Mixed-methods library evaluation integrating the patron, library, and external perspectives: The case of Namibia regional libraries

The article presents a mixed-methods evaluation of regional libraries in Namibia, which incorporates three perspectives: the patron perspective (library users), the library perspective (library staff, management, and related officials), and the external perspective (including evaluators and monitoring data). Seven data collection methods were used: patron surveys, patron panel studies, focus group discussions, key informant and staff interviews, secondary data analysis, media analysis, and observations. The goal of the evaluation was to assess library performance for both formative and summative purposes by addressing evaluation questions on areas such as library services, use, and operations. Building upon the literature review of how mixed-methods approaches can contribute to library evaluation, the aim of this article is to show how a mixed-methods evaluation can be designed to examine multi-faceted library performance and to illustrate how the evaluation design allows information complementarity and can be utilized to present diverse viewpoints of the above three perspectives. The evaluation design, analysis process, and lessons learned from this study may be useful to evaluators engaged in evaluation of public services or programs (including public libraries) that examine multiple aspects of service performance and involve a variety of stakeholders.

Evaluation of hospital staff's perceived quality of librarian-mediated literature searching services

Objective

The research evaluated the perceived quality of librarian-mediated literature searching services at one of Canada’s largest acute care teaching hospitals for the purpose of continuous quality improvement and investigation of relationships between variables that can impact user satisfaction.

Methods

An online survey was constructed using evidence-based methodologies. A systematic sample of staff and physicians requesting literature searches at London Health Sciences Centre were invited to participate in the study over a one-year period. Data analyses included descriptive statistics of closed-ended questions and coding of open-ended questions.

Results

A range of staff including clinicians, researchers, educators, leaders, and analysts submitted a total of 137 surveys, representing a response rate of 71%. Staff requested literature searches for the following “primary” purposes: research or publication (34%), teaching or training (20%), informing a policy or standard practice (16%), patient care (15%), and “other” purposes (15%). While the majority of staff (76%) submitted search requests using methods of written communication, including email and search request forms, staff using methods of verbal communication, including face-to-face and telephone conversations, were significantly more likely to be extremely satisfied with the librarian’s interpretation of the search request (p=0.004) and to rate the perceived quality of the search results as excellent (p=0.005). In most cases, librarians followed up with staff to clarify the details of their search requests (72%), and these staff were significantly more likely to be extremely satisfied with the librarian’s interpretation of the search request (p=0.002).

Conclusions

Our results demonstrate the limitations of written communication in the context of librarian-mediated literature searching and suggest a multifaceted approach to quality improvement efforts.

[Online information service: the library support for evidence-based practice]

It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice.

Empowering your institution through assessment

OBJECTIVES

The objectives of this study are to describe the process of linking Association of Academic Health Sciences Libraries (AAHSL) data with 2002 LibQUAL+ data and to address four analytical questions created by the AAHSL Task Force on Quality Assessment that relate both to user satisfaction and to services provided by AAHSL libraries.

METHODS

For the thirty-five AAHSL libraries that participated in the 2002 LibQUAL+ survey, nested-effect of variance was analyzed using a linear mixed model. Using the Pearson correlation coefficient, this study explored four questions about the effect of user demographics on perceived levels of satisfaction with library services.

RESULTS

The supposition that library user satisfaction may differ according to library institutional reporting structure was unsupported. Regarding effect on mean overall satisfaction, size of library staff is not significant (P = 0.860), number of constituents is slightly significant (P = 0.027), and ratio of staff to constituents has a moderate and significant effect (P = 0.004).

CONCLUSIONS

From a demographic perspective, the 2002 LibQUAL+ survey represents the largest cross section of AAHSL libraries. Increased understanding of how qualitative assessment can supplement quantitative data supports evidence-based decision-making and practice. It also could promote changes in data collection and usage.

Clinical effectiveness and allied health professionals: an information needs assessment

OBJECTIVE

To determine the information needs and support required by AHPs whilst building services based on clinical effectiveness.

METHODS

A qualitative approach using action research in co-operation with a Rehabilitation Department Clinical Effectiveness group, leading to interviews with eight therapists. The sampling strategy was purposive.

RESULTS

Therapists have well-developed professional networks, but are unsure how to access traditional library areas. Library training can stop AHPs in asking for help or services, whilst the library is thought to be very different to their everyday work, but confidence in using the library service can be acquired by getting to know a librarian. A departmental-based service was thought to provide better access to, and understanding of, information through mentorship, whilst also providing up-to-date evidence so that clinicians can concentrate on their clinical work whilst being more clinically effective.

CONCLUSIONS

When seeking information, AHPs are more likely to use professional networks than libraries. However, when working alongside an AHP, a librarian can upgrade information-seeking skills through mentorship, whilst named library contacts can make it easier to access the library for help.

"Smallball" evaluation: a prescription for studying community-based information interventions

OBJECTIVES

This paper argues that focused evaluation studies of community-based informational interventions conducted over the life-cycle of the project ("smallball" studies) are more informative and useful than randomized experiments conducted only at the project's conclusion ("powerball" studies).

METHOD

Based on two contrasting strategies in baseball, smallball and powerball studies are compared and contrasted, emphasizing how the distinctive features of community-based interventions lend advantage to smallball approaches.

RESULTS

Smallball evaluations have several important advantages over powerball evaluations: before system development, they ensure that information resources address real community needs; during deployment, they ensure that the systems are suited to the capabilities of the users and to community constraints; and, after deployment, they enable as much as possible to be learned about the effects of the intervention in environments where randomized studies are usually impossible.

IMPLICATIONS

Many in informatics see powerball studies as the only legitimate form of evaluation and so expect powerball studies to be done. These expectations should be revised in favor of smallball studies.

Libraries reaching out with health information to vulnerable populations: guidance from research on information seeking and use

OBJECTIVE

Two branches of applied social science have devoted substantial attention to researching information seeking and use. One branch is the field of communication, with its emphasis on the design of messages to effectively transmit expert information. The second is the field of library and information science, with its emphasis on meeting user needs. This paper is an overview and comparison of what is known about information seeking and use based on these two bodies of research, particularly as it applies to serving the needs of racial and ethnic minorities.

DATA SOURCE

This paper is informed by three in-depth literature reviews of the two fields and of the difficulties of bringing findings from disparate fields to bear on the same phenomena.

CONCLUSIONS

Twenty-five broad brushstroke propositions are extracted in a way that allows both commonalities and contradictions to be informative, particularly as they relate to how the flexibilities offered by electronic technologies may allow experts to serve user needs more effectively and efficiently. Remarkably, while both fields have approached their studies from separate viewpoints without much overlap, both have struggled with the baggage imposed on their research by information-as-transmission assumptions and both have moved toward approaches that focus on information-as-communication.

Community outreach: from measuring the difference to making a difference with health information

BACKGROUND

Community-based outreach seeks to move libraries beyond their traditional institutional boundaries to improve both access to and effectiveness of health information. The evaluation of such outreach needs to involve the community in assessing the program's process and outcomes.

PURPOSE

Evaluation of community-based library outreach programs benefits from a participatory approach. To explain this premise of the paper, three components of evaluation theory are paired with relevant participatory strategies. CONCEPTS: The first component of evaluation theory is also a standard of program evaluation: use. Evaluation is intended to be useful for stakeholders to make decisions. A useful evaluation is credible, timely, and of adequate scope. Participatory approaches to increase use of evaluation findings include engaging end users early in planning the program itself and in deciding on the outcomes of the evaluation. A second component of evaluation theory seeks to understand what is being evaluated, such as specific aspects of outreach programs. A transparent understanding of the ways outreach achieves intended goals, its activities and linkages, and the context in which it operates precedes any attempt to measure it. Participatory approaches to evaluating outreach include having end users, such as health practitioners in other community-based organizations, identify what components of the outreach program are most important to their work. A third component of evaluation theory is concerned with the process by which value is placed on outreach. What will count as outreach success or failure? Who decides? Participatory approaches to valuing include assuring end-user representation in the formulation of evaluation questions and in the interpretation of evaluation results.

CONCLUSIONS

The evaluation of community-based outreach is a complex process that is not made easier by a participatory approach. Nevertheless, a participatory approach is more likely to make the evaluation findings useful, ensure that program knowledge is shared, and make outreach valuing transparent.

Using volunteers in Ontario hospital libraries: views of library managers

BACKGROUND

Volunteers have been a resource for all types of libraries for many years. Little research has been done to describe the attitudes librarians have toward library volunteers. More specifically, the attitudes of hospital librarians toward volunteers have never been studied.

OBJECTIVE

The objective was to explore and describe the extent of volunteer use and to determine library managers' attitudes toward volunteers.

DESIGN, SETTING, AND PARTICIPANTS

An anonymous, self-report 38-item questionnaire was mailed to the target population of 89 hospital library managers in Ontario. Seventy-nine useable questionnaires were analyzed from an adjusted sample of 86 eligible respondents, resulting in a response rate of 92%. SPSS 11.5 was used to analyze the data.

FINDINGS

The data revealed the attitudes of managers using volunteers did not differ significantly from the attitudes of managers not using volunteers. The findings showed that a majority of managers did not believe their libraries were adequately staffed with paid employees. Sufficient evidence was found of an association between a manager's belief in the adequacy of staffing in the library and the use of volunteers in the library (chi2(1, N=76)=4.11, P=0.043). Specifically, volunteers were more likely to be used by managers who did not believe their libraries were adequately staffed. The presence of a union in the library and the use of volunteers were also associated (chi2(1, N=77)=4.77, P=0.029). When unions were present in the library, volunteers were less likely to be used.

IMPLICATIONS

This research has implications for hospital library managers in the management of volunteers. Volunteers should not be viewed as a quick fix or as a long-term solution for a library's understaffing problem.

Understanding the foundation: the state of generalist search education in library schools as related to the needs of expert searchers in medical libraries

PURPOSE

The paper explores the current state of generalist search education in library schools and considers that foundation in respect to the Medical Library Association's statement on expert searching.

SETTING/SUBJECTS

Syllabi from courses with significant searching components were examined from ten of the top library schools, as determined by the U.S. News & World Report rankings.

METHODOLOGY

Mixed methods were used, but primarily quantitative bibliometric methods were used.

RESULTS

The educational focus in these searching components was on understanding the generalist searching resources and typical users and on performing a reflective search through application of search strategies, controlled vocabulary, and logic appropriate to the search tool. There is a growing emphasis on Web-based search tools and a movement away from traditional set-based searching and toward free-text search strategies. While a core set of authors is used in these courses, no core set of readings is used.

DISCUSSION/CONCLUSION

While library schools provide a strong foundation, future medical librarians still need to take courses that introduce them to the resources, settings, and users associated with medical libraries. In addition, as more emphasis is placed on Web-based search tools and free-text searching, instructors of the specialist medical informatics courses will need to focus on teaching traditional search methods appropriate for common tools in the medical domain.

State of the art of expert searching: results of a Medical Library Association survey

OBJECTIVES

Medical Library Association (MLA) members were surveyed to gather background about the current state of expert searching in institutions. The survey results were intended to guide the recommendations of the Task Force on Expert Searching for promoting the importance of expert searching and implementing those recommendations.

METHODS

MLA members were surveyed, and data obtained from the survey were compiled and analyzed to answer three general questions: what is the perceived value of searching skills to the institution, how do health sciences librarians maintain and improve their searching skills, and how are searching services promoted and/or mandated in the institution.

RESULTS

There were 256 responses to the survey. Over 95% of the respondents saw their expert-searching skills were of value to their institutions, primarily through performing mediated searches and search consultations. Over 83% of the respondents believed that their searching skills had improved over the past 10 years. Most indicated that continued training was very important in maintaining and improving their skills. Respondents promoted searching services most frequently through orientations, brochures, and the libraries' Web pages. No respondent's institution mandated expert searching. Less than 2% of respondents' institutions had best practice guidelines related to expert searching, and only about 8% had guidelines or policies that identified situations where expert searching was recommended.

CONCLUSIONS

The survey supports the belief that health sciences librarians still play a valuable role in searching, particularly in answering questions about treatment options and in providing education. It also highlights the need for more expert searching courses. There has been minimal discussion about the perceived need for expert-searching guidelines in the institutions represented by survey respondents.

Expert searching in public health

OBJECTIVE

The article explores the characteristics of public health information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise.

METHODS

Public health searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant public health information.

RESULTS

The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered.

CONCLUSION

Expert searching in public health differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and public health terminology to perform as expert searchers in public health.

Systematic reviews need systematic searchers

PURPOSE

This paper will provide a description of the methods, skills, and knowledge of expert searchers working on systematic review teams.

BRIEF DESCRIPTION

Systematic reviews and meta-analyses are very important to health care practitioners, who need to keep abreast of the medical literature and make informed decisions. Searching is a critical part of conducting these systematic reviews, as errors made in the search process potentially result in a biased or otherwise incomplete evidence base for the review. Searches for systematic reviews need to be constructed to maximize recall and deal effectively with a number of potentially biasing factors. Librarians who conduct the searches for systematic reviews must be experts.

DISCUSSION/CONCLUSION

Expert searchers need to understand the specifics about data structure and functions of bibliographic and specialized databases, as well as the technical and methodological issues of searching. Search methodology must be based on research about retrieval practices, and it is vital that expert searchers keep informed about, advocate for, and, moreover, conduct research in information retrieval. Expert searchers are an important part of the systematic review team, crucial throughout the review process-from the development of the proposal and research question to publication.

The role of expert searching in the Family Physicians' Inquiries Network (FPIN)

OBJECTIVE

This article describes the contributions of medical librarians, as members of the Family Physicians' Inquiries Network (FPIN), to the creation of a database of clinical questions and answers that allows family physicians to practice evidence-based medicine using high-quality information at the point of care. The medical librarians have contributed their evidence-based search expertise and knowledge of information systems that support the processes and output of the consortium.

METHODS

Since its inception, librarians have been included as valued members of the FPIN community. FPIN recognizes the search expertise of librarians, and each FPIN librarian must meet qualifications demonstrating appropriate experience and training in evidence-based medicine. The consortium works collaboratively to produce the Clinical Inquiries series published in family medicine publications.

RESULTS

Over 170 Clinical Inquiries have appeared in Journal of Family Practice (JFP) and American Family Physician (AFP). Surveys have shown that this series has become the most widely read part of the JFP Website. As a result, FPIN has formalized specific librarian roles that have helped build the organizational infrastructure.

CONCLUSIONS

All of the activities of the consortium are highly collaborative, and the librarian community reflects that. The FPIN librarians are valuable and equal contributors to the process of creating, updating, and maintaining high-quality clinical information for practicing primary care physicians. Of particular value is the skill of expert searching that the librarians bring to FPIN's products.

Standards for the academic veterinary medical library

The Standards Committee of the Veterinary Medical Libraries Section was appointed in May 2000 and charged to create standards for the ideal academic veterinary medical library, written from the perspective of veterinary medical librarians. The resulting Standards for the Academic Veterinary Medical Library were approved by members of the Veterinary Medical Libraries Section during MLA '03 in San Diego, California. The standards were approved by Section Council in April 2005 and received final approval from the Board of Directors of the Medical Library Association during MLA '04 in Washington, DC.

An evolution of experts: MEDLINE in the library school

QUESTION

What is the real value that medical librarians bring to the health care environment? How have library science educators, frequently former practitioners themselves, responded to the challenge of expert searching?

METHODS

In this paper, I give an historical introduction to the landscape of medical information retrieval through the development of MEDLINE. I then look at the evolution of training in online searching and its place in the context of library school education and particularly the effect of generalist education on future specialists. Finally, I acknowledge the new role of the informationist as another assertion of our professional expertise.

CONCLUSIONS

The three interdependent subsystems of our professional machine-our schools, our association, and our professional peers- must all respond to this challenge by asserting our expertise in our curricula, in our continuing education, and in our dialogues with each other. Only by acknowledging the interaction of these subsystems will real and positive changes be effected to benefit our profession and our constituencies.

The librarian's roles in the systematic review process: a case study

QUESTION/SETTING: Although the systematic review has become a research standard, little information addresses the actions of the librarian on a systematic review team.

METHOD

This article is an observational case study that chronicles a librarian's required involvement, skills, and responsibilities in each stage of a real-life systematic review.

MAIN RESULTS

Examining the review process reveals that the librarian's multiple roles as an expert searcher, organizer, and analyzer form an integral part of the Cochrane Collaboration's criteria for conducting systematic reviews. Moreover, the responsibilities of the expert searcher directly reflect the key skills and knowledge depicted in the "Definition of Expert Searching" section of the Medical Library Association's policy statement, "Role of Expert Searching in Health Sciences Libraries."

CONCLUSION

Although the librarian's multiple roles are important in all forms of medical research, they are crucial in a systematic review. As an expert searcher, the librarian must interact with the investigators to develop the terms required for a comprehensive search strategy in multiple appropriate sources. As an organizer and analyzer, the librarian must effectively manage the articles and document the search, retrieval, and archival processes.

Introduction to Reference Sources in the Health Sciences: an interview with Jo Anne Boorkman, Jeffrey T. Huber and Fred W. Roper. Interview by Elizabeth Connor

Few works serve as solid a framework for the field of health sciences librarianship or provide as many insights and detailed knowledge as Introduction to Reference Sources in the Health Sciences. Now in its fourth edition, the book's editors and contributors represent an impressive range of experience, expertise, and subject knowledge appreciated by practicing librarians in a variety of settings and by students of health sciences librarianship. Jo Anne Boorkman, Jeffrey T. Huber, and Fred W. Roper answered a series of questions about the latest edition of this seminal work, and offered opinions about reference works, services, and librarians.

Evidence-based databases versus primary medical literature: an in-house investigation on their optimal use

OBJECTIVE

The objective is to investigate the effectiveness of evidence-based medicine (EBM) resources in providing evidence for complex clinical questions versus general care management questions to identify situations for their optimal use.

METHODS

In this investigation, forty complex clinical questions were randomly selected from an in-house archival database of questions received by librarians during clinical rounds. An additional forty questions were selected from a list of general care management questions received by the library from Pathways teams. To measure the effectiveness of resources in answering the questions, a team of librarians was asked to search UpToDate, the Cochrane Database of Systematic Reviews, and HealthGate Clinical Guidelines (formerly, EBM Solutions). The team then established consensus on whether a question was fully or partially answered by one of the above-mentioned EBM resources and was instructed to record the instances in which the primary literature needed to be used to answer the question completely.

RESULTS

The study found that the EBM resources completely answered 20.0% of the 40 complex clinical questions and 47.5% of the 40 general care management questions, partially answered 40.0% of the complex clinical questions and 22.5% of the general care management questions, and did not answer 40.0% of the complex clinical questions and 30.0% of the general care management questions.

CONCLUSION

The pervasive use of EBM resources in answering clinical questions is making it imperative for information specialists to develop an expertise on their appropriate use. By exploring their use in answering complex clinical questions and general care management questions, this paper underlines the strengths and weakness of EBM resources and provides information specialists with some basic knowledge about how these resources can be combined with the primary literature to strengthen their effectiveness.

Academic health sciences library Website navigation: an analysis of forty-one Websites and their navigation tools

BACKGROUND

The analysis included forty-one academic health sciences library (HSL) Websites as captured in the first two weeks of January 2001. Home pages and persistent navigational tools (PNTs) were analyzed for layout, technology, and links, and other general site metrics were taken.

METHODS

Websites were selected based on rank in the National Network of Libraries of Medicine, with regional and resource libraries given preference on the basis that these libraries are recognized as leaders in their regions and would be the most reasonable source of standards for best practice. A three-page evaluation tool was developed based on previous similar studies. All forty-one sites were evaluated in four specific areas: library general information, Website aids and tools, library services, and electronic resources. Metrics taken for electronic resources included orientation of bibliographic databases alphabetically by title or by subject area and with links to specifically named databases.

RESULTS

Based on the results, a formula for determining obligatory links was developed, listing items that should appear on all academic HSL Web home pages and PNTs.

CONCLUSIONS

These obligatory links demonstrate a series of best practices that may be followed in the design and construction of academic HSL Websites.

Information-seeking behavior changes in community-based teaching practices

A National Library of Medicine information access grant allowed for a collaborative project to provide computer resources in fourteen clinical practice sites that enabled health care professionals to access medical information via PubMed and the Internet. Health care professionals were taught how to access quality, cost-effective information that was user friendly and would result in improved patient care. Selected sites were located in medically underserved areas and received a computer, a printer, and, during year one, a fax machine. Participants were provided dial-up Internet service or were connected to the affiliated hospital's network. Clinicians were trained in how to search PubMed as a tool for practicing evidence-based medicine and to support clinical decision making. Health care providers were also taught how to find patient-education materials and continuing education programs and how to network with other professionals. Prior to the training, participants completed a questionnaire to assess their computer skills and familiarity with searching the Internet, MEDLINE, and other health-related databases. Responses indicated favorable changes in information-seeking behavior, including an increased frequency in conducting MEDLINE searches and Internet searches for work-related information.

Evidence-based retrieval in evidence-based medicine

OBJECTIVE

Clinical decisions based on a meta-analysis that is based on an ineffective retrieval strategy may have serious negative consequences for patients. The study objective was to investigate the extent to which meta-analyses report proof of their retrieval strategies' effectiveness.

METHODS

The authors examined a random sample (n = 100) of articles in the 1996 to 2002 full-text subset of Ovid MEDLINE indexed as "meta-analysis." We classified the articles in three ways: the article (A) reported both a retrieval strategy in sufficient detail (such that it could be repeated) and with evidence of the strategy's effectiveness, (B) reported a retrieval strategy in sufficient detail but not with evidence of the strategy's effectiveness, or (C) neither reported a strategy in detail nor evidence of the strategy's effectiveness. Articles classified as (A) were further classified according to the level of evidence reported.

RESULTS

Of the eighty-nine articles in our final analysis, six (6.7%) were classified as category (A), fifty-seven (64%) as (B), and twenty-six (29%) as (C). Articles in category (A) reported a previously validated search, a published strategy, or strategy based on expert opinion.

CONCLUSION

Peer-review standards must be developed that require authors of meta-analyses to report evidence for the effectiveness of their retrieval strategies.

One library's experience with review and selection of chat software for reference

When Michigan State University (MSU) Libraries decided to make the foray into virtual reference, the first thing that needed to be done was to decide on the software to use. This article discusses the process used including the items considered essential (deal-breakers) for software to make the first cut, what other features needed to be included, and what features would be useful but were not critical. A literature review of some useful current articles on virtual reference is included. The vendor and software ultimately selected was not one of the original vendors; how MSU Libraries was able to evaluate and select Docutek is presented. A matrix for software comparison is included in the appendix.

Using SERVQUAL in health libraries across Somerset, Devon and Cornwall

This study provides the results of a survey conducted in the autumn of 2001 by ten NHS library services across Somerset, Devon and Cornwall. The aim of the project was to measure the service quality of each individual library and to provide an overall picture of the quality of library services within the south-west peninsula. The survey was based on SERVQUAL, a diagnostic tool developed in the 1980s, which measures service quality in terms of customer expectations and perceptions of service. The survey results have provided the librarians with a wealth of information about service quality. The service as a whole is perceived to be not only meeting but also exceeding expectations in terms of reliability, responsiveness, empathy and assurance. For the first time, the ten health library services can measure their own service quality as well as benchmark themselves against others.

Standards for hospital libraries 2002

The Medical Library Association's "Standards for Hospital Libraries 2002" have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges.

When less is more: a practical approach to searching for evidence-based answers

The information needs of practicing clinicians are distinct from the needs of students, researchers, or nonclinical personnel. Clinicians seek information to stay current with new relevant medical developments and to find answers to patient-specific questions. The volume of available information makes clinicians' tasks of rapidly identifying high-quality studies daunting. New tools evaluate the rigor and relevance of information and summarize it in the form of synthesized clinical answers. These sources have the opposite focus of many other information tools in that they strive to provide less information rather than more. With the development of these sources of validated and refined information, a new search approach is needed to locate clinical information in which speed is the benchmark. The existing medical literature, including these new refinement tools, can be conceptualized as a pyramid, with the most useful information, based on validity and relevance, placed at the apex. Use of this hierarchy allows searchers to drill down through progressive layers until they find their answers. Librarians can play a significant role in evaluating the ever-increasing variety of these synthesized resources, placing them into the searching hierarchy, and training clinicians to search from the top down.

Students and overdue books in a medical library

At the University of Ilorin Medical Library, sixty-one randomly selected medical students with overdue books were surveyed using a questionnaire with a view to (1) finding out why they had not returned the library books in their possession, (2) determining their perceptions of eight given overdue measures, and (3) seeking suggestions on how else to reduce overdue books. Most of the overdue books were as a result of (1) the students not finishing with the books and (2) the students being forgetful. Providing for renewals was the most favored overdue measure, while the need for increased multiple copies and extended loan periods for students were also stressed. Thus, a notice urging readers to return or renew borrowed library books was mounted on the issue desk as a reminder to all readers borrowing books. The library is being automated, which will facilitate timely generation and sending of overdue notices. More copies of some titles were purchased, while a copy each of others was transferred to the reserve collection. The need for an extended loan period will require further investigation, while the judicious use of other overdue measures to complement providing for renewals is recommended.

A study of issues in administering library services to nursing studies students at Glasgow Caledonian University

Glasgow Caledonian University has had a Scottish Office pre-registration nursing and midwifery contract since 1996. Nursing studies students seemed dissatisfied with the library service and there were frequent complaints. A major study was undertaken during 2000 consisting of: an initial lis-link enquiry, separate analysis of returns from nursing studies students of the Library's annual general satisfaction survey (conducted every February), separate analysis of returns from nursing studies students of the Library's opening hours planning survey, and four focus groups held in October 2000. These studies showed the concerns of nursing studies students to be similar to other students but more strongly felt. The four main issues were textbook availability, journal availability, opening hours and staff helpfulness. Working conditions, placement requirements, study requirements and domestic circumstances were all found to be important factors. IT skill levels tended to be low but there is a growing appreciation of the need for training in this area. Concluded that: Library's services to nursing studies students have become enmeshed with the problems of delivery and assessment of education for nurses. Greatly extended opening hours are essential including evening opening during vacations. The problem of access to textbooks is so severe that conventional solutions are not going to work. Programmes of core text digitization and the promotion of e-books are needed. Reciprocal access programmes with local hospital libraries is essential.

Users' information-seeking behavior on a medical library Website

The Central Medical Library (CMK) at the Faculty of Medicine, University of Ljubljana, Slovenia, started to build a library Website that included a guide to library services and resources in 1997. The evaluation of Website usage plays an important role in its maintenance and development. Analyzing and exploring regularities in the visitors' behavior can be used to enhance the quality and facilitate delivery of information services, identify visitors' interests, and improve the server's performance. The analysis of the CMK Website users' navigational behavior was carried out by analyzing the Web server log files. These files contained information on all user accesses to the Website and provided a great opportunity to learn more about the behavior of visitors to the Website. The majority of the available tools for Web log file analysis provide a predefined set of reports showing the access count and the transferred bytes grouped along several dimensions. In addition to the reports mentioned above, the authors wanted to be able to perform interactive exploration and ad hoc analysis and discover trends in a user-friendly way. Because of that, we developed our own solution for exploring and analyzing the Web logs based on data warehousing and online analytical processing technologies. The analytical solution we developed proved successful, so it may find further application in the field of Web log file analysis. We will apply the findings of the analysis to restructuring the CMK Website.

Real-time, evidence-based medicine instruction: a randomized controlled trial in a neonatal intensive care unit

PURPOSE

The study assesses potential for improving residents' evidence-based medicine searching skills in MEDLINE through real-time librarian instruction.

SUBJECTS

Ten residents on a rotation in a neonatal intensive care unit participated.

METHODOLOGY

Residents were randomized into an instruction and a non-instruction group. Residents generated questions from rounds and searched MEDLINE for answers. Data were collected through observation, search strategy analysis, and surveys. Librarians observed searches and collected data on questions, searching skills, search problems, and the test group's instruction topics. Participants performed standardized searches before, after, and six-months after intervention and were scored using a search strategy analysis tool (1 representing highest score and 5 representing lowest score). Residents completed pre- and post-intervention surveys to measure opinions about MEDLINE and search satisfaction.

RESULTS

Post-intervention, the test group formulated better questions, used limits more effectively, and reported greater confidence in using MEDLINE. The control group expressed less satisfaction with retrieval and demonstrated more errors when limiting. The test and control groups had the following average search scores respectively: 3.0 and 3.5 (pre-intervention), 3.3 and 3.4 (post-intervention), and 2.0 and 3.8 (six-month post-intervention).

CONCLUSION

Data suggest that measurable learning outcomes were achieved. Residents receiving instruction improved and retained searching skills six-months after intervention.