This book brings together health information practitioners with a huge variety of experience across health information work within healthcare knowledge and library services in the NHS in England. If there is one overarching message that can be taken away from this book, it is that healthcare knowledge and library services offer a valuable gift to their medical practitioner colleagues – the ‘gift of time’. This clearly shows why these services offer vital ongoing support in this important sector.

Each chapter focuses on an essential aspect of health information work and provides a practice handbook and an insight into how health information services operate. The provision of healthcare knowledge and library services continues to develop. With this in mind, it should be noted that Health Education England (HEE), which is mentioned in every chapter, ceased to exist and was replaced by NHS England on 1 April 2023. Given that the vast majority of the work took place under the auspices of the HEE, we felt it fitting to recognise and record that contribution here. The work remains as valuable as ever, but remember to bear in mind that the organisation now has a different name.

The chapters do not need to be read in order and you don’t need to read them all. They are standalone, but they are cross-referenced where appropriate. There is a wealth of case studies to show how the ideas put forward here are put into practice. Each chapter has a reference list and there are suggestions for further reading as appropriate.

The book contains an introductory chapter setting the scene and detailing the structure of the NHS and the health information landscape. What follows is a series of in-depth, practitioner focused chapters that describe all aspects of healthcare, knowledge and library work in the health sector.

Chapter 1 is an exploration of the wider healthcare environment, including an overview of the complex structure of the NHS and how the healthcare, knowledge and library services work within this framework.

Chapter 2 foregrounds how the training development needs of health information practitioners are identified and met.

Chapter 3 explains how information, knowledge and library services support the critical area of evidenced-based practice that is necessary for a successful health service.

Chapter 4 describes how information practitioners successfully advocate for their services by building meaningful relationships between the service, medics and decision makers.

Introduction

In this chapter, we explore definitions of health literacy in relation to individuals and wider society. We will examine which groups in society are more likely to be affected by low health literacy and describe how having low health literacy impacts on a person’s health and wellbeing and the services that support them. We’ll also set out tools and techniques that can help people with low health literacy and promote health literacy in practice. Finally, we outline the context for work by health library and knowledge specialists in promoting health literacy.

What is health literacy?

Health literacy can be defined in relation to an individual and to wider society.

Individuals

For an individual, health literacy describes the extent to which a person can find, understand, use and apply health information as well as interact with healthcare services to make health-related choices for themselves and others. Health information behaviour and health literacy are complex phenomena that have received much attention in information behaviour research, such as how people engage with or avoid health information (Saironen and Savolainen, 2010). Critical health literacy (Sykes et al., 2013) is one notion that has been employed to empower individuals to make informed decisions. However, information behaviour research demonstrates that whilst some individuals will readily seek health information, some will actually actively avoid it in order to reduce the risk of experiencing negative emotions such as fear, anxiety and depression (Saironen and Savolainen, 2010; Case and Given, 2016). Although the vast majority of people will seek health information to reduce anxiety, for some, engaging with health information can increase their anxiety (Pifalo et al., 1997).

Society

For a society or healthcare system, health literacy relates to the provision of information and services in a way that is accessible to all and empowers people to make informed healthcare decisions. However, the COVID pandemic and the scare regarding the link between the Measles Mumps and Rubella (MMR) vaccine and autism (Lewandowsky et al., 2012) have put into stark relief how health misinformation can spread, often quicker than good quality information (Spring, 2020). The term ‘infodemic’ aptly describes the former phenomenon (Zaracostas, 2020). What we can conclude from this is that, as health information professionals, it isn’t simply a question of providing good quality health information, there is also a need to actively combat misinformation and deliberate disinformation which is so easily available via the internet.

This is a landmark book. When a book such as this arrives on the actual or virtual shelves it demonstrates that a subject area has come of age. Annemaree Lloyd has brought together the most important methods and techniques in qualitative research for information literacy into this new volume. What marks this work out from others is the numerous examples included from information literacy research which enable the reader/researcher to further pursue their interests. Equally valuable is that Annemaree emphasises that it is the research question or problem that drives the methodology and methods that follow. The explanations of research philosophies, paradigms, method - ologies, methods and techniques and how they relate is second to none in this welcome addition to our research toolbox.

But why is qualitative research so valuable? I thought I would describe an incident which alerted me to the significance and the richness of carrying out qualitative analysis and how it can get beyond the numbers to create a rich narrative of the subject you are researching. It is these ‘rich narratives’ which give us in-depth insights into the participants or subject we are researching. For me this was my first piece of ‘real’ information science research. It was my PhD which provided me with an abiding motivation to continue with qualitative research for the rest of my career.

In the initial stages of my PhD on information literacy, longer ago than I care to remember, I recall that I was fixated on garnering numerical data for my thesis, thinking it was superior in quality to a bunch of quotes. How utterly wrong I was. The qualitative data I gathered through actually talking to people revealed insights and issues I had not thought of. It also gave a deep and nuanced meaning which the numerical data could never unearth.

I had asked students to tell me what they thought of the information literacy reflective practice exercise I had given them – thinking they would have loved every minute of it. They were very honest! They took me aback to be frank. The insights were hard to take at first but deeply revealing. Learners were asked what they thought about reflective practice and collaborative learning.

Ground-breaking can be an overused and hackneyed phrase but it is entirely true in this case, and an apt pun, for a book that focuses on information landscapes in their infinite variety. But that's not to say that it is narrow in view, this is a much broader treatment on the discourse of information literacy – it is a sure-footed and forensic exploration of the topic. Drew's discussion on the history of information literacy is a very clear break with received wisdom of the past and especially questions the hegemony of thought embodied in powerful Western voices. Drew provides us with a critical overview, in a sense an information literacy of information literacy, which has been sadly lacking but now rectified in this volume. However, it is the notion of the information landscape that defines this work.

When Mark Hepworth and I wrote our book on information literacy, we were very conscious of the ‘information character’ of an information source (whatever that might be), but never fully developed what we meant by that. Drew gives us a clear notion of what information character is through this notion of an information landscape (not as metaphor but as embodied social practice); how we inhabit, map and navigate it to become, not just informed, but to make well-calibrated judgements of the information we encounter. It is notable that Drew draws our attention to the overlooked, and often misunderstood issue by those outside the information profession, that information literacy is not simply about technical competencies, no, it is much more than this. Indeed, it is about our practice as we move through, encounter and use information for whatever purpose.

Information literacy is a social and cognitive set of practices which help us locate ourselves in the world. These practices are contextual (work, education or play), negotiated and re-negotiated and, are not entirely rational. Therein lies a problem, which Drew highlights very eloquently, in effect the limited perspective that information literacy taught in higher education brings. Educators are excellent at enabling or even empowering students to become information literate within the educational context but this does not translate well to the workplace because, like the geographical landscape where mountains and valleys are very different places, the information landscapes of education and work are entirely different too.

Introduction

This chapter explores current research on how young people make judgements about the information they encounter. There will be a discussion on why some young people appear to trust, without question, online information whilst others show remarkable powers of insight and critique. Evidence on how this might affect their physical and mental well-being will be provided. Why this is important both in educational and political terms is discussed. There will then be an exploration of the approaches that can be employed to help young people develop a more discerning approach to engaging with the information they see, hear and read in any context.

The discussion put forward here is based upon a synthesis of research findings involving three groups of young people from the UK – 16–17-year-olds, at a secondary school, 18–19-year-old university students in their first undergraduate year and finally 18–24-year-old men recruited for an experiment, mostly undergraduates – all carried out in the UK. For the first two groups there was a concern voiced by teachers and academic tutors respectively that their students exhibited a noticeable lack of the necessary capabilities to make well-calibrated judgements in order to select good-quality information to support their work for assignments. The 16–17-year-olds were working towards gaining their Extended Project Qualification (EPQ)1 – a mini-dissertation in addition to their A-level study. Walton et al. (2018a) provide a comprehensive reflection of these studies. The 18–19-year-olds were working towards completing their first assignment and had to find good quality information about a sporting issue of their choice (see Walton and Hepworth, 2011; 2013 for a more detailed account). These two groups are quite similar in their context and we will see that their comments and experiences and our analyses align in an encouraging way. How? They both appear to indicate that most (but by no means all) students present with remarkably poor capabilities in making judgements about information, which prevent them from making the most suitable choices. The third group were recruited to find out whether the cognitive process of information discernment has a physiological component. Why? We wanted to find out whether being good at information discernment is related to positive responses to stress.

Introduction

This chapter explores digital literacy in the context of a project which intended to motivate school students to read for pleasure using information and communications technologies (ICT) and creating digital artefacts (eartefacts). We define e-artefacts as digital work created in different formats such as text, video, audio, image or animation, or a combination of these. This project, called AMORES (An approach to MOtivating learners to Read in European Schools; www.amores-project.eu), was funded by the EU Comenius multilateral strand of the Lifelong Learning Programme. AMORES ran from 1 December 2013 to 30 November 2015. It aimed to improve students’ engagement in reading national and European literature through a methodology based on ICT, interactivity and collaboration. Students from five countries exchanged their e-artefacts on national literature online and at a final event. Preliminary work with teachers enabled them to meet their partner school colleagues to develop an online community to support the implementation of a new digital literacy teaching methodology. The common working language was English and the teaching methodology was subsequently translated into their mother tongues for implementation. The project involved 400 students aged 9– 14 from Croatia, Denmark, Poland, Sweden and the UK.

In this chapter we explore the thinking which underpinned the design of the new teaching methodology. An example learning scenario is presented to show how the teaching methodology can be realised. Findings from the pilot implementation are presented. A range of recommendations are discussed including pedagogy, tools and technologies, and social media. The new teaching methodology's potential limitations are also outlined.

Context

Before discussing the project in more detail, it would be useful to begin with a statement of our understanding of what is meant by digital literacy in this context. Digital literacy for our research is defined as ‘a combination of all those capabilities which equip an individual for living, learning and working in a digital society’ (Jisc, 2011, 2). This includes the critical evaluation of digital content and (in an educational context) its application to learning, for teachers in their pedagogic practice and for students as part of their learning. In addition, we believe that there is a social dimension to digital literacy in that digital literacy includes the ability to use digital media for social participation in any context, whether for leisure, education, work or citizenship.

Strand Two is informed by the belief that change occurs throughout the learning process as a natural, inevitable and sometimes challenging aspect of learning. Building on the transitional issues identified in Strand One, Strand Two positions the concept of ‘learning to learn’ as a lifelong framework for encountering, evaluating and assimilating new information, including evidence that conflicts with or challenges the learner's beliefs and world view.

The concept of the autonomous learner is fundamental to this vision. Rather than endeavouring to teach students how to deal with every kind of information, this strand aims to facilitate their emergence as individuals capable of generating strategies for dealing with new information contexts as required, at every stage in their lives.

Geoff is a well known researcher and practitioner in the information literacy field, and a member of the RIN Working Group on Information Literacy. He has written and published widely in the field as well as conducting doctoral research, and took part in the ANCIL expert consultation.

We are delighted that Geoff 's colleague Jamie Cleland, a senior lecturer in Sport Sociology at Staffordshire University, has co-authored this chapter, making it an outstanding example of interprofessional collaboration.

Institutional context and module development (Geoff)

This chapter will draw upon six years’ work carried out in collaboration with academic colleagues in Sport and Exercise Science at Staffordshire University, especially Dr Jamie Cleland, who also contributes to this chapter. The specific focus is a core first-year module called Research and Professional Development (between 120 and 160 per cohort). Before the module leader and I became involved in this particular module it was notoriously unpopular amongst students, who found it boring, unnecessary and full of material they ‘knew already’ because they had ‘done it all at college’. Yet these students, who, according to their own informal self-assessment, seemed to have arrived at university with a complete set of study skills and with claims that suggested they were at the highest levels of information literacy, produced essays and other assignments that told a very different story.

It is perhaps unsurprising that the narrative from the module leader and his team was one of frustration: students produced essays with poor sentence structure, could not argue effectively, and used inadequate, often internet-based resources found via the first page of a two-keyword Google search.

Introduction

ASK is a web-based tool designed to support undergraduate students encountering their first assignment. In June 2007 it was awarded the CILIP University, College and Research Group (UC&R) Award for Innovation. ASK is the work of the Information Literacy Project Working Group within Staffordshire University (SU) Information Services (IS). The ASK team includes librarians, information professionals, IT developers and e-learning experts. The software was created by the complete adaptation of open source software used by the University of Minnesota in their Assignment Calculator. Scripts were re-used and rewritten to allow local relevance, for example, UK date and time format. The software, viewable at www.staffs.ac.uk/ask, links to a number of useful learning support web pages both internal and external to the University (see Figure 14.1 on page 140).

At present ASK is at the end of Phase 1 of its development. The software is generic and web based in its approach but we intend to develop it further by investigating the feasibility of integrating Web 2.0 functionality. The team were mindful that the wish to add new Web 2.0 functionality needed to be balanced against the success and usability of the current product and any changes/additions must add to the flexibility of ASK without alienating those who prefer a simple approach. Czarnecki's (Anon, 2007) statement that ‘we are always in a state of [constant] beta’ when using Web 2.0 implies that, by definition, there is no best way to ‘Web 2.0’ an existing application, so the emphasis initially will be on allowing students to opt in to some of the new functionality, rather than forcing it on them in its entirety. ASK does, however, already fit with the Web 2.0 philosophy of openness and sharing and this will be retained in Phase 2 through the application of a Creative Commons licence.

Phase 1 development pre-Web 2.0

The first task was to agree an appropriate IL structure for ASK which would meet the needs of SU students. Informed deliberations within the IL Project Group concluded that IL models have many similarities and few differences, a view shared by Owusu-Ansah (2003) and Andretta (2005). This is to some extent unsurprising as many are drawn from the ACRL (ALA) model (2000) or are a synthesis of a number of existing models.

Introduction

To personalize has been defined as to ‘design or produce (something) to meet someone's individual requirements’. That products and services should be focused on a target community and fulfil the demands, wants and needs of that community is accepted as a truism by marketers in virtually all domains. A successful product, whether it is a car seat, a bar of chocolate or a computer game, tends to be inspired by a deep knowledge of the consumer derived either through systematic market research or expert knowledge via practice. Such products tend to satisfy either a long, thin horizontal niche across a wide population or a deep, narrow niche vertically within a population. Information products and services, although paying lip service to user-centred design, have tended not to be geared to the specific needs of the user. However, current developments in personalization are beginning to lead to information products that can be both generic and specific by being able to adapt to the specific needs of the user.

In the past this ‘consumerist market philosophy’ has only partially penetrated the design and development of information products. Services such as portals as well as libraries, compact discs, online databases, public access catalogues, portals, web-based information services, even the computer desktop itself and most computer applications have tended to be generalized and aimed to meet the common needs of a broad community.

In fact there is still doubt in some quarters about the general value of investing time on personalization. Neilsen (1998), for example, who has gained quite a reputation in the area of human–computer interface design and usability, has stated that it is better to concentrate on general characteristics of good interface design than on personalization. Despite the stress on personalization features in an increasing number of products – portals, online catalogues, virtual learning environments, world wide web search tools, e-messaging services, as well as by e-commerce vendors – few studies have been conducted into the impact of personalization. One exception is in personalized health information provision where Kreuter and Strecher (1996) showed the benefit of personalized information provision. Whether or not this has similar lessons for information products that serve a less focused need is as yet unproven.