Nursing educators’ perceptions of collaboration with librarians *

Both information literacy and evidence-based practice (EBP) require nursing educators to rethink their curricula and consider how these skills can be integrated throughout their programs. They also require nursing educators to examine their own abilities to find and utilize nursing research that is relevant to their practice, research interests, teaching pursuits, and students' practical needs. Collaboration amongst those involved in education is vital to producing future nurses who are information literate and are able to apply this literacy in their daily practice. Skiba calls for nursing educators to look at information literacy as librarians do and begin to see that without it, EBP cannot flourish [1]. The National League for Nursing (NLN) calls for “dramatic change” to “create and shape the future of nursing practice” [2]. Their statement calls for all those involved in educating nurses of the future to collaborate in order to be truly innovative and have a positive impact on nursing practice. The NLN statement came just prior to the much cited Pravikoff, Tanner, and Pierce study that showed current nurses did not appreciate research and lacked the skills necessary to find research [3]. Producing an evidence-based nursing workforce must begin prior to licensure as registered nurses. Librarians are natural partners for this education and have key skills that can help both nursing educators and students become information literate and appreciate the role of research in daily practice [4]. 
 
Though the library literature qualitatively describes collaborations with nursing faculty that have been positive experiences [5–7], studies examining how librarians perceive working with faculty in general paint a grimmer picture [8,9]. Few quantitative data exist regarding faculty perceptions of collaborating with librarians. Of the studies that report faculty openness to collaboration with librarians [10–13], none investigate what faculty perceive collaboration with a librarian means. As noted in Leckie and Fullerton's study, “Perhaps faculty and librarians have quite different interpretations of what it means to deliver information literacy in a collaborative fashion” [12]. The purpose of this small pilot study in two states was to investigate how a small group of nursing faculty defined and perceived collaboration with a librarian in order to quantify anecdotal evidence of their perceptions and gain improved understanding of how librarians can approach future collaborations with nursing faculty.


INTRODUCTION
Both information literacy and evidence-based practice (EBP) require nursing educators to rethink their curricula and consider how these skills can be integrated throughout their programs. They also require nursing educators to examine their own abilities to find and utilize nursing research that is relevant to their practice, research interests, teaching pursuits, and students' practical needs. Collaboration amongst those involved in education is vital to producing future nurses who are information literate and are able to apply this literacy in their daily practice. Skiba calls for nursing educators to look at information literacy as librarians do and begin to see that without it, EBP cannot flourish [1]. The National League for Nursing (NLN) calls for ''dramatic change'' to ''create and shape the future of nursing practice'' [2]. Their statement calls for all those involved in educating nurses of the future to collaborate in order to be truly innovative and have a positive impact on nursing practice. The NLN statement came just prior to the much cited Pravikoff, Tanner, and Pierce study that showed current nurses did not appreciate research and lacked the skills necessary to find research [3]. Producing an evidencebased nursing workforce must begin prior to licensure as registered nurses. Librarians are natural partners for this education and have key skills that can help both nursing educators and students become information literate and appreciate the role of research in daily practice [4].
Though the library literature qualitatively describes collaborations with nursing faculty that have been positive experiences [5][6][7], studies examining how librarians perceive working with faculty in general paint a grimmer picture [8,9]. Few quantitative data exist regarding faculty perceptions of collaborating with librarians. Of the studies that report faculty openness to collaboration with librarians [10][11][12][13], none investigate what faculty perceive collaboration with a librarian means. As noted in Leckie and Fullerton's study, ''Perhaps faculty and librarians have quite different interpretations of what it means to deliver information literacy in a collaborative fashion'' [12]. The purpose of this small pilot study in two states was to investigate how a small group of nursing faculty defined and perceived collaboration with a librarian in order to quantify anecdotal evidence of their perceptions and gain improved understanding of how librarians can approach future collaborations with nursing faculty.

METHODS
The study used a twenty-question survey (Appendix, online) consisting of both quantitative and qualitative questions on collaboration, EBP, and instruction presented via SurveyMonkey. The survey instrument was developed by the authors and reviewed by a nursing faculty member prior to distribution. Nursing faculty leaders, deans, and directors from nursing schools in the states of Indiana and Florida with nursing programs that were accredited by the NLN Accrediting Commission or Commission on Collegiate Nursing Education and that offered at least an associate's degree in nursing were contacted via email. An email containing a link to the electronic survey and a request to forward the link to their fulltime nursing faculty was sent to program directors. After approximately two weeks, librarians from these institutions (nursing liaisons/subject specialists or other identified reference librarians serving nursing schools) were contacted by email and asked to personally forward the email to their respective faculty. A total of seventy-four nursing schools were contacted: thirty-five from Indiana and thirty-nine from Florida. Indiana and Florida were chosen as a convenience sample because they were the home states of the authors and could roughly approximate any potential differences between the Southeast and Midwest. The survey remained open from August 28 to September 30, 2006. Questions on the survey relating to collaboration were analyzed for this article.

Demographics
A total of 112 responses were gathered. Seventy percent of the responses were received prior to the second request sent to subject librarians. Of those who reported a state (104), 47% of the respondents were from Florida and 53% were from Indiana. To simplify the institutional review board approval, the authors elected not to ask for institutional affiliation of each respondent. Thus, it was not known how many different schools were represented. The majority of respondents (60%) reported a master's degree as their highest level of education. A third (33%) reported a doctoral degree as their highest level of education related to nursing. Seven percent of respondents reported degrees at the baccalaureate level or lower or a master's degree in an area other than nursing. Years on faculty ranged from 1 month to 46 years, with an average of 13.51 years. The median number of years on faculty was 12 years; the mode was 6 years.

Descriptions of collaboration with a librarian
Immediately following demographic questions, participants were asked, in an open-ended question, to define what collaborating with a librarian meant to them. Responses to this question were analyzed thematically. Each response was examined to determine the central themes. All responses were then categorized and scored using these themes, if possible. Some responses contained more than one theme. Results from this analysis are presented in Table 1 (online). The 2 most common themes present in the responses were providing reference assistance to faculty and students (appearing 40 times) and communicating needs and resources (appearing 27 times). Very few faculty members responded in a way that would indicate that they see librarians as partners in either the educational process or research pursuits, with only 14 of 106 (13%) responses mentioning instruction specifically and only 9 (8%) responses speaking of researching and/or publishing together as scholars.
Additionally, although the question asked how they would define collaboration with a librarian, it was evident that many responded about their previous experiences collaborating with a librarian. The vast majority of respondents did state they had some kind of experience, as another survey question showed that 72.1% of respondents had had librarians conduct instructional sessions for a course they taught at some point in their teaching career. Certainly, experiences may serve to define what collaboration means to nursing faculty. However, this seems to indicate that many faculty members think about collaboration in terms of past experiences and are not envisioning different or additional possibilities for the future.

Perceptions of specific educational situations as collaborative
One of the survey questions was a Likert-type question presenting ten different scenarios where a librarian and nursing faculty might collaborate. This question was purposely presented after the question asking the respondents to define collaboration with a librarian to prevent suggesting ideas that might skew their definitions. Respondents were asked to rate how strongly they felt the situation represented collaboration on a five-point scale from strongly disagree to strongly agree, with neutral in the middle. The ten situations broadly represented three categories of interactions: instruction, assessment, and program or curriculum development. For statistical analyses, the scale categories were reduced to disagree, neutral, and agree, where disagree included ''strongly disagree'' and ''disagree'' and likewise ''strongly agree'' was combined with ''agree.'' A definite pattern emerges from the results of this question, and these results are presented in Figure 1. The results indicated a very positive response in the assessment and program or curriculum development categories, but, in the instruction category, results were more evenly distributed and a greater percentage of respondents answered with a neutral response. Because the question asked the participants how strongly they felt these situations represented collaboration but did not ask them how likely they were to actually participate in such a situation, these results cannot definitively say that nursing faculty would or would not participate in these activities with librarians. However, the results did show a theoretical receptiveness to collaboration, specifically in regard to assessment and program or curriculum development.
Responses to this 10-part question were analyzed using chi-square analysis by the state in which the faculty taught, years on faculty (grouped by 5 and 10 year intervals), highest level of education, and selfrated ability to use library or knowledge-based resources. No statistically significant differences were noted when data were analyzed by state or self-rated ability to use library or knowledge-based resources such as online databases or electronic journals. Possibly because of low frequencies in certain response categories, chi-square analysis did not show a significant difference for education. There was statistical significance in the responses of faculty with 10 or fewer years' experience: they agreed that having a course primarily related to searching and evaluating literature taught solely by a librarian represented collaboration (chi square512.86, df54, P50.012).
A principal component analysis with Varimax rotation was performed on the 10-part question to identify possible redundancies (i.e., strong intercorrelations) in question responses. The results supported the existence of 3 distinct categories with high loadings (i.e., above an absolute value of 0.5) representing the 3 categories of questions. These results also suggested participant consistency in responses within these categories-those agreeing on one category question also tended to agree on other questions in the same category.

Role of the librarian in relation to evidencebased practice
Ninety-two respondents answered the open-ended question, ''What do you feel is the role of librarians in supporting the trend toward evidence-based practice?'' The themes in these responses were analyzed thematically in the same manner previously described. Results of this analysis are presented in Table  2 (online). Faculty overwhelmingly viewed the librarian's role in EBP as the search expert who knows where and how to search (appearing in sixty-five responses). Only four respondents noted that librarians could help with evaluating the literature they have helped to find and retrieve. Results from this question reaffirmed the lack of strong support evident in responses with regard to possible instructional collaborations reported above, with only ten responses expressing specifically that librarians could provide instruction or support for instruction.
Additionally, the survey asked participants whether the emphasis on EBP had affected their willingness to have a librarian present instructional sessions in their courses. The majority of respondents noted that EBP had greatly (24.1%) or somewhat (36.1%) increased their willingness to have a librarian present an instructional session in their courses. The remainder noted that EBP had not changed their willingness.

Searching abilities
Nearly three-quarters (72.1%) of respondents rated themselves as either excellent or good at using library or knowledge-based resources. However, while 83.9% and 87.5% of respondents noted using PubMed/ MEDLINE and CINAHL, respectively, for searches, far fewer noted using these database's specialty features that librarians consider essential for searching related to EBP. Just over a quarter of respondents noted using Medical Subject Headings (MeSH), and 33.9% noted using subheadings. Less than 1 in 5 (18.8%) noted using the explode feature found in PubMed and other interfaces of MEDLINE as well as CINAHL. The most common feature used for searching was simply keyword searching, the method reported by 86.6% of participants.

DISCUSSION
Results from this pilot study indicated that nursing faculty in Indiana and Florida responding to this survey strongly perceived collaboration with librarians as meaning having librarians provide traditional services such as reference assistance and communication of needs and resources. Additionally, this Brief communications: Schulte and Sherwill-Navarro group of nursing faculty perceived the role of librarians in EBP to be the expert in search and retrieval of evidence. Despite this recognition of the librarian as an information expert, there appeared to be a disconnect between valuing librarians' searching expertise and seeing how it might be applied in instructional settings, as few respondents mentioned providing instruction as a role for librarians in EPB.
While between 40% and 50% of respondents agreed that most instructional situations, ranging from 1-time sessions to full teaching of courses related to EBP, represented collaborations, responses to this category of collaboration showed greater distribution and higher levels of disagreement compared to responses to assessment and curriculum development situations. This may seem discouraging to librarians for whom instruction seems to be the most likely way to achieve information literacy and EBP goals. However, about 60% of respondents noted that EBP had greatly or somewhat increased their willingness to have librarians conduct instructional sessions. EPB seems to represent an opportunity to continue to communicate the benefits of librarian instruction to nursing faculty, especially to newer faculty, who indicated a significantly positive response to having a librarian solely teach a course related to searching and evaluating literature. Additionally, based on the most common type of searching noted by these respondents (keyword searching), librarians need to increase efforts to educate faculty, perhaps using a train-thetrainer method.
In contrast, responses to potential collaborations related to assessment and curriculum development received strongly positive responses. This is an important finding, especially considering the emphasis on assessment in higher education today, and possibly represents an attitude of inclusion of librarians in educational collaboration in a more in-depth way. Klem and Weiss cite Francis and Fisher, who describe some of these new, more in-depth models of collaboration, noting librarians ''are involved in the development, teaching, and evaluation of courses; instruction is directly tied to required course work or assignments; and students' knowledge of information principles are formally evaluated and graded'' [4]. The results of this study seem to indicate that perhaps nursing faculty in this sample are open to these collaborations in spite of their relatively traditional perceptions of librarians. The challenge to health sciences librarians is how to actually initiate and implement creative and farreaching collaborations.