Related Articles

World understanding is more than a desirable goal today: it may be crucial to our survival. Many universities realize this and have in the past decade spent a great deal of time and money to ensure a steady flow of faculty and students between the U.S. and other countries. Librarians with faculty or academic status may benefit from promoting such relationships themselves. Job exchanges and training programs offer librarians in the United States the opportunity to become acquainted with their counterparts in other countries. Such programs enable librarians of various countries to become aware of one another's special needs and common problems, and allow them to share ideas and expertise. This paper presents an overview of international training programs for foreign librarians in the United States, focusing on programs for health sciences librarians in United States medical school libraries. Information is given on the availability and types of institutionally sponsored programs, as well as on MLA's Cunningham Fellowship Program. Some of the difficulties and the benefits of such programs are discussed.

In this environment of expanding information needs, spiraling journal costs, and curtailed financial resources, medical libraries must take advantage of the rapid evolution in document delivery services. There are exciting developments in transmission technology, from fax machines to scanners to the Internet. There is also a notable shift away from the traditional reliance on library networks toward use of commercial vendors as document providers. These changes require reevaluation of interlibrary loan (ILL) and document delivery systems on many levels, including pricing structures, work flow, and impact on collection development. As commercial vendors develop increasingly effective products, librarians can test, evaluate, and incorporate them into their ILL operations to enhance service to users and relieve the pressure to acquire new resources; in this way, librarians can move from the "just in case" practice of building an on-site collection to the "just in time" model of providing timely delivery of materials to users as needed. This paper describes a beta test of the Faxon Finder/Faxon Xpress table of contents and document delivery services conducted by the Treadwell Library of the Massachusetts General Hospital.

Access to biomedical literature has been shown to reduce the patient's length of stay and thus reduce the cost of the hospital visit. Unfortunately, access to the most current information, at the time and place of need, requires a substantial commitment of resources in the form of staff expertise, computer hardware and software, and user training. The cost of these resources may be prohibitively high for all but the largest institutions. The Arizona Health Information Network (AZHIN) brings together librarians, information systems specialists, and health care professionals from hospitals throughout the state in an effort to share resources and expertise. By reducing the cost of access, AZHIN has increased the availability of health-related information across the state. Progress in AZHIN's first two years is described.

After ten years of experimentation in computer-assisted cataloging, the Washington University School of Medicine Library has decided to join the Ohio College Library Center network. The history of the library's work preceding this decision is reviewed. The data processing equipment and computers that have permitted librarians to explore different ways of presenting cataloging information are discussed. Certain cataloging processes are facilitated by computer manipulation and printouts, but the intellectual cataloging processes such as descriptive and subject cataloging are not. Networks and shared bibliographic data bases show promise of eliminating the intellectual cataloging for one book by more than one cataloger. It is in this area that future developments can be expected.

Hospital librarians and information systems (IS) staff regard themselves as information professionals and have coexisted in the same institutions for many years. While hospital librarians have increased their computer literacy, IS staff have begun to recognize the value of knowledge-based information as an IS resource. Parallel growth and mutual interest have resulted in increased opportunities for information professionals to share skills and network for mutual advantage. Creating positive relationships between the hospital librarian and IS staff can be critical to the success of the hospital library. This paper provides a framework in which to explore the levels of relationship that exist within institutions between hospital librarians and IS staff. The "knowing/caring ladder" is presented as a model to illustrate levels of relationship and their consequences. The authors contend that recognition of the levels of professional relationship determines the success or failure of team building.

Picture-archiving and communication systems are complex entities, but at core they consist of compute processors that are networked together to store and retrieve objects. Therein lay fundamental aspects of both performance benchmarking and predicting future costs, provided one can accurately predict trends in both exam volumes and sizes. Hence, determining the correct amount of capital to reserve annually for the information technology infrastructure can be a difficult process for the administrator of a medical center. Both exam volumes and sizes tend to increase over time. In addition, users demand more compute-intensive applications and expect exam delivery to the desktop to be ever timelier despite the increase in size. Against this, storage, compute, and networking costs tend to decrease over time for the same performance level. At the end of the day, the question of whether to budget more or less capital for next year’s infrastructure is not trivial. This paper develops a methodology that uses current baseline data to predict the “ampleness” of a budget to meet future needs.

A survey to determine attitudes toward end-user searching was made at Loyola University's Medical Center Library using MEDIS, an online full-text and bibliographic medical retrieval system. One hundred forty-one completed questionnaires were analyzed for this report. Information was collected on user familiarity with computers, end-user training, system use, mechanics of searching, and attitudes toward future use. Computer familiarity was highest among the faculty users. Ninety percent of the respondents saw librarians as a crucial agent in training and in providing end-user assistance. Respondents identified five major reasons for using the system: helpfulness, convenience, time savings, rapid feedback, and presentation of needed information. Searching the MEDLINE database rather than the full-text database was the search method of choice. Continued use of both mediated and end-user searching was intended by most of the respondents. Survey results support a perceived need for end-user searching and confirmed recommendations of the Association of American Medical Colleges on medical information science skills.

A survey was conducted to solicit data related to health professionals image of librarians. Physicians, residents, nurses, medical students, dentists, pharmacists, physical therapists, and occupational therapists were questioned about their experiences with and opinions of librarians, particularly the skills and characteristics needed by helpful, successful librarians. Health sciences librarians were also questioned about their own professional image and their perceptions of their patrons' impression of librarians. Librarians and health professionals alike ranked good communication as the most important skill for librarians. Computer or technological skills were ranked fourth by librarians but second by health professionals. Although librarians tended to describe themselves in slightly more positive terms than did their patrons, health professionals viewed librarians as approachable, responsive, supportive, and open to change. Health professionals also reported that they received accurate, reliable, and timely information from librarians and that this information was valuable.

An in-house library system based on a dedicated mini-computer has been in operation in the Israel National Medical Library since the summer of 1979. The integrated system, called MAIMON, features on-line access to bibliographic and circulation records. It replaces manual procedures in cataloging, searching, lending, and reservations. The system provides previously unavailable statistics on items in heavy use and demand, items to be removed from the active collection, and who uses what in the library. It is designed to be user cordial and to save users' time. The system has been very favorably accepted by patrons, and frees professional librarians from time-consuming clerical routine tasks. The system is evaluated in terms of performance, convenience, and cost.

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.

This paper describes the means by which a computer-supported group interaction system known as the Computer-Mediated Tutorial Laboratory (CMTL) is used to support Problem-Based Learning Tutorials. The Problem-Based Learning Tutorial process has traditionally been solely a group process, sharing both the advantages and the disadvantages of any group process. This paper discusses the nature of Problem-Based Learning, the logistics of integrating computer mediation with the tutorial process and how computer mediation can be used to facilitate the eliciting and recording of individual input while enhancing the powerful effects of the group process.

Very powerful data base management systems (DBMS) now exist which allow medical personnel access to patient record data bases. DBMS's make it easy to retrieve either complete or abbreviated records of patients with similar characteristics. In addition, statistics on data base records are immediately accessible. However, the price of this power is a large computer with the inherent problems of access, response time, and reliability. If a general purpose, time-shared computer is used to get this power, the response time to a request can be either rapid or slow, depending upon loading by other users. Furthermore, if the computer is accessed via dial-up telephone lines, there is competition with other users for telephone ports. If either the DBMS or the host machine is replaced, the medical users, who are typically not sophisticated in computer usage, are forced to learn the new system. Microcomputers, because of their low cost and adaptability, lend themselves to a solution of these problems. A microprocessor-based intelligent terminal has been designed and implemented at the USAF School of Aerospace Medicine to provide a transparent interface between the user and his data base. The intelligent terminal system includes multiple microprocessors, floppy disks, a CRT terminal, and a printer. Users interact with the system at the CRT terminal using menu selection (framing). The system translates the menu selection into the query language of the DBMS and handles all actual communication with the DBMS and its host computer, including telephone dialing and sign on procedures, as well as the actual data base query and response. Retrieved information is stored locally for CRT display, hard copy production, and/or permanent retention. Microprocessor-based communication units provide security for sensitive medical data through encryption/decryption algorithms and high reliability error detection transmission schemes.

Highly modular software design permits adapation to a different DBMS and/or host computer with only minor localized software changes. Importantly, this portability is completely transparent to system users. Although the terminal system is independent of the host computer and its DBMS, it has been linked to a UNIVAC 1108 computer supporting MRI's SYSTEM 2000 DBMS.

The goal of this study was to conduct an outcomes-based evaluation of the National Cancer Institute-Frederick (NCI-F) Scientific Library’s Laptop Librarian service, where librarians took a laptop and spent time in research buildings. The authors used statistics from the Laptop Librarian sessions, a NCI-F community-wide online survey, and in-person interviews to evaluate the service. The Laptop Librarian service increased the accessibility of librarians and saved patrons’ time. Users gained useful information and expressed overall satisfaction with the service. The Laptop Librarian service proves to be a useful means for increasing access to librarians and providing users with necessary information at this government research facility.

Conceptual connections between users and information sources depend on an accurate representation of the content of available information sources, an accurate representation of specific user information needs, and the ability to match the two. Establishing such connections is a principal function of medical librarians. The goal of the National Library of Medicine's Unified Medical Language System (UMLS) project is to facilitate the development of conceptual connections between users and relevant machine-readable information. The UMLS model involves a combination of three centrally developed Knowledge Sources (a Metathesaurus, a Semantic Network, and an Information Sources Map) and a variety of smart interface programs that make use of these Knowledge Sources to help users in different environments find machine-readable information relevant to their particular practice or research problems. The third experimental edition of the UMLS Knowledge Sources was issued in the fall of 1992. Current priorities for the UMLS project include developing applications that make use of the Knowledge Sources and using feedback from these applications to guide ongoing enhancement and expansion of the Knowledge Sources. Medical librarians are involved heavily in the direction of the UMLS project, in the development of the Knowledge Sources, and in their experimental application. The involvement of librarians in reviewing, testing, and providing feedback on UMLS products will increase the likelihood that the UMLS project will achieve its goal of improving access to machine-readable biomedical information.

Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services.

Background

Learning the exact demographic characteristics of a neighborhood in which a public library serves, assists the collection development librarian in building an appropriate collection. Gathering that demographic information can be a lengthy process, and then formatting the information for the neighborhood in question becomes arduous.

As society ages and the methods for health care evolve, people may take charge of their own health. With this prospectus, public libraries should consider creating a consumer health collection to assist the public in their health care needs. Using neighborhood demographic information can inform the collection development librarians as to the dominant age groups, sex, and races within the neighborhood. With this information, appropriate consumer health materials may be assembled in the public library.

Methods

In order to visualize the demographics of a neighborhood, the computer program ArcView GIS (geographic information systems) was used to create maps for specified areas. The neighborhood data was taken from the U.S. Census Department's annual census and library addresses were accumulated through a free database. After downloading the census block information from the data was manipulated with ArcView GIS and queried to produce maps displaying the requested neighborhood demographics to view in respect to libraries.

Results

ArcView GIS produced maps displaying public libraries and requested demographics. After viewing the maps the collection development librarian can see exactly what populations are served by the library and adjust the library's collection accordingly.

Conclusions

ArcView GIS can be used to produce maps displaying the communities that libraries serve, spot boundaries, be it "man-made or natural," that exist prohibiting customer service, and assist collection development librarians in justifying their purchases for a dedicated consumer health collection or resources in general.

Librarians are exploring new approaches to information sharing to cope with a rapidly changing environment dominated by budget cuts, information explosion, and globalization of the economy, science, and culture. In 1990, the University of Illinois at Chicago Library of the Health Sciences (UIC LHS) initiated a pilot project aimed at establishing an effective balance between state-of-the-art information technology and traditional library methods and promoting cooperation among health information professionals by establishing the Health Information Referral Network (HIRN) in the state of Illinois. HIRN's background and development, Internet home page, and networking techniques reviewed in this paper are applicable to multitype libraries and information centers interested in improving information use and the referral process.

Nonprint materials are rapidly becoming important information and learning resource materials for the health science library. Because of their long experience in organizing and utilizing informational materials, libraries represent highly appropriate repositories and sites for utilization of these new materials. Nonprint materials differ from printed materials in several ways, and this may account for the resistance of some librarians to dealing with them. One of the most important differences is that a machine must serve as mediator between the information and the user of nonprint materials. Also, the great variety of formats and machines can confuse the novice. The librarian must learn to deal with these differences in a creative way through a process of cooperation and collaboration with media and educational technology specialists.

Health sciences librarians have historically viewed disseminating information to health professionals as a major role. Typically, they have provided individualized services and are among the professions that help health professionals further their education after finishing formal education. Another group directly involved in health professional continuing education is continuing education (CE) providers who offer ongoing learning through group activities. These two professions often reached the same audiences in the past, and their different approaches--individual and group--were complementary. Health professionals who needed information immediately or who wished individual learning used the library while those who wanted to hear eminent colleagues tended to use CE meetings or seminars; some did both. The librarians and CE providers rarely interacted, but this is now changing. With the introduction of personal computers, medical librarians have expanded their responsibilities to include formalized classroom instruction. At the same time, CE providers have increased their scope beyond formalized group instruction into individualized education. Librarians and CE providers can either collaborate and share their expertise or they can compete against each other.

This paper presents the User Software Engineering (USE) approach for developing specifications for an interactive information system (IIS) and shows how the method is applied to the specification of a Perinatal Data Registry system. Two linked views of the system are developed: a user view suitable for computer-naive users, and a design/verification view, suitable for computer-knowledgeable users.

The user view is intended to facilitate user participation in the analysis task and in the definition of the user/system dialogue. The verification view is intended to facilitate design and testing of the resulting system. The two notations share their notations for data base definition and for specification of the user/system dialogue; however, the user view may utilize narrative text for describing the operations, while the design/verification view relies on a more formal specification method.

The specification method encourages effective communication between users and developers and permits refinement of the specification in order to ensure that the resulting specification is as complete, consistent, and accurate as possible before proceeding with design and implementation.

The Care Windows development project demonstrated the feasibility of an approach designed to add the benefits of an event-driven, graphically-oriented user interface to an existing Medical Information Management System (MIMS) without overstepping economic and logistic constraints. The design solution selected for the Care Windows project incorporates three important design features: (1) the effective de-coupling of severs from requesters, permitting the use of an extensive pre-existing library of MIMS servers, (2) the off-loading of program control functions of the requesters to the workstation processor, reducing the load per transaction on central resources and permitting the use of object-oriented development environments available for microcomputers, (3) the selection of a low end, GUI-capable workstation consisting of a PC-compatible personal computer running Microsoft Windows 3.0, and (4) the development of a highly layered, modular workstation application, permitting the development of interchangeable modules to insure portability and adaptability.

*MEDLEARN*, a second-generation computer-assisted instruction (CAI) program available (nationally) since October 1976, provides on-line training for MEDLINE, one of the National Library of Medicine's (NLM) Medical Literature Analysis and Retrieval System (MEDLARS) data base. *MEDLEARN* was developed as a joint effort between NLM and The George Washington University Medical Center. Using MEDLINE formats throughout, *MEDLEARN* combines tutorial dialogue, drill and practice, testing, and simulation. The program was designed in three tracks oriented to basic methods, advanced techniques, and new developments. Each topic is presented on two levels, permitting an alternate explanation for users encountering difficulty. *MEDLEARN*, coded in the computer language PILOT, was developed with a modular structure which promotes ease of writing and revision. A versatile control structure maximizes student control. Frequent interactions check immediate recall, general comprehension, and integration of knowledge. Two MEDLINE simulations are included, providing the student an opportunity to formulate and execute a search, have it evaluated, and then perform the search in MEDLINE. Commenting, news broadcasting, and monitoring (with permission only) capabilities are also available. Subjective field appraisals have been positive and NLM plans to expand *MEDLEARN* and produce similar programs for other data bases.

Many ongoing selective dissemination systems designers assume that the librarian can be omitted from active participation in execution of the master plan. ISI's four years of experience with ASCA® service have shown that librarians must be an integral part of the system and engage in an active dialogue between users and the machine. Specific examples of how librarians can best serve the information needs of scientists using SDI systems are examined. It is the basic contention of this paper that the librarian should serve as an intermediary between users and the numerous new information media. In this manner the librarian can filter and translate the requirements of individual scientists to conform with the inherent limitations of all machine systems while exploiting their capabilities to the fullest.

Objectives: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies.

Methods: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service.

Results: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included.

Conclusions: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.

The information age demands that health sciences librarians take active roles in the educational process. Librarians have traditionally taught users how to access information. Now, with the proliferation of information, librarians must accept new roles and teach the user efficient techniques for evaluating and processing information as well. Innovative roles for librarians at Texas Tech University Health Sciences Center include teaching users to use technology for information management, to appraise literature critically for quality, and to develop skills for lifelong learning. This paper reviews the history of educational activities in health sciences libraries and describes the teaching programs at Texas Tech.