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Tying it all together: The Integrated Academic Information Management System being implemented at Maryland.

With the National Library of Medicine serving as the catalyst, the University of Maryland at Baltimore, Campus for the Professions, entered into a major initiative to integrate information management systems in support of the campus missions of education, research, and clinical care. Strategic planning initiated the integration process and continues in an iterative mode. In support of integration, changes were made in the campus organizational structure and in its technological infrastructure. Implementation involves transforming the Information Resources Management Division into an information utility on a phased and incremental basis. Collaboration with the Health Sciences Library is key to this transformation, as are numerous outreach activities.

Computers↗

International cooperation and the European Association for Health Information and Libraries.

This paper describes cooperation between European libraries: what EAHIL hopes to achieve, and how it may be done. Since its founding in 1987, EAHIL has been working for professional development and to improve cooperation and exchange of experience amongst its members. In 1995 a working programme entitled 'EAHIL--Aims towards year 2000' was approved, and it consolidates some of the most important aims of EAHIL. In this paper, only three of the six aims are referred to: conferences and workshops arranged by EAHIL, the development of an efficient network system in order to increase communication and information among members, and the establishment of agreements for cooperation with medical and health science libraries in Eastern and Central Europe in particular.

Communication↗

Building the library/information center of the future.

Changes in the mission, roles, and infrastructure of academic health sciences libraries pose an enormous challenge to those designing and planning new library buildings. The library will be judged by its ability to respond to changing information dissemination patterns, changing missions, technologies not yet contemplated, and curricular trends, notably the rise of informatics and problem-based learning. Key questions are posed; the answers will shape library building now and in the future.

Architecture↗

Clinical teaching and learning in midwifery and women's health.

Although there is an abundance of literature about clinical teaching in the health professions, a much smaller body of information focuses on the art and science of clinical teaching in midwifery and women's health. We reviewed preceptor handbooks, training manuals, and Web sites created by nursing and nurse-midwifery education programs, medical and pharmacy schools, and national associations of health professionals. Using the search terms "clinical teaching, clinical learning, preceptor, clerkship, residency training, and midwifery education", we searched the MEDLINE and CINAHL databases and health sciences libraries for relevant articles and books. The information and practical strategies about clinical teaching that we found are synthesized and presented in this article. It includes a discussion of challenges in clinical teaching; an overview of expectations and responsibilities of the education program, students, and preceptors; suggestions about orienting students to clinical sites; clinical teaching strategies and skills; suggestions for incorporating critical thinking and evidence-based care into clinical teaching; guidelines for giving constructive feedback and evaluation; characteristics of excellent clinical teachers; and suggestions about how education programs and professional associations can support and develop clinical sites and preceptors. The Appendix contains manuals, books, and Web sites devoted to clinical teaching.

Clinical Competence↗

The conceptual validity of a taxonomy of nursing interventions.

The purpose of this paper is to report validity evidence for the nursing intervention taxonomy developed as part of the Nursing Intervention Lexicon and Taxonomy (NILT) Study. Using eclectic classification methods of library science, cognitive science, nursing science and computational linguistics, a taxonomy of nursing interventions consisting of seven categories was developed. These categories which incorporate care as a central concept are described and defined, and prototypical examples of each category are presented. Brinberg & McGrath's validity schema provides the framework within which evidence for validity as value, validity as correspondence and validity as generalizability were examined. Comparison of the NILT categories with previously published categorizations of nursing functions and interventions provides strong support for the validity of this classification. Additionally, comparison of the NILT categories with two internationally derived categorizations of nursing functions supports the robustness or generalizability of the NILT classification.

Job Description↗

Mirage or reality?

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Evidence-Based Medicine↗

Patterns and costs of printed and online journal usage.

This study in an academic medical sciences library setting examines the correlation of usage of a matched set of print and online titles, the validity of e-journals usage statistics and the impact of online journals on print journal usage. The print and online usage was determined for 270 journals, both versions of which were available. Print usage was determined annually since 1997 using the reshelving and the error-copies method. Online usage statistics were delivered by five publishers and corrected for redundant multiple accesses. Print journal usage decreased by 22.3 and 30.2% respectively over each of 2 years after the introduction of online journals. Journals published both in print and online lost 30.4% of their print usage within 2 years. The total loss of usage of print-only titles in the same period was somewhat higher, at 45.8%. The average correlation between online and print usage is 0.60 and 0.67 respectively. For the examined titles, users accessed the online versions ten times as often as the print version. Two clearly distinguishable groupings emerged: while with Academic Press and Elsevier, e-journal usage exceeded print usage by a factor of 3 or 4, the e-journals of Blackwell, HighWire and Springer were used on average 14.6 times as frequently as the corresponding print journals. Each usage of a print article cost 2.79-50.82 Euro, each usage of an online article 0.31-15.10 Euro, depending on the publisher. On average, the usage of an online article was 5.4 times cheaper. Within 2-3 years the usage of online journals has outstripped that of print titles by a factor of ten, but the specific spectrum of usage remains much the same as when only print journals alone existed. Print titles not available online suffer a greater decline in usage compared with print/online journals. This confirms that what is read or purchased is determined primarily by ease of access and that there is a steady tendency to reduce the multiplicity of access modes to a manageable few. The availability of journals online seems to have created a new clientele, at least in the case of the German-language Springer journals. The connection between supplier and supply is much less clear with e-journals than it is with print titles. Therefore it is very important to stress and encourage the role of the library as the supplier of this sort of information in the university environment. Collection building issues are discussed in the light of the results.

Costs and Cost Analysis↗

An evidence-based evaluation of EMS protocols.

OBJECTIVE: To determine the extent to which prehospital patient care protocols incorporate the findings of the peer-reviewed scientific EMS literature. METHODS: Using a computerized literature search, articles published from eight institutions known to be active in prehospital care research were identified and obtained from the local health sciences library. Animal or bench research, analysis of administrative practices, evaluation of educational or quality assurance techniques, collective reviews, and air medical articles were excluded. We compared the findings of each article with the guidelines contained in 12 sets of prehospital care protocols, ranking them as: 1) consistent; 2) partially consistent; 3) not discussed; or 4) not consistent. The rankings for the article-protocol comparisons for each EMS system were compared using the Kruskal-Wallis test. RESULTS: Forty-nine papers were compared with 12 sets of protocols, resulting in 588 comparisons. More than half (53.1%, n = 312) of the comparisons were ranked as "consistent." Only 28 (4.8%) of the comparisons were found to be "not consistent." There was no significant difference in the rankings assigned to the comparisons for protocols from each individual system, nor in the rankings for protocols from the EMS system associated with the source of the article, from other systems with academic affiliations, and from systems without academic affiliations. CONCLUSION: Most EMS protocols are consistent with the published peer-reviewed research. There is no difference in the level of consistency when comparing protocols from EMS systems associated with the source of the articles, those associated with other academic institutions, and those without strong academic affiliations.

Clinical Protocols↗

A randomized trial of librarian educational participation in clinical settings.

In order to evaluate the librarian's educational role in patient care settings, an information service was provided for health professionals, patients, and families by two part-time clinical librarians. Eight clinical areas were randomly selected from a pool of settings which met predetermined entry criteria. Four of these settings were randomly allocated to the experimental maneuver (that is, the clinical librarian service), and four were control settings. Results showed that the clinical librarians were accepted by health professionals and that services to all groups were viewed as successful. Significant differences in information-seeking patterns were found between study and control groups of health professionals. In particular, the study group was more likely to use the library for direct patient care and rated the librarian and library resources more highly as sources of information. This time-limited and education-oriented model would be useful for settings in which a full-time librarian program is not feasible.

Attitude↗

AHEC in West Virginia: a case study. Area health education centers.

This case study describes the area health education centers (AHEC) program in West Virginia, spanning 30 years from a first-generation project at Charleston in 1972 (AHEC 1) to a newly funded statewide program (AHEC 2). The outcome is an evolving university-community partnership designed to meet changing work-force and community health needs in the heart of rural Appalachia. West Virginia University's (WVU's) application of the original Carnegie Commission AHEC recommendations (1970) resulted in the Charleston AHEC, now part of the Robert C. Byrd Health Sciences Center of WVU. AHEC today trains more than 135 residents and interns, and one-third of the third-year and fourth-year WVU medical students. Charleston offers clinical and continuing education for nurses, dentists, pharmacists, and allied health professionals. A health sciences library, distance learning, and a network of primary care clinics help define Charleston's unique AHEC role. This AHEC hub continues to meet the classic Carnegie goals of recruiting and retaining health professionals, and providing access to care in the original service area and statewide. Based on the Charleston experience, four new federally funded AHECs are being developed to link rural primary care residencies with the state-funded West Virginia rural health education partnerships. These rural consortia AHECs are applying the concept of community competency, a performance-based methodology, to integrate learning while achieving the goals of Healthy People 2010.

Academic Medical Centers↗

Establishing a psychiatric library.

The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future.

Humans↗

Access to the internet in an acute care area: experiences of nurses.

The internet is expected to play a key role in delivering evidence-based practice (Department of Health (DoH), 1997, 1998a; Beyea, 2000). In the UK, poor access to the internet and a lack of knowledge and confidence have been identified as barriers to nurses accessing evidence via the internet. The study described here aimed to evaluate how open access to the internet in an acute ward area had an impact upon the evidence-based practice of nurse and allied health professionals. The study was funded by the Department of Health. It incorporated a survey of over 200 staff, semi-structured interviews and monitoring of internet use. The results indicate that the ward-based internet facilities were valued and used by nurses. However, time, support and training are required for nurse to realize the full potential of the internet. Future partnerships between health science libraries and the NHS are recommended to help staff to access and use the internet in order to answer clinically derived questions.

Access to Information↗

BRS Colleague MEDLINE end user training follow-up survey.

The amount of recent literature describing end user training programs is substantial, yet there are few reports evaluating the effectiveness of such training. This article reports on a follow-up survey of the first seventy-five trainees of a four-hour BRS Colleague MEDLINE training program at the Health Sciences Library of East Carolina University. The 90.7 percent response rate to the questionnaire provided information about both those who performed searches and those who had not. It indicated how trainees felt about their training, their ability to perform searches or reason for not performing searches, and types of additional training the trainees desired. Survey results are discussed in terms of effectiveness of the training for the end user with infrequent search needs, possible modifications to improve the effectiveness of the training, and possible alternatives to BRS Colleague MEDLINE.

Attitude of Health Personnel↗

An AIDS information center.

Because busy members of the health care team are confronted with a plethora of articles and information on AIDS, the Health Sciences Library at the University of Alabama has developed a current awareness information center on AIDS. The materials in the center can be easily accessed by patrons. Books and audiovisuals are included in the center; however, the primary emphasis is on accessing articles in journals to which the library subscribes and the journals which have granted blanket photocopy permission. The planning and organization of the center are described.

Acquired Immunodeficiency Syndrome↗

Introducing computer literacy skills for physicians.

Computers are integral to medical practice, education, and research. While medical students learn computer skills during their training, many practicing physicians do not have the same computer experience. To familiarize this group with the exciting developments in medical informatics, the Himmelfarb Health Sciences Library and Department of Computer Medicine at the George Washington University Medical Center organized a workshop "Introducing Your Office Computer!" for attending physicians. The workshop featured a short lecture/video presentation on computer applications in medicine followed by a "computer fair" of five computer applications. Eleven physicians attended the workshop. Feedback was very positive; many called later to request more detailed instructions on using the programs demonstrated. It was a valuable experience for the staff, and new bridges were built between departments and clients.

Computer User Training↗

Information skills for distance learning.

In spring 1997, the Education Services department at the University of North Carolina at Chapel Hill (UNC-CH) Health Sciences Library (HSL) developed six Web-based tutorials designed to teach information skills. This paper describes how the modules were created.

Academic Medical Centers↗

A women's resource center in a rural setting.

Many health care consumers have become their own advocates in seeking information. In search of health information, consumers' choices vary--from the Internet, the news media, national and local associations, the public and health sciences libraries, to a growing number of consumer health libraries. To meet consumers' needs for reliable and current health information, the former Geisinger Health System developed the Women's Resource Center at the Geisinger Medical Center, a 548 bed teaching hospital in central Pennsylvania.

Delivery of Health Care, Integrated↗