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PubMed2004

Finding the answers in primary care: information seeking by rural and nonrural clinicians.

BACKGROUND: Information systems for rural practice may assume that rural clinicians have different information seeking, but studies have not directly compared rural and nonrural information needs using common methodology. OBJECTIVE: Compare rural and non-rural: 1) information needs; 2) information seeking; 3) effectiveness of information seeking; and 4) use of information resources. DESIGN: Observation and interviews during one half-day of office practice; telephone follow-up 2-10 days later. PARTICIPANTS & SETTING: Primary care physicians (39), nurse practitioners (42), and physician assistants (22) in ambulatory practices in rural and nonrural Oregon. MEASURES: 1) number of questions asked, 2) number of questions pursued, 3) number of questions answered), and 4) use of knowledge resources. RESULTS: Rural clinicians practiced in smaller groups, but were otherwise similar to nonrural clinicians. During half-day interviews, clinicians cared for an average of 8.2 patients (95% CI 7.5 - 8.8) and asked an average of 0.83 questions per patient seen (95% CI 0.73 - 0.92). At follow up, they had pursued an average of 47% of their questions (95% CI 40 - 53%), and reported being successful in finding an answer to 77% of those they pursued (95% CI 70 - 84%). There were no statistically significant differences between rural and nonrural clinicians for any of these variables. CONCLUSIONS: Rural and nonrural clinicians had similar information needs, information seeking, knowledge resource use, and effectiveness at finding answers to their questions. Human consultants, digital resources, and library-based resources were less available, but these differences in availability had little impact on their use.

Databases as Topic↗

PubMed1994

Enhancing reference services with the support of your colleagues.

The expertise of colleagues and experience gained through professional organizations is an overlooked resource for adding value to reference service. Collegial networks must be nurtured. They deserve the support and investment of the institution.

Interinstitutional Relations↗

PubMed2006

Developing a virtual community for health sciences library book selection: Doody's Core Titles.

PURPOSE: The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. SETTING/PARTICIPANTS/RESOURCES: The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. BRIEF DESCRIPTION: Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. RESULTS/OUTCOME: The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. EVALUATION METHOD: Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.

Book Selection↗

PubMed1981

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↗

PubMed1970

Integrating information services for dental schools into a health sciences library.

Standards for dental school libraries are first discussed, and the actual state of such libraries described. Advantages and disadvantages of combining the dental library with the health sciences library are weighed. A description is given of the experience at UCLA of integrating dentistry into the total Biomedical Library, with details on serial and monograph selection, together with figures on the size of the collection. Services required of a dental library are detailed, and particular services offered by UCLA described.

California↗

PubMed1998

Academic medical libraries' policies and procedures for notifying library users of retracted scientific publications.

Academic medical libraries have a responsibility to inform library users regarding retracted publications. Many have created policies and procedures that identify flawed journal articles. A questionnaire was sent to the 129 academic medical libraries in the United States and Canada to find out how many had policies and procedures for identifying retracted publications. Of the returned questionnaires, 59% had no policy and no practice for calling the attention of the library user to retracted publications. Forty-one percent of the libraries called attention to retractions with or without a formal policy for doing so. Several responding libraries included their policy statement with the survey. The increasing number of academic medical libraries that realize the importance of having policies and practices in place highlights the necessity for this procedure.

Academic Medical Centers↗

PubMed1972

Review of criteria used to measure library effectiveness.

This article reports the results of a survey of literature on measures of library effectiveness. This survey led to the formulation of six criterion concepts (accessibility, cost, user satisfaction, response time, cost/benefit ratio, and use). The advantages and disadvantages of each method of measurement are discussed. Several points which became clear during the analysis are discussed. First, there is a relative lack of concern with the rationale behind the evaluation process, although the results invariably lead to a confused interpretation when there is no clear understanding of the purpose of an evaluation. Second, the total library system is rarely considered; instead, each evaluation criterion is taken in isolation rather than as part of the whole. Third, the library's preservation function has not been considered at all.

Consumer Behavior↗

PubMed1996

The hospital library as provider of consumer health information.

The health care environment of the 1990s demands that hospital libraries develop creative strategies for providing consumer health information (CHI). Librarians at the Reuben L. Sharp Health Sciences Library at Cooper Hospital/University Medical Center have developed a multifaceted approach to the problem. Using a combination of institutional resources, private funding, and cooperative arrangements with public libraries, the Sharp Library helps to serve the consumer health information needs of the southern New Jersey community.

Community Participation↗

PubMed1999

IAIMS and JCAHO: implications for hospital librarians. Integrated Academic Information Management Systems. Joint Commission on Accreditation of Healthcare Organizations.

The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relationship of the two frameworks, provide a view of their commonalities, and establish the advantages of both for hospital librarianship as a profession.

Humans↗

PubMed1991

A study to enhance clinical end-user MEDLINE search skills: design and baseline findings.

OBJECTIVE: To determine if a preceptor and timely, individualized feedback improves the performance of physicians in searching MEDLINE using GRATEFUL MED in clinical settings. DESIGN: Randomized controlled trial. SETTING: A 300 bed primary to tertiary care teaching hospital. Computers were installed in wards and clinics of 6 major clinical services, and the emergency room, intensive care and neonatal intensive care units. SUBJECTS: All physicians and physicians-in-training from the departments of Medicine, Family Medicine, Surgery, Psychiatry, Pediatrics, and Obstetrics and Gynecology were included if they made patient care decisions for at least 8 weeks during the study period. INTERVENTION: All participants were given a 1-hour training class and 1 hour of individualized searching with 1 of the 2 study librarians. After training, participants were randomized to a control group who received no further intervention or to an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback by a study librarian on their first 10 searches, indicating search quality and providing suggestions for improvement. Feedback was mailed the first week day after the search was done. MAIN MEASURES: Baseline characteristics by study group, department and level of training, study participation rates, and searching rates. MAIN RESULTS: 308 of 392 eligible physicians joined the study. Participation was almost 80% with some variation by department and level of training. Excellent balance in the baseline characteristics was achieved for the 2 groups, as well as for the number who did first searches. Intervention group participants searched MEDLINE more often than did controls (3.5 searches per month vs 2.5 per month for controls, P = 0.046). The recall and precision for first searches for both groups was significantly less than that of librarians. The analysis of study data will be completed by September 1991. CONCLUSIONS: Clinicians are willing to do self-service searching of MEDLINE in clinical settings but their precision and recall are less than a trained librarian at baseline. Search skills enhancements are needed and the effect of feedback and preceptors is being tested. SOURCE OF FUNDING: U.S. National Library of Medicine and Ontario Ministry of Health.

Computer User Training↗

PubMed2002

Consumer Health Information for Asians (CHIA): a collaborative project.

According to the 2000 United States Census, the Asian population in Houston, Texas, has increased more than 67% in the last ten years. To supplement an already active consumer health information program, the staff of the Houston Academy of Medicine-Texas Medical Center Library worked with community partners to bring health information to predominantly Asian neighborhoods. Brochures on health topics of concern to the Asian community were translated and placed in eight informational kiosks in Asian centers such as temples and an Asian grocery store. A press conference and a ribbon cutting ceremony were held to debut the kiosks and to introduce the Consumer Health Information for Asians (CHIA) program. Project goals for the future include digitizing the translated brochures, mounting them on the Houston HealthWays Website, and developing touch-screen kiosks. The CHIA group is investigating adding health resources in other Asian languages, as well as Spanish. Funding for this project has come from outside sources rather than from the regular library budget.

Academic Medical Centers↗

PubMed2000

[Problem-based learning, description of a pedagogical method leading to evidence-based medicine].

Problem-Based Learning is an educational method which uses health care scenarios to provide a context for learning and to elaborate knowledge through discussion. Additional expectations are to stimulate critical thinking and problem-solving skills, and to develop clinical reasoning taking into account the patient's psychosocial environment and preferences, the economic requirements as well as the best evidence from biomedical research. Appearing at the end of the 60's, it has been adopted by 10% of medical schools world-wide. PBL follows the same rules as Evidence-Based Medicine but is student-centered and provides the information-seeking skills necessary for self-directed life long learning. In this short article, we review the theoretical basis and process of PBL, emphasizing the teacher-student relationship and discussing the suggested advantages and disadvantages of this curriculum. Students in PBL programs make greater use of self-selected references and online searching. From this point of view, PBL strengthens the role of health libraries in medical education, and prepares the future physician for Evidence-Based Medicine.

Education, Medical↗

PubMed1985

Reference services for a wellness program.

The concept of wellness, although an old one, has recently become an important part of health education. The theory behind wellness is that the person tries to achieve a state of self-directed wellness with the guidance of facilitators and educational materials, rather than being directed by an instructor. In 1981, York Hospital, York Hospital Library and the York County Public Library System, through an LSCA Title III grant, joined forces to promote wellness in the community through a series of Wellness Institutes and a combined, computerized health education bibliography, of which an updated edition is attached.

Health Promotion↗

PubMed1995

Using scientific evidence to improve information practice.

The recent policy statement of the Medical Library Association (MLA) takes the position that scientific evidence is the basis for improving the quality of library and information sciences now and in the future. Research activity is seen as the foundation of an evolving knowledge base for the profession--a knowledge base that will set health sciences librarians apart from others in an increasingly competitive world of information service providers. The statement represents the culmination of many years of activity by association members, during which the role of research in health information practice has been debated. Over a similar time period, the quality movement, with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research and its relationship to efficient and effective information practice as envisioned in the MLA policy statement.

Artificial Intelligence↗

PubMed1984

On the other side of the reference desk: the patron with a physical disability.

In order for reference librarians to overcome feelings of inadequacy which they experience in aiding physically disabled patrons, they must educate themselves about the special needs of these patrons. This article will address the concerns, common mistakes, and difficulties involved in personal interactions with disabled individuals, particularly as they relate to the reference setting. In addition, specific steps will be described to minimize the difficult aspects of these interactions; these will be presented in terms of attitudinal and service activities. An attempt also will be made to describe aspects of these reference interactions which are unique to various health care settings.

Persons with Disabilities↗

PubMed2001

Information needs of clinical teams: analysis of questions received by the Clinical Informatics Consult Service.

OBJECTIVES: To examine the types of questions received by Clinical Informatics Consult Service (CICS) librarians from clinicians on rounds and to analyze the number of clearly differentiated viewpoints provided in response. DESIGN: Questions were retrieved from an internal database, the CICS Knowledge Base, and analyzed for redundancy by subject analysis. The unique questions were classified into ten categories by subject. Treatment-related questions were analyzed for the number of viewpoints represented in the librarian's response. RESULTS: The CICS Knowledge Base contained 476 unique questions and 71 redundant questions. Among the unique queries, the top two categories accounted for 67%: treatment (36%) and disease description (31%). Within the treatment-related subset, 138 questions (59%) required representation of more than one viewpoint in the librarian's response. DISCUSSION: Questions generated by clinicians frequently require comprehensive, critical appraisal of the medical literature, a need that can be filled by librarians trained in such techniques. This study demonstrates that many questions require representation of more than one viewpoint to answer completely. Moreover, the redundancy rate underscores the need for resources like the CICS Knowledge Base. By critically analyzing the medical literature, CICS librarians are providing a time-saving and valuable service for clinicians and charting new territory for librarians.

Artificial Intelligence↗

PubMed1995

[While science grows and the number of libraries decreases, what will happen to information? (Decrease of medical journals in Hungary)].

The differences between the 1982 and 1994 subscriptions of the leading medical journals were investigated. Sample journals were taken from the impact factor rank lists of the Science Citation Index. The 1994 level was 45% lower than that of 1982. The information supply of the medical universities has weakened too, especially because they have too many small institutional library units. They are not able to supply the literature necessary to their readers and to the Hungarian medical audience.

Forecasting↗

PubMed2004

Information-seeking behaviour of nurse teachers in a school of health studies: a soft systems analysis.

AIM: This paper reports a small-scale study, undertaken as part of a higher degree, which aims to explore the information-seeking behaviour of a group of lecturers, based on one site, delivering a nursing and midwifery curriculum in the School of Health Studies of a higher education institution. METHODOLOGY: Checkland's [System thinking, System practice, Wiley, Chichester, 1981] soft systems methodology (SSM) was used as a theoretical model both to derive deeper insights into the survey data and suggest enhancements to this aspect of teacher activity. To obtain statistical data a survey design was employed, research methods including postal questionnaires complemented by selected interviews and a small amount of informal observation. RESULTS: Findings showed that, in order to access information, lecturers were most likely to access the School libraries, the Internet, advice from colleagues and their personal collections. Refereed journals were the top-ranked information resource with professional studies and research cited as the most sought after topics. Lecturers mentioned the role of library staff as integral to the information-seeking process. Main problems included their variable literature searching skills and time pressures. The methodology identified several features related to the information-seeking behaviour of lecturers that has resulted in an improved training programme for lecturers and prompted enhancements to the School's current awareness service and Library Intranet pages. CONCLUSIONS: The use of SSM for this study allowed the analysis of a broad and complex situation which enabled key changes to the information-seeking behaviour of lecturers to be implemented.

Behavioral Research↗