Information needs of users
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Information seeking is a common activity in most knowledge-based organizations today, and part of the ubiquity and ease of using mobiles and wifi in society. Satisfying basic information needs is central to the provision of reference services in health libraries within this web-saturated context. In the 21st century, teaching effective use of search engines based on the expressed information needs (and questions) of health professionals is a critical part of that work. Taylor (1962), a librarian, wrote one of the early seminal articles on this topic. The information needs of users merit close attention for they provide insight into the who, what, where, when and why of providing reference services. In PubMed, there are hundreds of studies that can help inform health librarians about how to satisfy the information needs of their users. In library and information science research, Kuhlthau is one of the pioneering researchers in the area of information-seeking attitudes and behaviours. For more than 20 years, she has spent time examining and framing the models and processes of information-seeking.
For a discussion of the impact of information skills training, see Ayre S, Barbrook J, Engel C, Lacey P, Phul A, Stevenson P, Toft S. Measuring the impact of information skills training: a survey of health libraries in England. Health Info Libr J. 2014.
Reasons to seek health information
In the 21st century, health professionals seek information for a number of reasons such as:
Other more specific reasons
Simon's classic “satisficing” principle argues that users tend to strike a balance between minimizing their efforts to find something useful in their searching while maximizing their decision confidence in what they do find. The Scottish word "satisficing" (= satisfying) was used by Nobel laureate Herbert Simon in 1957 to refer to problem-solving and decision-making that sets aspiration levels; in other words, searchers search for information until suitable materials are found and that satisfy the aspiration level of the searcher. The satisficing theory is known as a theory of user rationality, because it places constraints on the information-processing capacities of end-users. The concept has received a great deal of attention from theorists and also has a solid mathematical foundation.
Physicians seek answers to patient-specific questions every day. The number of questions dealt with depends on the practice (rural vs. urban), whether the physician practices with a group or is in solo practice, and several other factors - especially time. The average number of questions, as reported in many studies, ranges from 1 to 12 per day but most questions are simply never answered. Whether an answer is pursued depends on the urgency of the situation and whether a physician believes an answer exists. Studies in the medical literature reveal that physicians consult the most-available sources of information such as colleagues, personal libraries, journals and so on. With little time to search, physicians do what they can. One study found that the average time physicians will spend seeking an answer is 2 minutes - a major reason why most questions go unanswered in the clinic. Another study found that medical librarians find answers to questions about half the time by searching an average of 43 minutes per question. Physicians in other studies thought that suitable answers would have a “major” impact on patient care for more than 1/3rd of their questions. A further complication revealed in the studies is that when physicians have good search skills, they often do not have the needed time to perform searches for reliable, authoritative medical research.
Several medical databases are created to provide direct answers to questions. Some studies show that clear-cut answers (answers with specific information to guide practice) are available for about 50% of cases. If help from textbooks and journals is factored in, acceptable answers can probably be found in about 70-80% of cases. Physicians spend a considerable amount of time refining their questions and in planning their search strategies (even eliminating questions that cannot be answered without further information). Physicians spend time looking at questions for clinical relevance and refine questions that correspond to their original information needs.
In addition, database searches are often performed by physicians who are competent searchers in databases such as PubMed and the Cochrane Library. In one study from the University of Missouri, “point-of-care” searches were simply not fast enough to be useful to the clinician in question. "...searches in this study were based on a combination of efforts of 2 experienced physician searchers... (and) may not be replicable in the practice setting but do provide an objective best-case scenario assessment of the content of these databases" (Alper, 2001). Physicians were allowed 10 minutes per question; the average time spent was 2 minutes. Another limitation of the study was that accuracy and currency of answers was not evaluated based on current criteria. Librarians play a major role in teaching the skills required to search the databases but some information resources purchased by the health library may not be completely useful or practical. Another issue that must be mentioned is that relevant information will not always be available (in some cases does not exist) for all clinical scenarios. Another issue is what it costs to access the medical evidence, which is paid by academic, hospital and institutional libraries. In summary, physicians look for daily clinical information from practical sources that are relevant to the patient problems they are seeing; while they might have the skills to do so, many simply do not have the time or resources to search for the highest quality evidence.