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PubMed1999

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↗
PubMed2003

Promotion and evaluation of a virtual live reference service.

The University of North Carolina at Chapel Hill Health Sciences Library began providing virtual live reference service in the fall of 2001. The library was interested in exploring new ways to interact with users accessing electronic resources from outside the library. This article describes the background for starting the service, the methods used to promote the service, and the results of an evaluation conducted after the first seven months of operation. The service was lightly used during these months with only 82 interactions. An analysis of the transcripts examined referring Web pages, types of questions asked, software features used, and user login data. Text of two user surveys is included, with the data from the in-person survey analyzed.

Computer Communication Networks↗
PubMed2003

Not virtual, but a real, live, online, interactive reference service.

In today's fast-paced environment, traditional medical reference services alone are not adequate to meet users' information needs. Efforts to find new ways to provide comprehensive service to users, where and when needed, have often included the use of new and developing technologies. This paper describes the experience of an academic health science library in developing and providing an online, real-time reference service. Issues discussed include selecting software, training librarians, staffing the service, and considering the future of the service. Use statistics, question type analysis, and feedback from users of the service and librarians who staff the service, are also presented.

California↗
PubMed2003

Case studies from morning report: librarians' role in helping residents find evidence-based clinical information.

In primary care specialties, Morning Report is a traditional vehicle for expanding medical residents' training in diagnosis and treatment. At one academic medical center, residents and faculty in the Department of Family and Community Medicine use case-based teaching, centered around planning and reviewing patient management, to review intriguing cases from patient encounters in the department's hospital service. Seeking to improve the level of evidence-based information exchanged at Morning Report, department leaders invited reference librarians from the health sciences library to attend weekly Morning Report. The librarians saw this as an opportunity not only to improve residents' information-seeking skills, but also to improve librarians' teaching skills and understanding of the needs of users in clinical settings. This paper describes the evolution of librarians' involvement in Morning Report, examples of the kinds of contributions librarians have made in this setting, and changes made in Morning Report sessions to facilitate this activity.

Academic Medical Centers↗
PubMed2004

Evaluation of evidence-based medicine search skills in the clinical years.

The librarians of the Health Sciences Library worked with the director of the Primary Care Clerkship to reinforce the principles of Evidence-Based Medicine (EBM) searching, taught during the first two years of medical school, through an intensive workshop. The purpose of the program was to ensure that students apply EBM principles in a timely and effective manner in clinical situations. Working in teams led by a resident and librarian, students researched real cases and then evaluated the effectiveness of their approach to the problems. This paper outlines the rationale for the team approach, reviews the administration of a computer-based workshop, and discusses the evaluation process. Evaluation focused on both the current workshop and its implications for the informatics program presented to students during years one and two.

Evidence-Based Medicine↗
PubMed2004

Assessing reference staff competency in the electronic environment.

This paper shows how the Galter Health Sciences Library of Northwestern University's Feinberg School of Medicine developed and implemented a program to assess reference staff competencies for assisting users in the electronic environment after completing a new training program. The first phase was a year-long assessment of reference questions to identify the types of questions received at the desk. Next, a training program for reference was developed and implemented with an emphasis on answering the most common questions identified such as remote access, access privileges, holdings information, and database searching. The program included individualized instruction on library policies, electronic resources, access restrictions, and troubleshooting. The next phase was to create instruments to test staff competencies in answering questions after training. Based on the scores, additional training was individualized and provided to the appropriate staff member to enhance their skills where needed. The training system that was developed has proven to be effective as most staff scored better than 92% on initial testing. As a result, library management can be certain that users' questions are being answered correctly and that the staff has the skills required to work in an electronic environment.

Chicago↗
PubMed1999

Realizing the promise: delivering pulmonary continuing medical education over the Internet.

STUDY OBJECTIVES: Continuing medical education (CME) is meant to bridge the gap between new scientific observations and clinical practice. However, traditional CME has not been effective at altering the behaviors of physicians. One reason for this failure of traditional CME programs may be their inflexibility. In traditional CME, the clinician does not choose the topic, the pace of the program, or the place of learning, and the CME material cannot be easily delivered to the point of care where the clinician needs the information. Computers and computer networks have the potential to accomplish these goals. CME has begun to appear on the Internet; however, there have been few evaluations of its usefulness, acceptance, and effectiveness. Over the last 18 months, we have developed three on-line pulmonary CME programs, and we have delivered them on the Virtual Hospital, the University of Iowa's digital health sciences library on the Internet. We report our initial experience with this CME material. DESIGN: We measured the frequency with which the Internet-delivered CME is accessed by monitoring page accessions and by using a log file analysis program (Analog 1.2.3; University of Cambridge Statistical Laboratory; Cambridge, UK). In addition, we collected all completed CME examinations and evaluation forms submitted by registered users. MEASUREMENTS AND RESULTS: We have found that the frequency with which the Internet-delivered CME is accessed has continued to increase with time (2.3-fold increase over 18 months), that evaluations of technical and content issues are strongly favorable, and that some clinicians have been willing to pay to receive CME through the medium of the Internet. CONCLUSIONS: We feel that with adequate peer review and quality control, physicians will use the Internet-delivered CME. However, several obstacles to wide use remain. These obstacles include issues regarding training in using the Internet for physicians, reluctance of physicians to participate in on-line commerce, and the current unavailability of CME to be delivered in small-grained quantities to the point of care. As these issues are addressed, we feel that on-line CME will represent an increasingly important CME medium for clinicians.

Education, Medical, Continuing↗
PubMed1975

Computer retrieval of articles on the therapy of poisonings.

This paper describes the joint efforts of the Cleveland Poison Information Center and the Cleveland Health Sciences Library to develop a workable system for scanning the current journal literature for relevant articles on the therapy of poisonings and to develop a suitable system for reorganizing the present reprint files for the city's two units of the Poison Information Center. The use of the MEDLINE computer retrieval system for retrieving relevant current articles is discussed in detail as is the proposed reorganization of the Center's reprint file.

Costs and Cost Analysis↗
PubMedDate not supplied

Issues for South Asian Indian patients surrounding sexuality, fertility, and childbirth in the US health care system.

BACKGROUND: In 1998 ethnic minorities comprised 28% of the US population, and India is the third most common country of origin for immigrants. Many recently immigrated South Asian Indian patients are seen in health care settings in the United States. To deliver health care effectively to these patients, it is helpful for physicians to understand common cultural beliefs and practices of South Asian Indian patients. METHODS: Two illustrative cases are reported. One author's observations of the care of pregnant and parturient women in India and similar experiences in our own office spurred a literature search of the cultural behaviors surrounding sexuality, fertility, and childbirth. A literature search was conducted in Index Medicus, Grateful Med, and the catalogue of the University of Pennsylvania Arts and Sciences library, using the terms "Indian," "South Asian," "male and female gender roles," "gynecology in third world," "sexuality," "sexual health," "women's health," "women's health education," "obstetrical practices/India," and "female roles/India." RESULTS: Issues surrounding sexuality and childbirth that arise during the US physician-South Asian Indian patient encounter might not correspond to the commonly held knowledge, beliefs, and behaviors of the US health care system. Common cultural beliefs and behaviors of South Asian Indian patients around sexuality and childbirth experience include the role of the individual patient's duty to society, the patient's sense of place in society, lack of formal sexual education, prearranged marriages, importance of the birth of the first child, little premarital contraceptive education, dominance of the husband in contraceptive decisions, and predominant role of women and lack of role for men (including the husband) in the childbirth process. CONCLUSION: Lack of understanding of the Indian cultural mores surrounding sexual education, sexual behavior, and the childbirth experiences can form barriers to Indian immigrants in need of health care. These misunderstandings can also lead to patient dissatisfaction with the health provider and health system, underutilization of health services, and poorer health outcomes for Indian immigrants and their families. For this reason, it is important to teach cultural issues during undergraduate, graduate, and continuing medical education.

Adult↗
PubMed1999

Information needs of naval primary care providers and patients at sea.

OBJECTIVE: To optimally practice medicine, and to live healthy lives, providers and patients need convenient access to authoritative information. The goal of this study was to determine the information needs of naval primary care providers and patients at sea to aid development of a digital health sciences library for naval primary care providers and patients. METHOD: A literature-based needs assessment was conducted from articles identified using MEDLINE searching and U.S. Navy health care information sources. Recurring medical problems/diseases/topics were identified and categorized. RESULTS: Eighty-one articles and books were reviewed and abstracted, representing a broad base of naval medicine. Twenty-one medical and surgical theme areas and 125 medical problems/diseases/topics were recurrently identified. CONCLUSIONS: The common naval medical problems identified are nearly identical to the common medical problems in the general population, have changed little from the 18th century, and were consistent with first-hand information from naval primary care providers.

Databases, Factual↗
PubMed1994

A unique approach to multi-state networking: BHSL (Basic Health Sciences Network).

Development of a reciprocal multi-state shared resources network is described. The Basic Health Sciences Library Network (BHSL) is one the largest interlibrary loan networks free of direct charges to participants and any direct federal or state funding. Established in June 1986, BHSL started with 132 member libraries from three northeastern states. Current membership is 460 libraries in 10 states. Interlibrary loan activity for 1992 resulted in a collective cost savings of $592,672. This model of resource sharing can be applied to any group of libraries that access a common locator tool.

Cost Savings↗
PubMed1976

LATCH -- it works!

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Libraries, Hospital↗