Future visions for continuing professional development in health librarianship: an Australian perspective

It is generally accepted that continuing professional development (CPD) is a requirement of being a professional, and the purpose of CPD is for individuals to achieve their career aspirations and to maintain and improve standards of professional practice. The IFLA guidelines state: 'The responsibility for continuing education and professional development is shared by individuals, their employing institutions, professional associations, and library/information science education programs.' (2006:1).1 Each of these groups has a role and responsibilities in the CPD system, and there are similarities and differences amongst the professions in the ways these are carried out. Methods for ensuring the quality and future orientation of CPD activities are not universal. Some professions, and notably many of the health professions, have mandatory CPD, often with structured curricula, elaborate systems of accrediting CPD providers and programs, and assessment and adjudication processes to support these systems. Mandatory CPD is possible in professions which are regulated, that is, where legislation exists ensuring that professionals are registered, and professional colleges maintain a CPD system which recognizes a certified practitioner. In some groups, for example medical specialists, a 'licence' to practise at an advanced level confers a right to be a specialist; in other groups, for example, general practitioners, it brings a level of remuneration above that which is due to an uncertified practitioner; in all cases, maintaining this certified status is dependent on a professional's ongoing participation in their college's CPD program. The Australian Library and Information Association (ALIA) has a voluntary CPD scheme with a fairly simple administrative framework which facilitates recording and monitoring CPD activity. This does not guarantee, however, the quality of the CPD 'offerings', nor the outcomes. Indeed, it is questionable that any type of CPD program (mandatory or voluntary) guarantees quality outcomes. Putting aside the regulatory, administrative and other infrastructure barriers, and the question of evidence about the quality of outcomes, it is nevertheless the case that without a structured CPD program operating as a quality assurance mechanism, librarians risk not being viewed as equals with their colleagues in the health professional workforce. In the context of the Australian health workforce, in which national level registration with requirements for regular CPD are increasingly the norm, health librarians will lose credibility and status if they don't have a structured and regulated CPD system. In addition, and perhaps more importantly, they risk losing competitiveness in the health information professional market. There are many environmental drivers for change in the delivery of Australian health services, and this brief discussion will highlight two which have an impact on the health workforce generally, and on librarianship in particular. The influence of ehealth is one of the most important, as it will precipitate the integration of patient care systems, such as the shared electronic health record, with clinical decision-support information tools, consumer health information and other knowledge resources, all requiring customization at point-of-care. Implementation requires skills to consult with and train clinicians; information professionals will need to know how to manage the content as well as the technology which runs the systems. There is also a 'skills shortage' in the health workforce generally,2, 3 and in the technology area in particular, and this shortage, combined with the high median age (and imminent retirement) of many health librarians, will add to the pressure on health librarians to be competitive in the ehealth information/knowledge workforce. Another important driver in health services models is the trend towards multidisciplinary teams and the increasing role of clinical librarians and for 'informationists' (in a research context, see, for example, Whitmore and colleagues, 20084) with a dual function, that is, as health information specialists, these roles are defined by the requirements of the health services teams, and at the same time, they take responsibility for traditional librarian functions. The emphasis on evidence-based information for patient care decision-making, and public health policy and program development, will increase the demand for these 'dual purpose' librarians. A recent NHS study pointed to the possible need for clinical librarians in the UK reaching 800, and recommended the role of the 'Team Knowledge Officer' to be responsible for the 'input of evidence to enable the team to function properly'.5 Given that there is no legal requirement for registration, and no reason to acquire higher qualifications to practise at a 'specialist' or certified level, mandatory CPD is not possible in librarianship. Other options or 'levers' which may encourage compliance with an ongoing CPD requirement, need to be canvassed. These may take a 'carrot' or 'stick' approach, and should be built into a new CPD system, designed with participation from all stakeholders to encourage 'buy in' from practitioners and employers, and ensure that programs can be implemented in partnership with education/training organizations. To advance Australian health librarianship, we need to bring together the various stakeholder groups so each can contribute to a CPD system which produces the best outcome—the future health librarian workforce. Much work on the topic of knowledge, skills and attributes for health librarians has already been undertaken. The Medical Library Association lists seven professional competencies required of health librarians in its Education Policy Statement.6 The National Library for Health review suggests exploring the feasibility, cost-benefits and cost-effectiveness of a development programme for clinical librarians; and recommends that: 'The National Library for Health should devise and commission a national development programme for senior and lead librarians.' (37–44)5 In Australia, there is no national library for health, and this leadership is lacking. The Nexus institutional survey of the health library workforce is currently underway, following an initial, all-sector individual survey supported by ALIA.2 The challenge will be to use Hallam's findings regarding the future institutional requirements for their health library workforce to commission the development of future-orientated CPD programs. It is envisaged that a structured CPD system would produce specialist health librarians with recognized qualifications. It would extend the 'foundational knowledge base' of initial professional qualifications 'in a manner which transcends current fads and fashions (p. 2).'.7 It would combine academic units with other CPD 'offerings', and would articulate into a Masters or PhD qualification. Financial incentives would need to be negotiated with employers through industrial processes, with provision for 'professional development' and 'post graduate' allowances being built into collective agreements. This article has reviewed the current situation in Australian health librarianship with regard to the need for a system-wide approach to CPD and some of the drivers for change in the health industry. It has argued that health librarians are specialists within the health workforce, and as such, their CPD requirements are different from other areas of librarianship. This is evidenced in the increasing need for integration with national ehealth directions and strategies, and in the trend towards service models based on multidisciplinary teams, knowledge management and clinical librarian/informationist roles in different contexts of the health industry. Health librarianship is similar to other areas of librarianship in the requirement to extend continuously the core body of professional knowledge; and in the need for national leadership from our professional association to bring together all the different stakeholder groups to design a structured CPD system to deliver high quality programs, ensuring incentives and equity of access. AR has declared no conflicts.