The power of information literacy
Have you heard about the endangered tree octopus—the one that lives high in the forest along the Pacific coast? Click on zapatopi.net/treeoctopus, and you can read all about it. Many students have been enamoured by the tree octopus—at least until they begin to spot clues that signal the creature is a hoax. These include a credit to the “Wild Haggis Conservation Society” and mention of “Sasquatch” as an octopus predator.
It’s unlikely the website could convince many nurses to believe tree octopi exist. But the example reminds us that discerning the truth in a digital age takes a degree of literacy that far exceeds reading at a certain grade level. What’s more, the medical profession is not immune to fake news—or, in recent parlance, alternative facts. That reality raises a significant challenge for nurses, who have a professional responsibility to base their practice on the latest and best available evidence.
Even more concerning than tree octopi are ideas that appear authentic but are not grounded on sound research, says Meagan LaRiviere, senior manager of professional development and knowledge at the College and Association of Registered Nurses of Alberta. The persistent but non-scientific linking of immunization with autism, for example, causes many parents to fear immunizing their children, which puts large population groups at risk, LaRiviere notes. “Nurses have an ethical responsibility to locate and recognize credible information and translate it into lay language so patients and families can make the best decisions about care.”
Beyond locating, vetting, using and relaying information, nurses need to inspire those they work with to change their practice, says Sheli Murphy, senior operating officer at Covenant Health. Doing that well takes “virtual literacy,” she adds. A virtually literate nurse “reads” nonverbal cues while interacting with patients, families and colleagues, sensing what’s needed in each context.
Such attentiveness is tied to the central nursing tenet of evidence-informed, patient-centred practice, notes Jody Nelson, MacEwan University’s nursing liaison librarian. “The patient’s values, perspective and experience inform decision making, really situating the patient in the process.” That same tenet moves nurses to respond to patient views with respect, Nelson adds. “Rather than confronting misinformation by simply saying ‘you’re wrong,’ literate nurses point patients and families to tools they can use to evaluate information for themselves, so that they in turn become educators.”
Information literacy is essential to evidence-informed decision making—but what form does it take in nursing practice, advocacy and leadership? Nelson points to a study published in Nurse Education Today that describes levels of awareness among practicing nurses regarding information literacy. Most MacEwan nursing students begin at a lower level of awareness as “knowledgeable goal achiever[s]” seeking out information to meet specific goals. The hope is that nurses will progress to become “confident and trusted promoter[s] of justifiable change” or even become the “leader, philosopher and strategist” who wrestles with the ethical and philosophical conundrums that surface when using evidence to inform best practice.
Sheli Murphy, senior operating officer at Covenant Health, knows that struggle well. “We have finite dollars to do a potentially infinite number of interventions,” she says. A titanium hip lasts longer than steel or porcelain, but if it costs 10 times more, what does that mean to the system? On the other hand, the Canadian Health Institute says it takes 17 years to move evidence into practice, resulting in years of outmoded care even when the recommended improvement is affordable. “Balancing all those issues is a tall order,” Murphy says. “The more evidence nurses have in their area of expertise, the more they can contribute to the excellence of their care teams.”
Today’s exponential expansion of knowledge, coupled with the explosion of ways to find information, complicates the task of identifying credible and relevant information. There’s a reason Facebook is putting millions of dollars into creating algorithms to separate truth from fiction. Even with those new truth filters, however, Facebook will never tell nurses all they need to know, Nelson says. “Your newsfeeds on social media are based on what is new and most popular, not necessarily on information that is credible or significant.”
Nelson recommends putting more credence in vetted sources, including trade publications, association websites, juried journals and libraries. And as she tells students, look for the most current information available from people with relevant expertise.
Unsure about where to turn? Get to know the librarian at your hospital, health system, regulatory body and, or, nursing program. At MacEwan, for example, Nelson is happy to set up practice-specific RSS feeds, review disciplinary databases and suggest relevant peer-reviewed journals. “Librarians went into this profession because we like to help,” she says.
Information literacy is not only about finding, evaluating and using information, Nelson notes. Nurses become part of the cycle of producing information. Whether the topic is immunization, co-sleeping with infants or psychological health, nurses who sensitively communicate accurate information contribute to how patients and families understand themselves and their world. “We all need to think critically about how we communicate and construct authority,” she says. “As critical-thinkers, educators and nurses, we can counteract the tree octopus—together.”
The Centre for Professional Nursing Education provides continuing education for nurses and health-care professionals.