Opportunities and Challenges in Health Sciences Librarianship: Health and Medical Information Reteival

Frankie PasionFebruary 14, 20141Challenges and Opportunities in Health Sciences Librarianship: Health and Medical Information RetrievalDisclaimer: There are other challenges and other opportunities worth discussing, such as challenges of decreased budgets and funding brought on by economic factors, yet opportunities arise from public policies to fund billions of dollars for hospitals and medical centers to improve information/communications technologies (e.g. EHR, EMR)The length of this presentation will not allow me to elaborate on this, so I will focus on info retrieval1Overview2Explore the challenges in health sciences librarianship with respect to health/medical information retrieval

Explore opportunities created to respond to these challenges: new and emerging roles for health sciences librarians2Challenges3It is estimated that the doubling of medical knowledge in:1950 was 50 years1980 was 7 years2010 was 3.5

In 2020 it is projected to be 0.2 years just 73 days What was learned in the first 3 years of medical school will be just 6% of what is known at the end of the decade from 2010 to 2020.- Challenges and Opportunities Facing Medical Education, Denson, 2011So what does this mean for librarians and end-user populations?3Challenges4The rapid expansion of knowledge challenges our ability to assimilate and apply it effectively

Overwhelming amount of information on the internet and online

Google, Google Scholar, PubMed, OPAC, etc

Time constraints for end users to navigate through millions of articles, hundreds of journals and dozens of databases

End users are not trained to evaluate sources

Recent graduates in MLIS lack expert searching skills in health sciences librarianship

i.e. assimilate into our system and apply it for education and dissemination to use in health care and medicineNext 3 slides illustrates the amount of information retrieved from a basic search using keywords and phrasesNote most MLIS programs lack health sciences librarianship courses 58 schools programs reviewed by Detlefsen in 2012 article, the majority of programs offered only one course targeted to health sciences or medical librarianship. In my two years in my program it was offered only once, and I was lucky enough to take a class that was offered in my last semester! This is my own personal challenge45 SOURCESEARCH TERMSrheumatoid arthritisdrug treatments

rheumatoid arthritisdrug treatment therapy rheumatoid arthritis AND(therapy OR therapeutics OR treatment)(rheumatoid arthritis OR RA) AND(therapy OR therapeutics OR treatment) # of resultsGoogle11 million32.5 million23.5 million258 millionGoogle Scholar274,000773,0001 million4 millionPubMed11,00032,00057,000382,000UIC library catalog220,000(HS 41)173,000(HS 33)342,000(HS 151)2 million(1113)I created a table and graphs to illustrate challenges of basic search strategies using key words my search results were overwhelmingI chose places where end-users might typically do their initial searchAlso demonstrates that not all search engines, OPAC and databases are equal with search terms (which one auto OR, auto AND? Word order also matters for Google and GSDifferent scenarios that I expect from novice to good searches by end-usersNote: UIC e-sources are only a fraction of total results5A - drug treatments rheumatoid arthritisB - rheumatoid arthritis drug treatment therapyC - rheumatoid arthritis AND (therapy OR therapeutics OR treatment)D - (rheumatoid arthritis OR RA) AND (therapy OR therapeutics OR treatment)6Note: amount of results are in the thousands 100000=1 million, 300000=300 millionNext slide chart without Google6A - drug treatments rheumatoid arthritisB - rheumatoid arthritis drug treatment therapyC - rheumatoid arthritis AND (therapy OR therapeutics OR treatment)D - (rheumatoid arthritis OR RA) AND (therapy OR therapeutics OR treatment)7Still a lot of results from 32,000 to 4 million, but this can be reduced further using advanced search and retrieval skillsNote Boolean theory (more ORs than ANDs increase results as in C and D. A and B without Boolean, the search goes according to the particular database, platform or search engines default. Some default to AND some default to OR not all search systems are equal So what kind of information do end-user need among all these results?7Challenges8Examples of informational needs in evidence based medicine:Medical knowledgeText books, journals, databases, web sourcesPractice guidelines, drugs, clinical trials, research literature etc.Data (health and sickness in populations)Public health departments

Other informational needs:Policies, administrative, legal, local information on doctors for referral, etc.

Before you can find reliable and relevant information on EBM you need some expert skillsExplained on next slide by MLA 8Challenges9End users and recent MLIS graduates lack the skills required to be expert searchers

The Medical Library Association (MLA) defines 13 skills required to become an expert searcher:

Ability to identify and search resources beyond the electronically available published literature, gray literature, unpublished information, and Web documents

John Hopkins tragedy in 2001 prompts standardsHealthy 24 year old asthma volunteer died from hexamethonium,Researcher failed to find multiple citations that indicated risk (used only PubMed)

MLA webpage about standards in expert searching http://www.mlanet.org/resources/expert_search/policy_expert_search.htmlOlder articles were available in Medline and textbooks about the risks of hexamethonium.

9Opportunities10Traditional health sciences librarian roles remain the same today, but they are doing different things now to keep pace with technology.

Health sciences librarians are evolving with technology and trends to facilitate the delivery of information and knowledge to students, faculty, researchers, physicians and other medical professionals and consumers of health information

Though roles remain the same new opportunities emerge with changing job descriptions and new twists to old rolesWe now move on to opportunities to respond to the challenges of health and medical info retrievalRemember to add notes on what roles the different liaisons have at UIC health sciences library10Opportunities11New roles for health sciences librarians documented in literature from 1990-2012

Embedded Librarian:LiaisonInformationistClinical InformationistPublic InformationistDisaster relief information specialist

New Activities and Changing Roles of Health Sciences Librarians: A Systematic Review, 1990-2012, Diane Cooper and Janet Crum, 2013

Embedded Librarian: brings the library and the librarian to users in their work environmentLiaison librarians who are the primary contact between the library and one or more departmental or administrative units. Purpose is to improve transfer of information between the library and usersimprove quality of collections and services that meet clients needsimprove librarys imageResponsibilities are often divided among reference, instruction, and collection development

Informationist librarian answers clinical questions by reading FT articles, identifying and extracting relevant info, writing brief synopsis of their findings, and sending info to the user Clinical Informationist - a librarian with specific clinical and/or scientific qualifications gained either through graduate education or experienceE.g. Vanderbilt Universitys clinical informationists answered questions on rounds with synthesis of EBM literature.

Bioinformationist librarians act as first line of support, directing users to specific databases and researchers. Develop partnerships with units on their campuses and offer knowledge management, instruction, and electronic resource support. (At U of Florida, Harvard, U of Minnesota and Vanderbilt).

Public Health Informationist provides info to those who work in the public health sector

Disaster relief info specialist provide reference services during disasters (mobile homes), and contribute to emergency preparedness programs for hospitals11Opportunities12Systematic review librarian

Emerging technologies librarian (user experience librarian)

Continuing medical education librarian

Grants development librarian

Data management librarian (research data librarian, data services librarian)

New Activities and Changing Roles of Health Sciences Librarians: A Systematic Review, 1990-2012, Diane Cooper and Janet Crum, 2013

Systematic review librarian (note: a systematic review is a summary of literature that assesses and evaluates studies on a particular issue).Health sciences librarians now serve on systematic review teamsThey are often coauthors of published reviews

Emerging technologies librarian librarian focuses on methods that libraries can use to deliver services and information with new technologiesVarious job titles: information architects, system analyst, database designers, usability engineers, web application developer

Continuing medical education librarian librarians work collaboratively with CME teams to:Create educational activities that help clinicians maintain, develop, and increase their knowledge and skills

Grants development librarian health sciences librarians serve as resources for information about available grants, and can assist in the grant writing process

Data management librarian librarians help researchers develop their data plans to help them manage, curate, archive and share their data.12Opportunities13New roles for health sciences librarians identified by job announcements, 2008-2012

Metadata librarian

Digital content librarian

Scholarly communication librarian

Translational librarian

New Activities and Changing Roles of Health Sciences Librarians: A Systematic Review, 1990-2012, Diane Cooper and Janet Crum, 2013

Metadata librarian provides creation of and access to an institutions data and librarys digital and print content through metadata creation cataloging and metadata standards

Digital content librarian coordinates and promotes digital resources and services, assists in selection and implementation of digital resources

Scholarly communication librarian encourages participation in open access and facilitates scholarly communications, develops open institutional repositories for dissemination for dissemination for research results

Translational librarian explores and develops new methods of information support for basic and clinical biomedical research13Opportunities14New twists on old roles

Clinical medical librarian

Instruction librarian

Outreach librarian

Consumer health librarian

New Activities and Changing Roles of Health Sciences Librarians: A Systematic Review, 1990-2012, Diane Cooper and Janet Crum, 2013

Clinical medical librarianOld: attend rounds in patient care setting, note questions, find answers at library, and make copies for the medical teamNew: integral part of medical team in auxiliary capacity with special skills to contribute to vital clinical situations

Instruction librarianOld: teach users how to use the library catalog, print abstracts, indexes, and other library resourcesNew: in addition to old role, teach how to use new technology to access info. Also teach how to use bibliographic management systems

Outreach librarianOld: provided library services to clinicians in rural areas, groups of hospitals and health education centersNew: reach out to users in ones own institution. Trend of moving library services outside the library

Consumer health librarianOld: provide a service to manage and provide information to the public. Reach to community (e.g. offer pamphlets at health fairs and other community meetingsNew: Now involves advanced technologies like interactive websites, and connection of CHI to the patient record, bringing info for patients to the point of care.14Opportunities15Job listings, descriptions

Health sciences librarian (listed under healthcare occupations)

Health sciences librarian

Consumer health librarianJob 1 Job 2

Information scientist/librarian - pharmaceutical

Replace last one job listing expiredWe know move on to see the current job listing for titles ad job descriptions 15Opportunities16Posted on MLA website

Western New England University1617MLA listing

University of Michigan1718Biomedical/Research Services Liaison (UL306)

University of Minnesota actually a librarian position with MLIS18Conclusion19Challenges in health sciences librarianship: health and medical information retrievalOverload of internet and online information The untrained end user lack the skills to effectively retrieve reliable, relevant, results, and the ability to evaluate those sources.Recent MLIS graduates lack hands on experience and clinical experience.

Opportunities in health sciences librarianship: New and emerging rolesTo respond to these challenges new and emerging have developed where librarians have become information specialists, integral to medical teams and institutionsLibrarians contribute to emergency preparedness, assist researchers and others in data management, reach out beyond the library to serve hospitals and communities with health/medical information needs, provide access through metadata cataloging, select and implement digital sources, and other new roles related to new technologies.Recent MLIS graduate have opportunities via fellowships Fellowships at NLM, UIC, John HopkinsKey words and phrases that I take away: overload, untrained, lack of experience, info specialist, metadata, digital sources, new technologies

19Questions2020Bibliography21Arnott Smith, Catherine. 2005. An Evolution of Experts: MEDLINE in the Library School. Journal of the Medical Library Association 93 (1): 5360.Cooper, I. Diane, and Janet A Crum. 2013. New Activities and Changing Roles of Health Sciences Librarians: A Systematic Review, 1990-2012. Journal of the Medical Library Association: JMLA 101 (4): 26877. doi:10.3163/1536-5050.101.4.008.Densen, Peter. 2011. Challenges and Opportunities Facing Medical Education. Transactions of the American Clinical and Climatological Association 122: 4858.Detlefsen, Ellen Gay. 2012. Teaching about Teaching and Instruction on Instruction: A Challenge for Health Sciences Library Education. Journal of the Medical LibraryHaines, Laura L., Jeanene Light, Donna OMalley, and Frances A. Delwiche. 2010. Information-Seeking Behavior of Basic Science Researchers: Implications for Library Services. Journal of the Medical Library Association: JMLA 98 (1): 7381. doi:10.3163/1536-5050.98.1.019.Harrison, Janet, and Sally J. E. Sargeant. 2004. Clinical Librarianship in the UK: Temporary Trend or Permanent Profession? Part II: Present Challenges and Future Opportunities. Health Information & Libraries Journal 21 (4): 22026.

Bibliography22Martin, Elaine R. 2013. Shaping Opportunities for the New Health Sciences Librarian. Journal of the Medical Library Association: JMLA 101 (4): 25253.McGowan, Julie J. 2012a. Evolution, Revolution, or Obsolescence: An Examination of Writings on the Future of Health Sciences Libraries. Journal of the Medical Library Association: JMLA 100 (1): 59. doi:10.3163/1536-5050.100.1.003.. 2012b. Tomorrows Academic Health Sciences Library Today. Journal of the Medical Library Association: JMLA 100 (1): 4346. doi:10.3163/1536-5050.100.1.008.mlab_93_112.53_60.tp - zotero://attachment/177/. 2014a. Accessed February 12. zotero://attachment/177/.Savulescu, J., and M. Spriggs. 2002. The Hexamethonium Asthma Study and the Death of a Normal Volunteer in Research. Journal of Medical Ethics 28 (1): 34. doi:10.1136/jme.28.1.3.Schulte, Stephanie J. 2011. Eliminating Traditional Reference Services in an Academic Health Sciences Library: A Case Study. Journal of the Medical Library Association: JMLA 99 (4): 27379. doi:10.3163/1536-5050.99.4.004.Tarver, Talicia, Dixie A Jones, Mararia Adams, and Alejandro Garcia. 2013. The Librarians Role in Linking Patients to Their Personal Health Data and Contextual Information. Medical Reference Services Quarterly 32 (4). doi:10.1080/02763869.2013.837730. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818718/.