Importance of Including the Role of Clinical Medical Librarian in Library and Information Science Curriculum Development: A Review

Today Clinical Medical Librarianship fulfill many critical roles in the hospital setting by providing the correct information at the right time in a variety of ways to enhance the effectiveness in productivity of hospitals and medical staff. The other roles that have to play are optimize patient care, improve patient outcomes, and increase patient & family satisfaction about the services provided by the hospital. As Clinical Medical Librarians (CMLs) and their services provide an excellent return on investment for the hospital and help keeping its competitive edge, hospital staff should have access to the services of a professional librarian. The aim of this study is to use the findings from the literature to highlight the necessity of the Library and Information Science (LIS) curriculum to contain the role of the CML as well as the specialization course content of Clinical Medical Librarianship covering content distribution, learning protocol, and practical planning. Thus, the results of this study can be used as the basis for future developments in the Library and Information Science curriculum to provide a more appropriate and detailed curriculum that covers the required pedagogy on Clinical Librarianship. Relevant research articles published in 2000-2020 August were selected through a literature search. The 575 of those selected articles were further scrutinized for relevance and uniqueness. Then the three hundred twelve articles were selected for this study considering the relevance to emerging roles, professional settings, and contexts of CMLs. The importance of generating CMLs with the requisite skills, knowledge, and certifications is revealed by this study. As a result, it is suggested that a syllabus outlining the role of CML be added into the existing LIS curriculum in Sri Lanka. Further study recommended that the role of CML has evolved to meet the demands of healthcare now by taking their skills and expertise to the point of need and the role of CML appears to be an important member of the medical team, according to this study.


Introduction
The term "Clinical Librarian" was first used in 1971 by Gertrude is closely linked to the healthcare system, which identifies the information needs of healthcare providers and patients (Lappa, 2009).
Today the unique role of the CMLs has become more prominent, surpassing the role of the hospital librarian. CMLs provide health related medical information such as new therapeutics, clinical and standardized tests, guidelines, treatment modalities, drug monographs for the clinicians, nurses, allied health professionals, and other members, and the public at a time when information is needed for diagnostic process, treatment plan and general instructions. However, compared to the programmes and degrees offered for CMLs in the world, it is arguable if the current Master's programme in Library and Information Science (LIS) in Sri Lanka lack in providing adequate educational preparation for students who wish to work in the field of health information (Detlefsen, 2012). Since the provision of health information services is rapidly evolving, and a need for specialized library professionals is rising, it is essential to focus on creating and updating the cross disciplinary curriculum of higher vocational education (Detlefsen, 2012;. Specifically, outdated curricula and specific learning outcomes are often overlooked by the current emerging demands and challenges faced by healthcare libraries (Blake & Ballance, 2013;Wilson, 2008).
Furthermore, LIS educationalists have failed to develop in them an adequate understanding of the required training for Evidence Based Medicine (EBM) and updating CMLs activities through learning the LIS series (Detlefsen, 2012;Greyson et al., 2013;Lasserre, 2012;Dilhani et al., 2020). It has resulted in the issue of inadequate guidance and counselling for the students of the LIS who are pursuing a career as CMLs and then moving on to continuous professional development based on the general knowledge of librarianship which disconnects them from the specific skills requirements for it (Cooper & Crum, 2013).
In 2017, the Medical Library Association (MLA) published an updated list of professional competencies for Health Information Professionals (HIPs) titled "Competencies for Lifelong Learning and Professional Success," which includes (1) information services (2) information management (3) instruction and instructional design (4) leadership and management (5) (Ma et al., 2018). Attempts were made to review this scope to contextualize those professional skills and link them to the use of practical health information, to identify basic and theoretically achievable evolving CMLs skills and related professional settings through LIS curriculum development. It further extended to core journals in LIS as well as specialized health care journals.

Problem Statement
Changes in medical information together with education and healthcare have revolutionized the healthcare delivery system. In this context, the provision of health science/medical information service has become a specialized library professional field which is rapidly evolving (Ma et al., 2018). In line with these changes, health information professionals are compelled to move away from their traditional roles to take on new roles in order to meet the emerging needs of their users. The role of CML is becoming important in many aspects and becomes essential in certain situations in the university and clinical settings. With emerging needs and future trends, it is envisaged that a pool of trained and skilled, CMLs will be a necessity for the health care delivery system of the country. These librarians should be equipped with required competencies to face challenges. Therefore, it is important that a mechanism should be available for them to acquire the necessary knowledge and skills through the LIS in the country.

Objective of the Study
There is a need for the roles of CMLs in the Sri Lankan Library system. Therefore, the objective of the article is to introduce the concept of the CML into the LIS curriculum of the Sri Lankan system by reviewing the literature.
In this context, the following two research questions need to be addressed when introducing CMLs as an essential component of LIS education in Sri Lanka.

Research Questions
• Based on the research published from 2000 to 2020, how do the professional role of CMLs and their activities evolve?
• Could these identified roles be mapped on to the emerging needs and future trends of the Sri Lankan context and recommend the importance of inclusion of the role of CMLs in the LIS programmes in Sri Lanka?

Research Methodology
Databases searched included ScienceDirect, PubMed, EBSCO and HINARI. Search queries were tailored for different databases according to their respective controlled vocabularies:
While the definition varied across studies, overarching themes indicated that CMLs are taking on more active roles and functioning as teachers, collaborators, research experts, scholars, and content managers rather than more passive and exclusive roles as information providers, information outreach agents, or research assistants (Blakeet et al., 2014).

With such a large and loosely established professional position for
CMLs, it is difficult to reach a consensus when it comes to linking embedded librarianship to needed professional core competencies, as well as meeting the research objectives of the study. As a result, embedded librarians' responsibilities were divided into distinct positions based on their actual job responsibilities (Hageman, 2019;Hinrichs et al., 2020;Ma et al., 2018).  providing teaching and training to support evidence based practice. These activities will necessitate a high level of more complex abilities, as well as more engagement between CMLs and medical team, patients and community service programs.
CMLs must possess a variety of abilities in order to successfully fulfill their responsibilities of supplying information to medical teams.
Various studies have discussed CMLs' responsibilities and roles, as well as the various vital talents that they must possess in order to work on clinical teams as shown in the Table 1.

As an Expert Searcher
As an expert searcher, CML assists and guides medical students and other affiliated healthcare professionals on how to use medical software programmes, online databases, online resources, how to use search engines for EBM, and how to search the Internet for up to date as well as other medical health related information and services. Expert searching is characterized as a mediated process in which a patient with an information need seeks advice and assistance from a recognized expert, as defined by the MLA (2005) in the sense of this policy document. The known expert leads a quest that brings together and synergizes all of the essential skills and knowledge. Lasserre (2012) reported that the health science librarian's expert search is important and essential as it supports evidence based training and clinical error prevention related to basic functions performed by clients. As an expert searcher CMLs perform his or her role well, using his or her skills and up to date knowledge in an ethically resource efficient manner, providing healthcare professionals and the community, as well as patients and their families.

As a Communicator
Cheek (2010)

As a Collaborator
Though librarians have always been engaged in this role, its importance in collaboration started growing when more librarians were called to work on research teams and systematic review groups (

As a Patient Advocate
According to the literature, CMLs provide patient advocacy through outreach and promotion, which requires a thorough understanding of the socio political and cultural climates outside of their institutions. Librarians in similar roles, according to Mayo and Pestonjee (2004), contributed to outreach projects for Spanish speaking communities as well as providing easier access to grey literature. In addition, librarians at the University of Texas hospital system have developed free or low cost informational materials for a "multicultural, predominantly low literacy patient population"; these English Spanish materials are available in both English and Spanish. When delivering care to the community, CMLs may work closely with medical practitioners and other health workers to reduce patient uncertainty about questions.
Public librarians, according to Smith et al. (2014), will help the public by disseminating basic medical health related information and directing users to reliable, up to date information. Further, Schneider (2005) explained that CMLs are needed to assist families, patients, and the general public in locating trust worthy health records so that they can address problems with medical practitioners or seek care. In this type of role, Health Information Professionals (HIPs) often contribute to the development of collection in order to provide the best available health information services for each person, as well as act as expert searchers (Dudden & Protzko, 2011;Greyson, 2011). Researchers addressing the increasing need for culturally competent HIP librarianship recently discussed about the growing need for health information materials and programs to serve LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer) patrons or patients and about their specific information needs, necessitating HIPs to cultivate and practice cultural competency in these populations (Hawkins et al., 2017;Mi & Zhang, 2017;Morris & Hawkins, 2016;Sullo & Gomes, 2016).

As a Content Manager for Scholarly Communication
Despite the lack of literature on the topic, in general, many CMLs are urged for scholarly communication while performing their duties. (2017)  share, manage and protect large amounts of information, as well as intellectual property, copyright and licenses.

As a Teacher
While librarians have been referred to as teachers for many years, their pedagogical responsibilities have changed significantly. HIPs are expected to be able to present and sustain user interaction in active online and in person environments as online curricula and satellite medical education services increase in popularity (King et al., 2014).
Accordingly, CMLs teach doctors, medical students and other affiliated healthcare professionals how to use medical software programmes, online databases, online resources; how to effectively use search engines for evidence based medicine and how to search the Internet for up to date, and other medical health related information and services. In this regard, instruction has shifted them from being a gate keeper of knowledge to being a teacher of self sufficiency. Librarians use a number of pedagogical approaches to provide evidence based practice guidance, and further study is required to decide which methods are the most successful (Alcock, 2017). Librarians have been referred to as mentors and teachers for many years, and today their educational role has evolved considerably. Accordingly, many scholarly commentators are of the opinion that the role of the CMLs are out of the library and more immersed in the user's world /profession.
Based on the literature, five main areas were identified as barriers for CMLs as shown in Table 2: educational, executive, organizational and management, cultural, technological and research.

Conclusion
The current study aimed to introduce the concept of the role of CMLs into the Sri Lankan context. While going through the literature, this study suggested that the CML's role is an essential part for the medical community. Therefore, the activities performed by CMLs are considered to be important and essential today. Besides, patients and their families also seek enormous medical information to clarify certain issues in the hospital setting where they need to have access to a CMLs. Table 1 illustrates required skills, abilities needed and specific duties for CMLs.
Based on reviewed literature, it could identify roles of CMLs which have to be mapped into the emerging needs and future trends of the Sri Lankan context. Based on above mentioned skills, abilities and roles and duties, it could be recommended the importance of inclusion of the role of CMLs in the LIS programmes in Sri Lanka.
This study reveals that producing CMLs with the necessary skills, knowledge, and qualifications is important. Hence a syllabus covering the role of CML is recommended to be incorporated into the existing LIS curriculum in Sri Lanka.

Recommendations
The overall objective in librarianship, to make information available at the point of need, has been strengthened by the philosophy of the programmes of CML. Therefore, it is essential to develop the required competencies via LIS educational programmes, which, in turn, require a proper syllabus to cater for CMLs. Accordingly, the present study suggests that the LIS educators in Sri Lanka have to pay attention to include the role of CMLs in the LIS curriculum. Further, more studies examining the findings of national and international are needed to identify all the opportunities and challenges to carry out a need analysis of the importance of CML's role in the LIS curriculum development and suggest appropriate solutions.

Further Research
Several research issues will need further investigation in the future, according to the findings: