Find It Yourself or Ask a Librarian? Studies show medical librarian search gets better results and reduces costs

keypad&stethoscopeHealth care providers are incorporating more evidence-based practice skills and information sources into their patient care. When providers recognize an uncertainty in determining a diagnosis or treatment plan, they frequently turn to available knowledge sources. At University of Vermont/Fletcher Allen Health Care many providers and professionals turn to Library–licensed sources such as UpToDate, DynaMed, and Nursing Reference Center as their first stop in finding the evidence to answer a patient care question. These sources helpfully provide the “strength of recommendation” based on accepted standards of appraisal of research studies. The typical duration of a search session on DynaMed or UpToDate is less than five minutes, which is manageable at or near the point of care. When those sources do not answer the question adequately either because the latest findings are too new, or because the patient situation and values are too complex, clinicians often seek the primary literature through PubMed. In doing so, some find the search frustrating and time-consuming. If you are among those who need a potentially time-consuming and complex search of the primary literature, consider requesting a literature search from Dana Library medical librarians.

In a randomized trial, information retrieval searches performed by a medical librarian for complex clinical questions were faster and retrieved more favorable results when compared to physician self-searches. The librarians answered the question in 13 minutes compared to 20 minutes for physicians searching on their own. The physicians reported that the librarian results contained a higher level of evidence and had a greater impact on patient care than physician self-searches.1

In a controlled study, patient cases were presented at morning report with a medical librarian in attendance. The librarian performed a literature search on questions that arose and disseminated the findings to the attending physician and presenting resident. The control patients were drawn from patient records and matched for age and primary and secondary diagnoses. The study results included association with reduced hospital length of stay (LOS) for the case group. LOS differed by 2 days between matched cases and controls (3 days vs. 5 days, P < 0.024). Median total hospital charges were $7,045 for the intervention group, and $10,663 for the control group. 2

In these studies, the librarian-conducted literature search saved physician time, reduced hospital costs, and may have improved patient outcomes. UVM and Fletcher Allen physicians, residents, nurses, therapists, and others may receive help finding the literature to answer clinical questions, develop guidelines, and do background research for presentations. To request a literature search or consultation, go to Ask a Librarian on the Dana website to get help by phone, email, or in person.

1. McGowan J, Hogg W, Campbell C, Rowan M. Just-in-time information improved decision-making in primary care: a randomized controlled trial. PLoS ONE. 2008;3(11):e3785.

2. Banks DE, Shi R, Timm DF, et al. Decreased hospital length of stay associated with presentation of cases at morning report with librarian support. J Med Libr Assoc. Oct 2007;95(4):381-387.

Marianne Burke, MLS AHIP
Director, Dana Medical Library
marianne.burke@uvm.edu

Nationally Normed Survey Highlights Student and Faculty Success at Dana

LibQUAL_Logo_100px_highIn April 2013 the Dana Medical Library and Bailey-Howe Library made the LIbQual+ Survey available to UVM and Fletcher Allen faculty, staff, and students. Thank you to the 942 individuals who completed the survey.

The Dana Medical Library is committed to providing high quality medical and health sciences information and services to our patrons. One tool available to libraries for assessing service quality is the LibQual+ Survey. The U.S. Association for Research Libraries developed and rigorously tested this web-based survey. It has been used by more than 1,200 libraries, including University of Massachusetts, Northeastern University, University of Connecticut, University of Rhode Island, and SUNY Stony Brook.

The survey asked for patrons to indicate their minimum acceptable service level, their desired service level, and the level of service they perceive for 22 attributes.

The three attributes that Dana Library patrons were most satisfied with were:

  1. Employees who are consistently courteous
  2. Willingness to help users
  3. Readiness to respond to users’ questions.

Dana Library patrons indicated that their three most desired service attributes are:

  1. Print and/or electronic journal collections I require for my work
  2. The electronic information resources I need
  3. Making electronic resources accessible from my home or office

Mean scores for Dana Library services exceeded the minimum acceptable service level for all 22 attributes, including the three most desired attributes listed above.

Dana Medical Library also has data from its 2009 LibQual+ survey. Almost all scores were higher in 2013, but two specific changes stand out. First, survey results from 2013 indicated an increased score for “Employees who have the knowledge to answer user questions.” Second, the scores for “Community space for group learning and group study,” while not large in 2009 or 2013, were higher in 2013.

Stay tuned for Dana Library’s plans to use the data from the 2013 LibQual+ Survey, including information gleaned from survey comments.

Donna O’Malley, MLS
donna.omalley@uvm.edu

Top Dana Research Guides for 2013

MobileGuide

Research guides developed by Dana Librarians help you find key resources for your area of interest. Some guides focus on a clinical specialty, while others focus on types of resources, such as mobile apps or study guides. The Mobile Apps subject guide was the most popular subject guide on the Dana website in FY’13. See a full list of research guides for health sciences here (http://researchguides.uvm.edu/dana).

Top Dana Subject Guides (July 1, 2012-June 30, 2013)

Subject Guide

Views

Mobile Apps

4125

Nursing Resources for Clinical Practice

3061

Anatomy of a Scholarly Journal Article

2855

Clinical Care

1973

USMLE Study Guides

1461

Family Medicine

1391

Endnote and EndNote Web

1048

Anesthesiology

1023

Marie McGarry in Dana Interlibrary Loan Retires

Marie McGarry, Interlibrary Loan (ILL) Specialist, retires on February 28, 2014 after 29 years of service for the University of Vermont. Marie came to the Dana Medical Library in January of 1985. Initially working in cataloging, Marie then moved to ILL Borrowing, where she filled requests from UVM and Fletcher Allen patrons for materials to be borrowed from other libraries or institutions. Marie has borrowed books and other materials from as far away as Hong Kong and Australia, and is known for filling requests at lightning speed. ILL regularly receives requested journal articles as quickly as 4 hours after the request has been placed. Marie has been particularly good at meeting patron needs for high quality materials delivered quickly, and she does so while saving the Library money but never sacrificing quality patron service.

Many health sciences area patrons appreciate her work. In a recent survey of Dana ILL users, 87% indicated that being able to borrow materials for patient care, research or academic work was “essential”, with 13% rating it “very important.” Many respondents commented positively on Interlibrary Loan. “Being able to… request articles from the [Interlibrary Loan] service is absolutely critical to the teaching mission,” said one respondent. Another noted, “This [Interlibrary Loan] service is so efficient and reliable, I really depend on it to keep me up to date on related research, etc.” Speed of delivery was also rated as important and commented on by survey respondents. One respondent said, “I have been amazed that many of my ILL requests are filled the same day.”

Judging by patron feedback, Interlibrary Loan is an important service for all kinds of work: from student assignments to clinical practice. Dana Library is committed to continuing this high level of service, but there can be no denying that Marie has been a key member of the Interlibrary Loan team. She will be missed by colleagues and patrons alike. Dana Library faculty and staff wish her the very best in her new adventure of retirement!

CNHS Student Survey Results: “The atmosphere focuses me….”

In the spring of 2013, Librarians Frances Delwiche and Gary Atwood surveyed students in the College of Nursing and Health Sciences (CNHS). The eleven-question survey asked students about how they spent their time in the library as well as their level of satisfaction with library space, services and resources. Generally speaking, results show that CNHS students have a very positive view of the physical library and the resources and services that are offered.

index

Students were also asked to submit comments about the library. One of the major themes to emerge from these comments is the idea of the library as a refuge for serious study. In many cases, students cited specific attributes like the “comfy chairs” or the study tables as factors that contributed to this sentiment. Others referred to more intangible factors such as the lighting or the “sense of openness.” Students were equally pleased with the library’s resources with several mentioning online journals and e-books as important. They were also complimentary about library services such as the “incredibly helpful and patient” librarians at the Reference Desk and the staff who are, “ALWAYS willing to help.”

You know you mean business when you walk in. No messing around at the Dana. You can always get work done there.

Even when students did register complaints, they were usually tied to something that they liked about the library. In other words, students would cite a positive library characteristic and then request more of the same when asked about what they would change. Several respondents, for example, stated that they preferred to use the individual study carrels located near the back of the library and wished that they library would install more to ensure availability. From the library’s point of view, this is actually a very positive statement, because it shows that we are providing access to resources that students need and want to use.

Although we only heard from a sample of CNHS students, the results were very important. They show that the library is having a positive impact by providing students with a space conducive to serious study and the resources and services to help them complete their work. Of course, they also show areas where we need to continue improving, which we are committed to doing in the months and years ahead.

Gary Atwood, MSLIS
gary.atwood@uvm.edu

Technology Upgrades for the Library Classroom

Over the winter break many technological upgrades were made to the projector, screen and podium in the Library Classroom in order to improve the teaching and learning experience. Students will now have a larger screen that is clearer and easier to read, and instructors will be able to project content from their favorite devices, including tablets and laptops. All technological changes were made with a focus on flexibility. Good teaching and learning happens in a variety of modalities and environments, so having spaces that are flexible enough to accommodate those differences was a priority in planning the upgrades.

Most noticeable is the now very large screen. A new Eiki screen, 87 X 139 inches, or 164 inches diagonally, was installed. The larger screen is more visible from the back of the room and displays a clearer image.

computers_covered_in_plastic

The library classroom under construction.

The old projector was replaced with a new, significantly brighter projector, making the images projected onto the screen crisper and more detailed than before. The new projector can also project HD 1080p quality video in wide screen format, which makes it compatible with DVD movies and wide-screen PowerPoint presentations. It is also much more flexible than the old projector, and can accommodate other devices, such as tablets.

The electronics in the podium, except for the computer, have been completely upgraded. The VCR has been removed and a new DVD player that is capable of reading multiple formats (DVD Video/MP3/WMA/WAV, etc.) has been added. In addition, instructors can now plug in devices that are HDMI compatible (such as the iPad) in addition to just the standard VGA. Finally, there is a new Crestron touch screen control panel to run all of the technology in the podium. The new electronics in the podium can also be expanded to adapt to new technology, which will give instructors greater flexibility going forward.

Dana also obtained a new Sharp 55″ High Definition flat panel monitor mounted on a movable cart so that it can be moved from room to room as needed. Instructors and students can plug their laptops into the panel and display what is on their laptop on the monitor. Dana librarians foresee using this set up with smaller groups of people when the big screen would be too overwhelming.

As classes settle into this new space, Dana education librarian, Gary Atwood, who oversaw the project, will be surveying instructors and students alike for feedback on these technological improvements.

Laura Haines, MLS
laura.haines@uvm.edu

Collections News

Journal Citation Reports (JCR) Identifies Top Journals: JCR 2012 Now Available

jcrhdrAre you thinking of submitting a manuscript to Plant Cell but don’t know how high that journal is ranked in your field? Do you want to know more about the top journals in your field?

Journal Citation Reports can help! This resource allows you to evaluate and compare journals using citation data drawn from over 7,500 scholarly and technical journals from 3,300 publishers in over 60 countries. It covers the areas of science, technology and the social sciences. Journal Citation Reports displays the:

  • Most frequently cited journals in a field
  • Highest impact journals in a field
  • Largest journals in a field

Citation and article counts may indicate how frequently current researchers are using individual journals. By tabulating and aggregating citation and article counts, JCR offers one perspective for journal evaluation and comparison.

To use JCR, simply click on Articles & Databases on the home page and then go to Web of Science. Once there, click on the yellow tab at the top that reads Additional Resources. A link to Journal Citation Reports is in the upper left-hand corner.

Be aware that JCR is not the only way to evaluate a journal’s value or impact on a field. ISI, the makers of JCR, offer valuable advice on using this resource wisely, so consider reading this before you proceed.

Changes at Web of Science

WOSWeb of Science, the popular database of scientific and medical information, has made a few changes to its appearance and navigation. For more information about these changes, see Web of Science’s site. This video will help you navigate these changes effectively.

UpToDate Calculators

utdLogo

UpToDate includes more than 135 interactive medical calculators that allow you to enter the values in commonly used formulas to obtain numerical data. Calculators in UpToDate are organized according to subject areas, such as Oncology or Allergy and Immunology. Each subject area offers many different calculators. Endocrinology and Diabetes, for example, offers the following calculators:

Clinical Criteria

Medical Equations

When in UpToDate, click on the “calculators” tab (shown below) and navigate by topic area.

UTDCalcHome

New Resource: ClinicalKey!

Dana Medical Library now provides access to ClinicalKey. Replacing MDConsult and Procedures Consult, this new Clinical Insight Engine is designed to provide clinicians with fast, clinically-relevant answers from Elsevier’s library of proprietary medical and surgical content. ClinicalKey offers access to:

  • over 1,000 Elsevier medical and surgical reference books*Clinical_Key
  • over 500 Elsevier medical and surgical journals
  • all medical and surgical clinics of North America
  • Procedures Consult procedural videos
  • First Consult point-of-care clinical monographs
  • patient education handouts
  • additional videos and images, practice guidelines, patient handouts, and drug information.

It also supports researchers and instructors with the included presentation builder for use with ClinicalKey’s multimedia collection-export to PowerPoint. User guides are available at http://www.elsevier-data.de/ClinicalKey/ClinicalKey_user_guide.pdf.

*HTML version of chapters provided. To view PDF files you must create a FREE “User Profile” and login.

Laura Haines, MLS
laura.haines@uvm.edu

Favorite Dana Databases and Services

Which of the links on the Dana Medical Library home page are the most popular? Preliminary annualized data indicate that patrons visiting the Dana home page are most likely to click on links for PubMed, UpToDate, and the link to the page that lists all health sciences Articles & Databases. See the table below for more of the most popular databases and web pages.

Webfavorite

On the flip side, the following pages received fewer than 100 clicks: Renew a Book, Recommend a Purchase, For Users with Special Needs, and most of the links under UVM Libraries & Collections. The data are tentative at this point and based on combination of estimates and extrapolations. We will continue to gather this data to help us focus the web site on the needs of our patrons.

Donna O’Malley, MLS
donna.omalley@uvm.edu

Spring Library Classes Are Underway

Gary Teaching 1Please join us in the Dana Classroom for one or more of our spring workshops. All workshops are open to all UVM and Fletcher Allen students, staff, and faculty. Unless otherwise noted, preregistration is not required.

Questions about any of our workshops? Have a suggestion for a topic you’d like us to cover? Please contact Gary Atwood at gatwood@uvm.edu or (802) 656-4488.

February

PubMed Basics and Beyond **Online Workshop**

Are your PubMed skills a little rusty? Come to this workshop and brush up on the basics such as using limits and MeSH headings to zero in on the results you need. We’ll move beyond the basics by answering whatever questions you have so come prepared to share!

This is an online class so pre-registration is required. Please send your name, email address, and phone number to Gary Atwood at gatwood@uvm.edu.

Instructor: Gary Atwood

Tuesday, February 25, 2014
7pm – 8pm
Managing References with Zotero

Learn the basics of Zotero. Capture citation information about books, articles, web sites, and more while you search. Link to Microsoft Word to produce citations in a variety of formats. Share your citations with collaborators.

Instructor: Laura Haines

Wednesday, February 26, 2014
Noon – 1pm

March

Searching CINAHL

This workshop will cover how to find high quality nursing and allied health information in CINAHL. In it, we’ll cover topics like advanced searching, how to use subject headings in your search, and how to fine-tune your results.

Instructor: Gary Atwood

Wednesday, March 5, 2014
1pm – 2pm
Managing References with EndNote **Online Workshop**

Learn the basics of EndNote. The following tasks will be demonstrated: adding citations to an EndNote library through a variety of methods; attaching PDFs to citations; managing information in an EndNote library; creating a bibliography; adding citations to a paper using EndNote and Microsoft Word.

This is an online class so pre-registration is required. Please send your name, email address, and phone number to Gary Atwood at gatwood@uvm.edu.

Instructor: Gary Atwood

Tuesday, March 11, 2014
7pm – 8pm
Copyright

Know your rights! This workshop provides an overview of copyright law and related resources. It also provides guidelines to help faculty, staff and students comply with copyright law and public funding mandates.

Instructor: Jeanene Light

Wednesday, March 12, 2014
Noon – 1pm
From Arnica to Zinc and Acupuncture to Yoga: Information Resources for Complementary & Herbal Medicine

Despite their popularity, it is often a challenge to find reliable information about the effectiveness of non-conventional therapies. Join us as we explore high-quality sources of information, both in print and online, that can help guide the wise use of these practices and products.

Instructor: Nancy Bianchi & Frances Delwiche

Thursday, March 20, 2014
Noon – 1pm
Managing References with EndNote

Learn the basics of EndNote. The following tasks will be demonstrated: adding citations to an EndNote library through a variety of methods; attaching PDFs to citations; creating a bibliography; adding citations to a paper using EndNote and Microsoft Word.

Instructor: Gary Atwood

Wednesday, March 26, 2014
Noon – 1pm

April

Personal Knowledge Management: Better Organization for Better Problem-Solving

How do you organize all of the information you collect for your research, work and personal life? How can you manage that information better so that you can use it more effectively? This workshop will explore the concepts of Personal Information Management (PIM) and Knowledge Management (KM), and offer a few concrete tips for managing your information. Tools such as EndNote, DropBox, and EssentialPIM will be covered.

Instructor: Laura Haines

Wednesday, April 2, 2014
Noon – 1pm
Creating the Simplified Data Management Plan

The workshop will introduce the recommended elements of a data management plan (DMP) and resources at UVM that can help with data management planning. Sample data management plans will be provided. Participants will then create their own simplified data management plans.

Instructor: Donna O’Malley

Wednesday, April 9, 2014
Noon – 1pm

What else would you like to learn?

We can also custom design a workshop for you, your class, or for your workgroup. Workshops can be held in the Library or in another location that’s more convenient for you. Please contact Gary Atwood at gatwood@uvm.edu or (802) 656-4488 for more information or to schedule a session.

Workshops on these topics are readily available, but you can request any combination of topics:

  • Advanced MedLine
  • CINAHL
  • Citation and E-Journal Troubleshooting
  • Clinical Pharmacology
  • Consumer Health on the Web
  • DynaMed
  • EndNote
  • Evidence-Based Practice (EBM) Tools
  • Google / Google Scholar
  • Keeping Up with the Literature
  • MD Consult
  • Medical Images
  • Navigating the Virtual Library
  • Nursing Reference Center
  • Ovid MedLine
  • Poster Presentations
  • PsychINFO
  • PubMed
  • UpToDate
  • Web of Science

Questions? Please contact Gary Atwood at gatwood@uvm.edu or (802) 656-4488.

Exhibits Explore Generations in Medicine

John Dodds-1

John Hazen Dodds, UVM College of Medicine Class of 1898

The Dana Medical Library is currently displaying two exhibits that honor multi-generation physician families in Vermont and Virginia. “Multi-Generation Vermont Physician Families: Graduates of the UVM College of Medicine” highlights the Bove, Irwin, Terrien, and Upton families and is on view until April. The Library would like to thank the College of Medicine Public Relations Office for their assistance in creating this exhibit.

“The Henkel Physicians: A Family’s Life in Letters,” is a traveling exhibition developed and produced by the National Library of Medicine. It is on view in the Library until March 5, 2014. The exhibit offers a glimpse into the daily lives of men of medicine in Virginia’s Shenandoah Valley during the 19th Century.  Several generations of fathers and sons studied medicine after the Henkel family settled in New Market, Virginia in 1790. More information regarding this traveling exhibit is available here.

Please visit the Library to view these exhibits honoring Vermont and Virginia multi-generation physician families.

Susan Bishop
susan.bishop@uvm.edu