, representing a response rate of 71%. Staff requested literature searches for the following "primary" purposes: research or publication (34%), teaching or training (20%), informing a policy or standard practice (16%), patient care (15%), and "other" purposes (15%). While the majority of staff (76%) submitted search requests using methods of written communication, including email and search request forms, staff using methods of verbal communication, including face-to-face and telephone conversations, were significantly more likely to be extremely satisfied with the librarian's interpretation of the search request (p=0.004) and to rate the perceived quality of the search results as excellent (p=0.005). In most cases, librarians followed up with staff to clarify the details of their search requests (72%), and these staff were significantly more likely to be extremely satisfied with the librarian's interpretation of the search request (p=0.002). CONCLUSIONS: Our results demonstrate the limitations of written communication in the context of librarian-mediated literature searching and suggest a multifaceted approach to quality improvement efforts.

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This is the 19th in a series of articles exploring international trends in health science librarianship in the 21st century. The focus of the present issue is the Balkan Region (Bulgaria and Croatia). The next regular feature column will investigate two other Balkan states - Serbia and Slovenia. JM.

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Reference librarians, specifically those working in academic health sciences environments, have expanded their roles and taken on new and unique responsibilities. While librarians at The George Washington University's Himmelfarb Health Sciences Library continue to provide traditional reference services, they have gone beyond their comfort zone in many cases to become involved in activities that are outside of the librarian's established role. This article describes the current roles of Himmelfarb's reference librarians, as well as the way these librarians prepared for these roles and addressed the associated challenges.

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This feature presents research undertaken by Archana Deshmukh for her MA dissertation at the University of Brighton. She worked closely with Tom Roper, the Clinical Librarian at Brighton and Sussex University Hospitals NHS Trust, in a project to explore the feasibility of applying quantitative measures to evaluate the Clinical Librarian service. The investigation used an innovative participatory approach and the findings showed that although an exclusively quantitative approach to evaluation is not feasible, using a mixed methods approach is a way forward. Agreed outputs and outcomes could be embedded in a marketing plan, and the resulting framework could provide evidence to demonstrate overall impact. Archana graduated in July 2014, gaining a Distinction in the MA in Information Studies, and she is currently looking for work in the health information sector.

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It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice.

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