What do Medical Librarians Do?

Last school year my son was asked to talk about his parents and tell the class what we do at work.  He responded, “My mom is a librarian at a hospital and she finds stuff in books and on computers to help doctors.”  I was so proud.  Of course then he described what my husband at work.  “I don’t know what my dad does but his work has a lot of computers with video games and they have two slides and a bouncy castle you can play in.”  My husband is a web developer and yes his company has two slides within the building that employees, including the CEO, have used to get the ground floor.  But the rest of the stuff, the computer games, Wii, Guitar Hero, bouncy castle, etc. are only at my husband’s work during the children’s holiday parties.  Since my son really has only been to my husband’s work when there is a party, he assumes his Dad has Wiis and bouncy castles at work all the time.  

My son’s perceptions of what each of us does in our jobs is colored by what he sees us doing and our work environment.  Obviously my husband doesn’t have bouncer at his work place every day, and at 6′ 5″ he probably is slightly over the height restriction for that type of entertainment.  But since my son really only sees my husband’s workplace during the parties, that is all he has to go on for a point of view of what his dad does at work. 

Each person’s perception is colored by what they have seen and what they have learned from experiences.  When I am at various social gatherings I am often asked what I do.  I respond that I am a medical librarian and then I watch as the glazed look flits across their faces and they get that deer in the headlights stare.   Most adults have not been in a medical library, many more adults (more than I care to think of) were last in a library when they were in college or high school, some go to the public library with the their children.  Their library experiences are usually not in medical libraries.  So the glaze in their eye comes as they try and match their library experiences with their hospital or medical experiences, for most people that isn’t always easy to imagine. 

Those preconceived ideas are part of what we medical librarians are always dealing with.  Even within our own work environment, we have people who don’t realize that a hospital can/should have a medical library and what a librarian does.  These people not only have their on experiences of what a library is but they are most often very busy and completely immersed in their own work world that they may be unintentionally walking by the library with mental blinders on. 

That is why it is important to get the word out to people about what we do and most importantly what we can do for THEM.  Earlier today Dr. Ves Dimov  alerted Twitter followers  of this article, “Ask-A-Librarian Column: What Exactly Do You Do? A Clinician’s Guide to the Medical Librarian,” in Clinical Correlations, the NYU Internal Medicine Blog.  In the article, Jamie Graham does a great job of explaining what medical librarians do and what they can do for the Internal Medicine Residents.  She notes that we aren’t always in the library, that we are out and about doing other duties within the hospital. 

Graham mentions that the NYU librarians can be seen at or doing:

  • Clinical rounds
  • Faculty council
  • IRB sessions
  • Help with group or individual workshops
  • Finding patient education material
  • Finding evidence-based clinical care information
  • Teaching citation management programs (Refworks)
  • Create Table of Contents alerts
  • Find bibliometrics
  • Teach how to prepare manuscripts according to NIH mandates
  • Find medical multimedia
  • Participate on institutional projects (NYU’s ALEX system)

I wanted to share this article with others in the medical library world.  Not only is it a great article but it is published in the blog for Internal Medicine residents and is aimed right at a core group users who may or may not know what a librarian does or what one can do for them.  Perhaps you have a few more things to add to the list, feel free to add them by commenting here.  Others can read Graham’s article and the comments and can create a newsletter article of their own for distribution. 

I know we are all looking at ways to get our message out and to draw users’ attention to us and our services.  Not all of us have slides and bouncy castles to grab people’s attention to our jobs, so we need to try every other method available.

The Horror of Google Scholar

We love Google Scholar, we hate Google Scholar, which is it?  It’s a complicated relationship.  Librarians use it to find trickly little articles that are hiding in some dark crevice of the Internet and we search it probably just as much or more than the rest of the normal world.  So why does Google Scholar draw such frustration with librarians at times?  Why do we do our best impersonations of  The Scream  at the reference desk when researchers, doctors and nurses claim to have done an extensive search on Scholar? Part of the reason is us (librarians) and part of it is Google.

We are nerds who know that the information in Google is not always right. Just like a Trekkie debating the merits and flaws of Star Trek, The Next Generation, Deep Space Nine, Voyager, Enterprise, and all of the movies, we debate the merits and flaws of databases and information.  Google Scholar is just one of the various topics in our librarian geek debate camps.  As important as the debate over proper Klingon verb conjugation is in the Trekki community, it doesn’t usually impact the daily medical lives of many people.  (I know, I am going out on a limb there.)  Where as the information that librarians, researchers, doctors, and nurses retrieve from medical and other information databases usually does impact the lives of people.

As librarians we are trained to index, categorize, find and retrieve information.  As the Librarian Avenger  states, librarians “bring order to chaos.”  Nothing gets us more worked up than a database like Google Scholar that pretends to bring order to chaos.  I take that back.  Nothing gets us more worked up than when our patrons don’t realize that the Google Scholar database isn’t always right. 

Google Scholar indexes the full text of scholarly literature across many disciplines.  Yet Google keeps Scholar’s coverage and indexing a giant super secret.  Had Darth Vader employed Google Scholar creators, those pesky rebels would never have been able to sneak the plans out to destroy the Death Star.  This secrecy helps make Scholar a mess of a database.  Who knows what is in the that soup of information?  Some publishers do not allow Scholar to crawl their journals, but it is difficult for searchers know specifically which ones and adjust accordingly.  Like the unknown item in the Tupperware in the back of the fridge we don’t even know how fresh Scholar’s content is because it does not provide information on the frequency of its updates. 

As if not knowing what is in the database and how often it is updated isn’t bad enough, a recent article in Library Journal, “Google Scholar’s Ghost Authors, Lost Authors, and Other Problems” by Peter Jacso clearly will make any librarian (and should make any researcher) shudder over the idea of doing citation analysis within Scholar. 

Some of the problems Jacso found:

  • False authors like P Login (for Please Login), P Options (for Payment Options), and a whole bunch related to author affiliation such as CA San Diego.
  • Multiple listings of the same paper
  • Mismatched citation information – Scholar ignores existing, correct publication years, page numbers, volume numbers, etc.
  • Missing authors – Scholar in many cases replaces the real authors names with that of the false authors.

Really if it weren’t true it would make for a great comedy for librarians to laugh at, but with the 10.2 million records added from Google Books into the millions already within Scholar the story reads more like a B horror film. Not a campy one like Evil Dead, but more like the Blair Witch Project where despite the rave reviews (who gave that thing such great reviews anyway) leaves you nauseated and declaring it unworthy of even renting. 

However, I wonder if our patrons will even notice.  Will they even care about the fact that Scholar developers decided not to use metadata from scholarly publishers but instead built the database around a parser created by the developers and labeled as “imbecile” by Jacso?  Call me a cynical librarian nerd but I don’t think they will.  I have about as much hope that researchers will know or care as Jacso has for the Scholar developers to correct their massive mess. 

“The parsers have not improved much in the past five years despite much criticism. GS developers corrected some errors that got negative publicity, but these were Band-Aids, where brain surgery and extensive parser training is required. Without these, GS will keep producing similar errors on a mega-scale.”

WE may have a complicated relationship with Google Scholar and we will still be using it to find things, it is up to us, the Trekkies of the database searching world, to inform our patrons of the pitfalls as well as the promises of Google Scholar and to alert them to alternative resources and databases to use instead of Scholar. Because for every person who just wants something quick and easy, there are always those who happy to learn something new and will be amazed at what Scholar does not really do.

Medical Students and Unprofessional Online Content

The article “Online Posting of Unprofessional Content by Medical Students,” published in JAMA (JAMA. 2009; 302(12): 1309-1215. subscription required) looks at the activity of medical students on popular Web 2.0 sites such as Facebook, YouTube, Flickr, blogs and wikis. 

The article states than an estimated 57% of 25-34 year olds use social networking sites.  These 25-34 year olds are your medical students and your residents.  It is important to know that this study focused on the medical students not the residents out there in the work force at various hospitals.  The study found that 60% of the responding medical schools reported incidents of students posting unprofessional online content.  The unprofessional content ranged from suggestive sexual material, intoxication, drug use, discriminatory language, breaches of patient confidentiality. 

While this article focused primarily on the policies these medical schools might or might not have regarding unprofessional behavior, and the repercussions some students faced as a result of the unprofessional nature of the medical students online profile, it did not address the fact that their might be an actual need for education. 

We have all done stupid stuff in our lives, but until recently most of us did not have a permanent record (online or otherwise) available for all to see.  Go through the old keepsake box in your attic and look at the photos from your college days.  Bring back some memories?  Now somebody took that picture and at some point in time you decided it was worth keeping.  Did you blow it up and put in a picture frame on the fireplace mantel? No, you probably put it in the scrap book, or a box with your other things from college. 

Flickr, Facebook, and blogs are today’s scrapbook.  They record a person’s thoughts, feelings and pictures of a person’s life.  Unlike the scrapbook of old, these new scrapbooks are online, interactive and available for everybody in the world to see.  There lies the problem.  Patients, employers, colleagues could not go through your old scrap book in your attic and look through it and question your professionalism and integrity, but they can with Facebook, Flickr, Twitter, blogs, etc.

In addition to developing professional social networking policies, medical schools need to seriously look at conducting educational classes on professionalism in the online world.  Some schools have classes on medical professionalism in the workplace, but these days one’s private life is bleeding into and affecting the public life of the workplace.  I know there are some medical school libraries that offer classes on Web 2.0 and professionalism.  It would be interesting to know how many offer this type of class and whether it is tied into the medical school curriculum.  It would also be interesting to know, of the medical schools that have a class addressing online professionalism (either taught within their department or via the library) what percent have reported incidents of unprofessional behavior.

Remember I said this study focused on the medical students, yet 57% of the 25-34 year olds use social networking sites?  There is still the matter of those older people in that age range who have graduated medical school.  The residents and fellows out there working in hospitals.  Some hospitals have policies addressing social website behavior, some do not.  They too are on social web sites and I would be willing to be there are a few of them out there who have information and pictures on there that would be considered unprofessional and inappropriate.  Education has to start somewhere.

Nominations Sought for MLA Awards

The November 1st deadline to nominate somebody for an MLA award is fast approaching.  There are a lot of awards out there, surely you know of at least one person who would be perfect for an award, so get moving and nominate them! 

Virginia L. and William K. Beatty MLA Volunteer Award – This award recognizes someone who has been volunteering their time and going that extra mile to the Medical Library Association.

Estelle Brodman Award for the Academic Medical Librarian of the Year – This award recognizes a mid career medical librarian who demonstrates significant achievement and potential for leadership and continuing excellent. 

Lois Ann Colaianni Award for Excellence and Achievement in Hospital LibrarianshipNOTE: There wasn’t a winner for this award last year! So this year start thinking of a dynamic and exceptional hospital that deserves this award!  This award recognizes individuals who are visionaries and provide outstanding service in hospital librarianship.

Janet Doe Lecture – This nominee has a unique perspective on the history and perspective of medical librarianship.  The Janet Doe lecturer will be honored with a certificate, a $250 honorarium, travel expenses for the MLA meeting publication of their lecture in JMLA. 

Ida and George Eliot Prize – Awarded annually this if for a work published in the preceding calendar year (2008) which has been judged most effective in furthering medical librarianship.  The recipient receives a cash reward of $200 and a certificate at the annual meeting. 

Carla J. Funk Government Relations Award–  This award recognizes a medical librarian who has furthered the goal of providing quality information for improved health by demonstrating outstanding leadership in the area of governmental relations at the federal, state, or local level.  Nominees must have been members of MLA at the time of the contributions or activities which include but are not limited to increasing awareness of legislative agendas, testified before governmental bodies, met with policymakers or enhanced the Association’s governmental relations network. 

Murray Gottlieb Prize – This prize, established in 1956, is to recognize and stimulate health sciences librarians’ interest in the history of medicine.  It is awarded annually for the best unpublished essay on the history of medicine and allied sciences written by a health sciences librarian. 

T. Mark Hodges International Service Award– This award was established by the Medical Library Association in 2007. It honors an outstanding individual achievement in promoting, enabling, and or delivering improvements in the quality of health information internationally through the development of health information professionals, the improvement of libraries or an increased use of health information services. 

Majors/MLA Chapter Project of the Year Award – This award recognizes MLA Chapter projects that demonstrate advocacy, service, or innovation that contribute to the advancement of health sciences librarianship. 

Lucretia W. McClure Excellence in Education Award – This award, established in 1998 is given an outstanding practicing librarian or library education in the field of health sciences librarianship and informatics who demonstrates skills or leadership in education at national, regional or local levels.  The recipient receives a certificate at the Annual Meeting and an award of $500. 

MLA Fellows and Honorary Members – MLA has recognized for more than 50 years individuals who have made sustained, outstanding contributions to medical librarianship and to the advancement of the purposes of MLA and MLA Fellows.  Nominees must have been regular members of MLA for at least 15 years prior to nomination and have at least 10 years of professional experience in health information science. 

Rittenhouse Award – This award is for library students in an ALA accredited library school or an intern.  The award, established 42 years ago, is for an unpublished paper or web based project in health sciences librarianship or medical informatics.  Winners receive free conference registration to the Annual Meeting, $500, and a certificate.

Thomson Reuters/Frank Bradway Rogers Information Advancement Award – This award recognizes outstanding contributions in applying technology to the delivery of health sciences information.  The recipient will receive $500 and recognition at the Annual Meeting.

MLA Officially Getting More Social

Julie Kochi just published a post on MLA Connections about MLA’s New Association Management System (AMS).   The new AMS is in the process of being installed and it will enhance services to MLA members and make things a little more streamlined for MLA staff.  They anticipate it should be up and running in the beginning of 2010.

Some things MLA members will find the new system will do:

Password and username customization – MLA members will be able to set their passwords to whatever their heart’s desire and whatever their brains can remember.  Don’t worry if your brain reboots and you can’t remember, you will be able to click on “forgot my password” to retrieve it.  Krafty note: Thank you, thank you, thank you!

Profiles – Members will be able to set up detailed online profiles if they want to.  Members will be able to edit regular MLA directory contact information as well as add their job titles, IM handles, personal and professional websites, social networking profiles, and a photo.  Of course if you don’t want to add anything and you wish to remain just a name and contact information (from the directory) you can do that too.

Institutional Profiles – Institutional members will also be able to customize their information.  The MLA staff hope to have institutional information such as employees, constituents, collections and fiscal information included in the profile.

These are some great improvements and I look forward to using them in 2010.  The password issue was long overdue and will be one of the greatest improvements for all members.  I have only one thing to add to the wish list on the AMS, I would love for it to have a section where you can track your CME and AHIP things so that I can finally do away with the manila folder in my desk. 

Do you have any thoughts or suggestions?  The MLA staff would like your feedback.  If so please do not comment on my blog but go on to MLA Connections and comment.

Future of QuickDoc Update

A few weeks ago I postedabout the precarious future of QuickDoc now that its creator and the one person who was maintaining it passed away earlier this year. 

I am happy to report that I received an email earlier this week about QuickDoc and some possibilities for its continuation.

Here is a reprint of the email:

Dear Colleagues,

I am happy to report that we have a few possibilities for the take-over of QuickDoc. Jay’s daughter and son-in-law (Eowyn and Tommy Griffin) are endeavoring to find the best fit. An RFP went out to several vendors and independent programmers and the Griffins are pursuing the most promising offers. It is very important to them (and to all of us!) that whoever takes over QD will have the same dedication to the user base that Jay did. Be assured that Eowyn and Tommy are well aware of the time frame they have to work with and they are trying to come to an agreement as soon as possible. In the meantime, feel free to contact me with any questions or concerns. I will do my best to help!


Good news.

Rapid Research?

Scientific research is a time consuming process that can take years before the initial research findings are published and often much longer before clinical implications or treatments can found.  But what if there is a major medical event that can’t wait for the usual process to run its course? 

Rapid Research Notes  is a new resource developed by the National Center for Biotechnology Information (NCBI) to quickly disseminate the research results to the public in an open access archive.  The RRN archive was prompted in part by the 2009 H1N1 influenza outbreak but the archive will expand over time to include additional collections on time critical topics in other biomedical fields. 

PLoS Currents Influenza is the first in the collection to archived.  Publishers interested in archiving online, rapid communications in RRN should contact NCBI and general guidelines for participation are described here.  It is important to note these guidelines are provisional and may change as NCBI gains experience with the new RRN archive.

There are many places you can find information on H1N1.

I am a little confused.  So much as been flying around the Internet about H1N1 and the various free collections available.  It would be nice if all of these free collections (from reputable vendors and sources of course) were consolidated under one roof.  If I am reading the “About Rapid Research Notes” page correctly, then the RRN archive is intended to be that centralized site.  Right?  So we have PLoS articles in the archive but the other quality information from EBSCO, Cochrane, and others places is not in there.  Do these publishers have plans of adding their information in there?  If so, I would like to see some information on that.  If not, then what purpose does RRN serve other than as an archive?  Searchers and healthcare workers still have to look on several different sites to find the information on H1N1.  EBSCO has a very nicely organized site providing information to clinicians, nurses and patients using EBSCOs various databases (DynaMed, NRC, and PERC).  In addition to Podcasts and presentations, Cochrane has information on the interventions, and the prevention and treatment of influenza.  Don’t get me wrong, I think we need something like RRN archive (for H1N1 and other important biomedical events), but what is the point if it is missing information because other publisher choose not to put their information in RRN?  Not only will people have to search multiple sites, but where do those patient education pages from EBSCO or the Cochrane podcasts go once H1N1 is no longer a big deal anymore?

Am I wrong, confused, or just not seeing something?  Please let me know.

Apple Expanding Into Healthcare?

According to Neil Versel’s Healthcare IT Blog, Apple looks to make a push into healthcare.  

It seems inevitable, given the success of the iPhone in healthcare, but I’m hearing that Apple is getting ready to make a full-scale push into healthcare. I understand that the company invited several vendors to a meeting at an Apple office in Chicago this week. I have no further details on what was said or who was present, but I know that there are a couple of EMR vendors out there who have tailored their products for Macintosh, even if it’s just optimizing the view over the Internet for the Safari browser.

I don’t doubt Neil’s information that Apple is interested in jumping into the healthcare market where there are “billions of dollars in federal money funneled into health IT over the next eight years.”  But it is not a question of Apple getting into healthcare but more of a question of whether healthcare (read hospital IT departments) will allow Apple in. 

I am not talking about research departments or academic medical centers who seem to have a few more Macs on campus than average and where your IT departments are somewhat used to dealing with them.  I am talking about the regular hospital institution where finding a Mac is about as rare as finding a vegetarian at Outback Steakhouse.  They are there, but not always, and don’t count on them to work within the system. 

Neil specifically mentions the success of the iPhone in healthcare as perhaps the basis for this move.  It is true iPhone is a very popular in medicine, but it’s popularity is usually a personal choice that is not supported by the average hospital IT department.  Again the only areas where I have seen institutions adopt the iPhone as a supported mobile device have been in the academic medial area.  Many regular hospitals still don’t support the iPhone.  In these institutions doctors, nurses, and hospital employees who have iPhones cannot access their own hospital email using the iPhone much less get on to the EMR (if the hospital even has an EMR up and running, there are still a lot out there that don’t). 

Earlier this year when Citrix released an app for the iPhone I asked our IT department if they had any plans to finally allow iPhone users access to institutional email.  I was told by my IT department, “The iPhone is a great personal device, but is not suitable for our institution at this time.” (Yes they did use itallics for personal device.)  The email went on to say that only approved Blackberry devices were allowed access to institutional email.  The IT department either were unaware or completely ignored the fact that many people use this so called personal device in the professional lives.  People use the medical applications on the iPhone to help treat patients or do consult medical references.  Yet it is still considered a personal device by hospital IT departments.  I see more and more doctors using iPhones.  I think their numbers are beginning to rival those of the Blackberry devices, but until the iPhone is accepted as an approved device within the hospital IT department, you will still have medical professional who will forgo the iPhone. 

While Neil sees the popularity and success of the iPhone in medicine illustrating the potential growth for the Mac in the healthcare, I see the the lack of iPhone adoption among hospital IT departments as an indicator of just how hard it will be for Steve Jobs to break into the healthcare industry.  Am I saying it is impossible?  No, and if anybody can do it, Jobs would be that person.  I just see it as a very large uphill battle to convince an institutional IT department so dependent on PCs to accept Apple on a large scale.

A Runway Look at the 2010 MeSH

The sleek new 2010 MeSH line is here with new trees and vocabulary changes to keep the librarian database fashionistas busy. 

According to NLM, “In biomedicine and related areas, new concepts are constantly emerging, old concepts are in a state of flux and terminology and usage are modified accordingly. To accommodate these changes, descriptors must be added to, changed or deleted from MeSH with adjustments in the related hierarchies, the Tree Structures.”  To me, NLM  sounds a lot like Heidi Klum on Project Runway, “In fashion, one day you’re in, the next day you’re out.”

So let’s start the show.

What’s In:
Not content with just attending the show through keyword searching, 422 new descriptorsgrace the runway as full fledge MeSH terms.  Welcome Biofuels, Beekeeping, Blogging, Masculinity, Off-label use, and Vital Signs, Karl Lagerfeld NLM has deemed to you worthy to include in the collection.

The hem line of the MeSH world, changed descriptors, strut their stuff with the ever moody term Cyclones evolving to Cyclonic Storms and the stunningly popular Mass Immunization becoming Mass Vaccination.

What’s Out:
Liked crimped hair, neon colors, and bad prom dresses, these deleted descriptors have seen better days and are asked to leave the runway.  Goodbye Fungal Components (2002 MeSH born on date) your time has ended, now you are replaced with the younger model, Fungal Structures (2010 MeSH born on date). The many different styles of Eumycetozea, Mastigophora, Phytomastigophorea, Protozoa, Sarcodina, Sarcomastigophora, and Zoomastogophora are gone and replaced with the singular style, Eukaryota.  Following the same trend the specific term Specialties, Medical has been bumped by the broader more wearable term Medicine.

The 2010 MeSH collection is not yet available to the masses, I do not have a date as to when it will hit the shelves and go live.  But we should take this time and go through our closets of saved searches and take note of which strategies contain outdated terms and which could be better enhanced with the new terms.  That way when the time comes for us to update them and refresh them we can easily like Heidi say “Hallo” to the new and “Auf Wiedersehen” to the out.

Future of QuickDoc

Eric Schnell writes an interesting post  regarding the precarious future of QuickDoc now that its creater and maintainer, Jay Daly, passed away this Spring. Unfortunately even the National Library of Medicine is uncertain of the future of QuickDoc since they were not the producers of the program. 

Eric brings up a very good point, “As a community, libraries should not have to reply on innovative people like Jay develop systems that bridge the functionality gaps we expect from our systems.”  Eric is completely right.  Unfortunately this seems to be the case within the library community as well individual libraries.  Why are we still treating technology and programming as a add on feature?  These improvements and programs are valuable services and features.  We don’t treat cataloging or document delivery as whole like this, so why do we do this with the tools that help make these services possible?