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2.  The changing status of hospital libraries 1984 to 1989: characteristics and services in Region 7 of the National Network of Libraries of Medicine. 
Economic and political factors have had far-reaching effects on hospital libraries in the last decade, but quantitative evidence of these changes is not readily available. Through periodic evaluation surveys within its multistate region, the Pacific Southwest Regional Medical Library Service, the Regional Medical Library for Region 7 of the National Network of Libraries of Medicine (formerly the Regional Medical Library Network) has monitored hospital library changes over the years. This paper compares data from a 1989 survey with similar information gathered in 1984. Longitudinal analysis was performed on responses from 188 hospitals that responded to both the 1984 and the 1989 survey, as was cross-sectional analysis of all responses from both surveys. Results showed a small decrease in the number of hospitals with separate library collections. Staffing patterns had changed considerably, with a drop of approximately one entire full-time salaried equivalent per library and a decrease in libraries managed by a librarian with an M.L.S. The libraries that provide all of a set of predefined core services and resources decreased from 61% in 1984 to 44% in 1989. Libraries with M.L.S. staff were more likely to have core services than those without professional staff.
PMCID: PMC225642  PMID: 1600427
3.  1991 survey of recent health sciences library building projects. 
Twenty health sciences libraries reported building planning, expansion, or construction of new facilities in the association's second annual survey of recent building projects. Six projects are new, freestanding structures in which the library occupies all or a major portion of the space. Six other projects are part of new construction for separately administered units in which the library is a major tenant. The final eight projects involve additions to or renovations of existing space. Seven of these twenty libraries were still in projected, predesign, or design stages of awaiting funding approval; of those seven, five were not prepared to release the requested information. Six projects are reported here as illustrative of current building projects.
PMCID: PMC225633  PMID: 1600420
4.  Clinical medical librarian impact on patient care: a one-year analysis. 
The primary role of the clinical medical librarian (CML)--locating and providing quality-filtered, patient-specific information to physicians--has been questioned recently because of the dramatic rise in end-user searching. This study administered a questionnaire to evaluate the current impact of this service in a major hospital setting with a long established CML program. The study showed that the CML provided house officers with information that affected patient care (defined as diagnosis, diagnostic tests, or treatment) between 40% and 59% of the time. This was true even though most physicians reported they generally researched the question prior to consulting the CML. In addition, the house officers in this study indicated that they distributed the CML-provided information to other health care providers 56%-96% of the time. Based on these limited results, it appears that CMLs can continue to provide information that has a strong impact on patient care, despite the availability of an end-user local MEDLINE system.
PMCID: PMC225610  PMID: 1537012
5.  Research in health sciences library and information science: a quantitative analysis. 
A content analysis of research articles published between 1966 and 1990 in the Bulletin of the Medical Library Association was undertaken. Four specific questions were addressed: What subjects are of interest to health sciences librarians? Who is conducting this research? How do health sciences librarians conduct their research? Do health sciences librarians obtain funding for their research activities? Bibliometric characteristics of the research articles are described and compared to characteristics of research in library and information science as a whole in terms of subject and methodology. General findings were that most research in health sciences librarianship is conducted by librarians affiliated with academic health sciences libraries (51.8%); most deals with an applied (45.7%) or a theoretical (29.2%) topic; survey (41.0%) or observational (20.7%) research methodologies are used; descriptive quantitative analytical techniques are used (83.5%); and over 25% of research is funded. The average number of authors was 1.85, average article length was 7.25 pages, and average number of citations per article was 9.23. These findings are consistent with those reported in the general library and information science literature for the most part, although specific differences do exist in methodological and analytical areas.
PMCID: PMC225697  PMID: 1422504
6.  Total quality management (TQM) in a hospital library: identifying service benchmarks. 
Hospitals are turning to total quality management (TQM) to lower costs of providing care. A hospital library in a TQM environment needs to embrace corporate goals while maintaining its accountability as a contributor to quality patient care. Alliant Health System (AHS) Library at Norton Hospital and Kosair Children's Hospital in Louisville, Kentucky, conducted a study to establish TQM benchmarks and to examine the significance of its role in clinical care. Using a methodology designed to allow both library user and nonuser to respond, 2,091 surveys were distributed to physicians and nursing and allied health personnel. Areas surveyed included frequency of library use, impact of information received on clinical judgments, cognitive value of the information, and satisfaction with library products and services. Results confirm that the library has a substantial clinical role. Eighty-eight percent of reporting physicians agreed that information from the library contributed to higher quality care. Nursing and allied health were less convinced of the importance of the library's clinical role. Sixty-nine percent of nursing personnel and 58% of allied health personnel agreed that the library contributed to higher quality care. Nursing and allied health personnel also used the library less frequently than physicians. With these results as benchmarks, improving the clinical role of the library will take commitment to the TQM process and a willingness to change.
PMCID: PMC225698  PMID: 1422505
7.  Imperatives for continuing research education: results of a Medical Library Association survey. 
This paper reports the results of a survey assessing the interest of Medical Library Association (MLA) members in acquiring or improving research skills through continuing education (CE). It describes respondents' educational preparation for research and selected research activities, reviews MLA's experiences with offering CE courses on research topics, and discusses MLA's role in providing education to prepare members for research. The paper includes recommendations for improving research skills through CE and other professional activities. Topics of greatest interest to MLA members were survey development, problem identification, evaluation and cost studies, survey methodology, and methods of data collection. Many respondents preferred local courses. Academic health sciences librarians, as a group, were found to be more productive publishers than hospital librarians. Many respondents reported the availability of free or subsidized research-support services, but more than half did not. More than 90% of respondents indicated that MLA should actively encourage, require, or offer research education. A comprehensive plan for obtaining research skills through CE, along with individual self-assessment and counseling, is recommended.
PMCID: PMC225659  PMID: 1525614
8.  Prototyping an institutional IAIMS/UMLS information environment for an academic medical center. 
The paper describes a prototype information environment designed to link network-based information resources in an integrated fashion and thus enhance the information capabilities of an academic medical center. The prototype was implemented on a single Macintosh computer to permit exploration of the overall "information architecture" and to demonstrate the various desired capabilities prior to full-scale network-based implementation. At the heart of the prototype are two components: a diverse set of information resources available over an institutional computer network and an information sources map designed to assist users in finding and accessing information resources relevant to their needs. The paper describes these and other components of the prototype and presents a scenario illustrating its use. The prototype illustrates the link between the goals of two National Library of Medicine initiatives, the Integrated Academic Information Management System (IAIMS) and the Unified Medical Language System (UMLS).
PMCID: PMC225668  PMID: 1326371
9.  Trends in medical school library statistics in the 1980s. 
Ten years of statistics from over 140 U.S. and Canadian medical school libraries are analyzed to determine trends in library collections, staffing, services, and expenditures. In addition, ratios of use patterns and personnel utilization are shown. Costs over the ten-year period are examined in both actual and constant dollar amounts. The trends in costs show continuous rises in absolute and constant dollars both for materials and personnel. The number of serials subscriptions remained fairly constant while the number of monographs added declined slowly. Collection use grew, although traditional external circulation declined. Interlibrary lending and borrowing increased throughout the decade. Reference service workload increased, while the use of external databases decreased. The longitudinal data indicate trends in medical school libraries that may assist administrators and staff to shape future services, staffing patterns, and budget requests.
PMCID: PMC225609  PMID: 1537018
10.  The medical libraries of Vietnam--a service in transition. 
The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation, they have somehow managed to provide a sound basic level of information services for health care professionals.
PMCID: PMC225670  PMID: 1525617
11.  Selected list of books and journals in allied health. 
This list of 396 books and 77 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Due to the necessity of limiting the scope of coverage because of the large number and wide range of allied health professions and occupations, the recommended publications are focused primarily on the twenty-eight programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, medical secretarial, nutrition, and speech pathology/audiology. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals is followed by an alphabetical title listing. Items suggested for initial purchase (194 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1992 subscriptions) would require an expenditure of about $22,800. The cost of only the asterisked items totals $10,850.
PMCID: PMC225661  PMID: 1525616
12.  A multidisciplinary approach to information management and critical appraisal instruction: a controlled study. 
A study of the effectiveness of a collaborative course in teaching library and critical appraisal skills was conducted at the University of Illinois College of Medicine. A critical appraisal and library skills course was taught at the Peoria site during the third-year medical clerkship. The performance of Peoria students on a twenty-item multiple choice posttest was compared to that of third-year students in Rockford, who received no library or critical appraisal instruction during their medicine clerkship. The two groups were similar in self-perceived library skills, critical appraisal skills, and other demographic values. Peoria students scored significantly higher on library, critical appraisal, and total posttest questions. An improving trend during the year was not observed at either site, implying that students were not acquiring these skills in day-to-day clerkship activities. Results suggest that this multidisciplinary course is effective in teaching library and critical appraisal skills.
PMCID: PMC225611  PMID: 1537013
13.  The landmark citation method: analysis of a citation pattern as a collection assessment method. 
The landmark citation method is a new collection assessment method based on the citation record of a single landmark article. This citation record is developed by identifying sources which cite the landmark article. A bibliography, extracted from the citation record, is then used to complete an assessment of the collection. This method was developed and used to assess the biotechnology collection of the National Library of Medicine. The information gained from this study, in addition to demonstrating the technique, also provided insight into the evolution of the biotechnology literature.
PMCID: PMC225700  PMID: 1422507
14.  In support of research. 
PMCID: PMC225707  PMID: 1422514
15.  Creating the future: IAIMS planning premises at the University of Washington. 
In September 1990, the University of Washington (UW) received a Phase I IAIMS Planning Grant from the National Library of Medicine and embarked upon a planning process involving the entire health sciences center. As a result of our relatively late entry into IAIMS planning, we have been able to learn from the experiences of other health sciences centers and to leverage our existing institutional efforts. Consequently, our progress has been rapid, and in a little over a year, we drafted a long-range plan and embarked on several related research and development projects. The hallmarks of our planning process include careful study of both the UW institutional environment and the experiences of other IAIMS institutions throughout the United States; broad, interdisciplinary participation of faculty, librarians, and administrators; an intensive educational process; a focus on people rather than technology; and, above all, leveraging of existing institutional and research projects that support our vision for the future.
PMCID: PMC225669  PMID: 1326372
16.  ACOGQUEST: the model phase of the IAIMS project of the American College of Obstetricians and Gynecologists. 
In 1990, the American College of Obstetricians and Gynecologists (ACOG) became the first national organization to receive a model phase Integrated Academic Information Management System (IAIMS) grant from the National Library of Medicine. The goal of the ACOG model phase project is to develop and test a prototype for an integrated system that will meet the needs of ACOG and NAACOG members in patient care, research, education, and administrative information. The model phase goal will be accomplished primarily through ACOGQUEST, an integrated approach to providing accurate, current, quality-filtered information to ACOG and NAACOG members in a variety of formats. Another method of information dissemination now being tested is a heuristic-based patient management database, which will include a concise, interactive display of ACOG-reviewed information that can be incorporated into patient records.
PMCID: PMC225667  PMID: 1326370
17.  IAIMS development at Baylor College of Medicine. 
At Baylor College of Medicine, we are developing the technical and intellectual resources needed to realize the Integrated Academic Information Management System (IAIMS) concept fully. The substantial technical, organizational, and financial commitments involved demand that we align our efforts with the strategic purposes of the college. The support of science, therefore, has become the principal, but not exclusive, focus of Baylor's IAIMS effort. Even so, the information technology architecture we have created for biomedical research is proving valuable in other settings as well. And the infrastructure we are creating--the communications architecture and the linkages to information resources--serves many purposes in addition to those of research. The architecture accommodates a diversity of workstations, networks, and informational and computational servers. This will be the greatest possible chance of transferring the fruits of our Phase III development to other academic medical centers.
PMCID: PMC225664  PMID: 1326367
18.  Bringing back the librarian, Part Three. 
PMCID: PMC225648  PMID: 1600431
19.  Authorship outlets of academic health sciences librarians. 
Journal articles are the most common publication format for U.S. academic health sciences librarians. This is consistent with the findings of other researchers. Of the total publications in this study, 68% were in journals. Watson found that 69% of the academic librarians' publications were published in some type of journal [8]. Similarly, Yerkey and Glogowski found that 67% of the publications in their study were journal articles, although their population consisted of all types of authors of library/information science materials [9]. Both the present study and Watson found that monographs were the second most common publication outlet. Watson found that 16% of the total publications were monographs; the current study identified 14.8% of the total publications as monographs [10]. Although Watson's findings are similar to the newer results, it is important to note that Watson's study was conducted in a different manner and included book reviews, which were not counted in the present study. The health sciences librarians in the present study published more than two thirds of their articles in library/information science journals and 27% in health sciences journals. Similarly, in Yerkey and Glogowski's study, the second-largest number of library/information science articles appeared in medical and health sciences journals [11]. Fang also found that 22.57% of the journal articles on health sciences librarianship or by health sciences librarians were in medical journals [12. This seems to demonstrate the desire of health sciences librarians to communicate with the health professionals. Yerkey and Glogowski that library and information science is an interdisciplinary field, "borrowing and supplying information to and from other disciplines"[13].
PMCID: PMC225644  PMID: 1600429
20.  Medical knowledge for clinical problem solving: a structural analysis of clinical questions. 
Despite technological advances that support wide-ranging access to and transfer of knowledge, practicing physicians continue to underutilize current biomedical literature. This paper explores the nature of clinically applicable medical knowledge through a structural analysis of clinical questions. The author analyzed a set of sixty questions, based on actual online search requests of practicing physicians, for stated and unstated needs, certainty levels, implicit and explicit assumptions, decision-making processes, and type of answer required. As a result, four states of information valuable in patient care were identified: prediagnostic assessment, diagnosis, treatment choice, and learning. These states are presented in frame-like structures that integrate declarative and procedural components of medical decision making. It is concluded that clinical problem solving requires a blend of declarative and procedural knowledge. The ratio depends, in part, upon the reasoning process underway at the time of the request. Procedural knowledge required for clinical problem solving may be absent from current biomedical journal literature or difficult to identify.
PMCID: PMC225637  PMID: 1600423
21.  Impact of end-user search training on pharmacy students: a four-year follow-up study. 
The Alfred Taubman Medical Library at the University of Michigan has offered instruction in online literature searching to third-year pharmacy students as a component of the course "Drug Information and Scientific Literature Evaluation" since 1983. In the spring of 1989, a follow-up study was conducted to assess the impact of instruction on four classes of graduates. Of a pool of 151 graduates, 90 (60%) responded to a mailed questionnaire on their use of information and computerized literature searching. The respondents were divided into four subgroups: end-user searchers, users of intermediaries, end users who used intermediaries, and those who did not use computerized literature search systems. Seventy-two percent of the respondents used some type of computerized literature searching, and 42% performed their own searches. The four subgroups differed in general computer use, familiarity with MEDLINE search terminology, information use, reasons for using or not using literature searching, and characteristics of searches (i.e., type, time frame, amount, and frequency). Training in end-user search systems appears to have had an impact on the continued use of computerized literature searching several years after the formal educational program.
PMCID: PMC225635  PMID: 1600421
22.  User interactions with the PDQ cancer information system. 
Searches by end users and intermediaries on the online PDQ (Physician Data Query) cancer information system were observed. With the National Library of Medicine (NLM) menu-based interface, end users (physicians) averaged fewer steps per question, while with the BRS command-drive interface, intermediaries appeared to be more efficient. Cancer Information Service (CIS) searchers, who have more PDQ experience than end users or intermediaries, made greater use of command stacking to anticipate menu selections. Retrieval was more complete in the NLM system, where both the menus and predefined print formats assisted the searchers.
PMCID: PMC225612  PMID: 1537014
23.  Dial-in access to CD-ROM databases: beyond the local area network. 
Although it has meant additional work, CDLink has enhanced the productivity and effectiveness of the library's public services program. CDLink enables the library to offer dial-in access to databases, either in CD-ROM or other MS-DOS formats. The VAX MS-DOS connection is a cost-effective way to combine the benefits of remote access and multiple simultaneous use. From the user's perspective, CDLink provides free, twenty-four-hour remote access to databases in a friendly, menu-driven environment. For the library staff, the CDLink service represents the achievement of a long-awaited goal.
PMCID: PMC225704  PMID: 1422511
25.  Syndrome--a changing concept. 
Syndrome is one of the oldest terms in the medical vocabulary. Traditionally, the term has been used mainly as a designation for complex medical entities, such as multiple abnormalities, that are characterized by clusters of concurring symptoms, usually three or more. During the mid-twentieth century, the meaning and the use of the term were altered. First to take place was an attempt to eliminate physicians' names from syndrome nomenclature, resulting in a significant increase in the use of descriptive designations in proportion to eponyms. But the trend was counterbalanced by the creation of new classes of eponyms. Eponymous syndrome nomenclature now includes the names of literary characters, patients' surnames, subjects of famous paintings, famous persons, geographic locations, institutions, biblical figures, and mythological characters. This was followed by a relaxation in the scope of the definition of syndrome, wherein the term could also be used as a modifier indicating a special (sometimes unspecified) complexity of an already named pathological condition. Eventually syndrome changed from its original use as an exclusively medical term and came to mean anything unusual, abnormal, bizarre, or humorous, whether medical, social, behavioral, or cultural. This unrestrained use of the term is the principal cause of an enormous volume of the sometimes irrelevant syndrome literature cluttering databases in the MEDLARS system and of the deterioration of "SYNDROME" as a specific MeSH term and a useful search parameter.
PMCID: PMC225693  PMID: 1422501

Results 1-25 (97)