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Circuit librarianship: a twentieth anniversary appraisal.

The twentieth anniversary of circuit librarianship is a fitting occasion to reflect on its history and success. The tradition of circuit riders is traced and the hallmarks and achievements of circuit librarian programs are described. Providing information services to remote health professionals has been a longstanding concern of medical librarianship, and it is presently a major focus of the National Library of Medicine. It is suggested that widespread adoption of circuit librarianship would not only satisfy the information needs of unserved health professionals but could enhance the image of the profession given the centrality of the librarian, not the library, in this model.

Health Services Accessibility↗

A successful cross-training experience of reference service at UCLA.

This paper describes a successful cross-training and reference librarian exchange experience involving two librarians at UCLA, one based at the Louise M. Darling Biomedical Library and the other based at the College Library, which primarily serves undergraduates. The experience has increased the reference skills and expertise of both librarians by introducing them to new sets of reference tools and databases, and has broadened their network of colleagues within the UCLA Library system. The participating libraries have also benefited from the exchange, and the program is expanding to include other UCLA libraries.

Inservice Training↗

Evaluation of a peer-reviewed career development and compensation program for physicians at an academic health science center.

OBJECTIVE: The Department of Pediatrics at the Hospital for Sick Children, which is funded by an alternative payment plan, has implemented a novel career development and compensation program (CDCP). Job activity profiles were used to more clearly define job expectations, benchmarks guided career development, and peer review was used to assess performance. The objective of this study was to evaluate the departmental pediatricians' satisfaction with the CDCP. METHODS: Pediatricians, all of whom had undergone CDCP annual reviews, could participate if they had undergone the in-depth triennial CDCP review. Each received a 5-point Likert scale-based questionnaire that asked how well the CDCP had conformed to the principles identified by the department during the development of the CDCP. Anonymous, confidential responses were collated and used to guide focus groups that discussed areas of greatest concern and attempted to identify solutions. Focus groups were led by external facilitators who were experienced in qualitative research. They audiotaped the sessions, transcribed the comments, and analyzed the data with the assistance of a qualitative analysis application. RESULTS: Sixty of the eligible 88 pediatricians participated, and 74% of their responses were that the CDCP had addressed the original principles "somewhat," "to a great extent," or "extremely well." The remainder indicated that some of the principles were either "not addressed" or "only to a small extent" by the CDCP. Results from the 11 focus groups (46 participants) indicated that the CDCP was an improvement over the previous method of career development and determination of the rate of remuneration. Most were also still in agreement with the purpose and design principles. Although they did not want the CDCP to undergo a major redesign, they identified areas that need improvement. Short-, medium-, and long-term action plans to address these areas are under way. CONCLUSION: Pediatricians at the health science center of the Hospital for Sick Children remain supportive of the CDCP.

Academic Medical Centers↗

The design and use of appropriate health technologies for developing countries.

Health care in developing countries is discussed in terms of the administrative systems, medical manpower and technologies which are most appropriate to the economic and cultural environment in which they will be used. Appropriate technology must be preceded by appropriate research and development and those involved in the training of overseas students should critically examine the relevance of the course to the needs of the students.

Biomedical Engineering↗

Hospital pharmacy staff development programs in Ohio.

Although staff development programs have been used to implement clinical services in Ohio hospital pharmacies, the majority of clinical services have been implemented without the use of staff development programs. The results of this study show that less than half of Ohio hospital pharmacy departments provide staff development programs. In those hospitals where the programs were provided, the average number of clinical services implemented through staff development was not significantly different from the average number implemented without these programs. Nor was there a significant difference in the average number of clinical services implemented through staff development between small hospitals (199 beds or less), medium hospitals (200 to 399 beds), and larger hospitals (400 or more beds); between government (city, county, or state) and private, nonprofit hospitals; and between hospitals whose staff development program coordinators were directors and hospitals whose coordinators were not directors. For the majority of departments that provided staff development programs, certification or testing of pharmacists was not required before providing clinical services. Results from the survey indicated that certification may not be necessary for all clinical services. Commitment to staff development programs in terms of management support and participation, awarding of continuing-education credit, and use in pharmacist performance evaluations was demonstrated by no more than 34 percent of all departments that responded. Financial commitment to these programs was low. Overall, since less than half of the departments reported providing staff development programs, the level of commitment to staff development appeared to be low.

Education, Pharmacy, Continuing↗

A policy for allocating off-site continuing education funds.

Providing support for travel to conferences, workshops and other off-site continuing education activities is an expensive component of a professional development program. The authors describe a policy addressing this issue which was implemented within the multidisciplinary environment of a comprehensive cancer centre. The policy is open, easily adapted to changes in overall funding and can be used to reflect the organization's expectations regarding employee performance in service, academic, management and leadership roles.

Budgets↗

Developing physician leaders in academic medical centers.

While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.*

Academic Medical Centers↗