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1.
2.

Question

What to do when a major database ceases publication?

Setting

An urban, academic health sciences library with four campuses serves a university health sciences system, a college of medicine, and five other health sciences colleges.

Methods

Usage statistics of each e-book title in the resource were carefully analyzed. Purchase decisions were made based on the assessment of usage.

Results

Sustainable resources were acquired from other vendors, with perpetual access for library users.

Conclusion

This systematic process of finding alternative resources is an example of librarians'' persistence in acquiring perpetual electronic resources when a major resource is cancelled.  相似文献   

3.

Purpose

The study evaluated medical students'' familiarity with information literacy and informatics during the health sciences library orientation.

Methods

A survey was fielded at the start of the 2013 school year.

Results

Seventy-two of 77 students (94%) completed the survey. Over one-half (57%) expected to use library research materials and services. About half (43%) expected to use library physical space. Students preferred accessing biomedical research on laptops and learning via online-asynchronous modes.

Conclusions

The library identified areas for service development and outreach to medical students and academic departments.  相似文献   

4.
5.

Purpose

The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements.

Methods

Thirty-eight patient-provider interactions in two health care outpatient clinics were observed.

Results

Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers.

Conclusions

Providers'' EHR skills and knowledge levels contribute to non-standardized patient education delivery.  相似文献   

6.

Objective

The research investigated topic priorities for data literacy training for biomedical researchers and staff.

Methods

An electronic survey was used to assess researchers'' level of knowledge related to data literacy skills and the relevance of these skills to their work.

Results

Most respondents did not have any formal training in data literacy. Respondents considered most tasks highly relevant to their work but rated their expertise in tasks lower.

Conclusion

Among this group, researchers have diverse data literacy training needs. Librarians'' expertise makes them well suited to provide such training.  相似文献   

7.
8.

Objective

This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship.

Method

The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample''s responsibilities and skill sets.

Results

Coordination of patient care and a bachelor''s degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams.

Conclusion

Such overlap may provide an avenue for collaboration between navigators and health sciences librarians.  相似文献   

9.

Question:

What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center?

Setting:

The development took place at the University of Pittsburgh Health Sciences Library System.

Method:

The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized “on the fly” into meaningful categories using clustering technology and are directly accessible from the results page.

Results:

After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center''s electronic health record.

Conclusion:

The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness.  相似文献   

10.

Objective

The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.

Methods

In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants'' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen''s d statistic to compare pre- and post-study effects sizes.

Results

Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen''s d increase of +1.50 compared to AccessMedicine users'' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen''s d.

Conclusion

Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.Keywords and Medical Subject Headings (MeSH) Clinical Decision Support Systems, Computer-Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide, Information-Seeking Behavior, Medically Underserved Area, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Public Health Nurses, Randomized Controlled Trial as Topic, Service Learning, Vulnerable PopulationsHealth care practitioners regularly seek to incorporate valid information into their evidence-based decisions. Electronic information resources now provide easy access to current health information and summarized forms of evidence to support clinical decision making.

Access effects on health care

Health care providers who are affiliated with well-funded institutions benefit from access to a variety of high-quality information resources to support their evidence-based practices. Practitioners who are not affiliated with academic health sciences centers rarely have access to these same resources due to prohibitively high licensing costs. Ely et al. report that not having access to easy-to-use, high-quality, current information can negatively affect sound clinical decision making. [1].Patients in Isaac et al.''s study who were admitted to hospitals that had access to an electronic evidence-based resource experienced reduced length of stay and lower risk-adjusted mortality rates for prespecified conditions [2]. That study was validated on a broader scale by a multicenter investigation on the utilization of information resources by practitioners [3].Primary health care practitioners who are not affiliated with academic health sciences centers, particularly those who practice in rural or remote areas, often articulate the need for increased access to health information resources. The authors'' literature search and review of 114 of the most relevant research articles about the information needs and information-seeking behavior of health care practitioners suggested that these professionals most value speed and accuracy. For example, they likely would prefer to use point-of-care (PoC) resources for quickly and accurately answering their clinical questions.

Desirability of point of care

PoC resources quickly guide physicians through the diagnosis, treatment, and management of commonly encountered clinical conditions. PoC resources can present compilations of highly authoritative, often evidence-based, information. Physicians can answer more questions and revise clinical decisions more often using these PoC resources [4]. Meanwhile, many health care practitioners still rely on textbooks familiar to them from their professional training programs, despite their potentially dated contents [514].

Limited access in rural New Mexico

A randomized controlled trial involving public health practitioners across the rural state of New Mexico reported many barriers in accessing valued information resources [15, 16]. In another study, researchers in New Mexico set out to determine and analyze information needs of health care practitioners who were not affiliated with an academic center. Fifty-one interviews of rural physicians, nurses, physician assistants, and nurse practitioners showed both a need and desire for access to information resources [17].

Goals and hypothesis

This study sought to determine which rural health care providers found more useful in answering everyday clinical questions: electronic PoC DynaMed, which is more clinically oriented, or electronic PoC AccessMedicine, which consists primarily of a health sciences textbook collection. We hypothesized that free access to the explicitly clinical format of the PoC resource DynaMed would result in more extensive use than a baseline of zero over a six-month period than the electronic PoC textbook collection AccessMedicine. We felt this would be due to greater utility of DynaMed in clinical practice. We also predicted that clinicians using the clinically oriented PoC would express higher levels of satisfaction than those using the textbook-based PoC and that clinicians using these PoC resources would prefer using them over other information resources.  相似文献   

11.

Objectives

This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course.

Methods

Community assessments employing focus group interviews and an online survey were utilized to determine course need and content.

Results

Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information.

Conclusions

A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library''s profile.  相似文献   

12.

Objective

The choice of bibliographic database during the systematic review search process has been an ongoing conversation among information specialists. With newer information sources, such as Google Scholar and clinical trials registries, we were interested in which databases were utilized by information specialists and systematic review researchers.

Method

We retrieved 144 systematic reviews and meta-analyses from 4 clinical endocrinology journals and extracted all information sources used during the search processes.

Results

Findings indicate that traditional bibliographic databases are most often used, followed by regional databases, clinical trials registries, and gray literature databases.

Conclusions

This study informs information specialists about additional resources that may be considered during the search process.  相似文献   

13.

Objective:

The research conducted a large-scale, multisite study on the value and impact of library and information services on patient care.

Methods:

The study used: (1) 2 initial focus groups of librarians; (2) a web-based survey of physicians, residents, and nurses at 56 library sites serving 118 hospitals; and (3) 24 follow-up telephone interviews. Survey respondents were asked to base their responses on a recent incident in which they had sought information for patient care.

Results:

Of the 16,122 survey respondents, 3/4 said that they had definitely or probably handled aspects of the patient care situation differently as a result of the information. Among the reported changes were advice given to the patient (48%), diagnosis (25%), and choice of drugs (33%), other treatment (31%), and tests (23%). Almost all of the respondents (95%) said the information resulted in a better informed clinical decision. Respondents reported that the information allowed them to avoid the following adverse events: patient misunderstanding of the disease (23%), additional tests (19%), misdiagnosis (13%), adverse drug reactions (13%), medication errors (12%), and patient mortality (6%).

Conclusions:

Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.

Highlights

  • Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.
  • Electronic access to information resources from multiple locations has increased the ability of health professionals to use these resources for improved patient care.
  • The roles of librarians are diversifying to include management of electronic resources, user instruction and support, specialized research and clinical information search services, and involvement in institution-level quality improvement.
  • It is possible to conduct a large-scale, multisite study on the value and impact of library services on patient care.

Implications

  • Ongoing studies of the value and impact of library and information resources will be important for advocacy and quality improvement.
  • Community-Based Participative Research methods hold promise as a way of ensuring the relevance of future research.
  相似文献   

14.

Objectives:

The research investigated the extent to which students, residents, and faculty members in Canadian medical faculties use mobile devices, such as smartphones (e.g., iPhone, Android, Blackberry) and tablet computers (e.g., iPad), to answer clinical questions and find medical information. The results of this study will inform how health libraries can effectively support mobile technology and collections.

Methods:

An electronic survey was distributed by medical librarians at four Canadian universities to medical students, residents, and faculty members via departmental email discussion lists, personal contacts, and relevant websites. It investigated the types of information sought, facilitators to mobile device use in medical information seeking, barriers to access, support needs, familiarity with institutionally licensed resources, and most frequently used resources.

Results:

The survey of 1,210 respondents indicated widespread use of smartphones and tablets in clinical settings in 4 Canadian universities. Third- and fourth-year undergraduate students (i.e., those in their clinical clerkships) and medical residents, compared to other graduate students and faculty, used their mobile devices more often, used them for a broader range of activities, and purchased more resources for their devices.

Conclusions:

Technological and intellectual barriers do not seem to prevent medical trainees and faculty from regularly using mobile devices for their medical information searches; however, barriers to access and lack of awareness might keep them from using reliable, library-licensed resources.

Implications:

Libraries should focus on providing access to a smaller number of highly used mobile resources instead of a huge collection until library-licensed mobile resources have streamlined authentication processes.  相似文献   

15.

Objective:

A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.

Methods:

Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors'' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.

Results:

When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.

Conclusions:

Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers'' advisory practices, are suggested.

Highlights

  • Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.

Implications

  • Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
  • Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
  • An understanding of the patient''s potential epistemological community can make the librarian''s recommendations more appropriate for the individual user.
  相似文献   

16.

Objective

The authors sought to determine whether unexpected gaps existed in Scopus''s author affiliation indexing of publications written by the University of Nebraska Medical Center or Nebraska Medicine (UNMC/NM) authors during 2014.

Methods

First, we compared Scopus affiliation identifier search results to PubMed affiliation keyword search results. Then, we searched Scopus using affiliation keywords (UNMC, etc.) and compared the results to PubMed affiliation keyword and Scopus affiliation identifier searches.

Results

We found that Scopus''s records for approximately 7% of UNMC/NM authors'' publications lacked appropriate UNMC/NM author affiliation identifiers, and many journals'' publishers were supplying incomplete author affiliation information to PubMed.

Conclusions

Institutions relying on Scopus to track their impact should determine whether Scopus''s affiliation identifiers will, in fact, identify all articles published by their authors and investigators.  相似文献   

17.

Question:

Can e-readers loaded with medical textbooks and other relevant material benefit medical students, residents, and preceptors in clinical settings?

Settings:

The settings are North Carolina community clinics served by Duke University Medical Center and St. Joseph''s Hospital in Bryan, Texas, and Scott and White Memorial Hospital in Temple, Texas.

Methods:

Duke University: Twenty second-year medical students and fourteen family medicine clerkship preceptors used Kindle e-readers in clinics during eight months of rotations. Students and preceptors provided feedback through an anonymous online survey. Texas A&M University: Nine fourth-year medical students in an elective compared medical textbooks in print, online, and on a Kindle. Six residents at a local hospital completed an anonymous online survey after a three-week loan of a Kindle loaded with medical textbooks.

Results:

The e-reader''s major advantages in clinical settings are portability and searchability. The selected e-reader''s limitations include connection speed, navigation, and display. User preferences varied, but online resources were preferred. Participants suggested additional uses for Kindles in medical education.

Conclusions:

The selected e-reader''s limitations may be resolved with further development of the device. Investigation of other e-readers is needed. Criteria for evaluating e-readers in clinical settings should include portability, searchability, speed, navigation, and display. Research comparing e-readers and mobile devices in clinical education is also warranted.  相似文献   

18.

Objectives:

The research sought to determine if first-year medical students consulted and cited resources specifically highlighted during library instructional sessions.

Methods:

Students attended a library resources instructional session. Resources that pertained to the students'' assignment were demonstrated and discussed. The students created a report including citations from relevant literature. The citations were analyzed and categorized as: a resource discussed at the instructional session, a resource found on the course LibGuide, a library resource, course material, or some other resource. All citations were subcategorized as print or electronic.

Results:

Three years (2008–2011) of data analyzing 2,983 citations showed that 49.55% of all citations were from resources discussed during library instructional sessions; 21.86% came from resources with links on the course LibGuide; 77.51% were from library resources; and 90.68% came from electronic resources.

Conclusion:

Students cited resources specifically highlighted during library instructional sessions for their assignments. The percentage of all citations coming from resources highlighted during the instructional sessions or found on the course LibGuide indicates that library instruction had an impact on the students'' work.

Highlights

  • Review of the literature shows that instruction about library resources accompanied by clear guidelines on scholarly research methods and resources provided by course instructors have the biggest impact on the quality of cited materials in student bibliographies.
  • Graduate medical students cited library resources more frequently than nonlibrary resources for their assigned coursework.
  • Graduate medical students cited materials and resources specifically highlighted during library instructional sessions for their assigned coursework.

Implications

  • Instruction about library resources tailored to medical students'' assignments impacts the resources that the students consult and cite for their assignments.
  • Using the information gathered from citation analysis to modify teaching plans can impact the effectiveness of library instructional sessions.
  相似文献   

19.

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.

Highlights

  • Data support reported trends in the decrease in the number of hospitals and hospital libraries.
  • About 44.0% of hospitals had some level of onsite library service in 1989, compared with between 33.5% and 29.1% of hospitals in 2005/06.
  • More electronic services and resources, such as Internet access and online materials, are being offered by hospital libraries, in addition to more traditional services
  • Library staffing appears to be more unstable today than in 1989, with more libraries reporting a decrease in the number of staff.

Implications

  • Hospital libraries continue to change in response to changes in the health care environment as health care administrators respond to financial pressures, library staff are downsized, degreed librarian positions are eliminated, and reporting structures change.
  • MLA must continue to track the status of hospital librarians and libraries in light of the changing environment with surveys and other means, in partnership with others such as the National Network of Libraries of Medicine.
  相似文献   

20.
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