Information needs of users

The information-seeking process should be understood and contextualized for users

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Introduction

See also Allied health professionals, Information technology topics and Teaching health library users

Information seeking is a common activity in most organizations in the digital age. The resulting information needs of users is therefore central in the work of health librarians around the world.

In the 21st century, health professionals seek information to assist them in a diverse range of activities such as:

• providing optimum care for individual patients
• developing evidence-based practices using resources that will assist in making clinical decisions
• keeping up-to-date with new and updated clinical information relevant to evidence-based practice
• locating authoritative information to explain risks to patients
• obtaining pharmacological information to back-up prescribing decisions
• satisfying intellectual curiosity, personal interests and inclinations
• resolving clinical uncertainty as much as possible and avoiding clinical error

Reasons to seek information

• To verify what is known i.e., establish knowledge-base
• To make decisions or provide individualized patient care
• To keep up-to-date about an issue or topic
• To obtain information for patients or to explain important risk factors, especially for well-informed patients
• To acquire pharmacological information (hard data to guide or back-up prescribing decisions)
• To fill specific gaps in knowledge on "new" diagnoses and therapies
• To satisfy curiosity, personal interest, and inclination
• To resolve issues around uncertainty and best or conflicting evidence

'Satisficing'

Simon's classic “satisficing” principle argues that users tend to strike a balance between minimizing their efforts to find something while maximizing their decision confidence. The Scottish word "satisficing" (= satisfying) was used by Nobel laureate Herbert Simon in 1957 to denote 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 bounded 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 has a solid mathematical foundation.

Information required

Physicians seek answers to patient-specific questions every day. The number of questions dealt with depends on the practice (rural vs. urban), whether in group or solo practice, and other factors. 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 are unanswered. 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 questions. A further complication revealed in the studies is that when physicians have good search skills, they often do not have time to perform those searches.

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 are found in about 70-80% of cases. Physicians spend considerable time refining questions and planning strategies (even eliminating questions that cannot be answered without further information). They spend time looking at questions for clinical relevance and refine questions that correspond to the original information need.

In addition, database searches are performed by physicians who are experienced computer searchers. In a study from the University of Missouri, “point-of-care” searches are not always fast enough to be useful. "The 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 currently evolving criteria. Librarians play a major role in teaching these skills but many databases do not apply evidence-based screening and their information resources are not completely useful or practical. Relevant information simply does not exist for all clinical scenarios. Another issue is cost for access which is often paid by institutional libraries. In summary, physicians look for daily information from practical sources relevant to patient problems but do not have time or resources to search for the highest quality information.