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Why Not Us?

21 Nov
Credit: NIH/NLM

Dr. Donald Lindberg, Credit: NIH/NLM

A couple of weeks ago, Francis Collins, Director of the National Institutes of Health, issued a gracious and thoughtful statement on the announcement of Donald Lindberg’s retirement as Director of the National Library of Medicine. Dr. Lindberg has held this post for more than 30 years and as any and everyone knows, the past 30 years in libraries and/or information science has seen monumental change. Dr. Collins lauded Dr. Lindberg’s leadership throughout this time. He also said this:

Trained as a pathologist, Don re-invented himself as an expert and groundbreaking innovator in the world of information technology, artificial intelligence, computer-aided medical diagnosis, and electronic health records.

Doctors seem to do this all of the time or at least they seem to be able to be many things at one time. We celebrate doctors who are also writers, doctors who are also artists, and doctors who are excellent teachers. We think little of showcasing their ability to be multi-talented. In this statement, Dr. Collins praises Dr. Lindberg for being able to be something else besides a doctor, or better put, to be an expert in medicine AND an expert in informatics. 

I share this because I was recently speaking with a doctor about how I was an expert in library science and something else. More specifically, I was explaining how my expertise in library and information science lent itself to being an expert in something else. And when I said this, the doctor looked at me somewhat quizzically. “Really?” she asked, the implication being, “I can’t even imagine.” 

I was hardly resentful about the encounter because to tell you the truth, it happens all of the time. While we don’t bat an eye at the fact that doctors can be multi-talented, the challenge is always there for us to convince them that they’re really not the only ones on whom this characteristic falls. And that’s part of our job. There’s no use grousing about it or getting all bent out of shape. Instead, we need to simply get out there and demonstrate that librarians can be experts in lots of things, too. Sometimes, we can even re-invent ourselves as experts in completely different areas without forsaking our expertise in librarianship. 

As we celebrate the many skills and talents of our patrons, let’s celebrate them in ourselves, too.

Librarians: Perfectly Aligned to be Opportunity Makers

10 Nov

Anderson

I subscribe to a couple of TED Talks feeds and thanks to that, I found a link in my email this morning to a talk by Kare Anderson, a columnist for Forbes who writes about how and why people make connections with one another. I took the 10 minutes required to watch the talk and couldn’t have been happier that I did. Not only was it inspiring on a personal level, but also because it was inspiring on a professional level. As Anderson shared a story about how she connected several people that she knew over a shared interest in public art, I couldn’t help but think and see how she’d make a great librarian (if she wasn’t a great journalist already). Bringing people together, connecting them, is what we need to do in our profession today, perhaps more than ever. As I’ve written before, the library long served as a physical place where different people gathered and found connections. If/when you’re working with a patron group who rarely if ever come to the library anymore, they’ve lost that opportunity to connect. We, the librarians who go out and meet them where they are, we bring that connectivity of the library to them. That’s a big part of our job. And as Anderson says, that work is the work of OPPORTUNITY MAKERS.

Near the end of the talk, Anderson lists the traits of opportunity makers:

So here’s what I’m calling for you to do. Remember the three traits of opportunity-makers. Opportunity-makers keep honing their top strength and they become pattern seekers. They get involved in different worlds than their worlds so they’re trusted and they can see those patterns, and they communicate to connect around sweet spots of shared interest.

Can you see where and how librarians fit this mold? I sure can!

Where the Buffalo Roam: Adventures in Health Sciences Librarianship in North Dakota

27 Oct

I’ve been on the road a LOT this month, traveling to North Dakota and Maine and, later this week, Virginia. It’s been a full schedule and I’ve missed catching up with my blog post each week. Here’s an attempt to begin filling in the holes.

Roamin' with the buffalo in North Dakota.

Roamin’ with the buffalo in North Dakota.

Last year, I was invited by members of the Program Planning Committee of the Midwest Chapter of the Medical Library Association to present a keynote lecture at their Annual Conference. As the meeting was to take place in Bismarck, ND and North Dakota was the only state of the 48 states in the Continental United States that I’d never visited, I jumped at the chance! I was flattered to be asked to talk about my work, too. 

I shared the first morning’s sessions with Betsy Humphreys, the Deputy Director of the U.S. National Library of Medicine. When we realized that we would be speaking back-to-back at the conference, Betsy and I arranged a quick phone call to talk about what we thought we were each going to say. It proved to be a really beneficial chat, as our keynotes ended up complementing one another very well.

Betsy’s talk, entitled “Points of Departure,” offers a survey of the current landscape in which medical libraries and medical librarians find themselves, and sheds light on the MANY places that professionals can insert themselves and their skills. From electronic health records to patient advocacy to health literacy to informatics, the opportunities abound for those individuals and libraries who are willing to step out (or step up) to the challenges, rather than saying the future holds no place for us. “Set out from any point,” we were reminded. They all lead to opportunity. (You can see my sketchnotes of Betsy’s talk here.)

I titled my own keynote, “Making the Case: Health Sciences Librarians Staking their Claim in a ‘New World.’” You can download the slides here, but I’ll provide an annotated version of the talk in this post.

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I confess that in those times when I’m facing many deadlines, feeling stressed, feeling bored, or feeling tired, I have a particular vice that I indulge in. Fortunately for me (though not necessarily for my practices in discipline of any sort), my vice is pretty easy to partake in, as it involves a certain television show that one is hard pressed to not be able to find airing at any hour of any given day. As the deadline for this talk loomed larger, I found myself giving in to my vice so often that eventually, I figured I’d use it as a framework for my talk. Here goes…

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A disclaimer.

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Imagine the infamous “duhn duhn” sound. (It played during the talk.)

Sally-Gore-keynote_Page_04Our episode starts at a dinner party in Louisville, Kentucky, some time in the late 1980s. Everyone had finished eating and gathered in the living room, sitting in a circle and chatting, when someone said, “I know. Let’s go around the room and everyone share a dream.” 

The usual suspects were offered up; “I hope for a family.” “I want to have children.” “I want to travel around the world.”

When it came my turn, I shared what has, for as long as I can remember, been my life’s dream,” I want to win the Oscar for Best Original Screenplay.”

“GET SERIOUS!” shouted this woman who, by the way, I’d never met in my life. “Tell us something that you might ACTUALLY do!”

Sigh… My dream. Busted.

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Thank you, Lenny.

 

Sally-Gore-keynote_Page_06So, what’s your dream for libraries? When you think of what a library is and/or can be, what do you dream? Do you imagine the “Library of the Future,” complete with no books and lots of modular furniture, spaces for gaming and tools to help students and faculty and researchers fuel their innovative spirits? Do you dream of tranquility and order and the beauty of our National treasures, like the Library of Congress? Or do you see the library as not a place at all, but people embedded in research centers, bringing the services of libraries directly to the patrons?

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And what do you dream for librarians? Do you miss the “good old days” when we held the keys to the information kingdom; when we were the gatekeepers that everyone had to pass through and by in order to access what they needed? Do you miss the heady power of those days? Or do you dream of times when librarians are no longer associated with libraries; when we’re not even called librarians anymore? What do you dream?

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And for all of those dreams, do you have any kind of plan in mind for how to get there?

Sally-Gore-keynote_Page_09My own library recently had our annual all-staff retreat in which our Director, Elaine Martin, delivered her “State of the Library” address. She covered where we’ve been the past year, where we are now, and where we’re likely headed over the next months. One of these future places involves the development of a new strategic plan. Looking ahead five years, where do we think we’ll be? That’s the question Elaine posed to her staff.

When I think back on all of the change that’s happened here in the past 10 years (the amount of time that I’ve worked at UMass Med), I find it pretty hard to even imagine that I ever could have imagined the things I’ve seen come and go, the transformations we’ve endured, and the many different roles we’ve taken on as a library (and as librarians). The thought of imagining the next five years seems daunting, if not downright impossible for me, and it got me to thinking about how I do go about planning my work, my roles, and my future as a health sciences librarian.

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Backyard camping!

I grew up in a camping family. We camped weekends and summer vacations. We camped in the mountains, occasionally at the beach, and often in New England and Canada. My father was also a backpacker and he took my brother and I on week-long backpacking adventures, alternating years between us, during spring breaks. The first time I went on one of these trips, I was probably about 10 years old. My dad, being a good bit taller than me, often hiked ahead on the trail. He’d make his way up the path, me following behind, always being sure that he never got too far ahead that I couldn’t see his pack. (It was always a bright color – red or orange – so that I could easily see it.) 

As I thought about how I strategically plan my work, I came to realize that I do so very much like I strategically made it through the Appalachian Trail in Virginia. I call my strategy…

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It works. Not just for hiking along unknown trails, but also for making one’s way down the mysterious, always developing and ever evolving paths of medical librarianship.

Sally-Gore-keynote_Page_12And as every strategic plan needs goals and objectives, these are the ones that I propose for my Backpacking model:

  • Know yourself – what you do well, what you don’t do well, what you like to do, what you don’t like to do, etc.
  • Know your environment – the people, places, and things that surround you and make up your workplace.
  • Know how to bring these two things together – YOU and your environment.

Sally-Gore-keynote_Page_13We talk a lot in our profession about the gap between what students, faculty, staff, and researchers want from health sciences libraries and what health sciences librarians know how to do. We’re very focused upon identifying the skills that we need to develop to close this gap and become, again, a vital and relevant resource to our patrons. The gap produces a great deal of anxiety for many of us; we don’t know how we’ll ever keep up, ever gain the skills we need, and/or ever meet our patrons’ needs again.

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So I propose an exercise…

I've had LOTS of jobs.

I’ve had LOTS of jobs.

Take some time to think about every single job that you’ve ever had in your life. Write them down. Every job, everything you’ve ever volunteered for, every class that you’ve ever taken in formal education or not. List them all.

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And then, take that list and from it create another list of all of the many, many, many things that you know how to do. Yes, you’re a librarian and you have a whole host of skills that come with that, but think of others. Think of how all of the other things that you’ve done in your life have helped you gain expertise in information management or communication or team building or organization. And once you have that list, look around you at all of the many, many, many needs your current environment offers. Can you now, with all of these lists in hand, find one or two or a dozen matches, opportunities where you can put yourself, the librarian, to good use to meet these needs? As Betsy Humphreys noted in her talk, these opportunities are our POINTS OF DEPARTURE. They are our keys to relevancy and the future of our profession.

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My list looks like this.

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And it defines me, the health sciences librarian, as a person who does all of those things. As we each redefine ourselves and our roles, we will, ultimately, redefine our profession. Sally-Gore-keynote_Page_19

And our value will no longer be such a mystery.

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This plan, I think, pretty much closes that gap that worries us so.

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Next, I provide a bunch of examples from my own work. For each, I offer the project that came to be and the skills used to meet the needs of each.

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I can imagine some new projects and dream up some new places to perhaps find myself working.

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I can dream of really BIG things on the horizon, areas that could offer countless opportunities for a librarian.

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For my closing argument, I offer up my good friend, Cindy Stewart. If you’re a medical librarian, you may well know Cindy, for up until just a few weeks ago, she was an Associate Director for the health sciences library at Dartmouth’s medical school. Today, though, she’s the new Program Manager for Dartmouth’s Clinical and Translational Science Award. Do you think she stopped being a librarian, simply because she assumed this new position? NO. Do you think that she got this position in large part because of all of the skills she honed over the years as a medical librarian. YES. Cindy was able to sell herself as the person for this job because of all of the things that she knows how to do, from being a librarian, that fit all of the information needs (and more) that the researchers at Dartmouth and their CTSA program have and/or are going to have over the next few years. She closed that gap, but good.

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Next I read a great passage from this book, but I’m not going to post it here. Suffice it to say, it summed up how we do a lot of things in life, develop a lot of habits and patterns and trains of thought, based upon not much more than a couple of horse’s asses. (The story is about why railroad tracks are the width that they are.)

Sally-Gore-keynote_Page_30Did I make my case?

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You decide.

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There were other tremendously great talks at the conference. I won’t recap them all here, but I’ve posted my sketchnotes for each:

 

 

Teaching Like a Ninja!

1 Oct

Massachusetts Health Sciences Library (1)I attended a really terrific continuing education event last Friday, co-hosted by the Massachusetts Health Sciences Library Network (MAHSLIN) and the Western Massachusetts Health Information Consortium (WHMIC). It featured two excellent speakers and a “sold-out” crowd.

First, Rebecca Blanchard, PhD, MEd, from Baystate Health, Academic Affairs Division, led us through a session focusing on the idea of “stealth teaching,” i.e. teaching people without them knowing that they are being taught. This is a great approach to education and one particularly suited for those of us who work in harried environments and with people who generally have little time or attention to give towards learning something new. From one-on-one encounters to small group instruction to formal classroom teaching, we learned and practiced ways of moving people from the place where they don’t know and/or don’t even know that they don’t know, to a place of knowledge, all by ways that facilitate learning. Dr. Blanchard has coined her approach, “ninja teaching” and by the time the session was over, we’d all earned our white belts in ninja school! 

After learning about teaching, we enjoyed a time of stress reduction – a perfect thing for a Friday! Donna Zucker, RN, PhD, FAAN, from University of Massachusetts, School of Nursing taught us all about the use of labyrinths in stress reduction. We learned about the very long history of labyrinths and the practice of walking them, including their modern day use in clinical settings, health care, and rehabilitation. We got to see a short video about a project that Dr. Zucker is involved with at a county correctional facility, where the inmates built a labyrinth and use it for improving their own stress management skills, something that benefits them greatly when they return to society.

Perhaps the coolest thing … We learned about the use of labyrinths in libraries! Sparq Meditation Labyrinth is a portable, projected labyrinth that was developed by Matt Cook who works at the University of Oklahoma’s library. His project has been installed in his library, as well as at the University of Massachusetts – Amherst’s, W.E.B. DuBois Library. I found this FASCINATING! The science behind labyrinth walking and stress reduction abounds and it was really great to see libraries and librarians aware of the anxieties students face and using this incredibly unique tool to help them manage their stress. I’m going to keep up with this project. Who knows? Maybe we’ll get to install it in my own library one day.

Big thanks to Margot Malachowski of Bay State Hospital’s (Springfield, MA) library for arranging this event for her colleagues, and to MAHSLIN and WMHIC for supporting it!

Here are my sketchnotes from the day:

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FlipQuiz: A Great New Teaching Tool

24 Sep

I’m teaching Health Sciences Librarianship for the University of Rhode Island’s Library and Information Studies graduate program this semester. Sometimes, I think we can learn as much being a teacher as we do being a student. In this case, I’ve been learning to use a number of new tools, new concepts, and new ways to teach online, and for distance learners. I’ve had to read a lot of theory and try out a bunch of resources and it’s still only September!  Fortunately, I think my students are both patient and open to the trial and error of my learning. 

This week, I discovered a terrific new tool that I want to share via this blog. I think others will find it pretty useful, too. If you’re a fan of learning via games (as I am), give FlipQuiz a try!

NCBI Game

Feel free to click on the game board and play, but don’t share answers with my students! :)

ACCESSories

12 Sep

For years, I lived on Lower Flying Point in Freeport, Maine, one of those fingers of land that stretches out into Casco Bay. You can get to Lower Flying Point one of two ways; Flying Point Road off of Bow Street, which is off of Main Street in Freeport (turn right at L.L. Bean) or Flying Point Road by way of Pleasant Hill Road by way of Highland Road by way of Maine Street in Brunswick, ME. You can probably tell, just by the description, that the former is the fastest, straightest route.

One summer, Mill Stream, which ultimately flows into and becomes the Harraseeket River, flooded. REALLY flooded. Over the banks and over the surrounding fields and over Bow Street/Flying Point Road. In its flooding, it took with it the very large culvert that ran underneath the road and, with the culvert also went the road itself. For weeks after, the only way to get to and from home was the very round-about and out-of-the way route through Brunswick. People were good sports about it, even though it was a major inconvenience and added as much as a half-hour to one’s commute, and when the road was finally re-opened, we hung balloons and had a party. Access restored.

In her book, Access to Medical Knowledge: Libraries, Digitization, and the Public Good, Frances Groen identifies three values that lie at the foundation of professional librarianship:

  • Providing access to information
  • Preserving the accumulated knowledge of the past
  • Helping the public understand how to use information

(Read a review of the book by Janice Kaplan in the July 2007 issue of JMLA.)

I’ve required the students in my Health Sciences Librarianship course at the University of Rhode Island to take part in one of the Thursday night #medlibs Twitter chats. Last night was an option and several were there, asking great questions and sharing in the discussion. The topic centered on the role of librarians in the clinical setting and was led by Julia Esparza, a Clinical Medical Librarian from LSU Health in Shreveport, LA. Julie asked some really pertinent questions around what it takes to have confidence in this role, what people most enjoy about it, and what some of the unique challenges to it are. My students expressed real surprise at how much clinical medical librarians can be involved in the hospital setting, particularly when it came to thinking about them being part of rounds, i.e. being at the patient’s bedside with the rest of the clinical team. To paraphrase… “What do patients think about that?” “How would I feel about it, if I was a patient?” “How does that make a patient feel, that a doctor has to look to a librarian for help finding information?”

Great questions, every last one of them! 

The medical profession is layered (and layered and layered) with levels of myth and entitlement and very entrenched beliefs about the respective roles of doctors and patients. Given our incredibly complex healthcare environment and the limitations of physicians in terms of how much time they have to spend with patients, there’s been a push for patients to become educated about their health, diseases, care, etc. Patients need advocates, be they a family member, friend, or stranger. It’s simply unwise to step into a situation involving yours or a loved one’s health, knowing little to nothing of what’s going on. But it happens all the time. Medical librarians, particularly those focused on consumer health resources, are tasked with providing access to the information that the public needs to be better prepared here. From the admonishment, “Don’t Google for Health Information!” to showcasing sites likes MedlinePlus to attending health fairs… medical librarians (and public librarians) are busy here, staying true to the values “Providing access to information” and “Helping the public understand how to use information.”

So how does this fit with librarians being a part of teams in the clinical setting? I argue that it’s merely an extension of the same. They are there to make sure that the doctors AND the patients have access to the information that they need, and they are there to make sure that everyone knows how to use it. But what does that mean? Providing access is one thing, but what does it mean to help someone understand how to use information? Doctors are there to diagnose, we all agree with this, but for the patient who doesn’t understand the information presented to them, does the librarian, perhaps, have a role in helping them understand it? After all, doesn’t understanding how to use information depend upon understanding what the information means in the first place?

Not being a clinical librarian, I really only have opinions here – not much actual experience or evidence to fall back upon. However, if I translate this setting to my own, i.e. the research team, and think of my role as a librarian there, are there any parallels? I think so.

There’s a debate among those who take part in systematic reviews and in-depth searches regarding how much a librarian should do. Do we simply develop and execute the search strategy, and then pass off the results to the rest of the team for review? Are we breaking some rule if we review the articles, too? Is it taboo for us to write synopses of papers, evaluations of them, or give our own thoughts upon whether or not they are worthy of inclusion in the study? Can we take the lead in writing more than the methodology of a systematic review? Can we make suggestions, share informed opinions, and discuss the topics at hand that extend beyond the subject of librarianship? 

For me, the answer to these questions lies at the heart of what it means to truly be embedded in the setting, be it research or clinical. It’s about being an equal part of the team and while each member has his/her level and/or area of expertise, to be more than an accessory, you need to step up and be equal – equally responsible, equally accountable, and equally invested. If I can explain some information to someone, to me that is part of helping someone understand how to use it. It’s a core value. To stop short of this because I believe that it’s not my role or not my responsibility, that’s falling short of what I believe is my professional place. 

I was in the hospital last month and while there, I overheard my medical team (just docs, no librarian) in the hallway talking about my EKG. The resident and attending doc were explaining to the medical student about the length of my QT segment and what my R wave progression might be telling them. I wanted to yell out into the hallway and tell them that I’d had a couple of semesters of cardiac electrophysiology as an undergrad and grad student, and ask if they might wish to come in the room and talk to me about it. But I didn’t. I listened to what they said about me in the hallway and then listened to what they said to me when they came to my bedside. And they were, as you can imagine, quite different.

After last night’s chat and then thinking about the questions and observations of my students, I wondered how this experience might have gone differently if a medical librarian was there. And then I realized that a medical librarian WAS there. Granted, I was the patient and really in no mood to make it a teachable moment, but that’s what it was. I could have talked to the doctors and let them know that I knew how to use the information they weren’t sharing with me. I could have said that as a medical librarian, it’s my job to make sure people know how to use the information they have. It’s not just my job to provide access to it. If this means explaining something – or making sure the clinician explains something – in a way that the patient understands it, then that’s what I do. I like to think that our role is a heckuva lot more than simply being a culvert.

 

 

The Doctor is Out

10 Jul

Psychiatric BoothAdmit it. We all know a lot better, a lot of the time. People know that sitting around all day isn’t the best thing for one’s health, but here we sit. We know that the label says there are 6 servings of macaroni and cheese in the box, but it really divides better by 2 or 3. We know that being distracted while driving isn’t the safest thing, but we text and we do our makeup and we fiddle with the radio and we play our ukuleles while we drive, anyway. And when it comes to information and data, of course we know that it’s best to back-up our files in multiple places and formats, to name our files a certain way so that we can find things easily, and to write down instructions and practices so that we, or others, can repeat what we did the first time. Of course we know these things because let’s be honest, it’s common sense. But… we don’t.

Personally, I get incredibly frustrated at librarians who think we’re adding something important to the world of data management, just by teaching people these notions that really are common sense. I think that there’s something more that we need to do and it involves understanding a thing or two about the way people learn and the way they behave. In other words, lacking a behavioral psychologist on your research team, librarians would do well to study some things from their camp and put them to use in our efforts at teaching, providing information, helping with communication issues, and streamlining the information and/or data processes in a team environment.

I’m preparing to teach a course in the fall and thus I’ve been reading some things about instructional design. In her book, Design for How People Learn, Julie Dirksen explains that when you’re trying to teach someone anything, it’s good practice to start by identifying the gaps that exist “between a learner’s current situation and where they need to be in order to be successful.” (p. 2) Dirksen describes several of these gaps:

  • Knowledge and Information Gaps
  • Skills Gaps
  • Motivation Gaps
  • Environment Gaps

More, I believe she hits the nail on the head when she writes, “In most learning situations, it’s assumed that the gap is information – if the learner just had the information, then they could perform.” I know that I fall into this trap often (and I bet that I’m not alone). I believe if I teach a student how to conduct a solid search in PubMed, that’s how they’ll search. I show them a trick or two and they say, “Wow!” I watch them take notes. I help them set up their “My NCBI”  account. We save a search. They’ve got it! I feel like Daniel Day Lewis in the movie, There Will Be Blood, “I have a milkshake and you have a milkshake.” I have knowledge and now you have the knowledge. Success!

Now if you do any work that involves teaching students or clinicians or researchers or anyone, you know not to pat yourself on the back too much here. I teach people, my colleagues teach people, all of our many colleagues before us (teachers, librarians at undergraduate institutions, librarians at other places where our folks previously worked) teach people. We all teach the same people, yet we keep seeing them doing things in their work involving information that make us throw up our hands. How many times do we have to tell them this?! 

Well, maybe it’s not in the telling that we’re failing. This is where I think understanding and appreciating the other gaps that may exist in the situations, addressing them instead of simply passing along information, could lead us to much more success. And this is where we could use that psychologist.

Earlier this week, I tweeted that I was taking suggestions for what to rename the systematic review that I’ve been working on with my team, for it is anything but systematic. A’lynn Ettien, a local colleague, tweeted back the great new name, “Freeform Review.” I loved that. Another colleague, Stephanie Schulte, at the Ohio State University, offered up a really helpful link to a paper on the typology of reviews. But it was what my colleague, Eric Schnell, also at OSU, tweeted that led me to this blog post:

Schnell

BINGO! Every person on my team knows what the “rules” are, but they keep changing them as we go along. I spend time developing tools to help this process go more smoothly, but still get a bunch of notes emailed to me instead of a completed form. I give weeks to developing a detailed table of all of the elements we’ve agreed to look at. Except this one. Oh, and this. Oh, and should we also talk about this? I put my head down on the table.

But Eric is exactly right. This is how most people deal with information. This is how we work. And it’s not a matter at all of people not knowing something, but rather it’s a problem of people not doing something. Or better put, not doing something differently. Sometimes people do lack knowledge. Many times, people lack skills – something that a lot of practice can fix. But an awful lot of time, what we really need to address are the gaps that have nothing to do with knowing what or how to do something.

Why won’t my people use the forms I’ve created and the tables that I’ve prepared? They said that they liked them. They said they were what they wanted. So… what’s the problem? I think it’s something that each of us who works in this field of information wrangling needs to become proficient at, i.e. learning to see and address all of the gaps that exist. At least the ones we can.

And I, for one, am still learning. 

 

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