Effect of evidence-based information management and practice training on librarians’ critical thinking: A randomized educational trial

Abstract

Critical thinking is one of the most important elements in making the right decision in every profession. Evidence based practice shows potential to empower the critical thinking skills of practitioners. The aim of this study was to determine the effect of evidence-based information management and practice (EBIMP) training course on the promotion of medical librarians’ critical thinking. This study is a randomized double-blind educational trial in the form of a parallel trial. A sample of 60 librarians were recruited nationwide in the study through the volunteer enrollment to the evidence-based information management and practice training course. Intervention group received a 10-module virtual course focusing on evidence-based information management. But the control group received a basic course of evidence-based medicine. The courses were delivered through virtual learning system and data was collected through California Standard Critical Thinking Skills Questionnaire Form B (CCTST). Data were analyzed with Covariance Analysis (ANCOVA), Chi-square (χ²), Kolmogorov-Smirnov and Levin tests, and t-test, using SPSS 25. The findings showed that the critical thinking skills of participants after training of the information management and evidence-based practice (EBIMP) had significant improvement in the intervention group compared with the control group regarding the “inference” (4.86 ± 1.94 vs 4.20 ± 1.32), “assessment” (7.90 ± 1.77 vs 5.90 ± 1.70), “Inductive reasoning” (8.67 ± 2.32 vs 6.37 ± 1.87), “deductive reasoning” (6.47 ± 2.04 vs 5.77 ± 1.97) subskills. Education of evidence-based information practice could be effective in promotion of critical thinking skills of medical librarians. This study suggests evidence-based information practice to be added to the curriculum of medical library and information science fields.

Trial registration: This study was registered with number 9000.1v1 in Registry of Efficacy and Effectiveness Studies (REES).

Keywords

Critical thinking evidence-based practice evidence-based practice librarians medical libraries training course randomized controlled trial

Background

Today, critical thinking is one of the most important goals of education (Tiruneh et al., 2014). It is embedded in curriculum of students and continuing education through various approached (Puig et al., 2019). Several approaches have been taken in account to be used as an intervention to increase the critical thinking of the students. Evidence based practice is one of the successful approaches that is intertwined with critical thinking and appraisal. During the past two decades the success of the evidence-based practice has led to the emergence of a new paradigm, which has inspired a radical change in policy and practice worldwide (Booth and Brice, 2004). Consequently, the need for change in medical library professionals’ education and practice was acknowledged by the Medical Library Association (MLA). Hence, in 2017, MLA revised competency recommendations for medical librarians with specific emphasize on critical appraisal, the evidence based practice, assessing research studies, using research and communicating research results to improve practice (Medical Library Association, 2017). MLA competencies emphasizes that librarians are educators, they train information literacy, critical apprising researches, evidence based practices for many years. They need to apply these skills in their own practice as well.

The evidence based practice provide a new framework through its five-step model that cultivates the ability of students to put forward questions, acquire knowledge actively identify authenticity and use rationally (Cui et al., 2018). The steps of evidence based approach is similar to information literacy standards addressed by the ACRL Standard (Adams, 2014). Literatures indicates that effective steps have been taken internationally to develop evidence-based librarianship, and it is officially offered in the United States and the United Kingdom (Crumley and Koufogiannakis, 2002).

But, despite the close relationship and interconnection between the evidence based practice, critical thinking, information literacy, and more importantly the impressive role of librarians in training evidence based medicine the library science education in developing countries fails in including evidence based practice through formal education for students and graduates (Zarea Gavgani, 2017). The curriculum of library science is not enough responsive and does not have credits with emphasis on critical thinking, apprising, evidence based practice, and strong research methodology themes (Shokraneh et al., 2011). Even the teaching methods used for transferring the course relies traditional teaching methods. This is while evidence shows that the critical thinking scores of library science students is below average (Zarei et al., 2017). Although the information literacy has close relationship with critical thinking but if not valued as component of teaching by the library professionals will rarely promote the critical thinking of their users (Goodsett, 2020). The main problem of education of librarianship and information science in developing countries like Iran is lack of attention to educational program and teaching methods based on new educational theories, creativity, critical thinking, and strong research designs (Fattahi, 2000). In the traditional teaching methods students remain dependent on teachers instead of building the capacity for thinking independently (Yue et al., 2017). So it is evident that the curricula and teaching methods should be modified to support critical thinking skills.

Information literacy and related processes as an important components of librarianship is closely related to critical thinking and strengthens the critical thinking (Ory and Braskamp, 1988; Weiner, 2011; Whitmire, 1998). Librarians foster the knowledge of evidence based databases and use of databases to other professions to support information literacy and the evidence based practice (Dehghan Salmasi et al., 2021). But practicing information literacy service has not necessarily ensured librarians critical thinking skills. Critical thinking must be taught thorough content, structure, and curriculum (Paul and Elder, 2019a, 2019b).

Therefore, practical steps for promotion of critical thinking of librarians’ mush taken in account through appropriate interventions. The evidence-based approach in many of its basic elements and in its philosophy has been institutionalized with critical thinking and information literacy processes. So that in the definition of evidence-based practice also the focus is on critical evaluation and judgment based on the current best (Sackett et al., 1996).

Evidence based practice can be considered as one of the approaches that shows potential for promotion of critical thinking of the practitioners. Evidence based practice in library science is important from two points of view, one as a service and one as a professional commitment. In one way librarians search and evaluate information as a service to satisfy the users’ information need, but on the other hand they implement the same functions as a professional practice for themselves (Esmaeilzad and Zarea, 2021).

A librarian with an in-depth knowledge of the various databases, expertise in search skills needs critical thinking skills to be able to design a suitable strategy for performing a quality search and successful retrieving evidence for clinical decision making. Therefore, critical thinking and evidence-based practice are both essential lessons to learn and practice in library science but both are ignored in LIS curricula.

Hence, harnessing the potential of evidence-based practice and its functional steps of information literacy, such as asking, accessing, assessing, and applying information, in promotion of critical thinking requires appropriate educational and functional interventions.

Therefore, at current circumstance, short course training is one of the practical approaches to overcome this failure in education and capacity building as well as empowerment of library and information professionals.

No study to date has, to the best of our knowledge, explored the extent to which evidence-based practice effect the librarians’ critical thinking skills in Iran and or other countries. Therefore, present study aimed to fill this gap by studding the effect of training evidence-based information and practice on promoting librarians’ critical thinking.

Materials and methods

Study aim

To evaluate the effectiveness of evidence-based information management and practice (EBIMP) training course on the promotion of medical librarians’ critical thinking.

Trial design

This study is a randomized double-blind educational trial study in the form of a parallel trial among 60 medical librarians working in medical science universities in Iran that enrollment to the evidence-based information management and practice training course. The flow diagram of the study design is reported in Figure 1.

Setting and participants

The study is being conducted on librarians working in medical science libraries at public universities across the Iran under the auspices of the Ministry of Health and Medical Education who are participating in the Call for Evidence-Based Information Management Virtual Training. (This call was active on the site from October 6, 2016 to February 15, 2017.) The sample size 60 people was determined based on the number of final registrants in the virtual course call. The study power was calculated using G * Power software version 3.1.9.7. The power value 0.85856 and effect size 0.3984326 were calculated. Inclusion criteria were: (1) Having at least a bachelor’s degree in librarianship. (2) At least 5 years of experience in the medical libraries. (3) Willingness to participate by registration in the call for evidence-based information management virtual training course. Librarians with a history of attending evidence-based training courses were excluded. Out of 73 librarians applying to participate in the course, 7 librarians were excluded from the study due to non-compliance with the inclusion criteria and 6 librarians were excluded from the study due to non-compliance with the informed consent form (Figure 1). Thus, the study population consisted of 60 librarians working in medical science libraries from public universities across the Iran. All participating librarians were enrolling in an evidence-based function course for the first time and had not previously participated in any formal evidence-based practice training program. Therefore, we are logically confident that evidence-based practice knowledge was similar in both groups.

Inclusion criteria

Inclusion criteria were: (1) Having at least a bachelor’s degree in librarianship. (2) At least 5 years of experience in the medical libraries. (3) Willingness to participate in the study by registration in the call for evidence-based information management virtual training course.

Exclusion criteria

Librarians with a history of attending evidence-based training courses were excluded.

Intervention protocol

This research is an interventional study that has been done in Tabriz University of Medical Sciences through the electronic learning management system at http://safa.tbzmed.ac.ir for 3 months from February 20, 2017 to June 2017. The intervention was a short-term virtual “evidence-based information management and practice (EBIMP)” course, and the outcome was “improvement of critical thinking skills.” A call for participation was distributed through university’s website (at https://b2n.ir/r74343) and the social networking groups. A librarian who was not aware of the objectives of the study was considered as a research assistant. His responsibilities included answering calls from registrants, receiving and reviewing required documents and registering applicants, sending emails and notifications on WhatsApp, and assigning codes to each registrant. Before starting the study, she received the necessary training on how to do the job.

Group allocation

A block randomization was used to equally assign the sample numbers into each groups using the Microsoft Excel software v. 2016. The participants were randomly divided into two intervention groups (n = 30) and a control group (n = 30) using RandList1.2 software program. The allocation concealment was done by the marked series of the closed envelops including the allocation code.

Intervention

An educational intervention is understood as a set of teaching activities, with special methods, stages, and rules, aimed at the attainment of desirable skills and attitudes. Considering the importance of teaching technologies in the development of CT, the use of educational interventions may be a good option (Ilic et al., 2015). In this study, intervention group and control group received the different theoretical concepts, but in a same approach.

In this study, both intervention group and control group received the training in the similar learning environments (Electronic Learning System of Tabriz University of Medical Sciences). The teachers in both groups were the same. To help learner’s better understanding of the presented lessons, instructors could use any visual aids and other features such as slides, pictures, and short videos. The difference between two groups was the content of the courses offered to librarians. The course was concurrently conducted in the form of virtual education for both groups. Both intervention and control group received a 10 web-based module through Electronic Learning System (LMS) of the Tabriz university of Medical Science. The lessons delivered to the intervention group focused on the practice of evidence based information management approach but the control group received some theoretical contents of evidence-based medicine instead (Appendix). The course was provided during a 3-month. The homework was delivered at weekends to the learners of both groups. The teachers had to provide appropriate feedback on the librarians’ homework by the beginning of the next week. Subsequently, the control group received the same educational contents after the completion of the research. Both intervention and control group completed the pre-test and post-test questionnaire at the beginning and at the end of the course.

Intervention group

Before the educational intervention, the lessons offered to the intervention group, based on evidence-based information management was adjusted, and validated by three library and information science experts and by the authors of this study. The lessons delivered to the intervention group included the following: the evidence-based practice process (the evidence-based practice in librarianship and information sciences, evidence-based medicine) critical appraisal of the evidence, critical thinking and mind map, systematic review, meta-analysis, structured questions, types of systematic questions, searching and retrieving evidence, systematic search and synthesis, levels of evidence, and writing a protocol/proposal for practice as optional task to receive certificate. In addition to the main modules, a series of scenarios on the medical librarianship were designed as assignment in each module to empower the critical thinking and judgment of participants in line with evidence based practice in the intervention group (Appendix).

Control group

Librarians randomized to the control group received the standard concepts that are offered in evidence-based medicine training courses. The lessons delivered to the control group was partially different from the syllabuses of the intervention group. The critical evaluation, concept map, and mind map was not delivered to the control group. The control group received the following lessons: introduction to evidence based practice, evidence based medicine in general, organizations and centers related to evidence-based practice, search and retrieval of information in databases, research types/level of evidence in medicine, publishing and distribution of information, structured questions, search and retrieval of evidence, systematic review, and systematic searching. Writing proposal was considered optional.

Data collection

The data collection tool was a two-part questionnaire. In the first part, demographic information of the participants, which included gender, age, level of education, and work experience, was collected. The second part was the California Standard Critical Thinking Skills Questionnaire Form B (CCTST). All participants CCTST were evaluated on the first day before the start of the course, and on the last day after the end of the activities. The CCTST questionnaire contains 34 multiple-choice questions with a correct answer that measures critical thinking skills in five dimensions of analysis, inference, evaluation, inductive reasoning, and deductive reasoning. The total score range is from 0 to 34 and the score range in each skill or (subscale) is 0–12. In scoring, an overall score of 1–22 indicates a lower level of critical thinking, a score of 22–28 indicates a moderate critical thinking, and a score above 28 indicates a higher level of critical thinking. For each dimension of critical thinking (or subscales) which includes: analysis, evaluation, inference, inductive, and deductive reasoning, score of 4 or less indicates weakness, and a score of 7 or higher indicates strength skill. CCTST have been widely used by researchers worldwide due to their strength of validity and statistical reliability. In Iran, this test was translated and validated into the Persian language by Khalili and Soleimani (2003).

Validity and reliability of evaluation tools

The California Critical Thinking Test has strong content validity. Internal reliability in the standard questionnaire, indicated by the Kuder-Richardson-20 test, is from 0.69 to 0.74. The validity, reliability, and standardization of this test in Iran have been investigated by Khalili and Soleimani. The reliability coefficient of the test was calculated by internal correlation and using the formula of Richardson’s 20 code 62%. Internal correlation and group differences methods were used to determine the validity of the test structure after factor analysis (Khalili and Soleimani, 2003).

Blinding process

In this study, due to the nature of study that is an educational RCT, blinding was not feasible. However, the learners (librarians) and the assessors were blind about the intervention and outcomes. The participants were not aware of the group allocation and the contents selection, data collection, and evaluation criteria.

Time periods of measurement

At the beginning of the study (before the intervention) and 2 weeks after the intervention, the subjects were evaluated by CCTST Questionnaires.

Statistical analysis

The analyses were carried out using the statistical software SPSS version 25.0. The Levene test was used to evaluate group homogeneity, and the Kolmogorov-Smirnov (KS) test was used to evaluate normal data distribution. The Chi square test (χ²) was used to evaluate the homogeneity of the groups for gender and age. In addition to the descriptive statistics, the paired t-test was subsequently used to compare mean scores and CT score changes in CCTST tests. The independent t-test was used for intergroup comparisons and study the effectiveness of intervention between the intervention and control groups. The Covariance Analysis (ANCOVA) was used to verify the influence of independent variables (gender, age, pre-test, and group) on CT scores. The significance level was defined as less than 0.05 (p < 0.05).

Results

We collected 60 valid responses from the participants in both intervention and control groups.

As shown in the Table 1, According to the demographic data of the study participants (n = 60), the majority were female (n = 49; 81.6%); the average age was 36.45 ± 7.125 years; and most of them were bachelor (n = 33; 55%). In relation to the period of the job experience, the majority (n = 24; 40%) were in the 11–15 years. The Chi square test was used to verify if both the intervention group and control group were homogeneous for age and sex.

Table 1.

Demographic characteristics of participants in intervention and control groups.

Variables	Control N = 30	Intervention N = 30	Total N = 60
Sex
Female	27 (90)	22 (73)	49 (81.6)
Male	3 (10)	8 (26.7)	11 (18.3)
Experience
5–10	7 (23.3)	3 (10)	10 (16.6)
11–15	13 (43.3)	11 (36.7)	24 (40)
16–20	6 (20)	6 (20)	12 (20)
Over 20 years	4 (13.3)	10 (33.3)	14 (23.3)
Age (years)
25–35	18 (60)	13 (43.3)	31 (51.6)
36–45	10 (33.3)	13 (43.3)	23 (38.3)
46–55	2 (6.7)	4 (13.3)	6 (10)
Level of education
Bachelor	14 (46.7)	19 (63.3)	33 (55)
MA	10 (33.3)	7 (23.3)	17 (28.3)
PhD	(20) 6	4 (13.3)	10 (16.6)

Chi-square test was used to assess the homogeneity of groups in terms of gender and age. The test results showed that there was no statistically significant difference between the study groups (p > 0.05; Table 2).

Table 2.

Gender and age homogeneity test in the studied groups.

	Intervention group	Control group	Total	p-Value	DF	χ²
Gender
Female	22 (36.7%)	27 (45%)	30 (50%)	0.095	1	2.783
Male	8 (13.3%)	3 (5%)	30 (50%)	0.095	1	2.783
Age (years)
25–35	13 (43.3%)	18 (60%)	31 (51.7%)	0.394	2	1.864
36–45	13 (43.3%)	10 (33.3%)	23 (38.3%)
46–55	4 (13.3%)	2 (6.7%)	6 (10%)

Overall CCTST means in the intervention group (n = 30) in the pre- and post-test were 26.43 ± 7.13 and 31.87 ± 5.65, respectively. On the other hand, overall CCTST means in the control group (n = 30) in the pre- and post-test were 27.16 ± 5.35 and 26.30 ± 5.29, respectively (Table 3). There was no significant difference between the groups in the pre-test for total CCTST scales or any of their subscales.

Table 3.

Critical thinking skills and total CCTST in intervention and control groups before and after intervention.

	Pre-test			Post-test
	Intervention group	Control group	p-Value	Intervention group	Control group	p-Value
	Average ± SD	Average ± SD	p-Value	Average ± SD	Average ± SD	p-Value
Analysis	3.73 ± 1.80	3.77 ± 1.38	0.936	3.97 ± 1.30	4.06 ± 1.72	0.755
Inference	4.77 ± 2.01	4.93 ± 1.28	0.704	4.86 ± 1.94	4.20 ± 1.32	0.126
Evaluation	5.57 ± 1.70	5.73 ± 1.55	0.693	7.90 ± 1.77	5.90 ± 1.70	<0.001
Inductive reasoning	6.40 ± 2.34	6.57 ± 1.71	0.754	8.67 ± 2.32	6.37 ± 1.87	<0.001
Deductive reasoning	5.97 ± 1.92	6.16 ± 1.82	0.680	6.47 ± 2.04	5.77 ± 1.97	0.183
Total score	26.43 ± 7.13	27.16 ± 5.35	0.654	31.87 ± 5.65	26.30 ± 5.29	<0.001

Nevertheless, on comparing the mean scores on the pre- and post-test, a significant difference was found for the intervention group on the CCTST evaluation subscale (t = −6.542; p < 0.001) and inductive reasoning subscale (t = −4.958; p < 0.001), but significant difference was not found for the intervention group on the CCTST analysis subscale (t = −6.542; p < 0.001), inference subscale (t = −6.542; p < 0.001), and deduction subscale (t = −6.542; p < 0.001; Table 4).

Table 4.

The comparison of the mean of difference between before and after CCTST score in two groups.

Variables	Intervention			Control
	Differences	t	p-Value	Differences	t	p-Value
Analysis	−0.23 ± 1.63	−0.782	0.440	0.52 ± 1.63	2.302	0.025
Inference	−0.100 ± 1.97	−0.278	0.783	−0.02 ± 2.0	−0.069	0.945
Evaluation	−2.33 ± 1.95	−6.542	<0.001	0.1 ± 1.94	0.357	0.723
Induction	−2.27 ± 2.50	−4.958	<0.001	0.12 ± 2.4	0.347	0.730
Deduction	−0.50 ± 2.22	1.231	0.228	0.17 ± 1.68	0.744	0.460
CCTST overall	0.62 ± 4.39	0.999	0.323	0.60 ± 3.36	1.279	0.207

The ANCOVA was used to analyze the influence of independent variables and covariates on CT. The independent variables of interest were group (Intervention group and Control group), age and gender, and the controlled covariates were the CCTST pre-course scores. Thus, ANCOVA controlled the effects of covariates on dependent variables of interest (post-course CCTST scores), and it was possible to verify how the independent variables acted on a dependent variable. ANCOVA verified that there was influence of the variables group and pre-test CCTST scores on the overall CCTST results and their subscales. The results as showed a significant effect on all the domains: analysis (F = 9.785; 95% CI, p < .05), inference (F = 8.273; 95% CI, p < 0.05), evaluation (F = 3.711; 95% CI, p < 0.05), deduction (F = 11.510; 95% CI, p < 0.05), and induction (F = 9.430; 95% CI, p < 0.05; Table 5).

Table 5.

Covariance analysis of CCTST according to group and pre-test CCTST scores.

Variables	Type III sum of squares	DF	Mean square	F	Significance
Analysis	30.603	3	10.201	9.785	p < 0.001
Inference	51.264	3	17.088	8.273	p < 0.001
Evaluation	40.161	3	44.604	3.711	0.17
Induction	113.097	3	55.784	9.430	p < 0.001
Deduction	89.788	3	29.929	11.510	p < 0.001

As for the CCTST scores, there was no influence of the variables gender, and age on the overall CCTST results and their subscales.

Discussion

This study was an educational randomized controlled trial (RCT) aimed to examine the effect of a short term virtual education of evidence-based information management and practice (EBIMP) on the critical thinking as well as cognitive skills of critical thinking among medical librarians.

We assumed that, the evidence-based practice education can improve critical thinking capabilities in librarians. Therefore, we delivered a short term virtual training on evidence based information management and practice education for medical librarians. The California Critical Thinking Skills Test (CCTST)-Form B was used to test librarians’ overall critical thinking score and the five subscales of critical thinking cognitive skills (analysis, evaluation, inference, inductive reasoning, and deductive reasoning).

Regarding improvement in librarians’ overall critical thinking, our study found a significant difference between mean score of critical thinking before intervention (n = 30; M = 26.43; SD = 7.13) and after intervention (n = 30; M = 31.86; SD = 5.29) in intervention group. But there was no significant difference between the mean scores of critical thinking between pre-test and post-test in the control group (n = 30; M = 27.16; SD = 5.35) and (n = 30; M = 26.30; SD = 5.29). Therefore, the present study showed that, a short term virtual education of evidence-based practice is effective in promotion of overall critical thinking skills among medical librarians (p < 0.05). Ory and Braskamp (1988) used the College Student Experiences Questionnaire (CSEQ), which measures the quality of effort that students engage in and found a strong relationship between library experiences and gains in critical thinking. Whitmire explored the relationship between the academic activities and library experience on critical thinking of academic librarian. They found moderate positive correlations between academic activities (library experiences, experiences with faculty, course learning, writing) and promotion of critical thinking for students in the honors (n = 74) and transitional program (n = 74) and low positive correlations between the two factors and with the regular students (n = 77; Whitmire, 1998). A quasi-experimental study was conducted to examine the effect of problem based learning and reasoning test in the level of critical thinking of master science student in Medical Library and Information Science (MLIS) using California Critical Thinking Questionnaire. The total score of level of critical thinking of students in the field of medical library and information science was week before the intervention (6.80 ± 80.95) and was increased significantly in this study after intervention (5.1 ± 83.25; Gavgani et al., 2021). Several eminent scholars emphasized that teaching information literacy or searching for evidence by librarians for users and faculties does not guarantee they may apply critical thinking for their own practice because they consider the critical thinking outside of their own scope (Bodi, 1988; Gibson, 1995).

However, there was not a research with evidence based practice intervention and critical thinking outcome in library science literature. But in nursing and medical science education there was some similar studies to be referred as background of study. The findings of our study was largely in consistence with the Poodineh Moghadam et al. (2015), that investigated the effect of evidence-based education on nurses’ critical thinking in a pre-test and post-test study using the CCTST tool. They found a positive relationship between evidence-based education and nurses’ overall critical thinking. According to the results of their study, the average score of students’ critical thinking before the evidence-based workshop was (N = 43; M = 10.30; SD = 3.82), which was increased to (N = 43; M = 12.04; SD = 3.25) 45 days after the workshop which was statistically significant difference (p < 0.001).

However, regarding the five skills of critical thinking, the effect of evidence-based practice training in our study showed statistically significant relationship between the skills of “evaluation” (p < .001) and “inductive reasoning” (p < 0.001) subscales rather than “analysis” (p = 0.755) “inference” (p = 0.126) and “deductive reasoning” (p = 0.183) skills with evidence based training.

The findings of our study indicated that the participants in the intervention group performed the tests significantly better in the “evaluation” subscale of critical thinking skills, after the EBIMP training (n = 30; M = 8.67; SD = 2.32) comparing to control group (n = 30; M = 6.37; SD = 1.87). In this regards also, the result of present study is consistent with the study of Poodineh Moghadam et al. (2015) who found that the mean score of the “evaluation” (p = 0.003) has increased significantly after intervention (Poodineh Moghadam et al., 2015). In contrast, Stack et al. (2020), studied the effect of Evidence Based Medicine training on the physician assistants’ critical appraisal skill with an objective structured clinical examination (OSCE) and found that intervention group performed no better than the control group (Stack et al., 2020). Liu et al. (2021) performed a multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses. They used the Critical Thinking Disposition Inventory (CTDI-SCV) to assess the critical thinking competencies among clinical nurses after the education program and found a small positive association between EBP and critical thinking based on the CTDI-SCV (r = 0.396; p < 0.01; Liu et al., 2021).

Also, according to the results of the present research, it should be said that the effect of evidence-based information and practice training on “inductive reasoning” (n = 30; M = 8.67; SD = 2.32) and deductive reasoning (n = 30; M = 6.47; SD = 2.05) of librarians in the intervention group have been higher than the control group (n = 30; M = 6.47; SD = 2.04; n = 30; M = 5.77; SD = 1.97) after intervention. However, the differences between two groups before and after intervention was statistically significant on inductive reasoning (p < 0.001) but not on the deductive reasoning score (p = 0.183). Cui et al. (2018) studied the effectiveness of evidence-based nursing on students’ critical thinking through a meta-analysis. The studies included in the meta-analysis measured the effect of intervention by two different tools namely Watson-Glaser Critical Thinking Appraisal (WGCTA) and California Critical Thinking Dispositions Inventory (CCTDI). WGCTA is close to California Critical Thinking Skills Test (CCTST)-Form B that we have used in our study. The WGCTA is an 80-item assessment tool for measuring critical thinking skills including inference, recognition of assumptions, deduction, interpretations, and evaluation of arguments. The Five out of nine studies measured by WGCTA in the meta-analysis included 525 students. Heterogeneity of studies was identified (I² = 97%), and the pooled results showed that evidence based practice training had a highly significant effect on the critical thinking (MD = 17.26; 95% CI [11.22, 23.30]; p < 0.00001; Cui et al., 2018).

It is important to emphasize that regarding the overall strength of critical thinking in librarians without intervention, the findings of this study do not correspond to the findings of studies performed by Motamedi et al. (2015) and Moalai Mazraei et al. (2013), and Fatemeh et al. (2015). Our pre-test according to CCTST, revealed that medical librarians’ critical thinking score was moderate before intervention in both intervention (M = 26.43; SD = 7.13) and control groups (M = 27.16; SD = 5.35); p = 0.654). But, Motamedi (2015) who concluded that the mean score of overall critical thinking among librarians was weak about 10.12–11.68, and under standard level (Fatemeh et al., 2015). Moalai Mazraei et al. (2013) evaluated the library science students critical thinking with CCTST and revealed that overall critical thinking of library science students is weak (N = 76, M = 10.41; SD = 6.69; Moalai Mazraei et al., 2013). The population of our study were medical librarians, so we argue that working closely with physicians in medical sciences universities and searching evidence for clinical decision making have imperceptibly affected the librarian’s judgment and concise evaluation skills, so that their critical thinking also has improved based on the environment. The literature review showed that beside the emphasizes of eminent scholars on the importance of critical thinking in LIZ education and practice, library science research lacks critical research designs to evaluate the critical thinking levels of LIS students and professionals through interventions.

Also, the results of this study showed that the changes in librarians’ critical thinking were more in the dimensions of evaluation and inductive reasoning, the change in the dimensions of analysis and inference was weaker. To justify this issue, we can refer to the results of Niu et al. (2013), which showed that complementary interventions which are longer than 12 weeks are more effective in increasing students’ critical thinking ability compared to short interventions. Also, in the research of Abrami et al., It has been emphasized that the dimension of analysis is related to higher stages of thinking and observing change in the level of understanding and data analysis requires time, training and experience in the relevant field (Abrami et al., 2008). This can be counted as of limitations for this study. The other limitation for our study was its relatively small sample size, which was limited to librarians from medical science universities willing to participate in EBIMP course which may show selection bias.

Conclusion

Virtual evidence based information management and practice (EBIMP) training is effective in improving the critical thinking of librarians. However, for sustainable effect long term education and practice is needed. The evaluation skills, inductive reasoning ability of the librarians substantially is affected by the EBIMP course. The evidence based information practice training may lead to strengthening the critical thinking, judgment, and evaluation skills of librarians and this may help them in improving their own profession and providing better service to the health system clients. Therefore, this study strongly suggests the evidence based information practice need to be embedded in the curriculum of library science students specially the medical/health science library science, at all level.

Footnotes

Appendix

Appendix.

Topic delivered in the EBLIP course.

Topics
1. Evidence-based practice in librarianship and information sciences
2. Introduction to evidence-based medicine
3. Critical thinking, concept map and mind mapping
4. Systematic reviews, meta-analysis
5. Structured question/question formulation (PICO/SPICE, etc.)
6. Types of systematic questions in relation with level of evidence
7. Searching and retrieving evidence
8. Systematic search and synthesis
9. Critical appraisal of the evidence
10. Designing a proposal for systematic reviews/meta-analysis proposal
11. Assessing the performance by guideline

Note. Lesson 3 was not presented to the control group it was replaced with publishing and distribution of information.

Acknowledgements

This study is based on the PhD thesis submitted to the Hamedan Islamic Azad University registered with the number 171483874268314162340. We expand our great appreciation to Dr Sakineh Hajebrahimi, Dr Fatemeh Sadeghy Ghyasi, and Dr Mortaza Gojazadeh from Evidence Based Center; Dr Alison Brettle from Salford niversity (UK) for their help in providing and delivering the educational contents. Also we would appreciate Mr Ahmadian (eng.) for his help in providing access to electronic leaning system (LMS) of Tabriz University of Medical Sciences, Dr Hakimeh Hazrati for their help with facilitating the course and keeping continual connection with learners 24/7.

Author contributions

SE and VZG developed the conception or design of study. VZG designed the methodology and contents for educational intervention. SE collected data. AZ and SF helped with interpretation of data. SE and VZG drafted the work. AZ and SF read the manuscript.SE, VZG, AZ, and SF all approved the final manuscript and agreed for authorship.

Availability of data and materials

The data described in this Data Note can be freely and openly accessed on the Zenodo repository under

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Ethical approval and consent to participate

This study was approved by Islamic Azad University of Hamadan, Ethics Committee (Approval ID: IR.IRU.H.REC.1399.001). In this research, all methods were performed in accordance with the relevant guidelines and regulations. The Helsinki Declaration was followed to respect the individuals, their right to make informed decisions and so on. Participants who had willingness to participate in the course, signed the Informed Consent Form, which contained detailed information on the trial and were informed in detail about the study. In addition, all information about the participants was kept confidential.

ORCID iD

Vahideh Zarea Gavgani

Author biographies

Sima Esmaeilzad is PhD Student in Knowledge and Information Science in Azad University. She is also a Medical Librarian at Dentistry School of Tabriz University of Medical Sciences, in Tabriz, Iran. She has co-authored books in Medical Library and Information Science and presented several workshop and consultation for research in Dentistry School.

Dr. Vahideh Zarea Gavgani, is professor of Medical Library and Information Scienceabriz University of Medical Sciences, One of the ranked universities in Tabriz city of Iran. She is pioneer in evidence based librarianship and information therapy service (providing Information Prescription service for patients) in Iran. She has published plenty of scholarly articles, supervised doctoral and graduate students’ thesis in the Library Science, Pharmacology and Medicine. Her field of interests are information literacy, evidence based practice and Altmetrics.

Dr. Atefeh ZareiZarei is associate professor in Knowledge and Information Science at Azad University in Hamedan, Iran. She also serves as a chief executive officer of public libraries in Hamedan City. Her field of research is critical thinking in library science and also interested in health service information in libraries.

Seyed Ali Akbar Familrouhany is Assistant Professor in Knowledge and Information Science at Azad University in Hamedan, Iran. He has supervised plenty of master and doctoral thesis in the field of Knowledge and Information Science at Azad University. He is interested in all library science research.

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