This edition of HILJ Club has been prepared by Catherine Jenkins, Health Literacy Project Manager, North East London Foundation Trust. @CathLynneJ
The paper for discussion is Kiely, Helen (2020) Library jargon creates barriers for potential users of health library and information services, Health Information and Libraries Journal, 37(3), pp. 228-232. https://doi.org/10.1111/hir.12289
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Background
This paper is based on a Masters dissertation. It captured my interest because I’m undertaking information science research at the moment, so I’m eager to learn from the dissertations of other researcher-practitioners in the field.
Objectives
The objective of this paper was to explore the extent to which users of a healthcare library service understood common terminology used by clinical librarians.
Methods
This study was comprised of a survey distributed to staff and students at an acute NHS Foundation Trust. 108 people participated over a 4-week period and were asked to provide definitions to terms commonly used by the healthcare library service.
Results
Analysis of the responses for accuracy and common themes indicates that jargon can be a barrier to user access. Recommendations are made with respect to the need for outreach to users and ensuring that the language used is accessible.
Conclusion
Terminology that might be assumed to be commonly understood in NHS services, such as Open Athens, is not necessarily fully understood by users despite repetition at inductions and training sessions. Further research is needed in this area to examine whether a standardised approach across Trusts would improve results, or whether the ability to adapt to local language could create better accessibility.
Questions for Discussion
What?
Why are library and information professionals using terminology that is unclear to users, and how can such terminology be changed or the messages from services made clearer to embed more inclusive language choices?
So what?
This was a timely article for the peri-pandemic era, when it is more important than ever that health-related communication choices are aligned with users’ (and our own!) ‘healthcare library literacy’.
Now what?
A lack of terminological understanding is something that healthcare library and information professionals must take into consideration when developing their outreach and promotional tools, and when speaking to users. The onus is on us as professionals to ensure that are services are inclusive and informative – not exclusive and confusing.
Consider the following questions for discussion:
- How can healthcare library services commit to embedding more accessible and inclusive language into their practice?
- Could serious games, like Dr Jargon, help healthcare library services to consider their language choices more carefully?
- Should there be a style guide for healthcare library services to follow? (see possible models below).
Please join in the discussion and let us know what you think of the article. If the article has affected your practice, do let us know below!
Further reading
NHS Digital, 2021. A to Z of NHS health writing. NHS.uk. https://service-manual.nhs.uk/content/a-to-z-of-nhs-health-writing
Sørensen, K., Okan, O., Kondilis, B., Levin-Zamir, D., 2021. Rebranding social distancing to physical distancing: calling for a change in the health promotion vocabulary to enhance clear communication during a pandemic. Glob Health Promot 28, 5–14. https://doi.org/10.1177/1757975920986126
Thomas, H., Hirsch, A., 2016. A progressive’s style guide. Sum of Us. https://s3.amazonaws.com/s3.sumofus.org/images/SUMOFUS_PROGRESSIVE-STYLEGUIDE.pdf
HILJ Club 
Some interesting discussion of this post over on Twitter https://twitter.com/search?q=hiljclub&src=typed_query&f=live
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I think embedding more accessible and inclusive language into our practice is key. We assume to much, we assume we are understood and expect people to ask if they don’t understand rather than making sure we have made ourselves understood by changing our words and pratice.
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This has been an issue in nearly every sector I’ve worked in. Even more generic library terms like “catalogue”, “subject guide” or “self-issue” can be problematic if you are not used to the context.
I wonder if some of the concepts are embedded into healthcare education under different terminology or not referred to with a particular name – for example, surely critical appraisal is a large part of medical training? Perhaps the concept is familiar, but not the term.
To be fair, terms like “knowledge management” and “information skills” are nebulous even to me at the best of times. A lot of what we dub “information skills training” is actually just service induction or demos of databases/platforms… probably more user-friendly to describe it in that sort of way.
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I had a colleague who was very keen to move away from the badge “training” for out information skills offer as they did not feel it met the definition of training. The problem was that had been the language I had seen used everywhere across NHS Libraries to that point which I felt meant users would know it the same way. I also questioned whether they would be so worried about pedagogical terminology niceties!
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Finally got to this great article. I really liked the methodology as a means to test our professions own (massively inconsistent) use of terminology. The over representation of Admin & Clerical might be a small issue – in my own durvey work I have found they can be more likely to respond to surveys but can also have lower levels of engagement with the service otherwise (ie they are more likely not to know).
A challenge with terminology is that sometimes we really should use the right term – testing labels on libguides with students we found poor understanding of the term Journals and a desire to replace it with Magazines. There has to be a point where accuracy and norms kick in.
OpenAthens is an interesting one – we take it as immutable but until not so long ago it was called Athens. The mess with Shibboleth, Access Federations and lousy implementations that see people needing to know to log in as NHS England (you know who you are publishers) rather than their Trust are not helping.
This research clarifies for me a need to focus clear explanations on a smaller number of terms / concepts at key contact points (basically induction) – people need to understand OpenAthens as the key that unlocks all the doors we can afford and to contact us when they are stuck.
There is a lot to be said for a standard style guide – consistency across the NHS would be a start. We also need to think more carefully about branding things. The new discovery tool is called Knowledge & Library Hub – this means nothing to no one. It could be a room (more than a few NHS libraries have these off shoot computer room type spaces). It abbreviates to KLH (ho hum). It gives no idea as to what it is. Fair enough NHS Evidence is on the NHS Evidence Search prime brand.
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Love the image of Athens as a key that unlocks the doors to journals, databases & so much more. Definitely something I will use in future.
I think a previous point about A&C staff often being key respondents in surveys is quite a valid one. As a group they are less likely to have come across some of the library concepts staff who have had the opportunity for higher level training will have had. Yet many of these staff will be highly skilled professional in their own right, & they also need a library service that meets their needs. Perhaps we need to investigate what it is they actually want, not what we expect them to use.
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Thanks for highlighting this thought-provoking article Catherine. I have not worked in the health library sector for very long and I must admit that I still find some of the jargon confusing, which has perhaps made me quite aware of the need to explain it clearly when I’m delivering training. Open Athens in particular seems to be a confusing concept for many library patrons that I’ve had contact with and I am trying to spend time explaining it during inductions and study skills sessions that I deliver. I agree with a previous comment that a style guide (perhaps containing definitions) would be helpful for healthcare librarians.
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Late to the party but really enjoyed this though-provoking article. I wrote a response on my blog https://bookssweatandtears.wordpress.com/2021/10/27/hiljclub-library-jargon-creates-barriers-for-potential-users-of-health-library-and-information-services%ef%bf%bc/
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Thanks for adding your thoughts – never too late!
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Love the idea of a health library language glossary! There are so many acronyms!
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Health library and NHS, a perfect storm!
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This looks interesting https://escholarship.org/uc/item/3qq499w7 Library Terms That Users Understand – “This document is intended to help library web developers decide how to label key resources and services in such a way that most users can understand them well enough to make productive choices. It compiles data from usability studies evaluating terminology on library websites, and suggests test methods and best practices for reducing cognitive barriers caused by terminology, and provides an extensive list of resources.”
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