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Clear and present questions: formulating questions for evidence based practice
Andrew Booth
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Clear and present

Clear and present questions: questions
formulating questions for
evidence based practice
355
Andrew Booth
School of Health and Related Research, University of Sheffield, Sheffield, UK Received 23 November 2005
Accepted 21 February 2006

Abstract
Purpose – The paper seeks to provide an overview and update of thinking in relation to the theory
and practice of formulation of answerable research questions within evidence based information
practice.
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Design/methodology/approach – The paper reviews the healthcare and information literature on

question formulation, augmented by structured and purposive internet searches.
Findings – Although a few key authors have published extensively on all aspects of the
evidence-based information practice process, including question formulation, there is little in the way
of empirical research.
Research limitations/implications – In the absence of an empirical research base from within the
specific domain of information practice, this conceptual paper extrapolates findings from healthcare
research to general librarianship.
Practical implications – This article models the process of question formulation using a proposed
conceptual framework (SPICE) and encourages practitioners to identify their own practice-based
questions.
Originality/value – This is the first article specifically to address question formulation for a general
(i.e. non-health) library audience.
Keywords Evidence-based practice, Librarianship, Research
Paper type Conceptual paper

Introduction
To be able to ask a question clearly is two-thirds of the way to getting it answered (John
Ruskin).

How many times in a working day do you question the value of established library
practice? What questions do you and your colleagues ask when contemplating the
introduction of some new technology or some innovative service? It is true that, on
occasions, lack of time or other logistic constraints will conspire to cause what we
might label an “evaluation bypass”. On such occasions we may continue to perform
some task or action even though we are not truly convinced of its efficacy or we may
move to uncritical adoption of a new technology or procedure. Hopefully such
instances are the exception rather than the rule. Nevertheless we must acknowledge
that it does take both time and effort to “start stopping” or to “stop starting” (Gray,
1997). Thus it becomes critical that all information professionals become efficient at Library Hi Tech
Vol. 24 No. 3, 2006
identifying, formulating and addressing relevant questions from their own practice. pp. 355-368
Within other domains of evidence-based practice, most notably evidence-based q Emerald Group Publishing Limited
0737-8831
healthcare, a considerable knowledge base has been built up around the formulation of DOI 10.1108/07378830610692127
 LHT questions. We know, for example, that on average physicians ask two questions for
24,3 every three patients seen (Booth, 2005). We know too that a large percentage of these
questions (30-60 per cent) will go unanswered – in some cases because the one asking
does not believe that the answer is to be found (Booth, 2005). Frequently questions will
be answered with reference to colleagues or from outdated textbooks (Booth, 2005). It
would be reassuring to believe that, as a profession, our knowledge of the research
356 literature in librarianship is such that we can correctly anticipate whether the answers
to our questions from day-to-day practice do exist. The truth is that very few of us have
regular and intensive contact with our own evidence base. This situation is further
aggravated by the fact that many of our activities lie within domains populated by
other research literatures, for example management, education, marketing and
computer science (Crumley and Koufogiannakis, 2002).

Why ask questions?

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Questioning the fundamentals of daily work practice is a defining characteristic of a

professional. As Geroud remarked almost a century ago:
No questions arise more frequently in the mind of the progressive librarian than these: Is this
method the best? Is our practice, in this particular, adapted to secure the most effective
administration? Are we up to the standard set by similar institutions of our class? These
questions are of the most fundamental type, and upon the success with which we answer
them depends much of the success of our administration (Gerould, 1906, p. 761, cited in Hiller
and Self, 2004).
To illustrate, the basic techniques of butchery have changed little over the last three
centuries. In contrast, over the same period of time surgery has evolved and developed
a knowledge base on the back of questioning practice. The former is a trade, the latter a
profession. One hopes a similar contrast exists between bookselling and librarianship!
Donald Schon points out that the concept of “reflection” is central to understanding
what professionals do (Schön, 1983). All too often in the past librarians have based
their practice on what Schon dismisses as “technical-rationality”, where a professional
learns specialized scientific and theoretical knowledge that he or she applies to the
situation at hand (Horton, 2002). Such a model does not equip us well to derive new
insights, especially when faced with new technologies. So, for example, we may view
web pages as an extension of page-based systems and online catalogues as analogous
to card catalogues, rather than developing a new paradigm that harnesses the latent
advantages of these new technologies.
In contrast Schon advocates reflection-in-action and reflection-on-action.
Reflection-in-action is what we might call “thinking on our feet”. We build new
understandings from our experiences, feelings and theories within a context or
situation as it unfolds. We do not come in with predetermined solutions but remain
alive to new insights as a situation develops. We may try something new (an
“experiment”) which helps us to gain an additional understanding and which may
modify the situation that we have encountered.
Reflection-on-action is done later, after an encounter. We may write up notes in a
“benchbook” or diary, we may analyse our experience with our supervisor or a
professional mentor or we may even share our insights via a discussion list or blog.
Valuable time spent reflecting-on-action enables us to explore why we acted the way
 that we did. In revisiting our experience we develop sets of questions about our Clear and present
activities and practice. questions
Having established a connection between professional, reflective practice and the
asking of questions it is appropriate to acknowledge that the catalyst for such
questions comes from a myriad of sources – for example, from daily practice, from
research or from the observations of our users. This is explicit in broader definitions of
evidence-based practice: 357
Evidence-based information practice (EBIP) is an approach to information practice that
promotes the collection, interpretation and integration of valid, important and applicable
user-reported, librarian observed, and research-derived evidence. The best available evidence,
moderated by user needs and preferences, is applied to improve the quality of professional
judgements (Booth and Brice, 2004a).
Similarly, the sources of evidence to answer such questions may themselves derive
from research, from the reports of users or from our own professional experiences. This
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many-to-many relationship, by which either source or satisfier of a question may

derive from any or all of these routes, corrects early misconceptions of evidence-based
practice which expected all roads to lead to the research literature.

The place of questions in evidence based practice

The first stage of evidence-based practice, whether in medicine, nursing, education or
librarianship, is to convert information needs from practice into “focused, structured
questions” (Rosenberg and Donald, 1995; Sackett and Rosenberg, 1995; Booth, 2000).
Of course this assumes that a practitioner is aware of their own knowledge deficits –
“knowing what they need to know” is a little-explored but nevertheless basic
requirement when initiating the process of evidence-based practice. By using the
phrase “posed questions” Eldredge (2000a) implicitly acknowledges the need for
articulation of information needs:
Questions drive the entire EBL process. EBL assigns highest priority to posed questions with
greatest relevance to library practice. The wording and content of the questions will
determine what kinds of research designs are needed to secure answers.
Related to this is the need for some degree of uncertainty to be present. If you, as a
library practitioner, have identified an issue that requires resolution (e.g. researchers
are having difficulty keeping up to date) but you automatically assume that you know
the answer (e.g. automated current awareness services) you will progress directly to
your preferred solution. Therefore the likelihood of you pursuing an answer for a
question depends less on whether the evidence to answer a question actually exists
than whether you are at a prior state of uncertainty. This phenomenon explains why
the role of mentor or research supervisor is often key to evidence based practice (Booth,
2004a) – the presence of a “naı̈ve” questioner can often provide the stimulus for a more
experienced practitioner to question long-held assumptions.
In the nursing profession, evidence-based practice received considerable stimulus
from challenging “nursing rituals” (such as preoperative fasting and perineal shaving)
(Walsh and Ford, 1989). Asking questions concerning procedures that had previously
proved immune from questioning can thus have a considerable impact. Do we actually
need a classification scheme in this age of machine-readable databases – would simply
using call numbers prove sufficient? Should we be buying books “just in case” or
 LHT should we rely instead on “just in time” ordering of interlibrary loans? Do we need
24,3 professionally qualified staff on enquiry desks or could paraprofessionals fill this role,
with reference to a professional colleague when necessary? No doubt readers of this
article already have a position on some, if not all, of these issues – but is it
evidence-based?
In their definition of evidence-based librarianship, Crumley and Koufogiannakis
358 (2002) hint that its emphasis should be on the diurnal (might we even say mundane?)
rather than on the novel and experimental:
Evidence-based librarianship (EBL) is a means to improve the profession of librarianship by
asking questions as well as finding, critically appraising and incorporating research evidence
from library science (and other disciplines) into daily practice (Crumley and Koufogiannakis,
2002).
Explicit prioritisation of questions is fundamental before we even get so far as their
formulation; focusing not simply on the most obviously costly areas of our practice but
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also on high volume, high impact, high risk, etc. (which, of course, may ultimately have
large cost implications). It has also been noted that identifying the “most important
research questions” risks conflating those that have yet to be answered (a research
agenda issue) with those that have been answered satisfactorily but which are yet to
impact upon practitioners (a dissemination issue) (Booth, 2001a, b).
The goal of this primary stage, variously called “focusing or formulating your
question” (Richardson et al., 1995), is to convert a precise, yet possibly vaguely
expressed, information need into an “answerable question”. This is mirrored within our
own profession where Crumley and Koufogiannakis state:
The first and most important step in enabling librarians to practice their profession in an
evidence-based manner, is to ensure they know how to ask well-structured questions; a much
harder task than one might initially suppose – having a well-built question focuses your
search for information (Crumley and Koufogiannakis, 2002).

Background and foreground questions

In the early years of evidence-based medicine, Richardson and colleagues proposed a
valuable distinction between “background” and “foreground” questions (Richardson
and Wilson, 1997). Background questions are typically asked by those who are
relatively inexperienced within a subject area. Thus a novice librarian might ask
“What are the likely causes of high rates of journal mutilation?” or “If the library
introduces e-books what are the likely consequences?”.
Alternatively a more experienced practitioner may ask a background question
when they are encountering a situation for the first time. They may ask “What are the
possible solutions to high rates of plagiarism or poor standards of referencing in
academic assignments?” or “What have my colleagues in other libraries tried to combat
this problem?”. The defining characteristic for each of the above four questions is a
need to address a general knowledge deficit. To answer such questions the professional
will wish to identify a broad range of options or explanations, perhaps through an
overview article or an informal survey of colleagues’ opinions. Having filled their
knowledge gap with reassuring detail they are then able to narrow down to a more
limited range of options. Alternatively, they may be able to identify more specific
knowledge deficits that require follow-up. Of course this assumes that their method of
 identifying options is not prone to bias; a review may selectively report alternatives Clear and present
according to its author’s preferences or interests while a solicitation via a discussion questions
list may attract those with polarised views rather than the “silent majority”.
Thus our prior level of knowledge on the topic often determines the type of question
that we ask. Background questions broadly equate to what we might describe as
“fact-finding”. Eldredge (2002a), in a preliminary attempt to characterise question
types, which might then map to particular sources of evidence, identified prediction 359
questions (“What would happen if . . .?”) and exploration questions (“What are the
likely causes of . . .?”) as two of the three major question types (see below).
In contrast, if I am already aware of two or more alternative competing choices of
action but I am unable to decide which course to take, this is a foreground question,
suggesting that I am at a point of decision-making (Richardson and Wilson, 1997). It
takes the form “In a population of engineering students are electronic journals more
effective than print journals in achieving awareness of latest technological advances?”
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As implied by this format, the level of prior knowledge required to pose such a
question is much greater than that required for a background question. Our choice
between such alternatives may be determined (assuming the existence of suitable
studies) from research studies published in the journal literature. Those who are more
experienced in a profession are most likely to ask foreground questions unless, as
previously mentioned, they face a situation or service that they have not previously
encountered. The existence of two or more alternatives suggests that some form of
comparative study will be most useful in addressing this question. Of course, where a
straight head-to-head comparison does not exist we may have to look at studies where
choice A and choice B are compared separately to a third alternative or arrive at some
crude “balance sheet” of likely advantages and disadvantages for each alternative.

Types of questions
Efforts to classify clinical questions into question types (Gorman and Helfand, 1995;
Barrie and Ward, 1997) initially predated and, subsequently, ran parallel to work on
question formulation within evidence based healthcare. In contrast, the early days of
evidence based information practice have seen attempts by Eldredge (2002a) to
disaggregate a wealth of practitioner questions into three main question types:
(1) prediction questions;
(2) intervention questions; and
(3) exploration questions.

Prediction questions typically seek to predict an outcome under specific predefined

circumstances. The preferred research design, the cohort study, involves a defined
population, exposure to some “change factor”, and observed outcomes (Eldredge,
2002b). Classic cohort studies include a comparison with a similar group that has not
had exposure to the “change factor”. They are particularly valuable within the area of
practitioner based research because, as “observational studies” they involve simply
recording what happens before and after a particular exposure without seeking to
prescribe or modify user behaviour in any way. Eldredge (2002a) has identified such
prediction questions as:
 LHT .
Are students who have been taught information skills more or less likely to
24,3 continue to further study?
.
Do library skills courses improve the information-seeking skills of students?
.
Do library desk staff members provide accurate responses to reference
questions?
360 Intervention questions seek to address foreground questions by comparing two or more
actions in terms of how “successful” they are in attaining intended goals or outcomes.
Characteristics of a study that addresses an intervention question are thus that it is
comparative and prospective (that is it compares two or more interventions forward over
a predetermined period of time). The classic research design for studying an intervention
is thus a randomized controlled trial which not only possesses these two desirable
characteristics but also adds the inherent advantage of seeking to ensure that each group
being compared is as similar as possible to the other groups (Eldredge, 2003). The
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presence of this “level playing field” at the beginning of a study makes it easier to
attribute any changes taking place to the relative effects of the intervention and not to any
pre-existing factors. However this is achieved at the cost of having to prescribe certain
user behaviours in the interests of conducting an experimental, rather than observational,
study. So, for example users may be asked to give prior consent to receiving training six
months later in the “control group” than in the corresponding experimental group. Again
Eldredge (2002a) has identified such intervention questions as:
.
Does weeding some classification ranges in a monographs collection result in
higher usage than the unweeded but otherwise similar ranges?
.
Which methods of teaching search skills result in clinicians searching for their
own evidence in patient care?
.
Do students learn searching skills more effectively from librarians or teaching
faculty?

Exploration questions typically seek to answer the question “why?”. As such they
frequently employ qualitative research designs. Factors mediating the intended effects
of some new service or training course are often grounded in variations in human
attitudes, opinions, feelings, thoughts or behaviours. As such they cannot be easily
explored in a large quantitative study where there is a predefined assumption, or
hypothesis, of how an intervention might work. Single studies for answering
exploration questions may be used to generate a hypothesis for subsequent exploration
in a cohort or randomized controlled study. Alternatively they may be used to explore
an effect that has been demonstrated in a quantitative study but which has not been
satisfactorily explained. For example, trainers frequently report that, while initial
training usually reduces anxiety, perversely further training may increase anxiety.
Only a qualitative study would be able to explore why this might occur – perhaps
revealing that a certain level of training may make readily apparent how complex it is
to obtain a full understanding of the subject being taught. Thus, for a student with no
knowledge of database searching it may be reassuring to learn how to search the ERIC
database. However, once they have obtained this valuable insight if we continue to
cover all the other databases available within education their initial anxiety may be
replaced by a different yet related concern – a qualitative study would reveal if this is
 the case. Of course qualitative research is not, in itself, a single research design but Clear and present
comprises a toolbox of such methods as “focus groups, ethnographic studies, questions
naturalistic observations, in-depth interviewing, Delphi techniques, nominal group
processes, and historical analyses”. Eldredge (2002a) has again identified such
exploration questions as:
.
Why do potential users, who are presently non-users, not use their library?
.
Why do some users prefer certain information resources over equally relevant
361
information resources?
. Do librarians improve or worsen users’ perceptions of information overload?

Of course, reducing library practitioner questions into these three discrete categories
may have the unintentional effect of blurring the wealth of information practice that
may be subject to a questioning approach. Exponents of evidence-based healthcare (the
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Evidence Based Medicine Working Group, 1992) devised a mixed typology including
both question-types, for example, diagnosis, (a)etiology, prognosis and therapy and
study types (e.g. economic analysis, systematic review, practice guideline). A more
purist typology for evidence based information practice (Booth, 2004b) might include:
. information needs;
.
information behaviour;
.
causation;
.
information delivery;
. use studies;
.
interventions to promote uptake and utilisation of resources;
.
information retrieval;
.
information presentation;
.
information impact;
.
cost-effectiveness/cost-benefit; and
.
service organisation and management.

Booth and Brice (2004b) use this taxonomy as a strategy for developing the CRISTAL
series of user guides, based on question types as opposed to study types, to enable
librarians to ask meaningful questions of published research. Currently such guides
exist for category 1 (Information needs) and category 5 (Use studies).
Crumley and Koufogiannakis (2002) have explored in much detail six domains of
library practice and their corresponding evidence base:
(1) Reference/enquiries – providing service and access to information that meets
the needs of library users.
(2) Education – finding teaching methods and strategies to educate users about
library resources and how to improve their research skills.
(3) Collections – building a high-quality collection of print and electronic materials
that is useful, cost-effective and meets the users needs.
(4) Management – managing people and resources within an organization.
 LHT (5) Information access and retrieval – creating better systems and methods for
24,3 information retrieval and access.
(6) Marketing/promotion – promoting the profession, the library and its services to
both users and non-users.

They suggest that matching librarianship questions to one of the above domains, or a
362 subsequently added domain of professional issues (Koufogiannakis et al., 2004), can:

.
help librarians decide the appropriate search terms to answer that type of
question;
.
determine the sources to be used to answer these questions; and
.
allow librarians to focus upon what they are really asking, rather than permitting
the question to snowball in many different directions.
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Structures for formulating questions

Clearly much work remains in establishing a consensual framework within which to
group and characterise questions for information practice. A further area of activity
which parallels developments within evidence-based healthcare is work to devise a
structure or “anatomy” for a “focused” or answerable question (Richardson, 1998;
Flemming, 1998; Geddes, 1999). Drawing on the terminology of epidemiology (the
study of populations), evidence-based practitioners are encouraged to analyse the
components of a foreground question according to four common features:
(1) population – the recipients or potential beneficiaries of a service or intervention;
(2) intervention – the service or planned action that is being delivered to the
population;
(3) outcomes – the ways in which the service or action can be measured to establish
whether or not it has had a desired effect; and, optionally
(4) comparison – an alternative service or action that may or may not achieve
similar outcomes.
Booth (2004b) illustrates this with an example that bridges the information
practice/healthcare domains: in pregnant mothers (population) is a touchscreen
information service (intervention) more effective than printed information leaflets
(comparison) in terms of knowledge of factors likely to cause prenatal harm (outcomes).
Occasionally the “I” of intervention in this PIOC or PICO mnemonic is replaced by
“E” for exposure where an action is unintentional or unplanned. For example,
increasing illiteracy (exposure) among school-leaving teenagers (population) measured
in terms of employability (outcome) compared with literate schoolchildren
(comparison) yields a similarly focused question (Booth, 2004b). Of course not all
questions have all four components present – indeed where only two components exist
they are what we have previously characterised as “background questions”
(Richardson and Wilson, 1997).
Once we have identified a topic which carries uncertainty, a specific question needs
to be defined in terms of its components. Does this uncertainty relate to all users or to a
particular group of users? Is it a particular service, or aspect of a service, that is
causing disquiet? What are the options or alternatives? How would you know if you
 could have done things better? Crumley and Koufogiannakis (2002) thus recommend Clear and present
that “Librarians should consider adopting a modified form of the well-built clinical questions
question (commonly known as PICO) for EBL”. Booth (2004b) responds to this
exhortation by devising a mnemonic – SPICE – which makes two significant changes
to acknowledge the particular needs of our profession. The first change recognises that
information practice is a social science, not a “hard science”, by splitting the population
component into both setting and perspective. This recognises that evaluation within 363
information practice is typically subjective and requires definition of the specific
stakeholder view that is the focus (e.g. undergraduate students, doctoral students,
academic staff, library staff, library managers, etc.). The second change is to encourage
a broader evaluation framework than might be indicated by the component
“outcomes”. This term is considerably more ubiquitous in healthcare than in
information practice where other terms might be preferred. By replacing “outcomes”
with “evaluation” the SPICE model incorporates other concepts such as “outputs” and
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“impact” together with less tangible effects of a library or instructional intervention.

The resultant SPICE framework thus comprises:
.
Setting – where?
.
Perspective – for whom?
.
Intervention – what?
.
Comparison – compared with what?
.
Evaluation – with what result?

So, from the perspective of an undergraduate student (perspective) in a university

library (setting) is provision of a short term loan collection (intervention) more effective
than a general collection (comparison) in terms of the percentage availability of
recommended texts (evaluation)?
Cynics may argue that there is, in fact, minimal justification for developing a
separate variant of the focused question specifically for information practice. It is true
that question formulation is not the prerogative of evidence-based practice, and other
models of question formulation, such as the typology devised by White (1998), may
appear more intuitive to an information professional. Even within evidence-based
practice other variants exist such as the ECLIPSE model devised by Wildridge and Bell
(2002) for questions regarding health policy and management. Indeed the SPICE model
may be dismissed as simply a mechanism for turning a once-implicit information need
into an answerable question – a means of getting people “to tell you what they want,
what they really, really want”. Such a facetious comment is supported by White’s
observation that the study of questions provides an “insight into the mental activities
of participants engaged in problem solving or decision making” (White, 1998).

Matching the research design to the question

A valuable principle established by the evidence-based healthcare movement is that
practitioners should not waste energies in arguing the inherent superiority of one
particular research paradigm or philosophical approach. Instead, the most appropriate
study design should be selected for each type of question (Sackett and Wennberg,
1997):
 LHT Our thesis is short: the question being asked determines the appropriate research architecture,
strategy, and tactics to be used – not tradition, authority, experts, paradigms, or schools of
24,3 thought.
Booth (2001b) models this process by taking three questions identified by the Medical
Library Association and attempting to match them to an appropriate research design.
Within the specific context of user studies Wildemuth (2003) makes a useful distinction
364 between questions that call for “extensive” methods and those that call for “intensive”
methods. Such a catholic approach to evidence and the range of study approaches
available to generate it goes some way towards countering Plutchak’s recent objection that:
As Eldredge and others have pointed out, the key to applying evidence-based principles is to
be sure to ask the right questions, and I have not been convinced that the questions that are
most important to librarianship are the kinds of questions that are amenable to the sort of
rigorous investigation that EBL, it has seemed to me, calls for (Plutchak, 2005).
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Evaluating the impact of formulated questions

In a recent communication to the evidence-based-health discussion list (August 2005)
Scott Richardson, an early proponent of question formulation, outlines seven potential
benefits from the question formulation process. Although research into question
formulation within our own professional context is much more immature it is
nevertheless possible to extrapolate that these benefits, albeit slightly reworded, also
exist for our own evidence-based practice:
(1) to use our scarce learning time on evidence that directly relates to our users’
needs;
(2) to optimise our scarce learning time on evidence that directly relates to our own
learning needs;
(3) to suggest high-yield search strategies;
(4) to suggest the forms that useful answers might take;
(5) to improve articulation and communication of problems with colleagues;
(6) when teaching, to help our learners understand the content of what we teach,
while modeling a useful skill for lifelong learning; and
(7) to build both our knowledge base and our learning skills and to reward (rather
than punish) curiosity.

Research within evidence-based healthcare suggests that a structured approach to

question formulation causes those who have learnt this to:
.
ask more questions (Villanueva et al., 2001);
.
undertake more searches (Cabell et al., 2001); and
.
use more detailed search methods and find more precise answers (Booth et al.,
2000; Rosenberg et al., 1998).

Precise questions have been linked to more efficient searching for the needed evidence
(Snowball, 1997; Eldredge, 2000b): “Fuzzy questions tend to lead to fuzzy answers”
(Oxman and Guyatt, 1988). Additionally, as many initial questions lead to other
questions, the question formulation process is an iterative activity (Eldredge, 2000a).
 Practitioners’ questions versus researchers’ questions Clear and present
There is a frequently reported mismatch between questions generated by practitioners questions
and those addressed by researchers. For example, Farmer and Williams (1999) asked:
“Why are practitioners’ research priorities so much more concrete than those of the
funding bodies?” – a theme echoed by Dwyer (1999) when she described the
practitioner’s “focus on answering practical questions”. While the initiative of Jonathan
Eldredge and his colleagues on the Medical Library Association’s Evidence-Based 365
Librarianship Implementation Committee (EBLIC) in asking practitioners to identify
the “most important research questions facing the profession” (Eldredge, 2001) is to be
commended, there is a danger that such lists are dominated by questions around new
technologies and interventions (“what we know we don’t know) rather than central
practices and procedures (“what we don’t know we don’t know”).
Such a complaint is by no means unique to the information sector with frequent
tensions between demand-led and more strategic approaches to research priorities.
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Within a health service context it has been bemoaned that question answering focuses
on the margins of the health services where new technologies make a peripheral
contribution rather than on the less glamorous core business. This situation is
compounded by the fact that researchers, and indeed research funders, are more likely
to be beguiled by keyhole surgery and neurological scans than by bandaging and
injection administration. What are our equivalents of bandaging and giving injections?
– things that we do every day without questioning our procedures and practice. These
should be the focus for our clear and present questions.
Bexon (2005), in a recent conference presentation, concludes that while
evidence-based librarianship is feasible “there needs to be a greater emphasis on
identifying relevant questions and applying the appraised evidence to real life”. In this
connection Crumley and Koufogiannakis (2002) provide the actionable
recommendation that “librarians should consider keeping an online list of questions
that have already been studied and those that need to be explored, similar to the trial
registries in medicine”.

Conclusion
Formulating the question is fundamental to evidence-based practice, irrespective of the
discipline involved. Question formulation, and indeed question answering, is a key
competency for our profession. Our practice may be informed both by research within
information science and by wider developments in evidence-based practice. Much
remains to be done in constructing a comprehensive typology of question types and
identifying priorities for primary research and for secondary literature review. Once we
have established the extent to which questions generated by information practitioners
have already been addressed the way will be clear for tackling the outstanding
questions that currently present themselves for our attention.

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Further reading
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8 August, No. 16, available at: www.jiscmail.ac.uk/evidence-based-health

Corresponding author
Andrew Booth can be contacted at: a.booth@sheffield.ac.uk

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