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Clinicians, librarians and patient safety: opportunities for partnership.

Librarians could improve the safety of medical care through greater participation in patient safety initiatives. A librarian's expertise in accessing the evidence base could enhance the safety and appropriateness of care in a clinical environment. In addition, librarians could apply specific technical knowledge management skills to medicine. To realize improvements from these skill sets, healthcare leaders must consider ways of working with librarians to enhance patient safety.

Cooperative Behavior↗

"Ask A Librarian": the experiences of four hospital libraries.

The librarians at four hospital libraries describe the electronic reference service, "Ask A Librarian," offered at their institutions. The hospitals are vastly different in size and in number of library staff, and offer the "Ask A Librarian" service to different clientele. The article illustrates that both large hospitals with a large library staff and small hospitals with a solo librarian and some volunteers can offer this type of service.

Databases, Bibliographic↗

The business of negotiating for hospital librarians.

Although many hospital librarians may find it difficult, negotiating with vendors has become a basic skill of library acquisitions. This article reports the results of a non-scientific questionnaire administered to hospital librarians and vendors attending a chapter meeting of the Medical Library Association in 2003. The answers revealed that vendors regard libraries as businesses, and while admitting that the role is often uncomfortable for them, librarians acknowledged that negotiating skills have become an important aspect of their jobs. Questions to help guide librarians through the negotiation process are provided in the Appendix.

Attitude↗

Academic health sciences librarians' publication patterns.

This study examines the publication patterns of U.S. academic health sciences librarians. A survey was sent to a random sample of Medical Library Association (MLA) members who work in academic settings. Some survey results are consistent with other research while others vary from the findings of previous studies. Faculty status requiring publication may be an incentive to publish; however, a large percentage of librarians in this study published despite the lack of a requirement. Academic health sciences librarians without advanced degrees other than a master's in library science produced about three quarters of the publications, whereas their colleagues with advanced degrees published slightly more than 25% of the publications. Results concerning professional maturity, position, and geographic location reflect findings of earlier studies of academic librarians' publication patterns. Publication productivity generally increased with professional maturity, most authors held administrative or supervisory positions, and many lived in the Northeast and Midwest regions of the United States. The differences in rates of publication between males and females was not statistically significant after controlling for respondents' professional maturity and position. Recommendations for future research are discussed.

Educational Status↗

Ethics and the role of the medical librarian: health care information and the new consumer.

Because medical libraries increasingly serve nonprofessionals, medical librarians may need to reconsider their role. In addition, as clients alter their expectations about librarians and begin to think of them as participants in health care delivery, librarians face new ethical challenges. This paper compares the values and goals of the library and medical professions in the provision of health care information. In examining the factors that health care professionals consider when deciding what information to share with patients, the author challenges medical librarians to reconsider their duties toward their nonprofessional clients, whether patients, patients' families, or other laypersons, and to clarify the goals of the health science library profession regarding the provision of information.

Adult↗

Integrating health sciences librarians into biomedicine.

Vanderbilt University Medical Center (VUMC) developed a model training program to prepare current and future health sciences librarians for roles that are integrated into the diverse fabric of the health care professions. As a complement to the traditional and theoretical aspects of a librarian's education, this mixture of supplemental coursework and intensive practical training emphasizes active management of information, problem-solving skills, learning in context, and direct participation in research, while providing the opportunity for advanced academic pursuits. The practical training will take place under the auspices of an established Integrated Advanced Information Management Systems (IAIMS) library that is fully integrated with the Health Center Information Management Unit and Academic Biomedical Informatics Unit. During the planning phase, investigators are analyzing the model's aims and requirements, concentrating on (a) refining the current understanding of the roles health sciences librarians occupy; (b) developing educational strategies that prepare librarians to fulfill expanded roles; and (c) planning for an evaluation process that will support iterative revision and refinement of the model.

Certification↗

How good are clinical MEDLINE searches? A comparative study of clinical end-user and librarian searches.

The objective of this study was to determine the quality of MEDLINE searches done by physicians, physician trainees, and expert searchers (clinicians and librarians). Its design was an analytic survey with independent replication in a setting of self-service online searching from medical wards, an intensive care unit, a coronary care unit, an emergency room, and an ambulatory clinic in a 300-bed teaching hospital. Participating were all M.D. clinical clerks, house, and attending staff responsible for patients in the above settings. Intervention for all participants consisted of a 2-h small group class and 1-h practice session on MEDLINE searching (GRATEFUL MED) before free access to MEDLINE. Search questions from 104 randomly selected novice searches were given to 1 of 13 clinicians with prior search experience and 1 of 3 librarians to run independent searches (triplicated searches). Measurements and main results from these unique citations of the triplicated searches were sent to expert clinicians to rate for relevance (7-point scale). Recall (number of relevant citations retrieved from an individual search divided by the total number of relevant citations from all searches on the same topic) and precision (proportion of relevant citations retrieved in each search) were calculated. Librarians were significantly better than novices for both. Librarians had equivalent recall to, and better precision than, experienced end-users. Unexpectedly, only 20% of relevant citations were retrieved by more than one search of the set of three, with the conclusion that novice searchers on MEDLINE via GRATEFUL MED after brief training have relatively low recall and precision. Recall improves with experience but precision remains suboptimal. Further research is needed to determine the "learning curve," evaluate training interventions, and explore the non-overlapping retrieval of relevant citations by different searchers.

Evaluation Studies as Topic↗

Clear-cut?: facilitating health librarians to use information research in practice.

In 1999, staff at the universities of Sheffield and Oxford commenced an unfunded project to examine whether it is feasible to apply critical appraisal to daily library practice. This aimed to establish whether barriers experienced when appraising medical literature (such as lack of clinical knowledge, poor knowledge of research methodology and little familiarity with statistical terms) might be reduced when appraising research within a librarian's own discipline. Innovative workshops were devised to equip health librarians with skills in interpreting and applying research. Critical Skills Training in Appraisal for Librarians (CRISTAL) used purpose-specific checklists based on the Users' Guides to the Medical Literature. Delivery was via half-day workshops, based on a format used by the Critical Appraisal Skills Programme. Two pilot workshops in Sheffield and Oxford were evaluated using a brief post-workshop form. Participants recorded objectives in attending, their general understanding of research, and whether they had read the paper before the workshop. They were asked about the length, content and presentation of the workshop, the general format, organization and learning environment, whether it had been a good use of their time and whether they had enjoyed it. Findings must be interpreted with caution. The workshops were enjoyable and a good use of time. Although the scenario selected required no clinical knowledge, barriers remain regarding statistics and research methodology. Future workshops for librarians should include sessions on research design and statistics. Further developments will take forward these findings.

Feasibility Studies↗

Integrating knowledge resources at the point of care: opportunities for librarians.

Health sciences librarians at the University of Washington (UW) are partners in the evolution of Internet-based clinical information systems for two medical centers, University of Washington Medical Center and Harborview Medical Center, as well as the UW Primary Care Network clinics. Librarians lead information resource and systems development projects and play a variety of roles including facilitator, publisher, integrator, and educator. These efforts have been coordinated with parallel development efforts by the Integrated Advanced Information Management Systems (IAIMS) clinical informatics group in developing electronic medical record systems and clinical decision support tools. The outcome is MINDscape, a very heavily used Web view of the patient medical record with tightly integrated knowledge resources as well as numerous Web-accessible information resources and tools. The goal of this article is to provide a case study of librarian involvement in institutional information systems development at UW and to illustrate the variety of roles that librarians can assume in hospital settings.

Computer Systems↗

Factors influencing research productivity among health sciences librarians.

Secondary analysis was performed of data collected in 1989 from a random sample of members of the Medical Library Association. Results show that about half the sample had at least one publication; academic health sciences librarians were much more likely than hospital librarians to have published. Almost half the sample had taken formal courses in research, but only a small percentage had taken continuing education (CE) courses in research. Institutional support services for research were most available in academic settings. The combination of institutional support, CE training, and research courses explained 31.1% of the variation in research productivity among academic librarians; these factors were less important in hospitals and other institutional settings. The authors suggest that health sciences librarians working outside academia should seek support for research from sources outside the employing institution.

Humans↗

"Mini-Medical School for Librarians": from needs assessment to educational outcomes.

PURPOSE: This study evaluates the outcomes of the "Mini-Medical School for Librarians" or "Medical School Experience," a continuing education symposium designed to improve librarians' understanding of medicine and medical education. SUBJECTS: The subjects are the symposium participants, a group that consisted of fifty-eight medical librarians and other information professionals. METHODOLOGY: Pre- and post-symposium self-evaluation surveys gauged participants' self-assessed confidence with the course content. A follow-up survey was administered six months after the symposium. A learning action plan recorded both the intended and actual applications of course content to professional settings. RESULTS: T-test analysis of paired pre- and post-symposium responses reveal a significant positive change in the mean self-assessed confidence with course content immediately following the symposium. Pairings of post-symposium and follow-up survey responses indicate a slight reversal in attendees' confidence in the months following the symposium, but pairings of pre-symposium and follow-up survey results demonstrate that the longitudinal impact of the program on self-assessed confidence with course content was positive and significant. Analysis of the learning action plan revealed a disparity in how participants planned to use the information they learned in the course and how they actually used it. CONCLUSIONS: Continuing education programs that address the content and structure of medicine can be an effective means by which to inform both the novice's and mid-career medical librarian's understanding of medicine and medical education.

Education, Continuing↗

Evaluation of a liaison librarian program: client and liaison perspectives.

OBJECTIVES: This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. METHODS: Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. RESULTS: Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. CONCLUSIONS AND RECOMMENDATIONS: Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

Communication↗

Assessment of MLA assertiveness training for librarians: students' behavior changes after taking C.E. 669, Assertiveness and Human Relations Skills.

C.E. 669, offered for three years, was MLA's first personal development continuing education course. Participants were asked to respond to a follow-up survey about their current assertive philosophy, awareness, and behavioral repertoire. They were also assessed by the Librarian's Assertiveness Inventory, a tool that indicates patterns of behavioral responses, for which some normative data were available from librarians who had not taken the class. Class participants were found to be more likely to behave assertively and less likely to behave aggressively than librarians who had not taken the class. In nine out of ten situational categories, librarians who had taken the class demonstrated assertive response patterns. They also reported remembering and using more than one third of the behavioral techniques covered in class, with particular use of the nonverbal techniques. A majority saw themselves as more assertive since taking the class, although most believed that others viewed them much the same as they had prior to the class. Positive progress toward reaching specific behavioral goals was also reported.

Assertiveness↗

Academic status for medical school librarians.

Results of a survey conducted indicate that most medical schools grant academic status in some degree to their professional librarians. Faculty appointments and benefits are not always awarded. In order to upgrade the stature and effectiveness of the medical school librarian in relation to his institution and to the teaching faculty, his having faculty status is desirable. It is the medical school's responsibility to grant faculty status to librarians who possess necessary qualifications; likewise, it is the responsibility of the medical school librarian to merit faculty rank on a basis with other teaching faculty. In three new medical schools, the library is considered an academic department, and other schools are considering such designation.

Faculty, Medical↗

The role of the medical librarian in the use of a MeSH-indexed computerized test question bank.

The University of Missouri-Kansas City School of Medicine utilizes a full-time medical librarian in a non-conventional position as indexer-bibliographer for its computerized Item Library. The responsibilities of the librarian are to edit, index, and reference items for inclusion in the data base; maintain the currency of the Item Library; search the collection; and construct examinations, including a comprehensive quarterly examination, required of all students in this six-year school. Early research in computer-assisted test construction suggested the need for a comprehensive, standard approach to the classification of item content. A professional medical librarian using MeSH descriptors satisfies this need. In existence since 1973, the Item Library is now composed of over 12,000 multiple-choice questions in the basic sciences and clinical medicine. All questions are indexed with up to fifteen MeSH descriptors and referenced to literature sources. The items may be retrieved using any single MeSH term or combination of terms. The collection is available at all times on terminals, and students are encouraged to make use of it for self study. Selected examinations are made available to other institutions by arrangement. Experience has proven both the value of this resource for self study and student evaluation, and the necessity of establishing and continuing the librarian's role.

Abstracting and Indexing↗

Team building with information system departments: a hospital librarian's experience in coexisting, collaborating, and cooperating.

Hospital librarians and information systems (IS) staff regard themselves as information professionals and have coexisted in the same institutions for many years. While hospital librarians have increased their computer literacy, IS staff have begun to recognize the value of knowledge-based information as an IS resource. Parallel growth and mutual interest have resulted in increased opportunities for information professionals to share skills and network for mutual advantage. Creating positive relationships between the hospital librarian and IS staff can be critical to the success of the hospital library. This paper provides a framework in which to explore the levels of relationship that exist within institutions between hospital librarians and IS staff. The "knowing/caring ladder" is presented as a model to illustrate levels of relationship and their consequences. The authors contend that recognition of the levels of professional relationship determines the success or failure of team building.

Computer Literacy↗

Transforming the present--discovering the future: the University of Pittsburgh's NLM grant on education and training of health sciences librarians.

BACKGROUND: The University of Pittsburgh was awarded a grant by the National Library of Medicine to study the education and training needs of present and future medical librarians and health information specialists through a collaboration of the university's School of Information Sciences and Health Sciences Library System. Goals and objectives for the year-long project included (1) assessment of education and training needs of medical librarians, (2) development of a master of library science curriculum and an internship program that would prepare graduates to take leadership roles in medical librarianship or information management, (3) development of continuing education programs for medical librarians in different formats, and (4) development of targeted recruitment efforts to attract minority group members and individuals with undergraduate science majors. The importance of this project, present practice, and success factors for programs seeking excellence in the preparation of health sciences information professionals are reviewed. A needs assessment involving a national advisory panel and a follow-up study of individuals who have participated in previous specialized training programs in health sciences information, compared with a peer group of medical librarians who did not participate in such programs, is described. This paper presents the goals and objectives of the project, describes the methods used, and outlines a curriculum, continuing education initiatives, and recruitment activities.

Career Choice↗

Nurses--their information needs and use of libraries: the views of some librarians.

An overview of the information needs of nurses is followed by a description of the findings of the Information Seeking Behaviour of Nurses Project. A brief comparison is made with the perceptions that librarians have of nurses' information-seeking activity followed by a more detailed discussion of the ways that librarians consider that nurses' use of libraries could be improved. It is concluded that library provision and use can be improved only by co-operation between nurses, students, educators, librarians and managers.

Attitude of Health Personnel↗