Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho**

Abstract

The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources. A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically. The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy. More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho. [PUBLICATION ABSTRACT]

Headnote

Objectives: The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources.

Methods: A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically.

Results: The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy.

Discussions/Conclusion: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho.

INTRODUCTION

Studies on information needs, information seeking, and use of information resources are designed to inform the development of information resources, training programs, and information services useful for specific populations. In recent years, several studies on the assessment of information-seeking behaviors, information needs, and information resource utilization have been conducted in allied health professions such as public health, nursing, physical therapy, speech-language pathology, and occupational therapy [1-7].

Speech-language pathologists (SLPs) and audiologists are primarily concerned with improving the communication of persons with communication disorders. SLPs focus on the speech, language, and swallowing of individuals with communication disorders, and audiologists focus on the hearing and balance systems of individuals [8, 9]. Because of the multidisciplinary nature of both professions, SLPs and audiologists must be aware of medical, educational, psychological, and linguistic databases to effectively employ evidencebased practice (EBP).

The American Speech-Language-Hearing Association (ASHA) serves as the professional and credentialing organization for SLPs and audiologists in the United States. Over the past five years, ASHA has established committees and resources for EBP [10]. Standard III-F in the ASHA certification process requires that applicants be knowledgeable about the research process and be able to integrate research principles into clinical EBP. These external forces require SLPs and audiologists to develop their information-related skills to find the best evidence to inform their assessment and treatment of clients with communication disorders.

Speech-language pathology and audiology in Idaho

Idaho is a rural state, and, of Idaho's 44 counties, 18 are designated as medically underserved areas and 19 counties are partially designated as medically underserved [U]. Idaho also has a growing need for SLPs and audiologists. The ASHA Leader noted that "9 states-Arizona, California, Georgia, Idaho, Indiana, Maryland, New Mexico, North Carolina, and Virginia-will have the highest rate of job growth, with a 50% or more increase in jobs in the next decade" [12].

Practicing SLPs and audiologists in Idaho may have inadequate access to information resources. Currently, many SLPs and audiologists are working in private practice, hospitals, clinics, and public schools that may not be able to afford expensive online databases and journals. While the Idaho Health Sciences Library serves as the National Network of Libraries of Medicine Resource Medical Library for the state, SLPs and audiologists may find it difficult to come to the library in person due to distance and time constraints.

Study objectives

The present study identified the information needs, information-seeking behaviors, knowledge and skills in information technology and searching, use of information resources, and preferred training methods of SLPs and audiologists in the state of Idaho. This study focused on the following research questions.

* Information-seeking behaviors:

1. How do SLPs and audiologists usually locate information regarding clinical practice and decision making?

* Resource use:

2. What resources, including both print and electronic, are used by SLPs and audiologists in clinical practice?

3. How frequently do SLPs and audiologists use these resources to find work-related information?

* Information technology and information searching proficiency:

4. What knowledge and skills do SLPs and audiologists have regarding information technology and EBP information searching?

* Educational needs:

5. In what training programs are SLPs and audiologists interested?

6. What training methods and time do SLPs and audiologists prefer if they indicate they are interested in receiving training?

METHODS

Questionnaire design

A questionnaire was developed based on Lee's study of public health professionals in Tennessee [1], modified to reflect the nature of SLPs' and audiologists' professional responsibilities and different work settings in Idaho. The researchers sent a draft of the questionnaire to five Idaho Speech-Language-Hearing Association (ISHA) members for feedback and revised the questionnaire based on their input (Appendix). The questionnaire and research protocol were approved by the Idaho State University Human Subjects Committee.

Sample and survey distribution

ISHA is the professional association for speech language pathologists and audiologists in Idaho. The 217 members listed in the 2005 ISHA Directory were chosen as potential participants to complete the survey [13]. Surveys were distributed to all ISHA members with a letter explaining the purposes of the survey and the options for responding. All participants were given the option of returning the survey online (WebCT) or as hard copy to be attached to email or mailed through the US mail. The letter and instructions for responding to the survey were distributed via email to all professionals with an email address listed in the directory. For undeliverable emails and those with no listed email address, the letter and survey, with a selfaddressed envelope, were sent via US mail. A reminder email or letter was sent three weeks later to professionals who had not responded. In addition, the survey was made available at the ISHA Annual Convention in March 2006 to professionals who had yet to complete it. During the convention, 16 surveys were distributed to such individuals.

Analysis

A student entered the data from the surveys into an Excel spreadsheet. A second reviewer checked the entries and noted agreements and disagreements. A third reviewer analyzed the disagreements and resolved them through examining the original data. Data were changed when 2 of 3 observers agreed. Point-bypoint inter-observer reliability was calculated based on the formula suggested by McReynolds and Kearns [14]. Inter-observer reliability between the student and second observer was 92.3%: they agreed on 4,620 of 4,851 entries and disagreed on 231 entries. The second and third reviewer agreed on 223 of the 231 entries (96.5%). SPSS (v 15.0) was used for descriptive analysis of the questionnaire data.

RESULTS

General survey information

Two hundred seventeen surveys were distributed to the ISHA members, and 84 professionals returned the questionnaires for a 38.7% response rate. The return results of 3 distribution methods were: 33 via mail (15.2%), 35 via online (16.1%), and 16 via onsite (7.4%). Providing a reminder increased the response rate from 71 to 84 of 217 potential participants (6.0%).

Survey results indicated that neither participants' age nor years of experience were significantly correlated with method of response (Table 1). Professionals who graduated within the last ten years were more likely to respond online, while those who graduated prior to that time responded with a hard copy.

Demographic information

Out of 84 respondents, 13 (15.5%) were audiologists and 69 (82.1%) were SLPs. One respondent was certified in both speech-language pathology and audiology, and 1 was a teacher of the hearing impaired and deaf. Forty-one of the 84 respondents (49.0%) were from the western region of Idaho, 32 (38.0%) from the southeast region, and 11 (13.0%) from the northern region. There were 6 males and 78 females among the respondents, in line with dominance of the female gender in this profession [15]. Concerning educational background, 79 of 84 (90.1%) had master's degrees, 4 of 84 had doctoral degrees, and 1 had a bachelor's degree. Forty-five respondents (53.6%) had more than 11 years of working experience in speech-language pathology or audiology. Fifty-nine (70.2%) reported that they work more than 36 hours per week and were classified as full-time.

Information needs and use

In the survey, participants were asked to rank order methods of locating information for use in their clinical practice. The results indicated that "Look for information yourself" was ranked as the most frequently used method, with "Ask a colleague" ranked second and "Contact an information specialists or librarian" ranked third (Figure 1).

Resource use

The survey asked respondents to indicate how frequently they consulted various print and other resources for finding work-related information. The results indicated that colleagues and personal contacts, books, journals, and websites were the most frequently used resources for information (Figure 2). Twenty-seven respondents (32.1%) indicated that they never used a library, and 46 of 84 (54.8%) indicated that they used a library less than once a month.

In general, web, email, and professional websites were frequently used to find work-related information (Figure 3). However, many SLPs and audiologists indicated that they never used electronic databases.

Computer and Internet access and skills

Almost all (97.6%; 82/84) respondents had access to a computer either at home or at work. Regarding whether they could access the Internet at work when they needed it, 59 of 84 respondents (70.2%) answered always, 17 of 84 (20.2%) usually, 6 of 84 (7.2%) sometimes, and 2 of 84 (2.4%) never. Nearly 27% of respondents (19/84) indicated that they had some knowledge of computer and information technology; 70.2% (59/ 84) indicated that they had sufficient knowledge; and 7.1% (6/84) evaluated themselves as an expert.

Skills and knowledge of database searching

In general, respondents did not assess themselves as proficient in searching various databases relevant to speech-language pathology and audiology (Figure 4). For example, only 5 of 84 (6.0%) of the respondents indicated they had sufficient knowledge of CINAHL, and only 10 of 84 (12.0%) indicated they had sufficient knowledge of PubMed.

Interest in training

Forty-two of 84 respondents (50.0%) did not know that the databases listed in the survey were related to their profession. Respondents indicated that they were interested in receiving training programs, such as workshops, on database searching and EBP resources as well as online tutorials (Figure 5). When asked to choose their preferred training methods, an in-person class or workshop was most popular, followed by an online tutorial or a distance learning class or workshop. Concerning training hours, 41 of 84 (48.8%) respondents indicated that they wanted to receive 8 hours of training, 19 of 84 (22.6%) preferred 4 hours, and 17 of 84 (20.2%) preferred 2 to 3 hours of training.

DISCUSSION

The response rate obtained in the present study indicated that the total rate using combined distribution methods was higher overall, 38.7% (84/217), compared to the rate reported in the recent Nail-Chiwetalu et al. study (21.0%; n=208/1,000) [7], which relied on regular mail. It should be noted that, while the current study included both SLPs and audiologists and was limited to Idaho professionals, the nationwide study by Nail-Chiwetalu et al. focused on SLPs only. However, the reliance on self and colleagues to meet information needs noted in the current study was similar to the information-seeking behavior of SLPs in the study by Nail-Chiwetalu et al. [7] and studies of other health professionals [2, 16-21]. Over 30.0% of respondents in the current study reported that they never used a library, and many respondents reported that they did not have access to the databases relevant to the professions of speech-language pathology and audiology. In the study by Nail-Chiwetalu et al, 24 out of 659 respondents used community libraries when they had a professional information need [7].

Computer and information-searching knowledge and skills

SLPs and audiologists had basic computer and Internet searching skills. However, they lacked knowledge of how to search premier medical resources. For example, 87.0% (73/84) of respondents indicated that they did not feel they had sufficient knowledge and searching skills for PubMed, which is freely available and covers much information about speech-language pathology and audiology. CINAHL, Cochrane Library, and PsycINFO also contain information related to speech language pathology and audiology. Except for universities, most employers likely could not afford these expensive databases; therefore, access to these databases was restricted for SLPs and audiologists, as indicated by the results of the survey. The survey results also indicated that SLPs and audiologists did not know how to search databases such as these to access the reliable health information they needed.

Evidence-based medicine and practice

According to ASHA's position statement,

The term EBP refers to an approach in which current, high-quality research evidence is integrated with practitioner expertise and client preferences and values into the process of making clinical decisions. In making clinical practices evidence-based, audiologists and SLPs now recognize the needs, abilities, values, preferences, and interests of individuals and families to whom they provide clinical services, and integrate those factors along with best current research evidence and their clinical expertise in making clinical decisions. [22]

Although 40 of 84 (47.6%) of respondents to this survey reported that they had no knowledge of EBP, 44 of 84 (52.4%) reported that they were interested in learning EBP and 40 of 84 (47.6%) were interested in learning to search PubMed.

Training program

The survey results indicated a desire for training programs on database searching and EBP for SLPs and audiologists. Most respondents preferred a workshop in person on these topics so that they could learn how to search and could obtain more hands-on practice. It makes sense that respondents chose online tutorials and distance learning as their second and third preferences, given the geography of Idaho and time constraints. Using online tutorials would allow SLPs and audiologists to learn about EBP and information searching at their own pace, in their own location, thus saving time and travel expenses.

Methodological considerations

This study has several limitations that must be acknowledged: first, the survey sample was limited to SLPs and audiologists in Idaho. The study did not sample professionals across the nation and might have limited generalizability. second, the results were based solely on self-report, and the results might not accurately reflect individuals' skills and knowledge. Third, the response rate of approximately 40.0% might limit the external validity of the findings. Further, survey distribution using the ISHA members list was not randomized, so participants ultimately self-selected to respond. Although the response rate was respectable, 61.3% (133/217) of ISHA members chose not to respond to the questionnaire. These practitioners' assessment of skills and knowledge might be different from those who did respond.

CONCLUSIONS

SLPs and audiologists in Idaho have self-reported basic computer and information searching knowledge and skills. Many of them, however, indicate a lack of knowledge related to searching databases related to their clinical practice, and a high percentage of SLPs and audiologists do not know of EBP. Survey results indicated that professionals are interested in learning about EBP and searching resources in speech-language pathology and audiology in Idaho. The results also provided information regarding the training methods and training logistics that SLPs and audiologists prefer.

Future research

To meet the information needs of SLPs and audiologists in Idaho, educational programs on EBP and EBP information searching should be developed. Launching workshops onsite and providing other forms of training should be planned and evaluated. Given respondents' preferences for self-paced training tools, developing related web-based tutorials should also be on the agenda for future research projects.

The results of this study may have implications for other health sciences librarians as they interact with a variety of health professionals. Health sciences librarians should be aware of the current knowledge and information needs of the specific groups of professionals they serve and be ready to collaborate with their constituents to meet their needs.

ACKNOWLEDGMENTS

We thank Linda Milgrom, Catherine Burroughs, and colleagues for their support in this research project. Without their encouragement, the project would not have been conducted and completed. We thank Diana J. Cunningham, AHIP, and Patricia Lee for sharing questionnaire information with the authors and Sherrilynne Fuller, FMLA, for reviewing a draft of this article. We also extend our appreciation to the Journal of the Medical Library Association editors and reviewers for their comprehensive and constructive review of our manuscript. Their suggestions were useful and beneficial.

Sidebar

Highlights

* Speech-language pathologists (SLPs) and audiologists in Idaho reported that they lacked knowledge and skills in information searching and evidence-based practice (EBP).

* In general, web, email, and professional websites were frequently used to find work-related information, however, some SLPs and audiologists indicated that they never used electronic databases.

* In-person workshops and online tutorials were the most preferred methods of instruction for building knowledge and developing skills in searching and accessing EBP information.

Implications

* Speech-language pathology and audiology are multidisciplinary, and SLPs and audiologists often require multiple resources to find the information they need.

* Using a combination of distribution methods may increase the total response rate for returning surveys.

* An information needs assessment is a useful tool to identify specific needs of SLPs and audiologists and then to design training programs for SLPs and audiologists.

Footnote

* This project was funded in part with federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under contract no. NO1-LM1-3516 with the University of Washington.

* A supplemental appendix is available with the online version of this journal.

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