D. Thiessen - Library Blog - Health Science

Scherrer, C.S. (2004). Reference Librarians’ Perceptions of the Issues They face as Academic Health Information Professionals. Journal of the Medical Library Association 92:226–32. [Available on the Web]

            -Academic health sciences librarians may need to assume new roles. Over the last 10 years reference librarians have seen many changes and are facing many challenges. This study used focus groups with reference librarians from both public and privately funded libraries and interviews with directors. The results indicated that changes include more teaching, outreach and designing Web pages in addition to traditional reference duties. Areas needing attention include adult learning theory, specialized databases and resources needed by researchers, technology and promotion and evaluation of the library.

                        Some new roles for health science  librarians include teaching in the professional school, developing evidence based medicine skills that will help with filtering and synthesizing the literature, supporting continuing educations, providing consumer health education, designing and managing electronic information systems,  expanding the liaison’s role, providing outreach as well as traditional reference services.

            RESULTS of the study strongly supported the expanded and changing roles of librarians.  The librarian’s suggested that teaching was the role that had changed the most. The second most mentioned role was outreach – making house calls at offices, points of care or classrooms. The third most mentioned role was Web page design. The responses did not differ greatly between those librarians working for public and private institutions.

DISCUSSION  -

                        1) TEACHING – The librarians required practical tips as well as instruction in setting learning goals, delivering content and appraising results. Knowing all the specialized databases well can also be a challenge, especially the NCBI databases. Patron MEDLINE searches may be quite poor. – “My concern is that sometimes peoples ‘level of confidence with online systems is higher than their competence.” (p. 228) Since MEDLINE is now available for free to anyone, patrons see no need for special instruction, but the searches indicate that there should be some method of instruction. As well, students are often uninterested in book resources and can’t distinguish between resources appropriate for students, clinicians or researchers.

                                    2) OUTREACH – is based on a need to answer patron inquiries by assisting them at their workplace. While many librarians were struggling with how to provide adequate point of care information for the evidence –based practice, they also believed they should be supporting researchers more effectively.

                                    3) USING TECHNOLOGY- Librarians desire to better understand technology and are aware of the learning curve and need to stay current. Often the librarian is the person who must assist with a patron’s difficulty with technological equipment. Librarians need to promote access to resources that are available within the library.

                                    4) REFERENCE DUTIES - While ready reference questions are decreasing, web pages can assist patrons in finding good quality information.

                                    5) INSIGHTS OFFERED BY DIRECTORS - The director’s noted the need for better marketing and public relations.  Outcomes data provide a fuller picture of a library’s performance; quality of service should be measured as well as quantity and frequency.

                                    6)  MISCELLANEOUS OBSERVATIONS -  Copyright is an important area that the librarians wanted to know better.

            I chose this article because one message that has been clearly communicated throughout this class has been the need to evolve in terms of service and technology.  The surveys indicate that many fewer patrons are entering the library, but often the library resources, particularly the on-line resource use is increasing. As a result, the librarians’role is evolving.  There is still a high need for their services, but the types of assistance are changing.  One particularly interesting trend is the possibility of addressing higher levels of needs, including assisting researchers.  I am very encouraged that I have entered this field at this time of evolution and hopeful that I may play a significant role in assisting to meet the library’s mission as it changes.

Doyle, J.D. (2003). A Job with a View: Perspectives from the Corporate Side of the Hospital. Journal of the Medical Library Association 84:209-16. 

            This article is written by the 2002 Doe lecturer as she moves from the position of library manager to hospital administrator. The Janet Doe Lecture is given on the history or philosophy of medical librarianship at the annual meeting of the Medical Library Association. 

            Similar to many of the surveys we have studied this term, Jacqueline Doyle highlights service as the core of her career and the element that has allowed her to continue to love her job despite low pay, poor funding, other’s ignorance about her role and the lack of administrative support.

            In the lecture, she highlights the different focus that administrators have on hospital libraries- the information they value, the challenges they face and what is important to them by using three perspectives – 1) service, 2) technology and 3) a unique sort of professionalism.

1)    Service – The concept of who the patron is, has been more and less restrictive, but Ms. Doyle believes it is of benefit to have an “open to the public” policy. It is also important to convince administrators of the value of acquiring needed items – using a customer centered argument was particularly effective, although previously she had used physician focused arguments and a management focus as well, to line up with the administrator’s view. Return on investment or ROI is also important to administrators. The main points are that service should be

·    Patron-centered

·    High-touch or using high tech to keep it personal and customized

·    Innovative

·    Flexible

·    Evidence-based

2)    Technology – There is a need to continually advance our knowledge and skills. Administrators may not see the advantage of being on the cutting edge.

3)    Professionalism – The article inquires whether librarianship is a profession or a vocation. While the answer tends more towards the semantic, the speaker suggests that a belief or faith in what one is doing is what makes librarianship special. However, administrators often do not understand this definition or recognize the value of the librarian’s focus.

            I appreciated the opportunity to read an inspirational article this week. What was clear in the tone of the article was the passion of the speaker, despite the change in her role.  She understood her new job as an extension of the vision she has always had, as a hospital librarian and it seems clear that the qualities she brought to the library position were valued and respected within the organization, which is why she moved into hospital administration. Her focus seems to have been to work with management and to fit the focus of the library into the corporate model of the moment.  It can be too easy to become cynical or develop an adversarial relationship with the corporate perspective, but often success in this model requires the ability to take a service perspective and recognize how to shape one’s own vision within the corporate strictures. In a hospital setting, a library can be too easily viewed as peripheral or a fringe service.  It is important to align the library with the core values of the corporation and to continue to highlight how the library meets the vision of the larger entity.           

1.    (#)Holst, R. & Funk, C.J. (2005). State of the Art of Expert Searching: Results of a Medical Library Association Survey. Journal of the Medical Library Association 93:45-52. [Available on the Web]
In 2002, MLA members were surveyed and 256 responded  to three general questions regarding  searching expertise, maintenance of searching skills and promotion of searching services in the respondent’s institutions. The respondents believed their search skills were valuable to their institution and that their skill had improved over the last 10 years. Expert searching has declined and was perhaps overstated based on a survey from 20+ years ago. However, a study from McMaster indicated that expert searchers are better in terms of recall and precision.
In 2001, concern and discussion about the decline in the role of medical librarians came to a head with the death of a research subject at Johns Hopkins University, which led to the appointment of a task force on expert searching.
How has the expertise of searchers been of value to their institution? The survey results indicated that mediated searchers requested by users were valued by 95% of respondents. Also consulting for individuals conducting their own searches and providing classes were seen as being of value.
How has the experts’ role been of value to a patient, health care provider or their institutions? The higest result (at just over 50%) was discovering best treatment options at the request of a health care professional.
How much time for reference work? More time is spent conducting searches than teaching.
How have search skills changed over the last 10 years? Most (83.1%) felt search skills had improved based on experience, training as well as other less significant influences.
Based on the survey result, the following actions were recommended by the task force.
-a policy statement regarding expert searching was developed.
-best practices were promoted through the MLA newsletter and website.
-courses on expert searching were offered.
-an email discussion forum about expert searching was developed.
This survey and the resulting article seem to indicate an issue not with the quality of librarian searches but with reality and the perception of reality. The reason for the task force was to recommend actions that would promote the importance of expert searching but the focus of the recommendations is internal to the MLA, not external. The actions taken as a result of the survey seem to address a problem that does not seem to agree with the survey results. The problem as defined and supported by the survey seems to be a marketing problem, not a skills problem on the part of the librarians.  The actions taken may increase the profile of expert searching within the MLA, but it would seem that the problem may be outside of the organization and within the institutions. I am left concerned about how the proposed actions will address the problem and how the task force became diverted from their original agenda.

I found this wiki located at University of British Colombia and related to their health science library and particularly courses in health librarianship.  I am always looking for Canadian sources for the courses I am taking and this one seems quite good, both specific to Canada and as a general resource.  It may even provide sources or information for your term paper.

http://hlwiki.slais.ubc.ca/index.php?title=Main_Page

1.     MacCall, S.L. (2006b). Clinical Digital Libraries Project: Design Approach and Exploratory Assessment of Timely Use in Clinical Environments. Journal of the Medical Library Association 94:190-7. [Available on the Web]

Can digital library collections be organized (so well, so comprehensively) that they can be used for clinical information seeking in a timely way? This study describes and evaluates the use of Clinical Digital Libraries Project (CDLP) as a tool in clinical information seeking. It evaluated a sample of CDLP web server log activity over a 12-month period, looking for timely information seeking after users were referred to this digital library. The interactions were evaluated based on how long to took to gain useful information. Of the 864 searches, 48% were less than 1 minute, 41% were 1 – 3 minutes and 11% were 3 to % minutes.

            The keys to timely information retrieval are systems that contain or point to relevant information and are easy to use. Previously book indexes provided the kind of deep information annotation that allowed for efficient searching. These indexes were consistently structured across different resources to enable consistent search strategies. Currently on-line resources do not have this kind of consistent structure.

            The CDLP is a research, service and teaching project of the schools of library and information studies at the Universities of Alabama and North Texas. Resources admitted to the collection must pass a quality check and include resources from the “invisible Web” .(They are from subscription-based database of full-text resources that are not indexed by typical Web search engines). The CDLP uses the principle of collocation or bringing like items together by topic through links to achieve a sufficient level of granularity to allow for timely searching and retrieval.

            In this study information seeking (seeking an answer to a specific problem) was distinguished from information gathering (searches of more than 5 minutes, which were not included in the study). As well, a limit of 6 hits was used to further distinguish the two activities.

            The results indicate that generally less than 1 minute searches predominate in the various study categories – by institution, by geography and by month and indicates that the CDLP can facilitate timely clinical information seeking by users.

            Since we had discussed the need for deep indexing in class, I was quite interested by this article and the method used to measure the effectiveness of this digital library collection. The challenges seem rather extreme with distributed access through the internet to the collection. Given the challenges, the method seems adequate but perhaps not completely desireable. It would be helpful to know the user’s degree of satisfaction with the results of the queries to the digital libraries. Any resource, if it proves adequate, should  be a consistent source of additional queries, so I would wonder about the number of repeat visits by repeat visitors.  Again this might be hard to track. As a health science librarian, I would generally assume that if a patron found information in the given timelines used for the study, that the search was successful.

Gault, Lora, Shultz, Mary, & Davies, Kathy. (2002). Variations in Medical Subject Headings (MeSH) Mapping: From the Natural Language of Patron Terms to the Controlled Vocabulary of Mapped Lists. Journal of the Medical Library Association 90:173-80. [Available on the Web]

            This paper provides a description of a study that compared the mapping of natural language patron terms to the Medical Subject Headings (MeSH) across six MeSH interfaces for the MEDLINE database. The study period was conducted over 9 months (April-Dec., 1998) with data from search requests made by patrons who used the Library of the Health Sciences at the University of Illinois at Chicago.

            To achieve the greatest recall and precision librarians often teach searchers how to use MeSH to find relevant articles indexed in the MEDLINE database. However there are differences in the interfaces of the vendor products (OVID, PubMed MeSH Browser, PubMed index, Internet Grateful Med (IGM), OCLC with two options for MeSH heading phrase and MeSH headings ). While the interfaces may suggest MeSH terms, the retrieval term choices vary greatly. The researchers collected forms submitted by the patrons to the librarians that provided their search requests.  These search request terms were mapped to the best MeSH terms (432 of 466 unique terms had matches). These 432 terms and phrases were entered into the six interfaces to see how they mapped to MeSH. The conclusion of the study was that the interfaces’ ability to successfully map to MeSH varied greatly and the choice of the interface could be critical to the success of searches.

            The variance in successfully finding the corresponding MeSH term  ranged from 79% for IGM to 44% for OCLC Heading. IGM provided the best success at mapping to the subject headings at 88%, next was PubMed at 72%, OVID at 65% and lower scores for OCLC. IGM is no longer available as a MEDLINE interface. If the correct MeSH term was provided, it generally appeared in the top 5 listings of the mapped lists for all the interfaces. A difficulty with IGM is that it provided the longest list of options, OVID provided the shortest list but still had a relatively high success rate. OCLC uses an alphabetical match to the MeSH while most of the other interfaces used a concept match.  The alphabetical match proved to be the least successful search.

            When the researchers studied the three concept-based mapping interfaces (IGM, PubMED MeSH browser and OVID), they found several interesting points.  Sometimes the cross-references from the printed MeSH were not mapped in the online version. Also the MeSH vocabulary has weaknesses – the search term “ingestion” did not successfully map to the MeSH term “eating” in any of the interfaces. From the study, it is clear that the interfaces are not making use of the full syndetic structure of the MeSH vocabulary (the search term “paramedic” has a see reference to “emergency medical technicians” in MeSH but none of the interfaces offered this search option).

                        There is an untold story here in why the best interface was no longer available by the time the study was released. This study does seem to have provided a very useful background for the choice of a search interface and does mention that no one else had evaluated the effectiveness of the interfaces using a technique to compare mapping to the MeSH terms.  Their methods outlined in the study are more than adequate to provide a good result and the objectives and results of the study provide very good information. However, ultimately the researchers are left with the rather inadequate recommendation that the search features from the failed interface should be incorporated into the other interfaces. I am left wondering if this study was a bit late and what criteria were used prior to this study in choosing an interface.  As a health librarian, this study would be invaluable in the decision about which interface to choose or to recommend.

Okay, so I too am a Canadian-version of an NPR addict - a good day is when I can do my job to the rhythms and discussion of CBC. 

Another excellent podcast on Web 2.0 stuff is the program Spark.  I would recommend the podcast posted this week. There is a feature on a company that provides their employees with a budget to purchase their own computers, which truly become their personal possession.   The Merlin Mann interview is about blogging for first timers and will be an ongoing feature.

On this episode of Spark:

• Spark listeners talk about their workplace computer woes
• Lisagaye Tomlinson and Paul Martine BYOC (Bring Your Own Computer) (full interview with Paul Martine)
• Nora talks to Merlin Mann about his upcoming series
• Jane McGonigal explains Superstruct, and gaming for the greater good (full interview)

2008-10-08 - Episode 48

http://www.cbc.ca/spark/

One item featured on the podcast is a reference to a couple of games.  I am not a gaming person, but these caught my interest - particularly http://www.chorewars.com - the ultimate family chore chart which allows the games mistress to post weekly chores that are completed for on-line points and prizes - I can see nirvana now.  Well perhaps just serenity now.

Lagu, T. et al. (2008). Content of Weblogs Written by Health Professionals. Journal of General Internal Medicine. Vol 23, #10/ October 2008. P. 1642-1646. [Available on the Web]

            -This study reviewed 5 blog entries for each of 271 medical-focussed blogs found through a Google search using the term “medical blog” for entries posted in the calendar year of 2006.  The entries were reviewed for scope and content and to determine how often they commented about patients, violated patient privacy or displayed a lack of professionalism. 

            -The results indicate that many health care professionals are easily identified in their blogs by the personal information they provide and that some patient information is revealed that may breach confidentiality.

            -The article contains a list of several links to medical related blogs which may be useful to fulfill the aggregator assignment for this class.

            -Three observations made about blogs

                        -1) medical blogs are now part of the literature and media of medicine

                        2) Medical blogs are part of the public face of medicine. This media is much less structured then most other medical communication – conferences, articles. Some authors censor themselves less than may be wise for a public presentation.

                        3) Medical blogs derive their credibility from their relationship to the health professions and reflect on those fields. However some blogs have a very unprofessional presentation in tone or content including negative comments about the profession, infrastructure or patients.

            I found this article very interesting and perhaps a bit short-sighted.  Medicine, as a profession, has a long and distinguished reputation, and yet obviously people are interested in the human dramas behind the professional demeanor. Hence the success of so many dramas set in hospitals – from Marcus Welby in the 1970s to ER through the 1990’s and 2000’s. While caution should be advised when it relates to the possible exposure of a patient’s personal information, I believe the profession can withstand the personalization and individualization that may come from blogs.  One radio program I quite enjoy is the CBC series “White Coat, Black Art” which airs weekly and is available by podcast.  I was hooked from the first broadcast, which addressed why we wait to see a doctor.  I particularly appreciated their description of the need to stop the clock to deal with certain issues – whether it was a patient’s personal life interfering with their health or the need to tell a patient some very bad health information.  The stories on this program are intensely personal and occasionally negative in nature. Someone who knows the doctors and health professionals who are heard on the program could probably identify the patients from the stories that are told. However, as long as the names of the patients are not used, there can be no unequivocal certainty as to the identity of the patients.  Likewise negative comments themselves are not unprofessional. It may be advisable to provide a code of conduct for health professional’s web blogs (and other communication), but I believe these blogs can access personal stories and critiques that may be of value and provide insight to the public.

(#) Tenopir, C., King, D.W. & Bush A. (2004). Medical Faculty’s Use of Print and Electronic Journals: Changes over Time and in Comparison with Scientists. Journal of the Medical Library Association 89:8-20. 

            -Objective – determine how medical faculty use scholarly journals, whether print or electronic journals are read more, patterns among types of users and similarities and differences regarding use of journals by medical faculty and other faculty.

            -Results – medical faculty read more than scientists to support primary research and tend to refer to print journals versus electronic.

            -Previous studies by Tenopir have found medical faculty are more resistant than other faculty to change because they are more reliant on journal articles to stay current. Three questions to be asked:

                        -How do medical faculty use scholary journals?

                        -Are print articles or electronic read more?

                        -Is there a pattern among types of users?

                        -What are similarities and differences between use of journals for medical and other faculty?

            -Literature Review – Curtis, et al found health sciences faculty use personal subscriptions as source of journal articles. Hurd study at U/Illinois at Chicago found 78% of scientists and 54% of engineers read journals in the library. Tenopir study found personal print or electronic subscriptions have declined from 5.8 in 1977 to 2.2 in 2000/2001 for scientists due to rising costs. Stinson and Mueller found personal subscriptions were most common source for articles for medical personnel. Williamson study indicated medical personnel found volume of material to be unmanageable.

            -Methods – Population is over 1000 medical faculty at University of Tennessee (UT). Survey sent randomly to 263 faculty in 2000/01. Return was about 30% at 79. Respondents varied by age and from diverse fields. Asked questions regarding what was read and what was read in depth. Average readings was 26.8/month. Over 60% were from personal subscriptions.

            -Discussion – Faculty read a lot but there is also a large variance in the reading.  Highest was 120 readings/month and least was 4/ month. King study results suggest this is higher than for non-faculty medical professionals but is still higher than for other scientists.  Tend to read scholarly articles which are considered essential for primary research. Also important for teaching, writing and consulting or advising others. 54 % of  articles were considered to  present new information and were useful. Med. Faculty tend to read thoroughly. About 120 hours/ person/ year are spent reading scholarly articles. Most readings were from articles published in the last year. Those who read more tend to have had an article published in the last two years. Also award winners tend to read more. About 22% of readings by medical faculty are from library-provided articles and tend to be described as more valuable. 70% of study readings were from print and generally their own subscriptions (verified by other studies). From previous studies, Tenopir found scientists tend to find articles by browsing and tend to read much less from personal subscription. Faculty with doctorate tend to use electronic resources more. No difference by age in this study in terms of how information was accessed.

            -Conclusions – Medical faculty read more articles but spend less time reading the articles. Challenge for publishers and librarians in providing access to information in efficient manner.

            Comments – I found this particular study to be a gold standard in terms of research.  The comparisons with other studies, the background of research which was drawn upon and the clarity of the evaluation all made this an excellent example of fine research. I also appreciated the depth of the research – the comments about award winners and those who had recently published articles reading more, suggests that the researchers had given their survey a lot of thought and determined how to get additional value out of the results. The results of the study were both surprising and enlightening in terms of thinking about how to respond to the resulting information needs and how to reconcile these results which seem to contradict the other studies, including particularly deGroote