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Objective:

The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities.

Methods:

The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis.

Results:

The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years.

Conclusions:

Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.

Objective: An expert consensus on the future of the library as place was developed to assist health sciences librarians in designing new library spaces.

Method: An expert panel of health sciences librarians, building consultants, architects, and information technologists was asked to reflect on the likelihood, desirability, timing, and impact on building design of more than seventy possible changes in the use of library space.

Results: An expert consensus predicted that the roles librarians play and the way libraries are used will substantially change. These changes come in response to changes in technology, scholarly communication, learning environments, and the health care economy.

Conclusions: How health sciences library space is used will be far less consistent by 2015, as space becomes more tailored to institutional needs. However, the manner in which health sciences libraries develop and deliver services and collections will drastically change in the next decade. Libraries will continue to exist and will provide support for knowledge management and clinical trials, provide access to digital materials, and play a host of other roles that will enable libraries to emerge as institutional change agents.

From the vantage point of her personal experience, the author examines milestones since the 1960s which have changed the medical library profession and helped shape the Medical Library Association. The advent of automation, including cataloging with OCLC and online literature searching through the SUNY Biomedical Communication Network, was a dramatic event that transformed the work and priorities of librarians, fulfilling the dreams of earlier visionaries. The application of technology in libraries led to an increased demand for education and training for librarians. The Medical Library Association responded with continuing education programs, and a series of important reports influenced how the association filled its role in professional development. Legislation providing federal funding, such as the Medical Library Assistance Act, resulted in a period of expansion for libraries and their services. The Medical Library Association has developed a legislative agenda to influence action in areas such as copyright. In the future, health sciences librarians must take a leadership role.

A Delphi study was undertaken to identify the changes in library roles and functions that the directors of academic health sciences libraries believe will occur over the next decade. The methodology is described and the results are summarized. Two scenarios resulted: one, highly desirable; the other, highly probable. They overlap by 64%. Library directors expect moderate evolutionary changes in the next ten years. Users are perceived to be the force maintaining the status quo, while technology is the force advancing change. The adoption of technology is seen as desirable and within the libraries' span of control. Education and service roles of librarians will expand. Library and institutional priorities are seen as obstacles to change.

Georgetown University's Library Information System (LIS), an integrated library system designed and implemented at the Dahlgren Memorial Library, is broadly described from an administrative point of view. LIS' functional components consist of eight "user-friendly" modules: catalog, circulation, serials, bibliographic management (including Mini-MEDLINE), acquisitions, accounting, networking, and computer-assisted instruction. This article touches on emerging library services, user education, and computer information services, which are also changing the role of staff librarians. The computer's networking capability brings the library directly to users through personal or institutional computers at remote sites. The proposed Integrated Medical Center Information System at Georgetown University will include interface with LIS through a network mechanism. LIS is being replicated at other libraries, and a microcomputer version is being tested for use in a hospital setting.

The fundamental idea of the library must change. The nineteenth-century idea of the library as the embalming of dead genius and the twentieth-century idea of the library as the repository for second-hand knowledge must give way to the idea of the library as the owner and the librarian as the manager of first-hand knowledge. In the coming era of knowledge capitalism, those individuals and organizations will flourish who are able to apply knowledge to create knowledge and to organize it to produce knowledge. The roles of present-day librarians and libraries will begin to differentiate sharply over the next decade. Some must seize the opportunity to participate in the transformation of libraries into online knowledge servers.

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The value of the library as place is examined in this Janet Doe Lecture. The lecture, which is intended to focus on the history or philosophy of health sciences librarianship, presents an overview of the library as a place in society from ancient times to the present. The impact of information technology and changes in the methods of scholarly publication from print to digital are addressed as well as the role of the library as the repository of the written historical record of cultures. Functions and services of libraries are discussed in light of the physical library facility of the future. Finally, librarians are asked to remember the enduring values of librarianship in planning libraries of the future.

The form in which knowledge is described and encapsulated has a major impact on the design of libraries and the functions performed within the library. Libraries as we known them have been primarily built to store and disseminate knowledge in book format. New technology and the changing needs of knowledge workers, which form important parts of the logocentric, practicentric, and democentric elements of our information infrastructure, have created profound changes in our culture, challenge our definition of knowledge, and necessitate flexible designs for our libraries. The invention of practical mediums for information access, such as the book in the seventeenth century, television in the twentieth century, and perhaps the Internet in the twenty-first century, open the door to self-education with little economic discrimination. New roles for libraries are emerging that require flexibility in building design for moving collections, services, functions, and equipment; restructuring staff organizations; introducing new services associated with new technology; eliminating unnecessary or nonaffordable services; and housing other institutional departments within the structure of the "new" library.

The Annual Statistics of Medical School Libraries in the United States and Canada (Annual Statistics) is the most recognizable achievement of the Association of Academic Health Sciences Libraries in its history to date. This article gives a thematic history of the Annual Statistics, emphasizing the leadership role of editors and Editorial Boards, the need for cooperation and membership support to produce comparable data useful for everyday management of academic medical center libraries and the use of technology as a tool for data gathering and publication. The Annual Statistics' origin is recalled, and survey features and content are related to the overall themes. The success of the Annual Statistics is evident in the leadership skills of the first editor, Richard Lyders, executive director of the Houston Academy of Medicine-Texas Medical Center Library. The history shows the development of a survey instrument that strives to produce reliable and valid data for a diverse group of libraries while reflecting the many complex changes in the library environment. The future of the Annual Statistics is assured by the anticipated changes facing academic health sciences libraries, namely the need to reflect the transition from a physical environment to an electronic operation.

As the Medical Library Association prepares to enter its second century of service to society, it can look back with pride on the remarkable record of achievements of the association and its members, both personal and institutional, which are preserved for posterity in the Janet Doe Lectures. Established in 1966 by an anonymous donor, the Janet Doe Lectures on the history or philosophy of medical librarianship trace the development of health sciences libraries and librarianship and the evolution of the Medical Library Association. The major themes which emerge from this comprehensive review of the lectures published between 1967 and 1997 include the changing roles and values of health sciences libraries and librarianship; education and credentialing of health sciences librarians; MLA activities and concerns; and MLA/National Library of Medicine relations.

As the technological environment changes and libraries assume new and more active roles in their institutions, the traditional library hierarchy ceases to be an effective organizational structure. Guided by theories that emphasize teamwork, quality, and employee empowerment and participation, libraries are developing flatter, more networked organizations. The Health Sciences Library at Columbia University in New York, New York, recently underwent a reorganization in an effort to become a more resilient, more flexible organization. The process was beneficial overall. While some errors and confusion occurred, these are seen as opportunities for learning and evidence of the library's new atmosphere of creativity and experimentation.

Hospitals are changing to cope with a new environment and their libraries are changing with them. We demonstrate that hospital librarians can influence the change process and that expanding the role of the library is one option. Four case reports are presented to illustrate generic problems and how each library has coped with them. The issues facing hospital libraries today are viewed within the broader perspective of the American health care system.

Background: Leaders in the profession encourage academic health sciences librarians to assume new roles as part of the growth process for remaining vital professionals. Have librarians embraced these new roles?

Objectives: This research sought to examine from the reference librarians' viewpoints how their roles have changed over the past ten years and what the challenges these changes present as viewed by both the librarians and library directors.

Method: A series of eight focus groups was conducted with reference librarians from private and public academic health sciences libraries. Directors of these libraries were interviewed separately.

Results: Reference librarians' activities have largely confirmed the role changes anticipated by their leaders. They are teaching more, engaging in outreach through liaison initiatives, and designing Web pages, in addition to providing traditional reference duties. Librarians offer insights into unanticipated issues encountered in each of these areas and offer some creative solutions. Directors discuss the issues from their unique perspective.

Conclusion: Librarians have identified areas for focusing efforts in lifelong learning. Adult learning theory, specialized databases and resources needed by researchers, ever-evolving technology, and promotion and evaluation of the library are areas needing attention. Implications for library education and continuing professional development are presented.

Among the factors which will influence the emerging roles of medical libraries will be the changing needs of the medical scholars who use them. The effectiveness of the medical practitioner will be determined to an increasing extent by his capacity to mobilize information with a rapidity sufficient to permit its application in day-to-day decision-making. The practice of medicine is becoming an increasingly academic pursuit. The library and the librarian will, therefore, become more directly involved in the practice of medicine, and the library will be a more crucial resource in providing superior patient-care. Changes in undergraduate and continuing medical education will make new demands on the library. These and other related developments will create new functions, new problems, and new opportunities for the librarian.

The Medical Library Association's certification plan, never of real significance in employment and promotion practices in health sciences librarianship, does not reflect the many changes which have occurred in swift progression since adoption of the code in 1949. Solutions to the problems which have accumulated since then are sought in a brief examination of trends in credentialing and certification in the health professions and in the library field, both general and special. Emphasis is given to the historical development of provisions in the MLA Code for the Training and Certification of Medical Librarians, the limited opportunity for practical implementation of most of the provisions, the importance of the code in stimulating the Association's educational programs, the impact of the Medical Library Assistance Act, Regional Medical Programs, and increases in demand for health information on manpower requirements for health science libraries, the specific dissatisfactions MLA members have expressed over certification, and the role of the Ad Hoc Committee to Develop a New Certification Code.

The Association of American Medical Colleges, under National Library of Medicine sponsorship, is conducting a study of the academic health sciences library's roles in education for the health professions as these may be affected by changes in health information handling and management. The study's aims, objectives, and methods are described. The study aims to develop guiding principles for the use of academic health center administrators, library administrators, federal agency personnel, and others involved in planning and policy decision making for health sciences libraries.

In response to an increasing concern on the part of the library staff over the role of the departmental libraries at The Milton S. Hershey Medical Center of The Pennsylvania State University, a questionnaire was developed by the George T. Harrel Library and sent to departmental libraries. From the analyzed responses, the authors were able to define the role of departmental libraries in a medical school/hospital situation, to analyze the Hershey Medical Center situation in an objective manner, to outline areas of possible cooperation between the main and departmental libraries, and to delineate some trends which appear to result from inadequate finding of a central library. Overall, the library found that departmental libraries at Hershey are currently maintaining collections consistent with the functional role of a departmental library.

Combinatorial libraries continue to play a key role in drug discovery. To increase structural diversity, several experimental methods have been developed. However, limited efforts have been performed so far to quantify the diversity of the broadly used diversity-oriented synthetic (DOS) libraries. Herein we report a comprehensive characterization of 15 bis-diazacyclic combinatorial libraries obtained through libraries from libraries, which is a DOS approach. Using MACCS keys, radial and different pharmacophoric fingerprints as well as six molecular properties, it was demonstrated the increased structural and property diversity of the libraries from libraries over the individual libraries. Comparison of the libraries to existing drugs, NCI Diversity and the Molecular Libraries Small Molecule Repository revealed the structural uniqueness of the combinatorial libraries (mean similarity < 0.5 for any fingerprint representation). In particular, bis-cyclic thiourea libraries were the most structurally dissimilar to drugs retaining drug-like character in property space. This study represents the first comprehensive quantification of the diversity of libraries from libraries providing a solid quantitative approach to compare and contrast the diversity of DOS libraries with existing drugs or any other compound collection.

This article introduces a series of articles examining the state of the medical library profession as practiced in the clinical context. It is widely understood that many changes across the spectrum of medical librarianship practice have been brought about by both technological advances and economic realities. These changes have created strains felt by many in the profession. Discussions of evolving roles for medical librarians that have gone on for years have taken on a new sense of urgency, not just because support of library services is at stake, but also because new opportunities, which many are eager to explore, await librarians. In June 2000, an editorial appearing in a mainstream medical journal proposed a reinvention of clinical librarianship that, if designed as presented in the editorial, would have a dramatic effect on current hospital-based library practice. This series of articles was developed in an effort to provide thoughtful consideration of the “informationist” model and to present new ways to look at the core competencies that define the profession.

Abstract

The growing public interest in health and wellness information stems from many sources, including social changes related to consumers' rights and women's health movements, and economic changes brought about by the managed health care revolution. Public, hospital, and medical center libraries have been ill-equipped to meet the increasing need for consumer-oriented materials, even though a few notable programs have been established. The “Information Superhighway” could be an effective tool for sharing health information if access to telecomputing equipment and training were available to those with an information need. The University of Cincinnati Medical Center, with its libraries in the leading role, is delivering NetWellness, an electronic consumer health library service, to residents of 29 counties in three midwestern states. Users connect directly through the Internet, through regional Free-Nets, and by visiting one of 43 public access sites where networked workstations have been installed. The continued success of the project depends on developing partnerships, providing quality content and maintaining fair access.

The Medical Library Association's fifth annual survey of recent health sciences library building projects identified twenty-five libraries planning, expanding, or constructing new library facilities. None of the fifteen new library projects are free standing structures; however, several occupy a major portion of the project space. Ten projects involve renovation of or addition to existing space. Information regarding size, cost of project, type of construction, completion date, and other factual data was provided for twelve projects. The remaining identified projects are in pre-design or early-design stages, or are awaiting funding approval. Library building projects for three hospital libraries, three academic medical libraries, and an association library are described. Each illustrates how considerations of economics and technology are changing the traditional library model from a centrally stored information depository housing a wide range of information under one roof where users come to the information, into an electronic model gradually shifting from investment in the physical presence of resources to investment in creating work space for creditible information specialists who help in-house and distanced users to obtain information electronically from any place and at any time. This new model includes a highly skilled library team to manage, filter, and package the information to users trained by these resident experts.

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Alternative models of subsidizing scholarly publishing and dissemination have germinated and gathered momentum in the fertile soil of dissatisfaction. Like the stubborn spring dandelion that needs but a small crack in the sidewalk to flower boldly, the first flowers of Open Access in library literature, including Biomedical Digital Libraries, have sensed their opportunity to change the existing paradigm of giving away our scholarship and intellectual property, only to buy it back for the privilege of knowing it can be read. Will biomedical digital library and informatics researchers understand their role in a new era of Open Access simply by desiring an immediate uninhibited global audience and recognizing the necessity of open access peer-reviewed literature to become self-sufficient?

Differential fluorescence induction (DFI) technology was used to identify promoters of Streptococcus pneumoniae induced under various in vitro and in vivo conditions. A promoter-trap library using green fluorescent protein as the reporter was constructed in S. pneumoniae, and the entire library was screened for clones exhibiting increased gfp expression under the chosen conditions. The in vitro conditions used were chosen to mimic aspects of the in vivo environment encountered by the pathogen once it enters a host: changes in temperature, osmolarity, oxygen, and iron concentration, as well as blood. In addition, the library was used to infect animals in three different models, and clones induced in these environments were identified. Several promoters were identified in multiple screens, and genes whose promoters were induced twofold or greater under the inducing condition were mutated to assess their roles in virulence. A total of 25 genes were mutated, and the effects of the mutations were assessed in at least two different infection models. Over 50% of these mutants were attenuated in at least one infection model. We show that DFI is a useful tool for identifying bacterial virulence factors as well as a means of elucidating the microenvironment encountered by pathogens upon infection.

Libraries will be changed by technological and social developments that are fueled by information technology, bioinformatics, and networked information. Libraries in highly focused settings such as the health sciences are at a pivotal point in their development as the synthesis of historically diverse and independent information sources transforms health care institutions. Boundaries are breaking down between published literature and research data, between research databases and clinical patient data, and between consumer health information and professional literature. This paper focuses on the dynamics that are occurring with networked information sources and the roles that libraries will need to play in the world of medical informatics in the early twenty-first century.

Changes in the role of information services librarians and in the health care environment have required a rethinking of the provision of reference services at the University of Illinois at Chicago Library of the Health Sciences. This is a report of a new service offered after that analysis. An information desk staffed by twenty-five library technical assistants was established. Details of staff training, scheduling, and data gathering for this new service are provided. After eight months of operation, an evaluation of services provided by the Information Desk was conducted. A combination of evaluation methodologies, both quantitative and qualitative, has been used to determine overall staff performance. Results from analysis of service statistics, structured observations of real-time services operations, and questionnaires distributed to information services librarians and to patrons are presented. The findings from this study are discussed in terms of comparison with similar studies in other libraries and identification of future research studies. The results confirm the value of the Information Desk and support the decision to continue this service model.