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Health sciences librarians and mental health laws.

Two U.S. Supreme Court decisions, O'Connor v. Donaldson and Bounds v. Smith, hold important implications for health sciences librarians serving in mental health facilities. The first, O'Connor, with its many ancillary holdings, puts mental health personnel on notice that patients have certain basic rights, which courts all over the country will now be required to enforce. In Bounds the court has ruled that prison authorities must assist prison inmates in preparing and filing legal papers. The ruling will most likely benefit all mentally disabled prisoners, and future litigation may expand this category to include: (1) persons committed under the criminal code, (2) persons under involuntary commitment not related to the criminal code, and (3) persons voluntarily committed. A selective annotated bibliography, consisting of background readings in mental health and the law, basic rights, law library materials, and mental health legal services, has been compiled to help librarians establish and develop legal collections in anticipation of court decisions that will expand the conditions of Bounds to include all mentally disabled patients.

Bibliographies as Topic↗

The clinical librarian: new team member for a Family Practice Inpatient Service.

A clinical librarian program was developed for the Family Practice Inpatient Service at the San Francisco General Hospital Medical Center. Objectives of this special service were: (1) to provide relevant articles and other printed resources relating to patient care problems; (2) to alert the team to library resources; (3) to assist the attending physicians in building a reading file for the inpatient service; and (4) to determine library service needs of the team. Two patient cases are included which illustrate how the clinical librarian service functioned. The program was successful and is recommended for inclusion in other family practice programs or inpatient units.

Family Practice↗

The development of education for medical librarians.

Formal education for medical library specialization was initiated only thirty-two years ago despite the fact that medical libraries received special treatment for many years before that time. The philosophy of specialized education was developed as early as 1925, and this theory was finally put into practice beginning with the medical reference and bibliography course given at Columbia in 1939. In the late 1940s the requisites for medical librarians were formalized into a certification code by the Medical Library Association, and since that time specialized education for medical librarians has grown stronger using this code as a guideline. This education consists basically of two types-formal library school courses and internship programs which offer a working-while-learning situation. Now that the established programs have a few years of history, there is a need for evaluation and restatement of goals and methods.

Allied Health Personnel↗

The medical librarian and computer-assisted instruction.

The requirements for a computer-assisted instruction (CAI) system in terms of hardware, communications, software, and personnel are discussed, and unique characteristics of CAI are reviewed. Current CAI applications in the medical field include programs in undergraduate medical and dental education, training of nurses and physical therapists, units for interns and residents, and continuing education for physicians. Certain problems exist in the current state of the art, however, including unsatisfactory aspects of each of the system components. The potential role of the medical librarian as a member of a CAI personnel team is explored, and contributions he can make in program development, monitoring, and evaluation are suggested. Medical librarians may themselves have opportunities in the future to use CAI to develop library skills and special subject knowledge. It is proposed that introduction of CAI may have the additional benefit of encouraging increased use of on-line bibliographic retrieval systems.

Computer-Assisted Instruction↗

Educating Hungarian medical librarians in special literature.

In Hungary the completion of a thirty-month course is required of those who wish to qualify as medium-level librarians. Medical librarians are given a special course which differs from the general course in that it covers the subjects of medical terminology and information in special literature. The latter subject is accorded the highest number of teaching hours, since the subject matter is vast and since, in addition to theory, much time must be spent on exercises and the presentation of reference books. The students become familiar with the main Hungarian and foreign information systems in the medical and related fields and with special bibliographies, encyclopedias, handbooks, and dictionaries. We take special care to familiarize students with the abstracting journals and indices. For several semesters they have homework and lesson exercises in the use of the Hungarian Medical Bibliography and Index Medicus.

Education, Graduate↗

Oral history and the medical librarian.

In recent years there has been an increasing interest in the "oral history," as a technique for creating records or source materials for medical historians. The unique aspects of this technique include the ability to supplement the written record with candid commentary, to create a record or collection of information about an individual or a specific subject area in those instances where a prior record does not exist, and to capture a sample of the personality of the person being interviewed by preservation of the tape recording. There is a lack of unanimity regarding the definition, limits, and goals of oral history. Some individuals insist that the oral historian must in fact be a trained historian and deplore the thought of librarians utilizing this technique. It is the feeling of the author that the interviewer's professional "label" is frequently unimportant, if that individual has prepared himself adequately for the interview. The ideal set of circumstances which combines the oral history memoir with the acquisition and review of the respondent's papers can be handled well by the librarian with the interest and time to conduct such a program. There is general agreement that the time has come when reasonable standards for this technique must be developed if the various programs are to command the interest and respect of those who will use these increasing collections of data. On a more practical level, it is only natural that those who are asked to provide financial support for oral history programs will demand evidence of attention to some sort of standards.

History of Medicine↗

Medical librarians and the White House Conference: from complacency, to concern, to commitment.

The evolution of a National Program for Library and Information Services has been a long and involved process. A major landmark in this evolution was the White House Conference held in November 1979. The participation of medical librarians was also slow to evolve from initial complacency to strong commitment. A description of this evolution and participation by medical librarians and the Medical Library Association in White House Conference activities is reported.

Congresses as Topic↗

Case-related use of the medical literature. Clinical librarian services for improving patient care.

Clinical librarian services provide highly specific, case-related medical literature searches in a manner that permits the information obtained to influence ongoing case management. We have measured the impact of such services on actual case management and on diagnostic thinking in a random sample of 50 searches over five months provided to house officers on medical and pediatric services of a university hospital. Patient management was affected in 20% of cases, and diagnostic thinking was influenced in an even higher percentage of instances. In comparison with information generated by other ancillary services such as clinical laboratories, clinical librarian services appear to be highly effective at an acceptable cost. Since the information generated by such searches may often result in further cost savings to patients, the potential overall efficiency of such services may be great.

Cost-Benefit Analysis↗

Evaluation of a clinical medical librarian program at the Yale Medical Library.

A clinical medical librarian (CML) program in a large university-based teaching hospital setting is viewed by the majority of clinicians as education-oriented, with slightly fewer clinicians viewing it as patient care oriented. The CML service has been utilized for research purposes only when it is clear that case-relevant information can evolve into research intended to have "clinical" impact. This study reports the results of a questionnaire circulated among clinicians receiving CML support by a large medical school library. Results indicate that (1) the CML effected a change in information-seeking behavior by the clinicians--they obtained information that would not have been available to them if the CML had not been present in patient-management conferences; (2) relevancy of information provided by the CML was judged by the clinicians to be very high; (3) the accuracy of the CML's search, coupled with the rapidity of delivery, was found to be highly satisfactory; (4) acceptance of the CML within the patient care setting was acknowledged by the majority of clinicians, who contact the CML in-hospital and overwhelmingly prefer to do so; and (5) there was no statistically significant variation in the manner in which different medical specialties use the services of a CML. These findings justify implementation of a clinical medical librarian program, on a modified basis, as an additional service to already existing reference services offered by a large medical school library.

Connecticut↗

JCAH accreditation and the hospital library: a guide for librarians.

The continuing effort to develop standards for libraries in health care institutions has resulted in the creation of two broad groups of standards: (1) quantitative and specific, and (2) qualitative and flexible. The library standards of the Joint Commission on Accreditation of Hospitals (JCAH), a major example of the second type, were revised and expanded considerably in 1978, bringing them into line with standards for other hospital departments. Possible areas of unclarity or difficulty for the librarian in complying with the revised JCAH standards are discussed, including those relating to staffing, consultants, library technicians, analysis of resources, assessment of needs, documentation, policies and procedures manuals, and the library committee. The JCAH site visit, including preparation of the Hospital Survey Profile, gathering information for the surveyor, and the summary conference, offers opportunities to librarians to participate in an institution-wide effort, to upgrade management practices, and to demonstrate the need for, and effectiveness of, library services in their hospitals.

Accreditation↗

Interdisciplinary multiinstitutional alliances in support of educational programs for health sciences librarians.

This project responds to the need to identify the knowledge, skills, and expertise required by health sciences librarians in the future and to devise mechanisms for providing this requisite training. The approach involves interdisciplinary multiinstitutional alliances with collaborators drawn from two graduate schools of library and information science (University of Illinois at Urbana-Champaign and Indiana University) and two medical schools (University of Illinois at Chicago and Washington University). The project encompasses six specific aims: (1) investigate the evolving role of the health sciences librarian; (2) analyze existing programs of study in library and information science at all levels at Illinois and Indiana; (3) develop opportunities for practicums, internships, and residencies; (4) explore the possibilities of computing and communication technologies to enhance instruction; (5) identify mechanisms to encourage faculty and graduate students to participate in medical informatics research projects; and (6) create recruitment strategies to achieve better representation of currently underrepresented groups. The project can serve as a model for other institutions interested in regional collaboration to enhance graduate education for health sciences librarianship.

Cooperative Behavior↗

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations.

Computer Communication Networks↗

Biomedical periodicals in Nigerian Medical Libraries: the medical librarian's dilemma.

The Nigerian medical librarian has an uphill task in his effort to satisfy the journal needs of users of his library. His problems stem from difficulties in the selection and acquisition of journals, delay in postal services, budgetary and other administrative controls, and the changing nature of medical education and health-care services in Nigeria. The librarian's attempts to solve these problems include increased subscriptions to journals and use of interlibrary loans, but the absence of union lists of holdings of other libraries, the heavy cost of photocopying services, and poor postal facilities present another dimension to his problems. Eventually his best solution seems to lie in the establishment of a national center for "least used" journals to serve as a source stock for the country's medical libraries.

Book Selection↗

Evidence-based resources and the role of librarians in developing evidence-based practice curricula.

The implementation of evidence-based practice (EBP) requires acquisition and use of a complex set of skills, including the ability to locate and critically evaluate clinically relevant research literature. In this article, we discuss information resources and tools that may be of value to educators faced with the task of teaching students to search for and evaluate research-based evidence. In addition, we discuss how health sciences librarians, with the use of new models of information instruction and delivery, can work with nursing faculty in developing curricula for training students in EBP.

Computer User Training↗

The legal responsibilities of the health-care librarian.

This article discusses the legal responsibilities that information intermediaries have towards the users of their services. The areas of law that affect legal liability are contract law, tort and strict liability. The likelihood of health-care librarians being held liable for the service they provide is assessed, and methods of reducing this risk are discussed. The key issues are: whether the recipient is relying on the information you provide and whether this reliance is reasonable; whether money changed hands; and whether the institution is under a statutory obligation to provide the information. All-embracing exclusion clauses are often used as an attempt to exclude liability, but their validity in law is doubtful, and they should be replaced by more reasonable ones. Adhering to good professional practice, and avoiding interpreting information for laymen are ways of minimizing liability. If court proceedings do take place, professional indemnity insurance can reduce financial loss.

Insurance, Liability↗

What do clinicians want from us? An evaluation of Brighton and Sussex University Hospitals NHS Trust clinical librarian service and its implications for developing future working patterns.

BACKGROUND: The Clinical Librarian (CL) Service at Brighton was established in 2003 with the aim of providing high-quality evidence to designated teams and fostering an evidence-based culture. OBJECTIVE: To evaluate the CL service at Brighton and discuss the implication of the findings. METHODS: A combination of internally collected data (n = 167), and an external evaluation of the service by questionnaires (n = 86) of users and non-users and interviews (n = 9) of users. RESULTS: Internal data suggest that the service is valued by its users and that patient care and continuing professional development are the most common uses for searches (confirmed by the external study); that searches generally result in some change in knowledge; and that this knowledge is disseminated. The external study found that visibility of the CL was crucial to the effectiveness of the role and that clinicians used the service mostly to get access to a wider range of resources and/or to save time. Users wanted the CL to include evaluative annotation with the results, and for the CL role to become more embedded in the team. Interview results expanded on the issues of integration of the CL and the need for annotation of results. CONCLUSIONS: To be most effective, CLs would be dedicated to one team, but financial constraints make this unlikely. Alternative working patterns are suggested as a possible compromise.

Access to Information↗

History of medicine on the Internet: resources for librarians.

This paper offers an inventory of resources on the history of medicine on the Internet. Some sites are bibliographic; they supply book and journal citations. Some provide leads (or links) to more specific information, and some include full-text articles or historical essays. Because this material is intended to furnish librarians with reference direction, more attention is given to bibliographic and "linked" sites.

Computer Communication Networks↗

History of medicine on the Internet: resources for librarians.

This paper offers an inventory of Internet resources on the history of medicine. Some sites are bibliographic; they supply book and journal citations. Some provide leads (or links) to more specific information, and some include full-text articles or historical essays. Because this material is intended to furnish librarians with reference direction, more attention is given to bibliographic and "linked" sites. This paper updates a previous version published in Medical Reference Services Quarterly in Spring 1998.

History of Medicine↗