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Tufts Health Sciences Database: lessons, issues, and opportunities.

The authors present their seven-year experience with developing the Tufts Health Sciences Database (Tufts HSDB), a database-driven information management system that combines the strengths of a digital library, content delivery tools, and curriculum management. They describe a future where online tools will provide a health sciences learning infrastructure that fosters the work of an increasingly interdisciplinary community of learners and allows content to be shared across institutions as well as with academic and commercial information repositories. The authors note the key partners in Tufts HSDB's success--the close collaboration of the health sciences library, educational affairs, and information technology staff. Tufts HSDB moved quickly from serving the medical curriculum to supporting Tufts' veterinary, dental, biomedical sciences, and nutrition schools, thus leveraging Tufts HSDB research and development with university-wide efforts including Internet2 middleware, wireless access, information security, and digital libraries. The authors identify major effects on teaching and learning, e.g., what is better taught with multimedia, how faculty preparation and student learning time can be more efficient and effective, how content integration for interdisciplinary teaching and learning is promoted, and how continuous improvement methods can be integrated. Also addressed are issues of faculty development, copyright and intellectual property, budgetary concerns, and coordinating IT across schools and hospitals. The authors describe Tufts' recent experience with sharing its infrastructure with other schools, and welcome inquiries from those wishing to explore national and international partnerships to create a truly open and integrated infrastructure for education across the health sciences.

Academic Medical Centers↗

Computer-assisted instruction in surgery.

Computer-assisted instruction (CAI) is an educational medium which provides a highly interactive, adaptive, and individualized learning experience for the student or physician. A CAI system has benn developed to prepare a curriculum in general surgery. The surgical seminars written on this system have been used enthusiastically by students, residents, and interns for the past 18 months. Using a computer terminal (printer or television screen) connected by telephone to a minicomputer, the user participates in simulated seminars with the authors, viewing information and answering questions based on the material presented. The student responds by typing the answer in his own words, and the computer (author) responds with further information designed specifically for that answer. This response may support or contest what the student said, may branch the student to material covered previously, or instead may lead the student through as much remedial material as he needs. A more sophisticated student will progress rapidly through the seminar. Twenty-five surgeon/authors (at 15 medical schools) are preparing seminars, and it is planned that a complete library in general surgery will be available to departments of surgery nationally by September, 1978, via the Health Education Network.

Computer-Assisted Instruction↗

Outreach to community organizations: the next consumer health frontier.

Outreach by health sciences librarians to various constituencies helps ensure that the information needs of these groups are adequately met. In the past, librarians have extended outreach to isolated rural health care providers, urban clinicians not affiliated with libraries, and consumers. One logical next step in outreach efforts is to partner with existing community groups who seek to improve the health of residents concerning such areas as lead contamination and rising asthma rates. This article describes a National Network of Libraries of Medicine-funded project, where librarians worked with a group of grass roots community organizations, schools, and clinics. Knowledge gained from past outreach projects was applied with mixed success because of the unique nature of community groups where many unanticipated issues arose. Lessons learned while extending outreach library services to community groups are described.

Chicago↗

An intrapreneurial approach to integrating information production services into an academic medical center library.

The many challenges faced by health sciences libraries of all types and sizes often require innovative solutions. When an innovative solution involves calculated risk taking, the approach is called intrapreneurial. At the University of Miami School of Medicine, an intrapreneurial approach solved the fiscal problems of the biomedical communications unit. The Louis Calder Memorial Library inherited these problems when the Department of the Library and Biomedical Communications was created in the early 1980s. In this paper, two intrapreneurial programs are described, and the benefit and suitability of this management style to information services are demonstrated.

Computer Graphics↗

New library buildings: Creighton University Bio-Information Center.

In May 1977 the newly constructed Creighton University Bio-Information Center, costing over $4 million and containing more than 57,000 square feet of space, officially began to provide services. This facility houses three educational support programs--the Health Sciences Library, the Learning Resources Center, and the Biomedical Communications Center--that primarily serve the University's health sciences schools of medicine, dentistry, pharmacy, nursing, and allied health, and the University's major teaching hospital, Saint Joseph Hospital. This article begins with a brief history of the development of the library and is chiefly concerned with the Health Sciences Library and the Learning Resources Center. Criteria formulated during the design phase of the Bio-Information Center are identified. A description of the center and its services, with an emphasis on the application of these criteria, is set forth. Finally, an assessment of the current increased utilization of library services and resources contained in the Bio-Information Center is presented.

Facility Design and Construction↗

"Understanding" medical school curriculum content using KnowledgeMap.

OBJECTIVE: To describe the development and evaluation of computational tools to identify concepts within medical curricular documents, using information derived from the National Library of Medicine's Unified Medical Language System (UMLS). The long-term goal of the KnowledgeMap (KM) project is to provide faculty and students with an improved ability to develop, review, and integrate components of the medical school curriculum. DESIGN: The KM concept identifier uses lexical resources partially derived from the UMLS (SPECIALIST lexicon and Metathesaurus), heuristic language processing techniques, and an empirical scoring algorithm. KM differentiates among potentially matching Metathesaurus concepts within a source document. The authors manually identified important "gold standard" biomedical concepts within selected medical school full-content lecture documents and used these documents to compare KM concept recognition with that of a known state-of-the-art "standard"-the National Library of Medicine's MetaMap program. MEASUREMENTS: The number of "gold standard" concepts in each lecture document identified by either KM or MetaMap, and the cause of each failure or relative success in a random subset of documents. RESULTS: For 4,281 "gold standard" concepts, MetaMap matched 78% and KM 82%. Precision for "gold standard" concepts was 85% for MetaMap and 89% for KM. The heuristics of KM accurately matched acronyms, concepts underspecified in the document, and ambiguous matches. The most frequent cause of matching failures was absence of target concepts from the UMLS Metathesaurus. CONCLUSION: The prototypic KM system provided an encouraging rate of concept extraction for representative medical curricular texts. Future versions of KM should be evaluated for their ability to allow administrators, lecturers, and students to navigate through the medical curriculum to locate redundancies, find interrelated information, and identify omissions. In addition, the ability of KM to meet specific, personal information needs should be assessed.

Abstracting and Indexing↗

[The role of support elements in medical education].

There is a definite and inexorable trend in medical schools toward changes in the training of physicians. This transformation of medical education is being seen in the most traditional schemes, which predominate in the medical schools of Latin America, and the most modern and complex approaches, even though they are relatively a minority phenomenon in many countries. This article examines the support facilities needed at each stage of this evolution: libraries, communication media, teaching and physical resources and technologies, and hospital and laboratory facilities. It also describes the influence of each of them on the physician's training. The author is of the view that the common denominator among all aspects of medical education, from the student's physical environment to the sophisticated resources embodied in computers, must be the interpersonal relationship. The ideal situation in which the healthy professions can profit fully from the rationalization and management of knowledge in the medical school setting is one of rapprochement between the transmitters (teachers) and receivers (students) of information, whether medical or in any other subject.

Computer-Assisted Instruction↗

Teaching gerontological content to schoolchildren in Israel as preparation for adult life.

An Israeli public school made gerontological content and experiences available to pupils aged 13-14. The learning process included library research, interviewing older residents in their homes, friendly visiting to a nearby home for the aged, formal lectures, role-playing before video cameras operated by classmates, and homework assignments. Children who participated were reported to have improved relations with their own grandparents. The school received public recognition for its pedagogic pioneering, and "town-gown relations" between municipal officials and the University were enhanced.

Adolescent↗

Observations of end-user online searching behavior over eleven years.

End-user searching of National Library of Medicine (NLM) online data bases during eleven years has been investigated through transaction logs, questionnaires, and follow-up interviews. From 1976 through 1984, pathologists and pharmacists performed 8,313 searches. Highlights of our studies are compared with a review of other end-user research. Volume of searching is directly related to the convenient placement of the terminal in the work place. Slightly fewer than half of all potential searchers actually search for themselves. Practices of pharmacists and pathologists do not differ in important ways. Nonmediated searchers feel they need answers more promptly than do those who obtain mediated searches. End-users perform very simple searches, mostly using only the AND operator. Problems with techniques are fewer and more easily solved than those with the vocabulary and content of the system. The major problems, with the most powerful capabilities of MEDLINE--subheadings and explosions--sometimes cause substantial loss of references, but in relatively few searches. One-on-one teaching is most popular, with trial-and-error the most frequent procedure used in actual learning.

Data Collection↗

Informatics and education in the health professions.

Informatics, the applied use of information science, is undergoing definition and development in the health professions with the encouragement of the National Library of Medicine and other professional organizations. Medical informatics and disciplinary subsets such as nursing and dental informatics look to optimize a growing range of applications ranging from video-disks to expert systems. Recommendations call for the integration of informatics into the education of health care professionals. Academic health sciences centers are developing informatics programs; the University of Maryland Campus for the Professions has convened a task force and a national advisory board on informatics.

Health Occupations↗

Fin-de-siècle Philadelphia and the founding of the Medical Library Association.

Philadelphia at the time of the founding of the Medical Library Association (MLA) is described. Several factors that promoted the birth of the association are discussed, including the rapid increase in the labor force and the rise of other health related professions, such as the American Hospital Association and the professionalization of nursing. The growth of the public hygiene movement in Philadelphia at the time of Sir William Osler's residency in the city is discussed. Finally, the rapid growth of the medical literature is considered a factor promoting the development of the association. This article continues the historical consideration of the MLA begun in the author's article on the three founders of the association. The background information is drawn from the items listed in the bibliography, and the conclusions are those of the author.

Health Occupations↗

Medical surfing.

The Internet has revolutionized information technology. Vast amounts of latest information are available on the Internet to medical professionals. Medical surfing is fast becoming part of a doctor's profession. But the way to approach the Internet and retrieve useful information from myriads of medical websites seems a daunting task to many. This review aims to help the newcomer, the medical students and doctors in obtaining fruitful medical information while surfing. It will prevent them from the feeling of getting drowned in the ocean of medical information. As medical information is not restricted to books and journals, providing Internet addresses of different medical bodies with few salient features, will go a long way in helping attain the required information without wasting time. The Internet will soon become a universal library. Medical surfing should be included in the curriculum of all medical schools and universities.

Education, Medical, Continuing↗

The teaching facility at the Eric Williams Medical Sciences Complex. An additional rising star from the west.

The teaching facility at the Eric Williams Medical Sciences Complex was designed to provide a comprehensive structural environment for a multidisciplinary Faculty whose teaching methodology utilized an integrated Problem-based Learning approach. Though the Faculty is over 11 years old, the full realization of the vision has not become a reality and the next 10 years will be devoted to fulfilling the dream.

Curriculum↗

Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

Colorado↗