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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↗

Stimulating growth and development of medical society libraries.

A library can represent the most valuable personal service which a medical society can offer to a physician; yet, libraries unfortunately are taking a lessening role in medical societies. Surveys show that medical society libraries have declined in number from seventy-one in 1942 to forty-eight at the present time. This paper offers a positive plan of action with the objective of enabling libraries to regain a position of eminence in medical societies. It is pointed out that there are four vital elements in stimulating the growth and development of a library. These are the constant enhancement of resources; the promotion of library services; the rendering of prompt, valuable services; and ultimately, the recognition of the library through gifts, endowments, and expressions of appreciation.

Libraries, Medical↗

Integration of information-seeking skills and activities into a problem-based curriculum.

Recent trends in medical education include a shift from the traditional, didactic, lecture-oriented approach to a more student-driven, problem-based approach to learning. This trend provides librarians with an opportunity to develop programs to teach information-gathering skills that support and are integrated into problem-based learning (PBL). In 1992, the University of Pittsburgh School of Medicine implemented the initial phase of a curriculum revision that emphasizes PBL. Since that time, Falk Library of the Health Sciences has provided a large-scale, intensive program integrating information-seeking skills and activities into the first-year Patient-Doctor Relationship course, a sequence that initiates medical school. A multimodal approach to information seeking and sources is emphasized, utilizing print and audiovisual materials, computerized resources, and subject experts. The Falk Library program emphasizes the gathering and use of information as central to both PBL and student skills development. An informal, post-course evaluation was conducted to gauge which information resources were used and valued most by students. This article presents evaluation results, including data on the use of information sources and services, and student perceptions of the librarian's role in the PBL sessions.

Curriculum↗

Planning the new medical school library in relation to local and regional information resources.

The first relationship of a new medical school library with local and regional medical libraries is one of dependence. This must change, as the new library grows, to a continuing state of interdependence. To accomplish this, the new library must thoughtfully design its collections and services, and must prepare for an extramural as well as an intramural clientele. Relationships with Regional Medical Library services and with Regional Medical Programs must be carefully planned. So too must be the adoption of EDP and related procedures where future compatability is important. Any new medical school library must have strength, but must never forget the need for true cooperation to give it viability.

Health Facility Planning↗

Determination of continuing medical education needs of clinicians from a literature search study. Part II. Questionnaire results.

Part II of this study of the needs of clinicians for continuing medical education (CME) examines the results of a questionnaire sent of Oklahoma physicians to determine if they would request formal CME courses in the same subject areas in which they had previously requested in formation from librarians. The degree of correlation between literature search requests and responses to the questionnaire confirms that the analysis of library information requests may be one approach to determining CME needs.

Bibliographies as Topic↗

Value of written health information in the general practice setting.

The value of a library for patients as a way of providing written health information in the general practice setting has been investigated using a questionnaire. In 15 months, 243 books were borrowed from one library. Each book contained a questionnaire and 163 questionnaires were returned (67%). It was found that 106 respondents (65%) would not have sought the information elsewhere and 159 respondents (98%) found the books they had read to be very useful or of some use. The perceived level of anxiety after reading was raised in nine respondents (6%) but reduced in 71 (44%). Patients read books on 53 separate topics overall, although 73 respondents (45%) read on 10 recurring topics. A patients' library thus enables most patients to gain useful information from their general practice without increasing their anxiety.

Anxiety↗

The introduction of evidence-based medicine as a component of daily practice.

Evidence-based medicine is an increasingly important concept in continuing medical education and medical school curricula. To cope with the rapid evolution of medicine, physicians need to remain abreast of the many new therapies and diagnostic tools that affect their practices. Unfortunately, along with the many changes there is also a surplus of relevant written material. Physicians are unable to read all of this information due to time constraints. Instead, they must choose information efficiently. Tools are needed to facilitate this process. Over a two-month period, a demonstration model was carried out at the Ottawa General Hospital to encourage faculty, residents, and students to incorporate evidence-based medicine into their daily practice. A study was conducted to investigate the level and type of information required by these individuals in a clinical setting. A literature searching service was introduced six months after the formal introduction of evidence-based medicine in the Department of Medicine. The logistics of and recommendations for providing such a service are presented in this paper.

Decision Making, Computer-Assisted↗

CD-ROMs review 1995-1997: a multicentre pilot trial.

This article describes an evaluation of CD-ROMs carried out at four NHS Trust Libraries in Wales. It covers interactive CD-ROMs which take the form of either computer assisted learning programs, encyclopaedia or well-known text books.

CD-ROM↗

The hospital library: access to information for rural health professionals.

This article examines some recent literature about the low physician-population ratios in rural areas. In an attempt to discover those factors which seem to preclude successful health care delivery in rural areas, it discusses a definition of the city as the place where the maximum lines of communication converge. A new concept, the "invisible city," is proposed, and the health care community in the United States is seen as an example. The library of the rural hospital, then, is defined as the location of the rural health professional's primary entrance into his own invisible city by means of professional communication through the biomedical literature.

Delivery of Health Care↗

Searching health education literature. Bibliographic and indexing tools.

The first two articles in this series looked in different ways at relationships between libraries and health education units. We now look at a selection of bibliographic and indexing tools that can be used to identify journal articles, books and other materials of interest to health educators. Audio-visual items are not covered.

Information Services↗

The NHS research and development programme and its impact on health care library and information resource centres.

This paper looks at the likely impact of the NHS research and development (R & D) programme on health care library and information centres. A brief description of the NHS R&D programme stresses the importance of the management of research and development findings to its success. This paper identifies a number of obstacles to the successful dissemination of R&D findings and discusses the role of health care libraries and information centres in overcoming some of these. It focuses on the essential contribution they can make in supporting the use of systematic reviews as the main source of quality evidence on the effectiveness of health care interventions.

Evidence-Based Medicine↗

Information needs in primary care: a survey of rural and nonrural primary care physicians.

OBJECTIVE: To compare the self-reported information needs of rural and nonrural primary care physicians. DESIGN AND PARTICIPANTS: Mail survey of active non-academic primary care physicians. DATA COLLECTION: A 60 item questionnaire regarding 1) demographic and practice setting data; 2) medical information needs; 3) medical knowledge resource availability and use; and 4) physician information seeking behavior. MAIN RESULTS: The response rate was higher among rural than non-rural physicians (55% vs. 42%, p< 0.001) and among Family Physicians than others (Family Medicine 53%, Internal Medicine 43%, Pediatrics 48%, p=0.015.) Rural physicians reported working more hours per week (45.3 vs. 42.7, p=0.033,) and seeing more patients per day (24.6 vs. 22.3, p=0.005) than their nonrural counterparts. Both groups reported a median of about 1 question for every 10 patients they see, with great variance among responses. Both groups reported pursuing answers to about 57% of their questions, and finding answers to about 70% of those they pursue. Knowledge resource preferences of the two groups were similar. Both groups reported frequent use of consultants, drug compendia, colleagues, and textbooks, and little use of library- or computer-based sources. Compared to nonrural physicians, rural physicians reported less frequent use of consultants, colleagues, librarians, and bound journals. These differences were small, and paralleled differences in availability. The two groups had equal access to textbooks and drug compendia, but for rural physicians, other resources were locally available significantly less often. CONCLUSIONS: Rural and nonrural primary care physicians reported equal information needs, similar information seeking, and similar resource preferences. Rural physicians reported less access to some information resources, but little difference in use of resources. Further studies are needed to determine how these differences impact rural practitioners and their patients.

Data Collection↗

The changing paradigm for continuing medical education: impact of information on the teachable moment.

The teachable moment is the time when a learner is ready to accept new information for use conceptually or in practice. Adult educators are always searching for that "moment" and models in which it has been incorporated. This article reviews the changing paradigm for continuing education of the health professional and the impact of information from the context of university-based providers of continuing education and information. Providers of continuing education and information face similar external opportunities and threats. The continuing education provider is a "marginal dweller" in the organization. The information provider (the library), although moving in that direction as technology affects the way information is accessed and managed, is much more a part of the core institutional mission. These parallel conditions provide opportunities for both organizations to work closely together to identify successful models to serve the "teachable moments" of all health care practitioners. A range of new library roles that suggest strong interaction with continuing educators is presented. Workable models are identified as well as characteristics of successful models. Suggestions for survival for continuing educators and librarians in "stalking the teachable moment" are discussed.

Education, Medical, Continuing↗

Are health science faculty interested in medical history? An evaluative case study.

This paper deals with the efforts of a medical library to stimulate interest in the history of medicine by utilizing its historical resources. It is based on a survey designed to evaluate the monthly publication of the library, the Bookman, and to determine the response of health science faculty to historical essays as well as to other sections of the publication. The results show that a large percentage of the faculty reads historical essays either regularly or occasionally, and reveal a trend contrary to the common belief that the teaching staff in health science centers is not interested in medical history. The authors suggest that a library with historical resources can contribute to the educational process in a medical community by actively publicizing its collections and providing opportunities for informal and self-initiated reading.

Attitude↗

A little help, a lot of independence. Retirement community advances the cause of aging with dignity.

Sometimes the elderly need only a little extra help to make it on their own. When this is the case, it behooves providers of healthcare and social services to meet those needs and allow these individuals to maintain the dignity of independent living as they age. At Resurrection Retirement Community, an independent living facility on Chicago's northwest side, the Garden Annex fills this niche in a unique model of independent living with additional services. Services include three meals a day in the common dining room, laundry service for household linen, and weekly maid service. Residents enjoy varied activities, exercise sessions, and socialization with friends and neighbors. They also have access to such amenities as daily religious services, a library, a beauty salon, and banking facilities. To live in the Garden Annex, prospective residents must meet certain physical and mental criteria and be able to function somewhat independently. In contrast to assisted living facilities, the Garden Annex does not provide nursing care or assistance with personal care. However, residents may take advantage of the continuum of care offered by Resurrection Health Care Corporation. They are afforded access to a medical center, a long-term care facility, and physicians' services.

Activities of Daily Living↗

Creating local bibliographic databases: new tools for evidence-based health care.

The Internet has created new opportunities for librarians to present literature search results to clinicians. In order to take full advantage of these opportunities, libraries need to create locally maintained bibliographic databases. A simple method of creating a local bibliographic database and publishing it on the Web is described. The method uses off-the-shelf software and requires minimal programming. A hedge search strategy for outcome studies of clinical process interventions is created, and Ovid is used to search MEDLINE. The search results are saved and imported into EndNote libraries. The citations are modified, exported to a Microsoft Access database, and published on the Web. Clinicians can use a Web browser to search the database. The bibliographic database contains 13,803 MEDLINE citations of outcome studies. Most searches take between four and ten seconds and retrieve between ten and 100 citations. The entire cost of the software is under $900. Locally maintained bibliographic databases can be created easily and inexpensively. They significantly extend the evidence-based health care services that libraries can offer to clinicians.

Costs and Cost Analysis↗