This edition of the HILJ club has been prepared by Rachel Holmes, Clinical Librarian, Royal Surrey NHS Foundation Trust @holmesrachelj
The paper for discussion is Lacey, P. (2021) Google is goodish: An information literacy course designed to teach users why Google may not be the best place to search for evidence Health Information and Libraries Journal 39 (1), 91-95 https://doi.org/10.1111/hir.12401 (Open Access)
The use of Google to find information in health and social care
Patricia Lacey starts her article by affirming that as librarians and evidence specialists our role is to help people access reliable and validated information to enable – especially in the health and social care setting – the implementation of evidence based practice.
Searching medical or nursing literature databases may be the gold standard if a clinical question arises but even with training, it takes time to carry out a reliable search. Lacey confirmed this with data from feedback after a literature search training course, and discovered that those working in the health sector or the local authority were often reliant on Google searches. Despite the lack of reliability and inherent bias with this, library users in this sector are often time pressured and need immediate information at the point of care so Google appears to be the solution even if they know that the evidence retrieved may not be reliable or be provided in context. Nevertheless, Lacey reports it is an uphill battle to stop library users choosing to search for information on Google. This article discusses how Lacey and her team developed a course as a result to not say ‘don’t use Google’ but rather how to develop an understanding of why it may not always be the best place to search, and give techniques to avoid potential pitfalls.
The course structure was based on a prior course, and was divided in to 7 sections;
- Common myths about Google
- Search results
- Fake websites
- Problems with Google Scholar
- Google searching
- Other forms of ‘fake’ information
- How to fact check
The sessions were run as discussion groups with links to TED talks, practical examples and quizzes incorporated, and they can be run face-to-face or on Microsoft Teams which would be engaging and appeal to all forms of learners.
Feedback from attendees was positive, both from health and social care staff who learnt new skills and from librarians who felt they now had ammunition to use when people asked why they can’t just Google their questions. However Lacey found that the attendance ranged and many people attended as it was part of a larger training day rather than specifically choosing to attend this course. As a result this is part of her advice for colleagues interested in running similar courses, to increase awareness of the course by finding a key promoter in the organisation and aligning it among other activities. She states it is a good time to run this course due to the increase in fake news and misinformation in general. Health and social care staff may not have made the connection between using Google for information searching and misinformation.
Points to consider if planning your own course is that how to search for information is constantly developing and a course like this needs to be reviewed regularly, for example they have now added a separate course for fake news as this area is growing so rapidly there was not time to address this fully in the original course.
Lacey concludes by reminding us that as librarians we deal with information on a daily basis and we instinctively recognise reliable information. It is not so easy for health and social care professionals who may not have had a chance to develop such skills and so this course appears to be an important role in their education on seeking information searching skills.
Reflection
What?
How can health librarians realistically empower busy health and social care professionals to improve their access to reliable good quality information?
So what?
Evidence based practice results in the best patient experience and outcomes and this is achieved by integrating the best research evidence with clinical expertise. However it is hard for health and social care professionals to find the time to search for such information and so searching Google for answers is not going to stop being the default option for many users. Indeed, depending on the topic in question, Google can provide useful answers from grey literature that would not appear in medical literature databases but it must be used in conjunction with reliable sources of evidence. A course like this may be the compromise that will help everyone access information in context.
Now what?
Health librarians often offer information literacy training sessions at present, and so sections of this course could be incorporated into these sessions. As mentioned above we won’t stop people using Google due to familiarity and the need for immediate solutions but we may give them a chance to view the information received in context. The sessions could be even more effective if they are taught in the context of the learner, for example a course for nurses could be run on searching for evidence to write a care plan or explain a medical diagnosis. My library service has recently started to offer alternative information seeking skills sessions, rather than just training health professionals how to search the databases we teach skills that are more applicable in clinical practice such as how to access other quick forms of reliable information such a clinical decision support tools like BMJ Best Practice and UpToDate for quick answers or how to request an evidence search by a clinical librarian for less immediate answers. I will definitely take time to reflect on how we could incorporate the information from this article in to those teaching sessions.
Questions for discussion
Should health librarians accept that Google searching is here to stay and start to teach such sessions as these or should we still be trying to promote the more traditional use of the medical and nursing literature databases?
What else can usefully be included in information literacy sessions taught by health librarians?
Will you change your practice as a result of reading this article? If so, tell us how?!
HILJ Club 
I was really glad to be prompted to read this article which is pertinent to questions on my mind at present about how we get users to adopt the Knowledge and Library Hub tool (declaration of interest I manage this) over the ease of hitting the google search box front and centre on their phone.
Google rose to prominence around the start of my time in NHS libraries and in the early days I ran courses that included elements similar to the course described in the article. The issues of unreliable websites were covered along with tips on using Google better and when it might not be such a good idea. We were in the business of steering people into Google when appropriate (and away from AskJeeves, Excite and the like).
Over time these courses tended to focus more on some of the more specialist options we were trying to steer people to – with a shift in emphasis to highlighting “better than Google”. This meant less on the perils of filter bubbles etc. I suspect the reduction in that content may not have been entirely to the benefit of the course attendees but we were aiming for short sessions (30mins or so) and we had good things to show them.
If I were running these sort of sessions now I would likely look to incorporate a bit more of this kind of thing because it is so pervasive in peoples lives. Given the role of google in patient and carer information seeking it is vital that hospital staff are well equipped to understand where the things that are informing their patients are coming from.
For my daily work we need to build the case for when using the Hub is going to be the quickest way to return the most useful answer.
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Thanks, Rachel! Really interesting article pick and discussion questions.
We offer sessions on “accessing resources for evidence based care” covering BMJ Best Practice, the Hub etc. and it feels like those are more relevant for some of the use cases were healthcare workers might currently use Google than the advanced database searching.
I have talked about Google in some one-to-one training and showed some tips for finding grey literature (usually the site:nhs.uk limit). There are situations were in the past I would have used NICE Evidence Search where I now use Google.
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This was a very interesting article. I think that we do have to accept that busy clinicians will search for things on Google because it is the quickest way for them to search. Whether this is out of habit or some other reason, until we provide as quick and easy to access way to search this is unlikely to change.
I think that, if we are to teach the use of Google to find evidence (which we probably should), we should also be teaching the information literacy skills needed to question the sources that are returned in the search.
Whilst the introduction of the Hub is a good thing, for most people working in a busy clinical environment it is too many clicks to get too. IT departments are reluctant to install it as a link on computers; it is (and other tools are) buried on LKS intranet pages (we all know how complex and deep intranet pages are). Therefore a search engine, whether Google or a rival, remains the easiest access for most people.
I regularly use Google, but I think that it is how and why we use it that we have to be aware of. I won’t be changing my practice, but perhaps my awareness of issues will be higher.
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Thanks for prompting us to read and think about this article. For context, I am a university librarian working primarily with student health professionals. Teaching about how to select reliable, relevant information is just as central to what I do as how to search. Indeed, the academic staff I work with are very much aware that this is what I am most passionate about.
The idea of a session demystifying Google is definitely a really good one. Helping people understand what Google does and doesn’t do, how to use it effectively and when not to use it is vital. The news of it being incorporated into training days is fantastic – as the author notes, this will mean that people who would not otherwise have thought about these things have the opportunity to explore them.
The author notes that it would be really useful to know whether/how attendees’ searching behaviour changed after the session. This is something I also often wonder about in the absence of funding/ethics clearance to research that!
The course sounds really interesting, and includes some things I had not thought to cover with students, which I will now be thinking hard about.
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Like many I have learnt to accept that our healthcare staff will use Google and its sub-sets (Scholar) as potentially their tool of choice. As Cedar Librarian has noted it is largely due to ease of access as against other resources that are hidden or require authentication to use. Many years ago I ran a Google Searching course to highlight the strengths and significant weaknesses of a Google search. What many did not realise was how limited a search could be, despite returning thousands if not millions of results! As others have stated it can be valuable for grey literature, but may miss impactful research, and thus should be incorporated into training as an adjunct but never as the primary tool for healthcare staff. Trish Lacey’s paper provides a mechanism to develop an effective training programme, which is valuable.
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