Time to set a standard for the standards: health libraries provide crucial support for Australian medical training programs

Health libraries are a critical component of the infrastructure required for post‐graduate medical training and are referred to in the accreditation documents for health services intent on providing medical training. Accreditation documents for medical training are provided by the Australian Medical Council, state‐based associations, and specialty programs overseen by the individual medical colleges (such as the Royal Australian College of Physicians). These documents set the standard for educational resources and facilities for medical trainees, including health libraries.

The 2022 Health Libraries Australia (HLA) Guidelines1 define a health library as:

• a collection of evidence‐based resources, such as books, ebooks, journals;
• a set of services to facilitate access to the collection, such as literature searching and collection management (ie, maintaining the currency of the collection); and
• a space that prioritises research and education (ie, separate from clinical areas) with access to computers, collections and staff to assist in research and education.

Medical colleges and associations adopt their own definitions of what is needed to support medical trainees in Australian hospitals, which gives rise to inconsistency.

In early 2023, we performed a content analysis of the accreditation documents of 52 medical colleges and associations to quantify this discord, using the HLA definition, and a conceptual analysis approach to the text provided by each college and association.2 Information extracted from accreditation documents was analysed in a spreadsheet by two researchers. Data were organised under these categories: Collections, Services, Space and the use of the noun “Library” and exceptions for journal access. All providers (100%) included a requirement for some level of library support for their medical trainees, but with varying information about what this entails.

Most providers (87%; n = 45) required host organisations to provide access to collections, particularly journals, with some colleges prescribing texts to be supplied to trainees. Requirements for library space were mandated by 54% of providers (n = 28), with 42% of providers (n = 22) specifying library services as requirements.

Trainees undertaking research projects benefit from library services such as education, which builds research skills capability. Additionally, library services support trainees in how to find and evaluate literature as well as providing intensive support for investigator‐led studies and evidence syntheses such as systematic and scoping reviews. We found frequent use of the noun “Library” in accreditation requirements, with 43 providers (83%) making general reference to “a library”, a “medical library” or “adequate library” as a core requirement for trainees. Libraries and library support is clearly valued in the medical education context; however, inconsistency in accreditation standards risks inequities for trainees across various medical disciplines who need library support to complete their medical training.

Given the inconsistency and vague terminology identified in our content analysis, and considering the essential support provided by libraries for medical education, developing a benchmark accreditation standard that adequately covers all components of the HLA definition is strongly recommended. Colleges and associations are urged to adopt the following statement as they update their accreditation requirements and partner with health librarians to ensure fair and equitable access to information resources, education space and specialist support by trained information professionals.

Recommended accreditation standard for library support for medical trainees:

• There is access to a curated collection of high quality information via a health library with online access appropriately configured for [physician] training.
• The health library is staffed by qualified librarians with expertise in literature searching and research practices and who provide training and individualised support to trainees undertaking research.
• The site shall provide access to a physical health library space with current and relevant resources, study space and computing facilities equipped with supportive software for research.

This recommendation has been endorsed by the Australian Library and Information Association, Health Libraries Australia (ALIA HLA).2

In summary, all medical trainees undertaking post‐graduate training in the Australian health care sector should expect equitable access to evidence‐based resources, study space and library support. Although there is a consistent expectation for general library support across medical education providers, extensive inconsistencies in accreditation requirements arise from non‐specific terminology and differing references to library collections, services and spaces. We recommend a comprehensive standard based on a national definition of health libraries. It is hoped that colleges and associations adopt this statement to improve consistency and equitable access to education and research supports. This will ultimately ensure Australia produces a highly skilled medical workforce that implements evidence‐based care.