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‘‘You’re just one of the group when you’re embedded’’ : report from a mixed-method investigation of the… Greyson, Devon; Surette, Soleil; Dennett, Liz; Chatterley, Trish 2013

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‘‘You’re just one of the group when you’re embedded’’: report froma mixed-method investigation of the research-embedded healthlibrarian experience*Devon Greyson, MLIS; Soleil Surette, MLIS; Liz Dennett, MLIS; Trish Chatterley, MLISSee end of article for authors’ affiliations. DOI: Embedded librarianship has receivedmuch attention in recent years. A model ofembeddedness rarely discussed to date is that ofresearch-embedded health librarians (REHLs). Thisstudy explores the characteristics of Canadian REHLsand the situations in which they are employed.Methods: The authors employed a sequential, mixed-method design. An online survey provideddescriptive statistics about REHLs’ positions andwork experiences. This informed a series of focusgroup interviews that expanded upon the survey.Through constant comparison, we conductedqualitative descriptive analysis of the interviews.Results: Based on twenty-nine survey responses andfour group interviews, we created a portrait of a‘‘typical’’ REHL and discovered themes relevant toREHL work. REHLs may identify more strongly asresearchers than as librarians, with correspondingprofessional needs and rewards. REHLs value‘‘belonging’’ to the research team, involvement in fullproject lifecycles, and in-depth relationships withnonlibrarian colleagues. Despite widely expressed jobsatisfaction, many REHLs struggle with isolation fromlibrary and information science peers and relative lackof job security.Conclusions: REHLs differ from non-embeddedhealth librarians, as well as from other types ofembedded librarians. REHLs’ work also differs fromjust a decade or two ago, prior to widespread Internetaccess to digital resources.Implications: Given that research-embeddedlibrarianship appears to be a distinct and growingsubset of health librarianship, libraries, master’s oflibrary and information science programs, andprofessional associations will need to respond to thesupport and education needs of REHLs or risk losingthem to the health research field.INTRODUCTIONEmbedded librarianship, in which librarians leave thelibrary to provide highly tailored information servicesto user groups with whom they are affiliated, hasattracted a significant amount of attention over recentyears, with both the Medical Library Association(MLA) [1] and Special Libraries Association (SLA) [2]issuing reports on embedded models of librarianship.Within the phenomenon, three primary models ofembeddedness have emerged: academic librarianswho are integrated into physical or online courses[3–10], special librarians who leave the centralizedcorporate library to collocate with users [2, 11, 12],and medical librarians who serve as clinical informa-tionists [13–17] or information specialists in context(ISICs) [15, 18, 19].Shumaker’s recent book on embedded librarianship[20] extensively reviews the history and evolution ofthese major models as well as other areas withpotential for embeddedness, such as public andschool libraries. Building on his previous report forSLA, in which embedded librarians were defined as‘‘direct information service providers who providespecialized services to one or more groups within theorganization’’ [2], Shumaker identifies three corefactors that he asserts define embedded librarianship:ongoing working relationships, knowledge of andcommitment to the group’s goals, and highly valuableand customized contributions to the work of thegroup in which the librarian is embedded.In health librarianship, the clinical informationist/ISIC model has been much discussed and studied sincethe Davidoff and Florance article in 2000 that estab-lished the term ‘‘informationist’’ and sparked greaterinterest on the part of health systems in clinicalembedded librarianship [13]. A 2006 multicenterMLA study defined an ISIC or informationist as ‘‘anindividual who possesses advanced information seek-ing and appraisal skills and knowledge of theinformation environment as well as advanced knowl-edge in a domain of healthcare/research and employsthis expertise as a member of clinical research teams’’[1]. The emphasis on additional, often clinicallyoriented, post-master’s of library and informationscience (LIS) training is common, although not univer-sal, in the clinical informationist literature. Studies havefollowed up on clinical informationist initiatives [21,22], noting the growth and evolution of the clinical* Conference presentations related to this paper will be given atthe 2013 Canadian Health Libraries Association/Association desbibliothe´ques de la sante´ du Canada conference and the 2013Evidence Based Library and Information Practice Conference.This article has been approved for the Medical LibraryAssociation’s Independent Reading Program , Appendix and Appendix B are available withthe online version of this journal.J Med Lib Assoc 101(4) October 2013 287informationist specialization, as well as the importanceof both commitment from management and a highlevel of informationist expertise. Qualitative explora-tions of clinically embedded librarians’ experiences [23,24] have underscored and affirmed expert searching ascore to informationists’ work, as well as the need forinformationists to assume an insider-outsider role tounderstand and add value to the clinical team.A subset of embedded librarianship not muchdiscussed in the literature, yet noted in preliminaryresearch and anecdotes as prominent and possiblygrowing, especially in health, is that of librariansembedded in research groups or teams. Carlson andNeale’s exploration of ‘‘embedded research librari-ans’’—academic liaison librarians embedded withinresearch groups at their universities—identifies de-grees of embeddedness, ranging from individualproject-based integration to ongoing programmaticintegration [25]. Lorenzetti and Rutherford’s prelimi-nary grounded theory study of information profes-sionals’ integration into health research teams exploredfacilitating and constraining factors experienced byembedded information professionals [26]. Both of theseearly explorations of research-embedded librarianshipemphasize the importance of relationship building,organizational support, and willingness to engage ininterdisciplinary work outside of one’s comfort zone.The authors suggest that there is an emerginggroup of embedded librarians, particularly prominentin health disciplines, who do not fully conform to thecharacteristics of either academic liaison librarians orclinically embedded informationists: research-embed-ded librarians. These research-embedded health li-brarians (REHLs) may have experiences that differfrom those of more traditional and embedded healthlibrarians in hospital or academic library settings. Thispaper proposes a definition of research-embeddedhealth librarianship and explores the research ques-tion: ‘‘What are the characteristics of research-embed-ded health librarians and of the situations in whichthey are employed in Canada?’’To explore the phenomenon of research-embeddedhealth librarianship, our team of four current orformer REHLs conducted a bilingual, nationwide,mixed-methods investigation that compared thedemographics of REHLs with other health librariansand explored the work and experiences of REHLs inCanada. Our prior paper reported the comparativedemographics of REHLs and non-REHLs, findingthat, when compared with non-research-embeddedhealth librarians, REHLs tended to be both youngerand newer to the profession, more likely to work forresearch institutes and nonprofit organizations, lesslikely to work in hospital environments, and morelikely to be hired on term-specific contracts than on apermanent basis [27]. This article follows on thosefindings and takes a closer look at REHLs and theirwork. For the purposes of both studies, our workingdefinition of an REHL is as follows:A research-embedded health librarian: participates in aresearch team(s) rather than focusing on traditional librarymanagement and services and provides tailored, intensiveinformation services to a health research team with whichshe or he is integrated.The following were not, for the purposes of thisstudy, considered to be REHLs: academic liaisonlibrarians, clinical informationists, general hospitallibrarians, librarians with library management–focused jobs, and self-employed information consul-tants. However, REHLsmay hold other non-embeddedpositions concurrently with a research-embedded job.METHODSAiming to generate a portrait of the characteristicsand employment situations of REHLs, we collecteddata through: (1) an online, bilingual (French/English) survey and (2) face-to-face and online focusgroup interviews with REHLs. The study wasapproved by the ethical review boards of theUniversity of Alberta and University of BritishColumbia.Data collectionThe REHL online survey was an immediate follow-upto a more general survey of 191 Canadian healthlibrarians conducted from March to April 2011.Survey questions were based on themes and surveysfrom previous literature on embedded librarianship(in particular, the Shumaker, Talley, and MiervaldisSLA report [2]) as well as attributes of REHLexperiences that we thought were important toexplore, capture, or benchmark. The survey wasdrafted in English, translated into French to ensureaccessibility across Canada, and piloted on a smallgroup of health librarians who had formerly workedas REHLs. The survey was administered via thebilingual Canadian FluidSurveys online software overa period of four weeks in March to April 2011.Survey participants were recruited via CANMED-LIB (the primary email discussion list for Canadianhealth librarians) and various smaller Canadian emaildiscussion lists of interest to health librarians. AllCanadian health librarians and information specialistswere invited to participate in the general survey,which included questions about educational back-ground and career history, employment conditions,and some demographic information. The total num-ber of Canadian health information professionals isunknown, preventing us from estimating relative sizeof the REHL population or calculating statisticalsignificance of these exploratory findings. However,the magnitude of response to this survey was similarto the responses received by the regular nationalsurvey conducted by the Canadian Health LibrariesAssociation/Association des bibliothe´ques de la sante´du Canada, the most recent iteration of whichreceived 186 responses (157 of these from the 341association members) [28].Upon completion of the general survey, respon-dents were presented with our working definition ofGreyson et al.288 J Med Lib Assoc 101(4) October 2013an REHL. Those who self-identified as meeting thisdefinition were invited to opt-in to a second surveymodule focused on their professional roles andresponsibilities. More complete details of the designand implementation of the general online survey arereported elsewhere [27]. REHL questions (Englishversion) are included in Appendix A (online only).We recruited focus group participants through theREHL survey module, where respondents wereinvited to supply contact information for possiblefollow-up interview, and through Canadian healthlibrary networks (email lists and our professionalnetworks). We conducted 4 focus group interviews, 3in English (participant total n511) and 1 in French(participant n53). Four of the focus group partici-pants were known to have previously answered theonline survey. The first of the English group inter-views was conducted in person at a national healthlibrarianship conference; the rest were conductedonline via WebEx Meeting Center. Two members ofthe investigation team assisted with each interview,one as interviewer and the other as observer and note-taker. Interviews ranged from forty-five to eighty-fiveminutes, with online focus groups generally requiringadditional time due to technical issues. We audio-recorded and transcribed the interviews for analysis.While the interview guide (Appendix B, online only)revolved around concepts of identity, contributions,and challenges, the semi-structured format allowedadditional themes to emerge.Data analysisDescriptive statistical analysis of the survey responsesinformed the subsequent focus group interviews.{ Weanalyzed focus group transcripts using qualitativedescriptive analysis [29], with an approach to codingthatwas heavily influenced by grounded theorymethods[30]. Through constant comparison [31], we built up frombasic, open codes to develop selective, thematic codesrelated to the characteristics, work, and experiences ofREHL study participants. Coding was done by hand;initial codebooks were developed by Greyson (English)and Surette (French) and then tested, expanded upon,and validated by coauthors. Focus groups were analyzedin their original languages and compared to affirm and/or challenge emergent themes. Differences among coderswere resolved via discussion. Selected key passages fromthe French interviews were fully translated into Englishfor the purpose of this report.The ‘‘insider’’ status, all of whom had workexperience as REHLs, shaped both the data collectionand analytic lens. Social science research traditionshave grappled with the advantages (e.g., ease ofinteraction and greater understanding of the popula-tion of interest) and disadvantages (e.g., lesser‘‘objectivity’’ and potential for erroneous assumptionsof understanding others’ experiences) of insider andoutsider epistemologies for decades [32]. While ourREHL experiences were not included as data for thisstudy, such experiences necessarily aided us in tailoringinterview questions to an REHL audience, guiding thefocus group conversations, and interpreting the data.RESULTSSurvey resultsOf the 191 individuals who completed the generalonline survey, 39 (20.4%) identified themselves asREHLs according to the study’s definition. EveryREHL accepted the invitation to proceed with thefollow-up survey. All survey questions were optional,thus responses to some questions do not total 39.Job description. Job titles fell into 4 categories:librarian/bibliothe´caire, information specialist or sci-entist/documentaliste, researcher/analyst, and other(Figure 1). Approximately one-third of the respondents(n514) held librarian positions, and another third(n513) had information specialist jobs. Of the remain-der, the majority (n59) had research positions thatwere not necessarily librarian-specific. Nearly half ofthese jobs were funded through operating funds of anorganization (n518), while others were grant-fundedpositions (n511). Several respondents were funded viaother means (n57) or did not respond (n53).REHL positions were not always full time and notalways a respondent’s only job. Less than half (n515)indicated that their REHL hours equaled their totalwork hours per week. Just over half (n520) of therespondents worked as solo librarians. Among therest (n518), the number of librarian colleagues rangedfrom 1 (most commonly) to a high of 15.Responsibilities performed.Weasked how frequentlyrespondents performed thirteen categories of researchlibrarian tasks as REHLs (Table 1). Information-relatedelements of the research process dominated, withresearch tasks that did not necessarily require informa-tion expertise following. ‘‘Traditional’’ library taskssuch as library management and staff supervision werethe least commonly performed and most commonlynever performed. Literature searching emerged as anear-universal core responsibility. Other tasks conduct-ed regularly by the majority were: research teammeetings; literature analysis, scoping, or summariza-tion; general reference; and horizon scanning/currentawareness. Additional major responsibilities that werenot captured by the thirteen categories included:financial/budget management, website maintenance,grant proposal writing, project planning, interlibraryloans, information systems management, knowledgemanagement, and review screening and coding.Embeddedness. In our sample, nearly half of thesurvey respondents (n517) worked with a smallpopulation of 1 to 5 researchers, and almost one-third(n512) worked with 6 to 15. The rest (n57) workedwith 16 to 30 or did not reply (n53) (Figure 2).{ Incomplete module responses were included in the analysis aslong as respondents clicked the ‘‘submit’’ button on the final pageof the survey.The research-embedded health librarian experienceJ Med Lib Assoc 101(4) October 2013 289Twenty-nine respondents had a desk physicallylocated with the researchers, and 13 had a desk inor near a library (answers were not mutuallyexclusive). Five worked from home, and 4 had a deskin another location or declined to answer. MoreREHLs ate alone (n515) than with other library staff(n59), researchers (n54), other staff members (n53),or some other arrangement (n56). Some weresupervised by a librarian (n514), slightly more by anonlibrarian (n518), some were co-supervised byboth (n56), and 1 was self-employed.Continuing education. Thirty-five of the 39 res-pondents indicated that they had participated inFigure 1Job titles by category* Categories were not mutually exclusive so number of responses may be greater than number of respondents.{ Other includes trials search coordinators, knowledge managers, and non-research-specific health jobs, as well as library technicians, which in Canada typicallyrefers to a credentialed paraprofessional library worker.Table 1Frequency with which research-embedded health librarian (REHL) job responsibilities are performedGreyson et al.290 J Med Lib Assoc 101(4) October 2013continuing education (CE) activities within the last2 years. The most popular CE category was researchmethods (n528), followed closely by health librarytopics (n526). Sessions on health (n519) and otherlibrary (n517) topics were also attended by nearlyhalf. The REHLs’ overall institutions usually fundedthis CE (n521); however, it was not uncommon forthe health research group and the REHLs themselves(n510 each) to pay. The topics on which respondentsmost commonly needed further training—statistics,knowledge transfer, and research methods—were notlibrary centric (Table 2).Focus group interviewsIn the four focus groups, we interviewed a total ofthirteen current and recently former REHLs (ten inEnglish, three in French). The geographic, age, andemployer-type distribution of focus group participantswere similar to the demographics of the REHL surveyrespondents [27]. Interview participants’ work experi-ence, both as librarians and specifically as REHLs,ranged from just a fewmonths tomore than thirty years.Major themes that emerged from our coding included:the work of REHLs, REHL identities, role evolution, theimportance of champions in establishing and maintain-ing REHL roles, successes and recognition thereof,challenges of this hybrid role, and future opportunitiesfor REHL work. To protect participant privacy, allnames in this report are pseudonyms and identifyinginformation such as province and employer are notdisclosed.Research-embedded health librarian (REHL) work.While participants’ jobs varied somewhat, there waswidespread consensus that expert searching—varyingfrom systematic reviews to environmental scanning—was central to REHL work. In one focus group,participants did not mention searching. When theinterviewer raised the issue, it turned out thatsearching was so obviously an integral part of REHLwork that participants thought that it was not evenworth mentioning. Julie clarified, ‘‘I took that as anassumption. It is the bread and butter of what I do…Itis my core business.’’Figure 2Size of regular user group of researchersTable 2Continuing education needs of REHLsContinuing education topic ResponsesStatistics 23Knowledge transfer 21Research methods 18Technology training 15Expert searching 14Leadership and management 14Knowledge organization 12Evaluation 10Budgeting 10Specific to projects 10Writing skills 9Instruction and teaching 9Records management 8Improving professional image 7Presentation skills 5Other 4No response 2The research-embedded health librarian experienceJ Med Lib Assoc 101(4) October 2013 291Research methods and writing were also importantskills, and participants had mixed feelings about theextent to which library school had prepared them forresearch. Several had taken or were planning to takeadditional courses on health research methods. Fay,who had a strong background in research methodsprior to library school, compared her REHL role withtraditional librarians’ lesser involvement in research:When I worked in the [academic health sciences] library,that was one of the things I missed—the research. So I thinkwhere I am now, I get to be involved with all differentaspects of the research process.Writing was framed as an integral part of theresearch process and a marker of being integrated intothe full cycle of research, rather than relegated to asearch-specific role. Grace emphasized the signifi-cance of strong writing skills:You can’t understate how important it is to have decentwriting skills because in so much of research the currencyis publications and grants and collaborating with others…Everything up to being deeply involved in writing a grant,or writing a budget, or proofreading a manuscript before wesend it off to a publisher.Project management, communications expertise,and information technology (IT) abilities were alsocommon skills among participants. About half hadadditional areas of specialization (varying fromlinguistics to statistics), which functioned as pointsof pride or selling points for those individuals.In addition to professional expertise, participantsidentified personal qualities they felt were importantfor REHL success. Chief among these was indepen-dence. Adaptability, attention to detail, and ability towork with demanding research ‘‘superstars’’ werealso named, as well as proactivity regarding relation-ships and networking. Ellen explained:[A] friend of mine with a similar position didn’t last very longbecause she found it very lonely and isolating. So I think youhave to be the type of person who really enjoys workingindependently. And for my particular situation, I think beingproactive, listening to the users and trying to go after themmore, find outwhat their specific needs are, and really trying tobe a member, a true member of the team is important as well.’’REHL identities. Focus group participants perceivedtheir REHLwork as clearly distinct from traditional healthlibrarianship. Grace described the commonly expressedfeeling of inhabiting an entirely separate work ‘‘world’’:I feel like I am in a totally different industry even though weuse a lot of the same skills, because I don’t work in a library. Idon’t manage a collection…Yeah, I really feel like it is a wholedifferent world…Theway I look at it is that I am using a lot ofthe same skills as a health librarian, or any other librarian. It isjust that I am using them in a totally different way.Some participants compared their REHL work withprevious experiences as hospital or academic librarians.They highlighted the more focused nature of REHLwork and the intimacy of relationships with one’s usergroup. Some participants rejected the language of‘‘users’’ altogether, asserting that rather than serving apopulation, they were working as part of a team.The sense of difference from traditional health librar-ianship called into question participants’ professionalidentities. Many experienced tension between maintain-ing a librarian identity and adopting a researcher identity,and there was diversity among the ways this played outfor individual REHLs. Anita, who was classified as areference librarian at her institution, explained:I wasn’t hired as a research librarian at all, but I’ve justslowly been asked to join more and more research groups,research teams, so I’m actually doing research with them,and now I’m doing…probably sixty or seventy percent ofmy time is spent doing research.Illustrating an opposing experience, Grace describedobtaining a ‘‘pretty standard’’ master’s-level researchposition as a librarian: ‘‘[T]hey posted the positionand…I was able to say, Hey you people need a librarian,and I kind of talked my way in.’’ However, she alsoexperienced identity challenges in this position, due toits complete lack of affiliation with the LIS world:You know, you don’t feel you have a connection to the otherlibrarians, so it is a little bit isolating. I actually have in mycareer a few times had a professional crisis of, ‘‘Am I even alibrarian anymore? Can I even call myself that?’’And I have gottento the pointwhere I feel like, ‘‘Yes, that is who I am, that iswhatI call myself, even if that is not my job title, even if the peoplearoundmedon’t really getwhat thatmeans.’’ I internally knowwhat that means and that means something to me.Another aspect of identity that arose across focusgroups was the sense of becoming part of a team withshared understandings and goals. This was evidentwhen interviewees described being integrated into thefull research process or project lifecycle, as well aswhen they talked about their interpersonal relation-ships with nonlibrarian colleagues. Kelly contrastedthis closeness with the lesser continuity of traditionallibrarian-researcher relationships:I just have much more of an intimate relationship and Iwouldn’t consider the people I work with my users. I wouldconsider them more my coworkers. I am part of the teamthere really, and provide much more specialized services.Whereas when I’m at the library I consider people comingby the desk as my users and I may not see that person everagain and I may not know whether what I have done forthem has helped them out really or left them more confused(laughs) or what. But when I’m at [my REHL job], I aminvolved in a project from beginning to end, I am part of theteam, I can see what goes on through the whole lifecycle.This intimacy allowed REHLs to develop in-depthknowledge of colleagues’ information needs andpractices, and develop extremely tailored services.Role evolution. Role evolution was a theme in thenarratives of many REHL careers. Participants withlong-time REHL jobs described evolution of the work,due both to digitization and an increasing emphasisGreyson et al.292 J Med Lib Assoc 101(4) October 2013on research productivity and competitiveness. SomeREHL positions were librarian jobs with graduallyincreasing research responsibilities, while others wereresearch jobs that assumed an information specialty.Anita, an REHL whose reference librarian jobmorphed over time, explained, ‘‘[T]hey just startedasking me to join various interdisciplinary teams,until now it’s a huge part of my job.’’ Graceexemplified evolution in the opposite direction:My job is not specifically a librarian job; it’s a [research staff]position, and there’s a number of different backgrounds thatwould have qualified to do this job. But because I do havethe library background, as I’ve progressed in the job, I’vebrought more of those library skills to it…because it helps itto be a more meaningful job for me, to be able to use thoseskills. And I think it makes me more valuable.REHL champions. Prominent and influential research-ers or administrators, with the capacity and need to hirelibrarians, were among those in a category of ‘‘cham-pions’’ that emerged in several narratives. Many REHLjobs had been started by champions with previousexperience with librarians. Cathy described an admin-istrator who, as a preexisting advocate for libraries andliteracy in the community, saw an REHL as the obviousanswer to her researchers’ access needs. Barbaraexplained how a principal investigator came to hire her:There was a librarian [at her previous workplace] that sheloved. So she had a natural love for librarians. So she couldsee the skill set and—I don’t think she realised she couldhire a librarian, but it just sort of happened that I applied forthe [researcher] job, and so it was kind of those two factors:the job grew and developed and also that she had met alibrarian that had really influenced her.Champions were also important to supportingongoing REHL integration into a research group.Anita described the key role of champions inpromoting her work to other researchers:[They] are really absolute about an information specialist beinga part of their research team, and that it is an essential person totheir team. And…when they do presentations or talks theywillactually make that really clear and sort of publicly declare that.So I think they kind of move other people over to that view.In many cases, it was important for an REHL to alsobecome her own champion. Many participants’narratives included the challenge of constantly havingto advocate for themselves, which might have beenmore challenging amidst a team of nonlibrarians whowere not necessarily familiar with the full scope oflibrarian expertise.Heidi described a process of working her way into asmany meetings as possible in order to build relation-ships. At first, her requests to attend meetings weremet with incredulity, but ‘‘Over the years it gets a littleeasier. But you still kind of have to look for theseopportunities to be there, to prove to other people thatyou should be there, that you have something tocontribute.’’ Several years into her REHL position,Heidi explained, ‘‘You can never sort of sit back andsay, Okay, that’s it. Everybody knows about me, so I don’thave to do any more work. It’s always a constant.’’REHL successes. Interviewees reported professionalsuccesses such as coauthorship or sole authorship,especially of search-intensive or information-related pub-lications. The value or helpfulness of research outputs wasoften emphasized, along with how enjoyable and educa-tional the project had been. Other successes includedobtaining grants, developing courses, providing instruc-tion or guidance, and improving organizational efficiency.REHL successes were recognized verbally and inwriting in the research environment. Interviewees alsodescribed recognition from the greater health researchworld, both formally (e.g., coauthor status) andinformally (e.g., word ofmouth). However, fewREHLsfelt that their accomplishments had been recognized inthe library community. Longtime REHL Barbaradescribed this, with an optimistic eye to the future:I think that that internal group that you work with definitelyrecognizes your value. I’mnot sure that it’s recognized outside ofthe groups you’reworking in. Because you’reworking outside ofother library groups…When I started working in [research]really there wasn’t that many people working as research-embedded librarians, and I don’t think it was recognized as areal job—as a real library job, because you weren’t working inthe libraries. So, I think that’s changing, so that’s good.REHL challenges. While the details of a particularposition influenced REHL challenges, two themes reso-nated across focus groups: stress due to limited jobsecurity and the challenge of isolation from LIS colleaguesand community, especially other REHLs. Many REHLjobs rely ongrants or renewable contracts. Cathydescribedthe stress of contract employment impacting her health:I think every job I’ve been in is a temporary job. But I’vekind of stopped thinking about that. I find you can’t letyourself think that way. I’ve been in temporary jobs almostconstantly since I was out of library school…and at onepoint the stress was so bad that I had [a stress-related healthcondition], I had—I didn’t realize how stressed I was until Igot a permanent full-time job and it all settled down.Barbara described wondering if she would still beable to obtain a ‘‘real’’ library job, should she need toapply for one in the future after years of REHL work:I wondered—or felt that, oh, we should be aspiring to get a reallibrary job, andwondered if Iwas losing, or didn’t have the skillsto do that, because I’d focused so much on lit searching and thatsort of thing, so that’s—for me that was a bit of a challenge.Isolation from colleagues, including a lack of peerfeedback and mentoring, was universally identified asa challenge. Longtime REHL Fay explained:I feel cut off…I don’t get enough stimulation as a librarian,and the librarian issues around librarianship that relate toresearch. I think it would be wonderful to have a group—that could include all the people who are on the phoneThe research-embedded health librarian experienceJ Med Lib Assoc 101(4) October 2013 293today, where we could address issues that we all comeacross, and learn from each other. I think that would bereally helpful…I feel like I’m kind of in limbo: I’m inresearch, but I’m in the middle.Heidi expressed a common anxiety about ‘‘keepingup’’ with both fields:I spend a lot more of my time going to continuing edsessions and opportunities that are outside my professionthan those that are in. So that is definitely an issue for me—the isolation and the fear that maybe you are not keeping upwith advances in your profession.While many attended conferences of the varioushealth fields in which they were embedded, few saidthey regularly attended LIS conferences. Fay ex-plained, ‘‘I guess I look at a lot of the conferencesfor librarians, but many of them don’t seem thatappropriate and it’s a lot of money to attend.’’ Severalparticipants had little or no funding for professionaldevelopment. Many pursued online continuing edu-cation (CE) and self-directed reading in order to keepcurrent, feeling that it was an effort to make a case totheir supervisors for funding to support CE outside oftheir health domain.Despite not attending much library-oriented CE,interview participants widely recognized the value oflibrarian peers, and those with local REHL colleaguesfound them quite useful. Kelly, a formerly solo REHL,described how wonderful it was to now have anREHL colleague:It’s completely different and it is such a good experience…Imissed this a lot being a single librarian. Just being able tobounce ideas off somebody or if you’re doing a search andyou can’t figure something out, just being like, why isn’t thisworking? and just having someone quickly look at it beinglike, Okay, this is why. And just learning about differentthings that are going on in the librarian community or thelatest research.Some REHLs had attempted to find communityamong local health sciences or hospital librarians butdid not report much success. For example, Barbararecounted that a local university, recognizing thegrowing number of unaffiliated health librarians, hadattempted to provide a group for mutual support:Once a month everybody that was working in health,regardless of whether or not you worked in the library,would get together and talk about various issues. So thatwas one venue. But quite honestly, I didn’t end up goingthat much, because the timing wasn’t convenient, really,and I worked off campus, so it would end up being a two-hour commitment—can you justify that? And a lot of thetopics weren’t relevant. They ended up being too university-focused, or library-focused.Julie had a similar story about reaching out to localhospital librarians, noting, ‘‘I don’t think I figured thisout very well—like this whole piece around profes-sional support and community. I guess I wish I wasbetter [at it], but I don’t actually have a solution onhow to make it better, unfortunately.’’This increased affinity for and identification withone’s research colleagues was described by manyparticipants. Cathy noted that in some ways theserelationships filled in the gaps left by the lack oflibrarian community, explaining, ‘‘I think you devel-op other professional connections, to your researchers.And they become a little bit of your community too.So you’re kind of floating in and out of twocommunities of practice.’’ She continued to considerthe professional and personal value of these relation-ships, saying:I think that’s really important. Getting a couple of friends inthose places, because they are the ones who will advocatefor you when your contract comes up for renewal, andthey’re debating, Do we want to do this again? But also…somedays you just need to get out of the office and go for coffee!And if you’re on campus, fine, you’ve got two otherlibrarians you can go with, But [if not] you need to sort ofbond with your clients that way, I think.REHL outlook. The general perception of the inter-viewed REHLs seemed to be that research-embeddedwork was an actively growing subfield of healthlibrarianship. Darlene, one of the newer REHLs,stated:One of the things that I think about with the research-embedded librarians, is that it’s growing…there’s lots ofopportunities there, and partly because I’m so recently outof library school…I’m really interested in raising theawareness of new students coming out, that there are jobsin this field, and lots of them, possibly more than there aretraditional librarian jobs.Marianne noted that energetic REHLs were fur-thering the uptake of the model, stating that ‘‘Newerlibrarians, and even some of those less new, havetaken the initiative to expand understanding of thework that information specialists do.’’Some participants attributed the upswing in REHLwork to the increased competitiveness of healthresearch funding. Barbara pointed out, ‘‘Research isgetting more and more competitive, and anything thatcan help a researcher with that competitive edge—you know, keeping current and really synthesizingthe information for them—I think will continue.’’ Tomeet the demand for qualified REHLs, participantshad suggestions for LIS education. Some thought thatresearch methods classes in library and informationdegree programs should be expanded and thatelective courses such as medical librarianship andevidence-based practice should be offered morefrequently.While there was consensus that the REHL life wasnot for everyone, interview participants emphasizedthat they loved the work. In an unsolicited wrap-upcomment, Fay expressed enthusiasm for her career:I guess I’d just like to say that I absolutely adore my job. Iwouldn’t trade it for any other type of position. It’s justgreat. It’s so exciting, always different, I’m always learningthings…so, from that respect I am extremely happy.Greyson et al.294 J Med Lib Assoc 101(4) October 2013Others immediately agreed, and this sentimentresonated across groups. Lucy asserted that her REHLwork was probably the most interesting thing she haddone in twenty years of librarian work. While REHLsfaced challenges finding professional support andsometimes had to deal with difficult personalities, theopportunities to learn, develop new skills, and pursueone’s own research interests were fun and rewarding.Cathy summed up common sentiments by stating:I think it’s a lot of fun. I mean I really—I’ve worked inhospitals, I’ve worked in an academic library. I think it’sreally fun to provide a high level of service to a small groupof people, as opposed to—I don’t want to say a low level ofservice, but I would say a very surface level of service to alarge group of people—and frankly to some people whodon’t care…[T]o work with really smart, highly motivatedpeople who really care about what they do, and areinterested in what you do, is very rewarding.DISCUSSIONOur proposed definition of REHLs focuses onlibrarians who participate in one or more researchteams rather than on traditional library managementand services and provide tailored, intensive informa-tion services to the health research teams into whichthey are integrated. For the purposes of this study,this definition serves us well, appearing to make senseto and resonate with the intended subpopulation ofhealth librarians in Canada. That said, the definitionmay exclude some allied research-embedded librarianswho are extremely embedded academic liaisons orindependent information specialist consultants, andthus the definition may evolve over time. Survey andfocus group results were consistent, allowing us tosynthesize the data and assemble a composite portraitof a ‘‘typical’’ REHL:Her information specialist position is funded by theresearch group within which she is embedded part-timeas a solo librarian. She works alongside one to fiveresearchers, regularly attends research team meetings, andprovides literature searching, scoping, and analysis as wellas current awareness and general reference. She does a fairbit of writing, editing, and instruction for the team andrarely if ever spends time managing an actual librarycollection.Although our prototypical REHL wishes she had acommunity of REHL colleagues for professional supportand development, over time she has come to really knowand identify with the researchers with whom she works andenjoys their company. While she may not feel connected tothe library community, her research colleagues appreciateher specialized skills and she enjoys knowing she is makinga difference to health and health care. While she occasion-ally worries about the future of her career, on the whole theREHL loves what she is doing and would recommend thistype of career to new health librarians who are up for achallenge.This profile clearly differs from non-embeddedhealth librarians, who typically work in libraries,manage collections, and provide discrete reference orsearch services, as well as from clinical information-ists who focus on patient care settings and are oftenrequired to obtain significant cross-training in healthdisciplines. It also differs from what REHLs weredoing just a decade or two ago. According to ourlongest-serving REHL participants, prior to theInternet and the access it provides to vast amountsof digital information, REHLs spent more timecurating personal libraries for star researchers, asopposed to functioning as a specialized researcher.REHLs do conform to many hallmarks of embedd-edness from previous literature, including Shu-maker’s trifecta of strong relationships, shared goals,and highly customized and valued contributions tothe group. They also experience challenges that manyother types of embedded librarians may experience,such as isolation and the need to keep up-to-date inmultiple fields. One thing that appears to distinguishREHLs from other types of embedded librarians,however, is the trend toward actual identification as aresearcher. While this trend is not universal, itappears typical to maintain at least a hybrid identity.{Other types of embedded librarians may be lessinclined, or less able, to cross over without significantprior qualifications or cross-training. A legal librarianwithout a law degree, for example, cannot easilybecome a lawyer, neither can a clinical informationistreadily slip into identifying as a nurse or doctor. Inacademia, however, the boundaries are fairly perme-able. While the growth of evidence-based librarian-ship encourages librarian-driven research in libraries,REHLs not only conduct library research, but becomehealth researchers with an information specialization.The evidence-based medicine movement has creat-ed an information imperative in health that has led tonew opportunities for health librarians [33]. Certainresearch funders emphasize knowledge synthesis andtranslation, including systematic and scoping reviewsof evidence. Given current priorities, we expect that aslong as REHLs continue to provide a benefit in termsof obtaining grants and publications, they will have asecure place in the health research landscape. Asclinical investigators and teams move further intoresearch activities, some informationists who areemployed by hospitals and clinical teams may growto more closely resemble REHLs. Additionally, ifevidence-informed practice continues to spread toother disciplines, similar research-embedded librari-anship trends may appear there as well.The presence, strength, and likely growth of theREHL workforce carry implications for the professionof librarianship. REHLs feel disconnected fromprofessional library associations, and unless associa-tions respond to the needs of this population, theyrisk losing REHLs to the health research field. Inhealth research groups, to which REHLs are turningfor CE as well as funding opportunities, there may bean emerging window of opportunity to create{ Research-embedded health librarians (REHLs) who fully identifyas researchers and not librarians may also exist but did not answerour recruitment call on library email discussion lists.The research-embedded health librarian experienceJ Med Lib Assoc 101(4) October 2013 295information-focused subgroups. In response to theincreased decentralization of information work, li-brary and information graduate programs shouldconsider offering specific training, including ad-vanced research methods, to prepare librarians forresearch-intensive career paths.Limitations and future directionsThe exploratory nature of this study dictates that wecannot be confident that our participants wererepresentative of the REHL population. There is nonational census of health librarians, let alone REHLs;therefore statistical significance and generalizabilitycannot be assessed, and the potential for response biasand social desirability bias (generally speaking andspecifically related to the status of the researchers asREHL peers) as well as focus group conformity biasexists. Additionally, this study focuses on onecountry. Future research on REHLs in comparatorcountries—such as the United States, United King-dom, and Australia—could add power to the existinganalysis and allow us to tease out whether there areparticularly Canadian aspects to the REHL phenom-enon. Follow-up studies over time would enable us toexamine changes in REHL work, and longitudinalstudies would allow us to examine career trajectoriesthat include REHL work.CONCLUSIONREHL positions share common attributes with otherforms of embedded librarianship; however, REHLsmay identify more strongly as researchers than aslibrarians, with professional needs and rewards thatdiffer from traditional librarians. REHLs value ‘‘be-longing’’ to the research team, being involved inprojects from conception through publication, anddeveloping in-depth relationships with nonlibrariancolleagues. Yet, despite widely expressed job satisfac-tion, many REHLs struggle with isolation from LISpeers, appropriate professional development, andrelative lack of job security in a grant-fundedenvironment.Gathering data and interpreting the stories ofREHLs can help frame possible futures for librarian-ship, as information professionals face the growingopportunity (and challenge) of working in evolvinginfrastructures of knowledge creation, management,and communication. If REHL positions are indeedboth distinct from other forms of librarianship and agrowing trend, degree programs, professional associ-ations, and libraries themselves will need to respondto the needs of this population or risk losing them tothe health research field.ACKNOWLEDGMENTSThis study was funded by a 2011 Chapter InitiativesFund grant from the Canadian Health LibrariesAssociation/Association des bibliothe´ques de la sante´du Canada. 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The space between: on being aninsider-outsider in qualitative research. Int J Qual Methods.2009 Mar 31;8(1):54–63.33. Mann M, Sander L, Weightman A. Signposting bestevidence: a role for information professionals. Health Inf LibJ. 2006 Dec;23, (suppl 1):61–4.AUTHORS’ AFFILIATIONSDevon Greyson, MLIS,, Information Specialist,1 Centre for HealthServices and Policy Research, University of BritishColumbia, 2206 East Mall, Vancouver, BC V6T 1Z3,Canada; Soleil Surette, MLIS,, Re-search Librarian and Education Lead,** Care Programfor Integrative Health and Healing, University ofAlberta, 8B19 Edmonton General Hospital, 11111Jasper Avenue, Edmonton, AB T5K 0L4, Canada;Liz Dennett, MLIS,, Informa-tion Specialist, Institute of Health Economics, 1200-10405 Jasper Avenue, Edmonton AB T5J 3N4; andPublic Service Librarian, John W. Scott HealthSciences Library, University of Alberta, 2K4.06 WalterC. Mackenzie Health Sciences Centre, Edmonton ABT6G 2R7, Canada; Trish Chatterley, MLIS,, Collections Manager, JohnW. Scott Health Sciences Library, University ofAlberta, 2K4.06 Walter C. Mackenzie Health SciencesCentre, Edmonton AB T6G 2R7, CanadaReceived February 2013; accepted May 20131 Current position: PhD Candidate, Interdisciplinary StudiesGraduate Program, University of British Columbia (same mailingaddress).** Current position: Manager, Assessment and Research, EdmontonPublic Library, 7 Sir Winston Churchill Square, Edmonton, AB T5J2V4, Canada.The research-embedded health librarian experienceJ Med Lib Assoc 101(4) October 2013 297


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