Tag Archives: Medical Library Association

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).

Austin Or Bust!

15 May

It’s one of my FAVORITE times of the year, the time to attend the Annual Meeting of the Medical Library Association. This year’s meeting is in Austin, Texas and its theme is “Librarians Without Limits.” I can’t wait to visit Austin and I love the theme. As a music lover, particularly Western Swing music, and a librarian who no longer works in a library or even goes by any job title close to “librarian,” the meeting seems to have been made for me! I’ve got a schedule planned out that’s filled with interesting sessions about non-traditional roles, plus a different music venue picked out for each night. Oh, it’s gonna be goooood!!

I’ll be tweeting throughout the meeting (follow along at #mlanet15 and/or @mandosally) and will also be sure to share more than a couple of thoughts and nuggets of inspiration that I experience next week. Until then …

… let’s get to Texas!!

Stay Put!

6 Mar
Sit, Eliza. Stay.  Our puppy on her first day home, Aug 2013.

Sit, Eliza. Stay.
Our puppy on her first day home, Aug 2013.

I read a couple of good blog posts this morning, over on the Medical Library Association’s blog, “Full Speed Ahead.” The first was by MLA President, Linda Walton, called, “The Time for Change is Now.” It offers a nice summary of the organization’s new strategic goals, each of which contains some level of a call for action. Like many professional organizations, MLA is challenged to find its purpose and goals in the ever-changing world of libraries, health care, and information. The second post is by MLA’s new Executive Director, Kevin Baliozian. “Words I Can Do Without” lays the foundation for what became the very strategic plan outlined in Linda’s post. Wondering what Kevin’s “no say” words are? SPOILER ALERT: They are “try” and “continue.” Again, you can see that MLA and it’s leadership are focused on moving forward, shedding the “same old, same old,” and making the organization as relevant and important to health sciences librarians and information professionals as its storied history shows it to be in the past. 

I serve on the Executive Board of my regional chapter of MLA and we are engaged in much the same type of work. What do we continue doing? What do we cast aside? Who do we reach out to? What defines us and makes us different, unique, worthy of a colleague’s membership dues and energy? Important questions, all.

I’ve got nothing against change. I think it’s important to take stock on a regular basis and adjust accordingly. In my new job as an evaluator, that’s one of the main focuses (foci?) of my work. More, it’s one of the main reasons for my work. I evaluate the research cores and programs of the UMCCTS to track their progress and to make corrections; to identify where changes need to happen. 

But all of this said, I do have one cautionary note about change: Change for the sake of change is no change at all.

I once counted the number of times that I moved between the ages of 20 and 30. I don’t remember the exact number today, but it was around 18. Eighteen moves in 10 years. I also had a number of jobs during that time. I changed all of the time, BUT I went nowhere. I never stayed in any one place long enough for it to feel like home and I never stayed in any job long enough to become very good at it. And it’s the latter that I sometimes fear when it comes to the bigger picture of organizational and/or professional change.

The other day, someone called me to ask for some “librarian expertise.” I told him that I no longer worked in the library, but I could still certainly help him because I still have librarian expertise. I have it because I stayed in a job for 10 years. My job in the library did not stay the same for 10 years, but I stayed true to a certain core ideal – to help the students, clinicians, and researchers of the Medical School with their information needs, whatever those needs might be. Whether I was building consumer health websites, answering reference questions, teaching how to better search PubMed, or building data dictionaries for research teams, in each I was staying true to that ideal. 

As we search and investigate and try on new roles as librarians – at the individual, institutional, and professional organization level – I hope that we stay true to our ideals. It’s a big challenge, but not impossible. It doesn’t mean we don’t change, but that we purposefully change. Change is expensive. It costs time to learn new things and time to become an expert. It costs time to raise the awarenesses of the people we serve regarding the things we now do. It costs people jobs, when roles and tasks disappear. It costs people their identity, when they’re tied closely to one in particular. 

In the past 2 months, I have changed jobs, moved offices twice, watched my mother-in-law pass away, and (just about – almost ready to sign the papers) bought a house. I seem to be forgetting another big thing, but that’s probably an innate defense mechanism, because let me tell you … all of this change has been exhausting. It takes a toll on a person physically, mentally, and emotionally. We all know this. So it’s all the more important to make sure that we undertake change that’s worth the expense.

I’m enjoying my new job, though it’s stressful to not be an expert anymore and I’d be lying if I said that I don’t miss the library. I’m going to love our new house, something that I’ve never had before in my life. And I do so love having an office for the first time, even if it’s across the campus from all of my old colleagues. All good changes. All worth it.

In the same way, I think that many of the changes that we’re talking about and making in the world of health sciences libraries and beyond are great – necessary and worth the cost. But I do wonder about some and I question their true connection to our ideals. Are we scrambling to change because we don’t know what else to do? Are we forced to change for reasons that have nothing to do with our work, e.g. budgets, space, etc. All very real forces of change, but I worry that sometimes the changes that they force aren’t necessarily in our best interest.

Change is difficult. Change is inevitable. And perhaps most importantly, change requires good leadership – whether you’re leading an organization or just trying to lead yourself in the right direction. In that respect, I feel pretty good about my professional organization. I paid my dues for another year. 🙂

 

Postcards from Chicago

2 Jun

I was on vacation last week and the week before spent most of the days in Chicago, attending the annual meeting of the Medical Library Association. As always, it was a meeting filled with great ideas, innovations, inspiration, and an awful lot of fun with friends and colleagues that I don’t get to see nearly enough. I wrote about one of the plenary sessions, “Reshaping Our Professional Identity,” over on the blog of the North Atlantic Health Sciences Libraries, Inc. Check it out there!

MLA_Plenary4

As for my vacation, let’s just say I enjoyed some early dog days of summer.

Hanging out with Eliza

 

Share and Share Alike

17 Jan

PMC ArticleBefore I even get started with this week’s post, let me first draw your attention to this little bit of awesomeness, after all, it’s not every day that you (well, at least I) get to see yourself in print. I feel that I just have to do a little shout out. Plus, my poetic welcome to the attendees of MLA 2013 may well be the most valuable legacy that I ever leave to my profession. 

———-

Back to the reality of our work at hand, I had a few experiences this week that got me thinking about where and/or how dissemination of knowledge fits into our role as knowledge and information management professionals. The first of these occurred during the weekly meeting of the mammography study team. This week’s meeting was different in that it involved bringing together not only the primary members of the team, but also the players from the technology aspects of it, specifically the programmers from Claricode, and the IT people from Fallon Insurance Company and Reliant Health Care. These individuals have played a key role in the study related to developing the software platform used to collect telephone interview data (the CATI system), pulling necessary data from insurance and health records, and coordinating the disparate data sources into a tracking database that can, ultimately, provide the data for analysis. It’s been no small task from the very beginning of the project. In fact, the very issues raised in the bringing together of these people to accomplish the necessary technological aspects of the study are the ones that led to Aim 2 of the informationist supplement grant that brought me to the study:

Aim 2: Assist investigators in identifying and reporting information technology issues that have arisen in the implementation of the study that may be of use to others.

Initially, we thought that the deliverable for Aim 2 would be a white paper; an outline of the different issues, along with references to the literature, that could be shared with both the clinical research and IT communities, with hopes that the information would prove helpful to those who sought to do this type of collaborative work in the future. In short, the team believes that they have learned some things, including some mistakes that others might want to avoid. However, as we began talking about the topic and I began searching the literature for relevant articles, I found that not much existed that touched on just what we were trying to articulate. This fact led us to discuss whether or not a white paper was the best way to go with this topic/issue. Perhaps a symposium, a meeting that could actually bring the different players – clinicians, researchers, computer programmers, software developers, etc. – together to share insights and brainstorm ideas for how we could all work better together. But this thought got us to wondering more about just who we’d invite. Who are the real stakeholders in this situation? Who would find this interesting? Do clinicians want to talk to developers? Do programmers have the faintest interest in problem-solving with medical researchers? We weren’t sure, so we decided the best way to begin would be to simply bring all of us together – all of the people who have worked on this project for the past 5 years – and see if this group, at least, could identify topics, issues, and/or projects in this area worth moving forward on. 

In short, we found out that the answer is YES!

That’s good news. We could easily list off any number of “lessons learned” and “things to consider next time.” Everyone agreed that we have knowledge that can be useful to others. Excellent!

Now let me tell you about a couple of other experiences of the week before I tie them all together. This one happened yesterday when a group of us from my library were taking part in a webinar for the current eScience Institute run by Duraspace, the Council on Information Library Resources, and the Digital Library Federation. The Institute is a continuation of a project funded by the Association of Research Libraries that began several years ago. It’s objective is to help research libraries assess the data and/or cyber-infrastructure needs of their universities, mostly through conducting environmental scans, surveys, needs assessments, and the like. It involves interviewing key stakeholders in each library’s respective institution, thus providing a better picture and/or road map for planning library services in the areas associated with data management. Our cohort consists of about 25 other libraries. Combined with the previous years, approximately 120 libraries have taken part in this initiative.

As we listened in, someone in our group asked, “Do we share our findings with the other libraries?” Our leader typed the question into the chat box and the answer we received was along the lines of “You can, if you wish.” Now this is, to me, well… well, it’s strange. I’ll just say it. Strange. It’s strange because of every profession on the planet, which one is best associated with sharing? I’m thinking that it’s us. Libraries. Librarians. Librarianship. We are founded on the principle of sharing. At least in part. One of the biggest forces driving the movement of libraries into data management is the concept (for some, mandates) of data sharing. We, of all people, know the benefits of sharing. That’s why we’re advocates here. So to me, it’s kind of strange to find a whole bunch of libraries involved in a project where all of the information, data, and most importantly, knowledge discovered in the process of going through these exercises isn’t being readily shared. Why? How can this be? Maybe I just misunderstood.

Also yesterday, my library’s journal club met and discussed the article, “The New Medical Library Association Research Agenda: Final Results from a Three-Phase Delphi Study,” (Eldredge, Ascher, Holmes, and Harris). The paper reports on the process undertaken by the researchers to identify the leading research questions in the field of medical librarianship as they were identified by members of MLA’s Research Section, as well as leadership within different levels of the organization. As we looked over and discussed the list of questions in the article, many people noted that they remain the same questions that we’ve been asking for years, e.g. questions of the value of librarians, the value of libraries, the information needs of our patron groups, etc. The comment was also made, both in our group’s discussion and in the paper, that some of these questions may well have been answered already. To this thought I commented, “Well evidently not well enough, if those with vested interests and notable involvement in our profession still have them.” Or maybe less cynically, my comment could have been, “Perhaps so, but if this is the case, we haven’t done a very good job of sharing that knowledge, because we still have the questions.”

All of this leads me back to a bigger question that’s become quite clear to me of late as I continue to observe or be a part of these type experiences, i.e. How do we share what we know with others?

To me, this is a HUGE need in the world of knowledge and information management where librarians can help. Quite honestly, I’m not clear on all of the ways that we can help, but I absolutely believe that there is a place for us here. We are experts in gathering and organizing information. We have the skills that allow us to make that information accessible. We know how to evaluate materials, weed out junk, and build strong collections (notice how I never use a certain trendy word in describing these activities). These are all foundations to sharing information and, ultimately, knowledge.

However, it’s the next step where we need to bring our own skills up to the task. It’s the next step that’s woefully missing in the whole “knowledge sharing” world. To me, that step is dissemination. Better put, effective dissemination. That is where the sharing of knowledge happens and I’m not sure that anyone is doing the best job at it today.

Researchers within their own institutions don’t know what their colleagues are doing; what their colleagues are discovering. How can we help them with this? They want to know. They tell us this. But so far nobody has been able to create the resources or the tools or the environment to make this happen, at least not in a seamless, integrated way. Libraries have tried, but as one of our Library Fellows said to me, “We have a ‘Field of Dreams’ mentality. We think that if we just build the resource, everyone will use it.” I agree. We are quite capable of building resource guides and special collections, but unless people use them, the information they contain just sits there. The knowledge that they are capable of spreading is trapped. A “Help Manual” is of no help when no one reads it.

I said to that same Fellow, “I have really no idea how to solve the problem yet, but that’s always the first step. Recognizing it.” But I do really believe that if we can become adept at whatever all of the skills are that we need to build and implement resources that fit into the workflows and the paths and the processes of our patrons, we will have discovered an entire new area of work for our profession. Part behaviorist, part ethnographer, part programmer, part librarian… likely a combination of these and more. It’s no simple problem to solve, but it’s an awfully big key to sharing and as we have long been the leaders in that act, I see no reason why we should stop now. 

*Interested in thinking about this more? Here’s a podcast and a paper that I’ve assigned as the material for the February journal club in my library. 

 

Words into Action

17 May

My blog post for this week is hanging out on the NAHSL blog. I hope you’ll pop over and give it a read. It’s a reflection on librarians and research. You’ll find several really interesting posts there from other colleagues reflecting on the sessions they attended at the Annual Meeting of the Medical Library Association last week in Boston. Good stuff!

Happy Weekend, everyone!