The education and training needs of health ... - Wiley Online Library

The education and training needs of health librarians—the generalist versus specialist dilemma Blackwell Publishing Ltd

Tatjana Petrinic* & Christine Urquhart†, *Cairns Library, John Radcliffe Hospital, Oxford and †Department of Information Studies, University of Wales Aberystwyth, Aberystwyth, UK

Abstract Aims and objectives: The aims of the study were to examine whether and how librarians with a generalist background can transfer to roles demanding more expert knowledge in the health sector. The objectives were (i) to compare the education and training needs of health librarians with science degrees with the education and training needs of health librarians with arts and humanities degrees; (ii) to compare the education and training needs of librarians working in the National Health Service (NHS) sector with the education and training needs of librarians working for the health sector but within higher education. Methods: Face-to-face interviews with 16 librarians, a convenience sample of librarians working in the Thames Valley NHS region. Results: The main findings confirmed that structured continuing professional development (CPD) is required to meet the rapidly changing needs in the health sector. The emphasis ought to be on teaching skills, outreach work, marketing and promotion, research skills and methods, subject knowledge and terminology, and management skills. Library school curricula do not appear to meet the demands of medical library posts. A first degree in scientific subjects is advantageous in the early stages of a career but diminishes with continuing training and experience. There is no evidence of a significant difference in training needs and provision between the librarians in NHS posts as opposed to those in higher education (HE) posts. Conclusions: The conclusions suggest that library schools need to update their programmes to include teaching skills, advanced search skills, project management skills, research methods, with more practical exercises. Particular attention should be given to librarians with a first degree in non-scientific subjects in terms of time allocated for CPD, quality of training and access to reliable mentorship.

Introduction The debate about the need for librarians working in scientific or specialist fields to have some education related to those fields has rumbled on for years, but any consensus is hard to reach. Specialist groups of information professionals evolve, often providing their own support for members. These Correspondence: Tatjana Petrinic, Cairns Library, John Radcliffe Hospital, Oxford OX3 9DU, UK. E-mail: [email protected]

groups may at some stage discuss their needs with library and information studies departments in universities, or other training providers. The large number of these specialist groups makes it difficult for higher education institutions to assess whether they are providing even the general needs required for new entrants to the profession in these fields, let alone the specialist skills and knowledge that might be required of a health librarian working in new roles in outreach, or clinical librarianship, or in support of systematic reviews.

© 2007 The authors Journal compilation © 2007 Health Libraries Group. Health Information and Libraries Journal, 24, pp.167–176

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Education and training needs of health librarians, Tatjana Petrinic & Christine Urquhart

Library and information services for National Health Service (NHS) staff in the UK may be provided by higher education libraries or by NHS-funded libraries. The setting for this study (Thames Valley) is typical of most English health library regional groupings, with a university library providing services at three sites (in this instance) and the NHS library services providing services at a much larger number of sites, as part of a network of small libraries, with at least one qualified librarian for each main site. The setting is less typical, perhaps, in having a long tradition of supporting structured continuing professional development for health librarians. The Librarian of the 21st century programme1 started in the Oxford area in 1995 and consisted of several workshops on knowledge of evidence-based practice, teaching skills, Internet searching, critical appraisal skills and database searching. The aim of the research, conducted as dissertation research for a postgraduate degree in information and library studies, was to inform future planning of continuing professional development of health librarians, and in particular to assist recently qualified professionals taking up a first post in the health sector. The aim was to assess whether, and how, librarians with a generalist background can transfer to roles demanding more expert knowledge in the health sector. There were two main objectives: (i) to compare the education and training needs of health librarians with science degrees with the education and training needs of health librarians with arts and humanities degrees; (ii) to compare the education and training needs of librarians working in the NHS sector with the education and training needs of librarians working for the health sector but within higher education. Background In 1990, Qureshi2 found a need for subject knowledge among US health librarians, noting that the traditional Master’s degree did not prepare them adequately for work in the health sector. Ten years later, in 2000, Davidoff and Florance3 called for the creation of informationists, who would have a sound knowledge of information science with a basic understanding of clinical science. Recent analysis of training needs for health library staff in

North America has focused on the opportunities and trends first and worked back to the skills required to enable health librarians to take advantage of emerging roles. Lyon4 observes that the lack of early training in biomedical sciences leads to a lack of confidence in librarians, especially as learning medical terminology and databases constitutes a huge challenge for librarians with a liberal arts background. This problem is exacerbated by the limited number of dedicated training opportunities in library schools. The medical library profession has been slow in responding to the need for continuing education and training of novice librarians without a science background. Liaison librarians may or may not require subject knowledge, but a recent survey of the University of Florida’s Liaison Librarian Program suggests that the clients rate subject background as important. However, liaison librarians may not necessarily have to obtain that subject background through prior formal education.5 In Canada, an online survey6 of health sciences librarians (n = 30, 32% response rate) found that the librarians viewed subject knowledge as very important, but that holding a degree in health sciences was not viewed as essential. However, the librarians with a biological sciences background did think their background important. Another study7 from the USA investigated health librarians whose previous career was in medicine. In the USA, Scherrer8 used eight focus groups of academic health care librarians (n = 47) to identify changes in role and the underpinning knowledge requirements. These included a greater emphasis on teaching (requiring underpinning knowledge of educational theory, more knowledge about genetic and other specialized databases), more outreach (requiring information about researchers’ needs, to provide filtered and synthesized information for them), more innovative use of technology to provide better access (requiring knowledge of web page design, personalization of web pages). There are now several modes of advanced training in the USA in bioinformatics for information and library professionals,9 including the Eskind Biomedical Library programme.10 There were no recent UK studies that examined the relevance of previous subject knowledge, although there have been several training needs analyses, including a national study in 1999.11 A

© 2007 The authors Journal compilation © Health Libraries Group 2007 Health Information and Libraries Journal, 24, pp.167–176

Education and training needs of health librarians, Tatjana Petrinic & Christine Urquhart Table 1 Demographic details of interviewees

Location and first degree/Time in current post

5 years or less

More than 5 years, less than 10 years

More than 10 years

HE—Arts and Humanities/Social Sciences HE—Science NHS—Arts and Humanities/Social Sciences (includes one LIS) NHS—Science

3 1 1 0

3 1 1 2

0 2 1 1

more recent training needs analysis in the UK was the workshop exercise conducted by the Health Executive Advisory Group of CILIP in May 2003.12 The main trends identified were service modernization, services centred on the patient, the emphasis on tackling health inequalities, public health, and improving patient safety, and performance monitoring through targets. The UK perspective stresses cross-sectoral working across health, social care and education, and working in multi-disciplinary teams, but the focus is more that of practitioner support, rather than the researcher support that might be responsibility of the informationist. A later synthesis of training needs analyses in the UK13 found that the advanced practitioners needed research skills and advanced information retrieval skills, but there was little emphasis on knowledge of health sciences. Some advanced practitioners may be found working as clinical librarians, and a survey of their education and training needs14 indicated the main priorities were advanced search skills, critical appraisal skills, knowledge of principles of health services research and evidence-based practice, and clinical knowledge, e.g. anatomy and physiology. Methods Sampling Participants were recruited using the directory of health library sites for the region, taking care to approach both university and NHS sites in the recruitment process, which involved checking that the interviewee was professionally qualified (some sites are managed by para-professionals). Of the 17 librarians approached, 17 agreed to participate, but only 16 could be interviewed in the time period available (response rate 94%). Of these, eight had

an arts and humanities or social sciences first degree, seven had a first degree in a science subject, and one had a BA in library and information studies. The sample was a convenience sample, of volunteers, to gain a range of opinions, according to length of career and background. Para-professionals were excluded from the study. No data could be found to assess whether this distribution of first degree qualifications was typical of health library staff in other regions of the UK. Methods The research approach was interpretative, as it was judged important to assess not only the extent of differences in attitudes but also the reasons for some of the differences. Personal interviews were chosen, as the potential participants were dispersed across a discrete geographical area, and faceto-face interviews were assumed to provide more detail, as well as being easier to conduct for a novice researcher (TP). To provide more flexibility in the direction and scope of the interview, semistructured interviews were chosen in preference to structured interviews, although key questions were addressed in each interview: (i) changing roles of health care librarians; (ii) the impact of the library school curriculum on skills and competencies for the health sector; (iii) relevance of the interviewee’s first degree and previous work experience for their current post; (iv) quality and format of continuing professional development (CPD) throughout their career; (v) perceived barriers to continuing development and ideas for improvements in the training provision; (vi) personal views on the future of the profession and (vii) personal advice and recommendations (Appendix S1). Demographic data was collected in an accompanying questionnaire, and details of


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their career (length of time in health librarianship), year of graduation from library school, and year of graduation from their undergraduate education enabled comparison of the views on importance of the subject knowledge against previous career and education. The informed consent form was designed in accordance with recommendations of the Department of Information Studies, University of Wales Aberystwyth, and interviews were only recorded if the interviewee gave consent. If consent for recording was not granted, interviewees were asked to agree to note taking that could be shared with them at a later point if they wished. Interviews were conducted over a period of 5 months (March–July 2005), and 15 of the interviews were conducted at the interviewee’s workplace, with one interviewee visiting the researcher’s workplace. Questions for the semi-structured interviews were designed using guidance from Oppenheim15 for prompts that were encouraging and directional without being suggestive. For example, in order to obtain views and perceptions regarding the impact of library school curriculum on skills and competencies in health care, prompts were used at various stages of the interview to build up a picture in stages. The first question would be general: How did library school prepare you for your present role? Some time later another prompt would encourage description of the first training needs at the beginning of a career in health care. Finally, at the end of the interview the participants would be prompted to offer advice to future students of library schools. All three prompts would help obtain different perspectives on the same topic. Ideally, a focus group workshop might have helped to triangulate some of the findings, but time constraints meant that the interview itself had to be designed to ensure that different perspectives were obtained. For the data analysis, interview transcripts were coded. Each of the required themes was given a code (13 codes in total), including, for example: A—current role and responsibilities; B—training needs early in the career; C—relevance of library school curriculum; D1—relevance of first degree (science); D2—relevance of first degree (humanities), etc. This was simple content analysis. After this, extracts for each theme were copied and pasted

into a separate Word file for further analysis, including identification of any emerging themes (e.g. attitudes towards electronically delivered CPD, reasons for differences in attitudes between arts and humanities graduates and the science graduates). Results Results are presented using simple descriptive statistics. The quotations are coded to indicate the number assigned to the interviewee, where the interviewee was located [NHS or higher education (HE) post], and whether their first degree was in arts and humanities (AH), science (S) or library and information studies (LIS). Current responsibilities and CPD The main responsibilities cited by the interviewees were literature searching (n = 13), reference service (n = 11), teaching and training (n = 11), outreach work in the clinical setting, primary care setting or other university departments (n = 9), delivering CPD for other team members (n = 9), publicity and marketing (n = 8), collection management (n = 7), web design, web editing and web-based training (n = 7). Only six were not currently engaged in some form of CPD, and the CPD generally reflected the responsibilities of their post. Several were undertaking programmes to improve teaching skills, and a few were improving their skills in critical appraisal or statistics. Most noted that the amount of mediated searching they were carrying out was declining. Perceived training needs A quarter (n = 4) did not perceive any training needs. Three-quarters (n = 12) did perceive training needs, which concerned a range of management topics, or teaching and training. Research methods and subject knowledge were only mentioned once. When asked about future training needs, over half (n = 10) mentioned outreach skills. Interviewees cited a wide range of training needs that might be associated with outreach work, typically as a clinical librarian and/or trainer. Subject knowledge/ terminology was cited four times, as were service



promotion skills, closely followed by skills for research, critical appraisal, and systematic reviewing. Interviewees felt responsible for identifying their own training needs, but acknowledged that the main barriers were time and money:

The main gaps that the librarians noted in their library school education was the lack of preparation for teaching and training, followed by the need for some knowledge on clinical terminology and basic clinical science:

‘I don’t think they provide any training at the minute on how to go about working in those (new) roles, so they know what’s coming up but there isn’t that much practical help from the ground to be able to do it so you do have to go to the more expensive course providers, people who provide evidence-based medicine courses, and honestly the opportunities to go and do those are fairly rare because of the cost of providing them.’ (02/HE/AH)

‘The terminology surrounding enquiries for guidelines searches in the emergency department was a problem, that was really uncharted territory, I didn’t know any of these terms, I used the dictionary.’ (13/HE/AH) ‘Clinical knowledge, that was the key, I mean I didn’t have any experience in mental health at all and I had to learn very quickly. Then learning how to teach people. I had done a little bit on user education but I had not actually done finding evidence workshops, so I had to learn about critical appraisal and how to train.’ (07/NHS/AH)

Professional qualification Of the librarians (n = 16) interviewed, 15 had postgraduate qualifications in librarianship and one had completed a bachelor’s degree in library and information studies. The earliest enrolment was in 1965, the most recent one in 2000. Five librarians had worked in a health care information sector prior to becoming library school students. Two interviewees had completed a postgraduate scheme aimed at science graduates to prepare them for information professional posts in scientific fields, and of the remaining 14, four had taken a health information module, and three had not, although one was available, and, for seven, there was no module available. Some (n = 6) had learnt more about the health sector during their dissertation research: ‘I did my dissertation on a specific health care resource, that was probably the biggest learning curve to get me into health care eventually and I realized on the course that it was a growth area, that it was expanding.’ (03/HE/AH) Others noted that experience, gained before, after or during their postgraduate programme had been the most useful preparation: ‘I took the health care module—it was kind of just doing things that I had already experienced in my job. There is no substitute for experience.’ (08/ NHS/S)

Some (n = 6) noted the need for more advanced information retrieval skills, others cited statistical knowledge, and more awareness about the research process. ‘I didn’t even know that you had to apply for ethical approval until afterwards and I think maybe that should be something that should start at library school because people have always moaned that practising librarians don’t do research, but is it because it’s so daunting, you know, you haven’t a clue what you are doing, so it was all very much learning on the job.’ (12/NHS/S) Influence of first degree Seven out of 16 librarians interviewed for the study had a first degree in scientific subjects: zoology (n = 2), biochemistry (n = 2), biology (n = 1), radiography (n = 1) and biomedical sciences (n = 1). The non-science graduates had a wide variety of backgrounds. The science graduates discussed the influence of their first degree on their health librarianship work, but the other graduates gave much shorter responses. The science graduates explained that their background gave them more confidence with the terminology and general subject background: ‘I think the first degree I did has stood me in good stead for lots of things but in particular in applying


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knowledge and finding, searching to find the facts. The scientific terminology was easy and that was the reason I was given the job. They interviewed me in January and because I actually understood the research all of them were doing, I am not too hot on immunology but at least I did know what an antigen was, that’s why they employed me and they were willing to wait till July for me to arrive.’ (01/HE/S) That background was seen to provide a comparative advantage over non-science graduates. ‘I have a benefit of having the first degree in biomedical sciences so while I don’t think that my colleagues who didn’t have that particularly suffered it was just useful to me because I had come across some of the terms before and knew that if somebody came up and asked for something on some obscure liver disease I’d probably heard of it already even though I didn’t know what it was. I wasn’t sort of asking them to write it down and spell it and asking exactly what it was.’ (08/NHS/S) The non-science graduates emphasized some of the transferable skills or other management skills. ‘My first degree helped to prepare me to a certain extent in presentation skills, with being analytical in general and working in teams, in a very general way it has helped. (03/HE/AH) My first degree helped very much the management side of things, the budgeting. It was a BA degree but we did the statistics, if you did the finance stream which I did you had statistics and accountancy and everything.’ (07/NHS/AH) Although most participants with the first degree in non-scientific subjects had no recollection of great difficulties with terminology at the beginning of their career in health care, and some simply stated that they had resorted to dictionaries, the majority of them referred to the need for better subject knowledge in the latter parts of the interview. However, the participants with the first degree in science were quick to acknowledge the positive impact that their undergraduate studies had had on their skills and competencies in health care. Both groups agreed that after a few years in the profession the subject knowledge levelled out

regardless of their backgrounds. However, there was no indication that the issue was openly discussed between colleagues or any comparisons made of their respective competencies. Influence of work environment Both the NHS (n = 6) and HE (n = 10) health librarians could access training through the NHS, and the librarians funded through HE could also access courses organized through the university library service. There were differences in perceptions of the training and awareness required. Only the NHS librarians mentioned that they required knowledge of the organizational structures and practices of the NHS: ‘First of all (I had to) understand the NHS, how it functions. Secondly, understand the Trust structure, particularly different nursing grades, different types of doctor, that was totally unknown to me ...’ (09/NHS/AH) HE librarians had a dual role, but were aware that it could be advantageous to know more about NHS developments: ‘I might be interested maybe in some courses on clinical governance and the categories of clinical governance and how they fit in with the NHS at the moment because it keeps changing according to what the Government decides every five minutes.’ (05/HE/AH) HE librarians mentioned formal training opportunities, whereas the NHS librarians stressed the value of informal networking with other NHS librarians. ‘Each of us in the Thames Valley has a particular area of expertise. When I go for instance to the Thames Valley Librarians Forum somebody will bring something up from their area of expertise; for example, outreach work and so on. We are very collaborative and we would support each other greatly.’ (11/NHS/S) ‘The networking side of training is really important, so I just try and remember that, I do just like



talking to each other sometimes and meeting each other, it’s a part of training which you lose when you go online, you wouldn’t have that networking opportunity.’ (14/NHS/LIS) Discussion The main perceived training needs reflected the roles and responsibilities of the librarians interviewed. Literature searching (reference work), outreach work, teaching and training responsibilities were reflected in perceived training needs. Interviewees indicated their awareness of roles opening up in outreach work such as clinical librarians and primary care trainers, but there was little consensus on the skills that were required for such roles. This could reflect the short-term nature of many of the new types of posts as these are often funded on short-term project basis. Interviews with five clinical librarians,16 as part of another survey of clinical librarianship, indicated that clinical librarians perceived a need for some (unspecified) knowledge of anatomy and physiology, origin and meanings of medical terms, project management skills, literature searching skills, knowledge of evidence-based practice, research methods (quantitative and qualitative) and epidemiology. Clinical librarians themselves acknowledged that the most likely way of obtaining this skill set would be training on appointment or structured continuing professional development. The training needs survey11 in 1999 noted some discrepancies between the generality of what UK health librarians wished to do, and the underpinning skills and knowledge required. For example, the lack of perceived need for training in quantitative and qualitative research methods (less than 3.5% required this) did not match the larger numbers wanting training in evidence-based decision making. The 2005 study for the NLH13 similarly found that ‘The lack of confidence in critical appraisal, and the problems in benchmarking are the tip of an iceberg called numeracy.’ Numeracy-related skills, and the influencing and persuading skills required by those working across organizational and departmental boundaries, need to be practised, and there may be a lack of opportunities to practise these skills.17 Lack of practice may lead to a rapid decline in skills and loss in confidence, and one solution may be mentoring or coaching, to promote confidence

and competence when taking on challenging new roles. The arts and humanities graduates among the interviewees who had some experience of financial management, or who could transfer some analytical skills from their first degree, perceived some benefits to their work in health librarianship. Most interviewees who had previous work experience in the health sector, or who had done a health-care module or health-related dissertation, had found this useful, given the gap between the skills and knowledge on initial qualification and the requirements of some health librarian posts. Booth and Brice18 suggest that UK library course curricula may need to consider incorporating statistics as a core competence for future information professionals, and this would benefit those working in the health sector who run critical appraisal courses or support systematic reviews. Several studies have identified the gaps in skills and knowledge between those acquired at library school and the requirements for librarians working in health libraries.19,20 In this study, both the science and non-science graduates observed that experience levelled out differences, but the science graduates believed that they were better prepared at the outset for health library work. If the curricula in librarianship courses provided more opportunities to practise analytical and numerical skills, and encouraged students to develop specialist subject knowledge at the dissertation stage, students with a non-science-based first degree should be more confident in their first post in a health library. Appreciation of ways of thinking and practice in a different discipline, or different communities should be part of the curriculum. Although the NHS librarians interviewed benefited from the networking opportunities and learning from each other, there could be a danger that they do not, collectively, or individually, perceive the skills gaps that truly exist. A survey21 in 2000 of skills required for health information work found that there were similarities in the skills required of librarians and the information analysts, information officers, but noted that ‘paradoxically, the possession of a librarianship qualification might be viewed as the entry to a career with very narrowly delimited prospects, whereas a graduate with general numerical, analytical and critical skills might be able to progress quite rapidly in a


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variety of information management posts in the health sector.’ One possible advantage of the Knowledge and Skills Framework22 for NHS staff, first published in 2004, is the opportunity for librarians to see how their skills and knowledge match up against those of other staff working in health informatics. Networking could be formalized to ensure that the arts and humanities graduates are supported by mentors with a science background who may be quicker to recognize what the subject knowledge gaps are, and how these may be addressed. The findings indicated that arts and humanities graduates were perhaps unaware of what they did not know at the outset, whereas the science graduates could immediately appreciate how their subject knowledge translated into subject knowledge required for the post. In higher education there seemed to be more formal training opportunities but there might be a value to mentoring across the sectors to provide the librarians in higher education with a better appreciation of the needs of the NHS, and the impact of policy changes in the NHS. UK science graduates may be more likely to choose the MSc programmes in information science or chemoinformatics, and the highly IT literate may now be choosing MSc programmes in bioinformatics. There are few programmes in the UK that resemble the ‘Information Specialist in Context’ schemes in the USA that allow nonscience graduates to acquire, formally, a basic grounding in clinical sciences and specialist information science knowledge and skills to work in more specialist posts. However, there are library schools in the USA that do not offer specialist health information modules, as a history of medical librarianship teaching at Syracuse23 illustrates. Up until 2000, medical librarianship was taught by a visiting faculty member or adjunct practitioner and, since 2000, it has been available as an extra, summer course taught by faculty at Syracuse. Other sectors, such as business studies, or law, also demand specialist searching skills, and it is hard for smaller library and information studies departments to span the range of domains as well as provide the basic curriculum for accreditation. The attraction of the health sector is the range of opportunities for library and information science graduates, but these graduates need to be prepared

to take advantage of opportunities to extend their knowledge and skills. For the more advanced practitioners, coaching may be required, particularly when they work in small library units. Conclusions The findings of this study should be transferable within the UK as the NHS and HE mix of library settings is typical of many health library regions in the country, and the long tradition of CPD in the region should mean that interviewees were able to reflect carefully on their training needs. The findings help to explain some of the recurrent themes in the training needs analyses of health librarians in the UK. The identified gaps often concern numerical, statistical and analytical skills, skills that should be more familiar to science graduates than to graduates with a first degree in arts and humanities, or some social sciences. As a result, science graduates feel more confident when starting out in health librarianship, particularly if their degree studies provided some background subject knowledge shared with the clinical sciences. This may provide greater rapport and confidence for teaching as well. The non-science graduates catch up, learning on the job, but they might benefit from earlier support in the basics of the specialist knowledge required. Curricula in library and information science departments could include an emphasis on numerical, statistical and analytical skills, preferably integrated into the teaching of other components such as management and research methods. The management part of the curriculum needs to include aspects such as financial management to meet the needs of those planning or operating new projects, that may or may not involve new roles and responsibilities. The research did not assess whether curricula have already changed to reflect those needs, but it would be useful to compare the extent of training in research methods, and the type of management training provided in library and information science curricula, as well as the ways in which an appreciation of domain knowledge is nurtured. Looking further afield, it seems unrealistic to expect all library and information science departments to provide a health information module, but the curriculum should encourage students



to appreciate the need for domain knowledge in their future career, and provide opportunities for developing some specialist subject knowledge, and relevant skills, in the dissertation, at least. Mentoring or support in the first professional role in the health sector seems highly advisable, as a way of helping new entrants to identify how their existing skills and knowledge might transfer, and how the skill and knowledge gaps can be addressed. Beyond that initial stage, information professionals working in the health sector need to capitalize on opportunities to gain specialist skills and specialist subject knowledge, as that will give them more confidence in the emerging new roles.

• Structured CPD is required to meet the rapidly changing needs of health librarianship, and needs of advanced practitioners. Implications for Practice • Access to reliable mentorship in the first professional role in the health sector is highly advisable. • Librarians with a first degree in non-scientific subjects benefit from structured support during early years of career. • Regular assessment of training needs is essential. References

Supplementary Material The following supplementary material is available for this article: Appendix S1. Prompts for semi-structured interview. This material is available as part of the online article from: http://www.blackwell-synergy.com/ doi/abs/10.1111/j.1471-1842.2007.00717.x (This link will take you to the article abstract). Please note: Blackwell Publishing are not responsible for the content or functionality of any supplementary materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article. Key Messages Implications for Policy • Courses for professional preparation of library and information professionals need to include teaching skills, advanced search skills, project management skills, research methods and statistics, to prepare students for work in the health sector. • The curriculum should encourage students to appreciate the need for domain knowledge and provide opportunities for developing some subject knowledge relevant for the health sector.

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Education and training needs of health librarians, Tatjana Petrinic & Christine Urquhart 12 CILIP. The Example of Health: A Prognosis for the Profession. Issues Raised at a Workshop held by the CILIP HEAG on 8 May 2003. 2003. Available from: http:// www.cilip.org.uk/aboutcilip/howcilipworks/structure/ committees/executive/exampleofhealth.htm (accessed 4 June 2007). 13 Urquhart, C., Spink, S. & Thomas, R. Assessing Training and Professional Development Needs of Health Library Staff. Aberystwyth: Department of Information Studies, 2005. 14 Ward, L. A survey of UK clinical librarianship: February 2004. Health Information and Libraries Journal 2005, 22, 26–34. 15 Oppenheim, A. N. Questionnaire Design, Interviewing and Attitude Measurement. London and New York: Continuum, 1992: 71–5. 16 Harrison, J. & Sargeant, S. J. E. Clinical librarianship in the UK: temporary trend or permanent profession? Part II: present challenges and future opportunities. Health Information and Libraries Journal 2004, 21, 220–6. 17 Urquhart, C., Durbin, J. & Spink, S. Training Needs Analysis of Healthcare Library Staff, Undertaken for South Yorkshire Workforce Development Confederation. Aberystwyth: Department of Information Studies, 2004.

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