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A Picture CAN Tell a Dozen Tables’ Worth of Data

10 Dec

[The following was originally written for the UMCCTS December Newsletter.]

When it comes to summarizing and sharing information with an audience, one important thing to remember is the audience itself. It’s a pretty simple concept, yet too often forgotten or dismissed when we’re preparing a talk, an article, a policy statement, patient education materials, and the myriad of other containers into which we fit our message.

Most recently, I’ve been working to pull together sections for the Final Progress Report for our initial Clinical and Translational Science Award. This is not my first time writing such a report and as has been the case in the past, we follow a template that goes something like:

Overall Objectives and Goals > Aims > Accomplishments Associated with Each Aim > Milestones Reached for the Same > Challenges Faced > Future Plans

These reports are lengthy and dry, filled with lots of bullet points and tables and numbers. I’m not privy to how these reports are read at NIH, but I imagine that the format fits how they are reviewed and makes it easier for funders to see a bigger picture across similar awards. Funders and reviewers are the audience, thus we present our information to them in the way they’re accustomed – the way that they understand.

Taking a break from all of the writing, I decided to turn one of the bigger tables of information I’ve received into something for a different audience. Sarah Rulnick, MPH, Project Manager for the Conquering Diseases Project, recently compiled some information regarding the work of the Biorepository and Volunteer Database. These are both integral pieces in the UMCCTS efforts to support clinical trials. I read through the narrative portions of Sarah’s summary and took in the full-page table giving yearly counts of things such as the number of patients consented for the biorepository, MiCARD searches performed, outreach events organized, and the like.

I started to think about a way that I could summarize this information for both people who have already enrolled in the Volunteer Database and those who might potentially do so, if they only understood a bit more about the importance of participation. It’s an audience that Sarah and her colleagues are charged to reach. I pulled out the data points that I thought best addressed this goal. I also brainstormed what came to my mind when I thought about conquering something. What I ultimately came up with is this:

Conquering Diseases

Coincidentally, right in the middle of writing this newsletter piece, I watched a 20-minute “Coffee Break” webinar from the American Evaluation Association. I hadn’t connected the webinar with this piece, but they certainly appear to be related. The webinar was entitled, “How to Develop Visual Summaries and Inforgraphics from Your Evaluation Findings,” and presented by Elissa Schloesser, a graphic designer and visual communicator based in Minneapolis. She, too, talked about knowing your audience and she offered an excellent example of how she prepared two very different materials for two groups; both from the same report. I felt I was on track with my message here.

Elissa has some other nice examples on her My Visual Voice. If you’re thinking of communicating some of your work visually, they might inspire you.

Illustrated Podcasting

2 Sep

My podcasting workshop last night wasn’t quite all that it was advertised to be, but I definitely learned a lot and feel pretty prepared to tackle the task. I was hoping to leave the class with a finished and distributed episode (per the course description). I like classes and workshops that promise such. It wasn’t to be, but for the $17.50 fee, plus the bonus of catching up with my friend, fellow librarian, blogger, beer connoisseur, and baseball lover, Dan, before, it was more than worth it. I sketched my notes, per usual, and share them here. And soon, catch the podcast I’m going to create!

PodcastClass_1

PodcastClass_2

PodcastClass_3

PodcastClass_4

For those keeping track of my office supplies, these sketchnotes are drawn in a FieldNotes brand ruled memo book, carried in my “never go anywhere without it” handmade “Everyday Carry” cover, with a refillable Pentel EngerGel pen that I’ve managed to hang on to for several years now. I hope that I never lose it, as both Rosanne Cash and Amy Dickinson have used it to pen a few words to me. It’s a treasure.

Listen Up!

17 Jul

podcastI need to offer up a HUGE thanks to my friend and colleague, Kate Thornhill, Research and Instruction Librarian for Digital Scholarship at Lesley University’s Moriarty Library in Cambridge, MA, for recently turning me onto the terrific podcast, Lost in the Stacks. From WREK, the student-run radio station at Georgia Tech University in Atlanta, the show is hosted by Charlie Bennett and Ameet Doshi, along with Anthony Nguyen, Fred Rascoe, Lizzy Rolando, and Wendy Hagenmaier. All librarians at Georgia Tech University in Atlanta, they bring an hour-long program offering really interesting interviews with librarians focusing on all sorts of cool themes. But it doesn’t end there. In between the interviews and/or segments, they play some pretty groovy tunes, an eclectic mix of great songs. I just LOVE it!

I imagine that Kate sent me the info on this show because one of their most recent programs, Once a Librarian, Always a Librarian, offered up interviews with Elizabeth Keathley, Chief Officer and Digital Asset Manager at Atlanta Metadata Authority and author of Digital Asset Management, and Nisa Asokan, Editor at WebMD and Co-Owner, Manager of the music production company, Tight Bros Network. Being one who easily falls into the “Once a Librarian, Always a Librarian” career category, I appreciated so much the thoughts, ideas, and insights shared in this episode.

The first segment begins, “One thing you might notice about the job titles for both of our guests is that they do not have the word ‘librarian’ in them, however, both have degrees in library science.” I could offer you a nice summary of what Elizabeth and Nisa had to say about their jobs, their work, their titles, and their salaries, but I’m not going to do that. Instead, I’m going to tell you to seek it out and listen. It’s a wonderfully optimistic – and very true – view of a profession that opens so many doors to so many fascinating careers, if one wants them.

With other episodes in their archive like Beach Libraries, The DC Punk Archive, and Avoiding Dead Air, you can bet that Lost in the Stacks is going to easily find its place on my Friday afternoon playlist from now on. Thanks, Kate! And thanks to those bringing us this show.

The Choices We Make

4 Jun

My blog post for this week is sitting over there on the NAHSL blog. I hope you’ll click on the link below and visit. My thanks, again, to NAHSL for offering financial support to help me attend the annual meeting of the Medical Library Association this year.

The Choices We Make

Choose Wisely

Choose Wisely

A Sheep in Sheep’s Clothing

28 May

[Alternate Title: The Sheep that Wags the Wolf’s Tail]

Photo Credit:  petsadviser.com

Photo Credit: petsadviser.com

A few years back, I made a deal with a friend to run the Chicago Marathon. I’d run several marathons previously, but none in a number of years. I was nowhere near the shape I wanted to be in when I made the deal and as both my friend and I were trying to be healthy, it was a win-win situation. At least it seemed that way. I trained in the winter, indoors on the treadmill. Once spring came, I moved outside. Week after week, I slogged through, never feeling like I was gaining any stamina, losing any weight, or getting any healthier. As summer came along and I started to stretch out my miles, I found myself getting pretty sick after running. I couldn’t eat anything without having serious digestive troubles. It got to the point that after running I’d stick with a smoothie and not much else. Even that didn’t always go well. I’d never had this experience in past training and kept chalking it up to being out of shape.

Then, one Friday evening I went for a 12 mile run – struggling through it as my gut rebelled against me. I finally finished, stopped by the 7-11 for a Gatorade, and drove home. After showering, I had a smoothie and settled in to watch the Red Sox. Next thing I knew, I was on the floor of my bathroom and next after that in an ambulance to the emergency room. I’d never been in an ambulance before – and that’s about the only positive I can think of regarding the experience.

After a night in the ER, tests that revealed nothing much, trips to my doc and a couple of specialists, the vascular surgeon told me that he suspected I had celiac artery compression syndrome (or median arcuate ligament syndrome). He also said, as I described my symptoms related to running with him, that he’d never heard of it being associated with exercise.

Being the medical librarian that I am, I set about searching PubMed (now that I knew some terms to search) to learn about what was going on inside of me. Mostly, I was looking for something that would link my training with this syndrome. Lo and behold, I found one. One. That was it. One case study about one individual – an elite runner who’d suffered something similar to what I was experiencing. Granted, I was hardly “elite” in my running, but the symptoms and situations described for this runner were just what kept happening to me.

I promptly sent a copy of the article to my surgeon and then, a couple of weeks later when I was wheeled into the operating room for an arteriogram to confirm his diagnosis, he said to everyone in the room, “If you have any questions, ask Sally. She’s read more about this than you have.” (Though fortunately not more than my surgeon!)

This is a long, round-about story to demonstrate a point – when it comes to evidence, a case study that resonates with you, the individual, is worth as much as any randomized control trial.

Evidence-based practice is THE term in medicine today. As noted by Stewart Donaldson, Christina Christie, and Melvin Mark in the introduction to their book, “What Counts as Credible Evidence in Applied Research and Evaluation Practice?” we live in an evidence-based society. Evidence-based medicine, evidence-based mental health, evidence-based management, evidence-based decision making, evidence-based education, evidence-based coaching, evidence-based policy, evidence-based sex education, evidence-based fill-in-any-blank are just some of the examples they list from a quick Google search of “evidence-based practice”. For those of us who have taught any course related to evidence-based practice, we know all about the EBM Pyramid and the hierarchy of quality when it comes to evidence. At the top of the pyramid sits the randomized control trial and systematic reviews. Further down, the anecdotal case study. In other words, something happening to one or two people – like me and that other runner – simply doesn’t qualify as enough evidence to state that there is any connection between exercise and celiac artery compression syndrome.

Except when it is enough. As it is/was for the two of us (and no doubt a few others).

I found myself thinking often of my personal case history and the evidence-based pyramid during a number of sessions that I attended during last week’s annual meeting of the Medical Library Association. Why? Well, mostly because I attended a lot of talks on the new roles that librarians and other professionals working within libraries, i.e. PhDs in bioinformatics, are assuming today. People are doing an awful lot of interesting things related to specialized services. I count myself in that lot. I may well be an evaluator now, but I personally think it’s simply an extension of the specialized work that I was doing in the library. But the thing that I kept noticing – and a point I raised in one of the sessions – was when, if ever, will we get past case studies related to these services? When, if ever, will we be able to say as a profession that the successful new roles and services that some libraries are offering today are roles and services that can be adopted broadly? When, if ever, will we have enough evidence that demonstrates the success is based more on the service and the role, and less upon the individual delivering it?

Watching Twitter throughout the meeting, I noticed one person tweet a picture of a slide from Bart Ragon’s (University of Virginia) presentation, “Where is My Data Scientist?” (Disclaimer: I was in a different session at the time, thus am taking Bart’s slide out of context.) The slide read, “Unless you are Kristi Holmes or Michele Tennant – Most librarians lack any of these skills.” For those less familiar with MLA, for many years, Kristi (formerly at Washington University, St. Louis, now the Library Director of Galter Health Science Library, Northwestern University) and Michele (University of Florida) were known as the two PhD biochemistry people in our midst. They were anomalies; scientists working in medical libraries. Today we have more – Jackie Wirz at Oregon Health Sciences University, Meng Li and Yibu Chen at the University of Southern California, and Tobin Magle at the University of Colorado Denver to name a few – but they still remain oddities.

When I asked the panel of Kristi, Tobin, Jackie, Meng, and Jerry Perry (former director of UC-Denver’s medical library, soon to be the same at the University of Arizona’s health sciences library) this question about case studies versus a broader body of evidence, Jackie admitted that sometimes she does wonder if people call on her because they think “Jackie can help” or if they think the bigger, “the library can help.” I don’t mean to suggest that the two are mutually exclusive, but how much are our trends towards specialized services redefining the health sciences/medical library profession, as a whole, and how much are they simply taking advantage of particular individuals and the strengths, expertise, etc. they bring to a particular library?

One of the bits of advice that Kristi Holmes offered during this session was, “Build the best library for your institution, thus what works here may not work there.” It’s hard to argue that this isn’t good advice, yet at the same time I can’t help but wonder about how well it sums up our future as a profession. It’s becoming more and more specialized, more and more individualized, and the parts aren’t easily interchangeable anymore. This can be either good or bad for us. Thinking to what Mae Jemison said in her McGovern Lecture (I wrote about this for the NAHSL blog and will share the link when it’s published), innovation is not inherently good or bad; progressive or regressive. It’s the choices that we make around our innovations, our new ideas, our new roles, and our new services that ultimately make the difference.

I’m a librarian with the title of “Evaluator” sitting in an office in the UMass Center for Clinical and Translational Science. Jackie Wirz is a PhD biochemist and molecular biologist with the title “Biomedical Research Specialist” and an office in the OHSU library. What do we have in common? What do we do that can be teased out, taught to others, and adopted by other libraries, centers, or institutions? To me, that’s a BIG question and something worth continuing to try and answer/address as our profession continues to redefine itself for the future (and now).

Turning the Tables

27 Mar

Earlier today, a very nice first year medical student came by my office and apologetically asked me if I could tell her where the offices of our Institutional Review Board people are. I don’t work in the library anymore, you might recall, and now my office sits in a maze of other offices on the 7th (top) floor of the ambulatory care center of our medical complex and medical school. It’s not a place that anyone wanders past. Mine is not an office that someone might simply pop in for a visit. It’s out of the way. And as I said to my former colleagues in the Library and my friends on Facebook, I admittedly miss such interruptions. Not all of the time, mind you, but one of the greatest joys that I knew as a librarian was simply answering someone’s question and / or helping them in some way that made their day better. The student was SO grateful when I got up and walked her around the corner to the IRB folks. She thanked me several times. It was a flashback to those days of yore … oh, 3 months ago or so.

For ten years, I spent the better part of my working days answering people’s questions. Either answering them directly, looking for the answer for them, or helping them learn how to find the answer for themselves. All day long, the overwhelming majority of sentences spoken to me ended in question marks. Librarians answer questions.

Evaluators, on the other hand, ask them. This is what I’m quickly learning. We are the ones who need the answers, thus we’re the ones who ask the questions. How well did “X” intervention work? How much time was saved by implementing “Y” into the process? What does “Z” do for you that no other letter of the alphabet ever did for you before?

But I’ve also learned that there’s a speed bump; the researchers and clinicians and other users of the resources and services that I’m evaluating … well … they typically aren’t librarians. In other words, I don’t think that they like answering questions as much as any librarian does.

“It’s a simple survey,” I claim.

“It won’t take more than 5 minutes of your time.”

“The results will help us help YOU!”

“I’d be ever so grateful,” said Babe the Pig. (If you miss the reference, check out the movie.)

And still, getting people to answer questions is way harder than I ever imagined. I’m actually very good at talking to people, and usually pretty good at getting people to talk to me. It was one of the skills and characteristics that I honed as a librarian / informationist that I figured would be easily transferable to my new role. Not so much. At least not yet.

It could be the method – the dreaded survey. People don’t like them. Heck, I don’t like them. But in some cases it is the most appropriate and most efficient method for getting the data (answers) you need for the evaluation. I read and studied and asked about writing good questions. I worked with seasoned researchers to put my survey together. I piloted it with different groups and made all of the necessary tweaks based on the feedback I received. I picked my target audience carefully. And once I felt confident about the whole thing, I let it loose.

And then … I waited.

And waited.

And sent out a couple of reminders.

And broadened my audience.

And worked some different angles to reach people.

And waited some more.

I’m still waiting; waiting for the responses to grow to some level that will afford me some information needed to present my findings to a couple of different groups. It’s coming along, but golly it’s slow. And such a cumbersome process. Ask me a question and I’ll happily answer for you, straightaway. But waiting for others to answer me … well, the tables have turned, my friends.

A turning table playing a different tune!

A turning table playing a different tune!

Politics is an Eight-Letter Word

26 Feb

A number of years ago, the librarians at Lamar Soutter Library, UMass Medical School, received the directive, “Get Out!” Our Library Director wanted us out of our cubicles and away from our desks. She wanted us to go to the people that we served. If people didn’t need to come to the Library anymore, the Library needed to go to them. And thus was born our embedded librarian program.

One of the very first lessons that I learned when I started getting out of the Library was that I needed to learn about politics. I remember going to my Library Director and asking if she could give us a lesson on the topic during one of our professional development meetings. Fortunately, she understood where I was coming from and from that point on, was open and willing to answering any questions any of us had regarding who was who and how things worked, politically, at the Medical School.

Our political system has become so broken the past few decades, it’s easy to think of politics as a dirty word. We think of corruption and conniving and backstabbing and the like. But the truth of the matter is that most, if not all, organizations and institutions exist in some sort of political atmosphere. If we’re lucky, it’s NOT a destructive framework, but it is an existing structure all the same.

Reframing 5th coverWhen I was earning my library science degree from Syracuse, I had to take a course on management and one of the required textbooks was Lee Bolman and Terrence Deal’s book, Reframing Organizations: Artistry, Choice, and Leadership. The “Political Frame” is one of four organizational frameworks that they present and they describe it as follows:

The political frame views organizations as alive and screaming political arenas that host a complex web of individual and group interests. Five propositions summarize the perspective:

  1. Organizations are coalitions of various individuals and interest groups.
  2. There are enduring differences among coalition members in values, beliefs, information, interests, and perceptions of reality.
  3. Most important decisions involve the allocation of scarce resources – who gets what.
  4. Scarce resources and enduring differences give conflict a central role in organizational dynamics and make power the most important resource.
  5. Goals and decisions emerge from bargaining, negotiation, and jockeying for position among different stakeholders.

(Bolman & Deal, Reframing Organizations, 2nd ed., p. 163)

Now that I work in a different environment than the Library, I’m learning a different political landscape. Different people, different personalities, different programs, different priorities. I’m still in the same institution, so I have a slight head start, in that I at least know the people; by name and position, if nothing else. I also know, thanks to my years in the Library, that walking into situations without respecting the politics is not only naive, but can be downright disastrous to any efforts you’re attempting. It’s a really important lesson and a skill set that’s not necessarily taught in graduate school or in continuing education classes. That’s a shame, because when we pretend that politics doesn’t matter or that it’s a dirty game that we want to avoid, we’re setting ourselves up for trouble. Politics is an eight letter word. There’s no need to not talk about it.