New roles of health librarians

According to an healthcare survey conducted by Bupa Health Pulse and supported by a report of the London School of Economics, 12.262 people from different countries get health information surfing the web.  At least 6 out of 10 interviewees declared to use Internet to get answers about health questions.  In pole position among questions that were asked, the survey found those about drugs (68% of  interviewees are Italians) or auto-medication and diagnosis while 39% of people usually asks advice or opinion about health to other patients online (blogs)(1).FDA provided direction on the use of digital communications in the pharma space(2). The European Union on the other hand prohibits direct-to-consumer advertising of prescription drugs and, therefore, European pharma companies have not been investing so much in digital communication on social media, contrary to the US.In Italy the law defines as advertising every information that may promote the prescription, sale or use of drugs(3).  Moreover, the Italian Health Department and the association of pharma companies(4) have recently sent out guidelines on information regarding over-the-counter drugs and Internet.  In Europe a debate is running  on a new directive regarding the information on prescription drugs to avoid that direct-to-consumer advertising increases the pharmaceutical expenditure (5).  New media present a culture clash, whose peculiar nature is a two-way interaction and content that it is easily portable and  sharable (6), aim to meet people’s need of health information. Nowadays Facebook and Twitter, the largest social media web sites, have more than 350 million users worldwide; there are about 168 millions blogs and the number of videos watched per day on YouTube are 2 billions (7).   A growing number of pharma-companies is testing the waters of social media such as  YouTube videos, Twitter, Facebook  and blog pages, even if - due to the added communication restriction imposed by the authorities and internal legal and regulatory department (8) (9) - Social Media use in the pharmaceutical industry can be significantly more complex than in other industries (10).It is well-known that many web applications allow users to customize, personalize and even do mashpus of information as they share it within their online communities(6). These lead to a more complicated situation for pharma companies because, in addition to authority’s rules, a new Facebook policy will require all them to leave wall messages or comments enabled on their Facebook pages. Moreover Google, with its “Sidewiki” application, can layer a social network of commentary onto any existing static Web site, with or without the site owner’s consent (7).Therefore, this leaves pharma-companies open to public criticism and also complicates federal rules requiring companies to report all stated drug side effects to authorities, a rule set in 1993, long before the social media advent (11).  Such situations create the risk of taking the original information out of context or even changing meaning entirely (6) and, in addition, of losing control over the content of the message.  Legal and regulatory uncertainties are important concerns when it comes to pharmaceutical participation in social networking (3) and it will be necessary to draw a line dividing a pharma company own media (company web side or company chat area) from other online resources about a disease or drugs(7).  Social media is about people connecting with people, it’s about sharing information and making connects, it’s about building a network of people who share resources around common topics of interest. The general audience is looking at pharmaceutical companies to be a resource of scientific information (10): thus, some pharma companies have health related social media applications to connect people with the same disease experience (3). It’s important for companies to develop their own guidelines for online content monitoring and communication based on standards for other promotional channels, including what constitutes a reportable adverse event. Having a formal plan on how to monitor, seek out, and respond to the conversations of online consumers can help manage risk and give employees the proper frame (3).

The Gruppo Italiano Documentalisti Industria Farmaceutica e Istituti di Ricerca Biomedica (Gidif.Rbm) - an Italian non-profit association of Librarians and Information Professionals in the Biomedical Research field, funded in 1983 in Milan - has organized a working group to explore communication through social media, to compare the different applications of these new tools in different fields and to discuss how health librarians can contribute to this new task. For this reason our acronym can be read as Good Information Dissemination without Frontiers. The difficulty to translate information without running afoul of legal and marketing restriction rules and the very nature of pharmaceutical communications that is highly controlled and vetted, needs quality peer review.  We think that librarians should be asked to participate in this process and give support not only - as usual - in evaluating the information choice (quality, updating, authoritativeness etc.) but also to be creative with entrepreneurial spirit.  Health librarians are used to work in an information field with strict rules providing results and references to scientists. In the future they need to transform the same quality and authoritative scientific information in a much more concise, friendly, and appealing-to-spread (to lay people) information and news.  In particular Librarians should collaborate and cooperate with the Communication Departments supporting them to issue clear scientific and referenced health related contents for consumers.  Another topic is to exploit the librarian capability and competences to create ontologies in order to classify information on diseases and therapies to allow consumers a rapid and easy comprehension of health-information and a friendly use of social media.Librarians can help also to promote the usefulness and convenience of web 2.0 among the pharma company staff informing them on the power of the new tools (12).

The purpose of this paper is to point out at the training responsibilities of librarians and information specialists with special reference to the NECOBELAC experience in a wide geographical area, including Europe and Latin America. NECOBELAC is a project funded by the European Commission in the years 2009-2012 (www.necobelac.eu) and supporting cooperation activities among institutions operating in the field of public health and ITC. The project partners are represented by institutions seated both in European and Latin American countries, thus conveying different skills and experiences in information dissemination practices, namely: Istituto Superiore di Sanità (ISS), Italy (project coordinator), Consejo Superior de Investigaciones Científicas (CSIC) Spain, the University of Nottingham (UNOTT), United Kingdom, BIREME/PAHO/WHO, Brasil, the Instituto de Salud Pública (ISP) Colombia, the Universidade do Minho (UMINHO), Portugal.

The Project training program is now in its second year of activity (April 2010-August 2011); the results achieved, together with feedback gained up to now, and in particular, the use of the NECOBELAC topic maps as an innovative support for training, represent the basic ground for the evaluation process of such activity. Up to December 2011, over 30 training initiatives were developed, in particular 7 train-the-trainer courses were organized by the project partners, in chronological order, in the following countries: Brasil, Italy, Colombia, Spain, Argentina, Portugal and Mexico, in cooperation with local public health institutions and universities; the train-the-trainer courses were followed by over 25 training replication activities organized at local level http://www.necobelac.eu/en/training.php .

Topic maps were planned as a teaching tool, based on the web semantic technology, linking concepts referring to scientific publication and open access publishing and associating them to graphic schemes, texts, online resources, etc. http://62.204.194.27/necobelac/indexing.jsp  Contents are available in the four Project languages: English, Italian, Spanish, Portuguese on the Project web site. The specific concept of “quality” will be shown as an example of the interrelation among concepts; in fact such concept appears in different places in the topic maps: within the modules of “Quality of journals”, “Peer review and Quality indicators”, “Metrics”, etc. Topic maps are particularly useful to stimulate discussion during the courses and as a reference tool to introduce selected online resources.

The feedback received by the attendants of NECOBELAC courses through online surveys, telephone interviews and personal contacts will be analyzed and discussed under different perspectives, with special reference to the use of topic maps and to courses carried out in Italy and Mexico. (Were topic maps used only by project partners in their role of teachers in training-for-trainer activities or were they used also in replication activities at local level, and how? Were the topic maps  useful for the learning process? ).

The NECOBELAC network currently includes over 200 institutions seated in 15 European and Latin American  countries http://www.necobelac.eu/en/contacts.php

This study may help reflecting on the NECOBELAC training approach and use of the topic maps as a valid support for training.

Objective

The role of the academic librarian  has rapidly become increasingly educative in nature. In this study, the critical friend method was introduced among teaching librarians in an academic setting of medicine and health sciences to ascertain whether this approach could be implemented to improve the teaching skills of these librarians as part of their professional development.

Methods

An extensive literature search was conducted on relevant topics. Seven teaching librarians and one educator from the faculty of medicine participated, and they all provided and received feedback. These eight teachers worked in pairs, and each of them gave at least one lecture or  seminar during the study period. The performance of one teacher and the associated classroom activities were observed by the critical friend (the other member of the pair) and then evaluated and discussed. The outcome and effects of critical friendship were assessed by use of a questionnaire. 

Results

The present results suggest that use of the critical friend method among teaching academic librarians can have a positive impact by achieving the following: strengthening shared values concerning teaching issues; promoting self-reflection, which can  improve teaching; facilitating communication with colleagues; reducing the sense of “loneliness” in teaching. This conclusion is also supported by the findings of previous studies.

Conclusion

The critical friend method described in this study can easily be implemented and developed among teaching librarians, without  the  being influenced by the  constraints and conflicting interests of the organization. This will benefit the individual teaching librarian, as well as the organization at large, as long as the goals and visions of the library organization are clear and are approved by management.

Introduction

In recent years the teaching element of the academic health librarian’s role has become increasingly formalized; no longer perceived as extra-curricular trainers but as valued members of the academic team, some librarians have sought professional accreditation for this aspect of their role, and nearly all have benefited from the wider recognition of the “seven pillars” of information literacy(1).

However, as new systems for information discovery and retrieval are emerging, it is an appropriate time to review the progress we have made and consider the next steps in the development of our teaching role.  Will the emphasis we have hitherto placed on information retrieval and management continue to be appropriate, or is it time to broaden our focus and promote IL as part of a suite of transferrable skills which students need to develop in order to succeed both at university and in their future careers?

Objectives

In recent years UK higher education has seen an increasing emphasis on the skills agenda, driven by several different factors.

Firstly, an era of increased participation in higher education initiated by the New Labour government (1997-2010) has led to an increasingly competitive graduate marketplace where a university degree is no longer enough to get a job; employers are looking for students to demonstrate “employability skills” in areas such as teamworking, problem solving and communication(2).  This is particularly true for health students as many professional codes now emphasise the need for similar competencies.

Secondly the introduction of student fees (and their subsequent trebling from September 2012) have led to a culture where students are demanding to see the value of the investment they have made in their education; making university educators increasingly explicit about the relevance of their courses to life-long learning and evidence-based practice.  

In an ever-expanding information universe, students’ (and future health professionals’) ability to think critically and evaluate sources is more crucial than ever; librarians can enhance their teaching of these principles of information literacy by linking them more closely with related areas such as effective notemaking technique (to avoid plagiarism), mind-mapping (to help plan and structure essays) and academic writing style.

Methods

Wingate argues that “learning how to study effectively cannot be separated from subject content and the process of learning”(4).  To teach IL effectively many librarians have established strong liaison links with their schools; however when students wanted to learn about essay writing they have usually been referred back to their lecturers (or to generic support staff). 

This division between information literacy and other academic skills is a somewhat artificial one, created by librarians as a way of ring-fencing territory and demarcating student support responsibilities rather than being designed from a student’s perspective.

At the University of Leeds, the convergence in 2008 of the Library and Skills Centre presented a unique opportunity to break down these boundaries and offer a more joined-up service.  The Skills Centre already offered a series of generic workshops and a drop-in enquiry service which students accessed either independently or via referral from their department.   While these services have always been favourably evaluated by those students who have accessed them, they could only scratch the surface of an alarmingly high proportion of students who admit finding the academic demands of University more difficult than they expected.

Merging the academic skills unit with the Library and involving the Faculty Teams, gave us the opportunity to deliver learner development which is holistic, integrating information literacy and other academic skills; contextual as it is situated within and informed by the curriculum; and universal: a chance for anyone who is motivated to get better marks in their assignments or increase their employability – rather than a remedial service for those who fail.

This radical evolution of the liaison librarian role would not have been possible without the development of LibTeach, an in-house staff development package designed to equip liaison librarians with the skills and confidence to support a broad range of academic skills.   Through a programme of blended learning comprising practical workshops and e-learning activities, LibTeach has nurtured a community of practice of library teachers who are ready to diversify their teaching to meet the broader learning development needs of the student community.  This presentation will discuss the experiences of participants in, and organisers of, the programme and its impact on our teaching practice. 

Results and discussion

Following the LibTeach programme, all liaison librarians are now offering a range of academic skills teaching.  Expanding the role of the subject librarian in this way at a time of cutbacks raised many questions about workload but through working smarter we have been able to achieve much more with only a modest increase in effort.

An online tutorial has replaced many face-to-face induction lectures; meanwhile librarians have been able to re-use generic materials developed by Skills Team while adding value by giving them context based on their knowledge of the curriculum in the departments where they teach.

Another objective of LibTeach was to help librarians develop confidence in their own teaching practice, and the programme was designed to prepare them for accreditation by the Higher Education Academy; most participants have now achieved Associate Membership and some are already working towards Fellowship.   This has given a boost to staff morale at a challenging time in the sector, and helps to demonstrate to our academic colleagues our commitment to learning and teaching.

Introduction

 The following study is continuation of the research that was presented during the EAHIL conference in Lisbon, where it was shown how medical librarian could support the process of patient education by helping physicians in the quality assessment of patient education materials (PEMs) produced in printed form. In her oral presentation the author introduced the results of suitability and readability assessment of written health education materials being used for education of patients in the Division of Pain Research and Treatment of the University Hospital in Cracow (Poland). The quality assessment of the health education materials was performed by using the Suitability Assessment of Materials (SAM) instrument. This tool was invented by Cecily and Leonard Doak [1] in order to help health care professionals and the authors of PEMs to choose/ produce the most suitable health education materials for their patients, in terms of their relevance for low literacy patients. SAM is only one of the few instruments which are commonly used by people involved in patient education to perform the quality assessment of PEMs. Medical librarians, especially these working in hospital libraries and health education centers should be aware of these tools and should be able to apply them in practice in order to support the process of evaluation of PEMs.

Aims

 The first aim of the study was to identify all published instruments, which were designed to help people involved in patient education to evaluate or select the most appropriated PEMs, produced in printed form (leaflets, pamphlets), for their patient population. The second aim of the study was to assess the methodological quality of the studies, where the instruments designed to perform the quality (suitability) of PEMs were described.

 Methods

 Systematic review of the studies published in English from 1995 to 2011 and available through library databases, which purpose was to develop the instrument/ checklist to assess the quality/ suitability of PEMs in printed form. Studies describing the validity and reliability of produced instruments, as well as the process of their development and describing the pilot studies of the produced instruments were included in the review. Studies do not describing how the instrument was develop or not measuring its psychometric properties and the studies describing other types of instruments (for e.g to assess the quality of web information or decision aids) were excluded from the review.

Quality assessment of included studies 

 According to the author best knowledge, there is no special method to perform a critical appraisal of the methodology of the studies describing the development of the instrument to be used to assess the quality of PEMs in printed form.  Therefore the alternative method was used to assess the methodological quality of the included studies.  It was checked if the authors of the studies aiming at the development of such instruments took into account all the necessary stages in the development and validation of criterion-referenced measures. It was performed by comparing the phases of the studies included in the review to the stages in the development and validation of criterion-referenced measures as it was proposed by Waltz by Waltz in the book: Measurement in Nursing and Health Research (2010) [2], especially taking into account the process of validation, reliability testing and pretesting of the developed instrument.

Results

  Nine studies describing the instruments designed to assess the quality of PEMs produced in printed form, met the inclusion criteria and were qualified for further analysis. All of the included studies have a good methodological quality and take into account all the necessary stages in the development and validation of criterion-referenced measures. For one of the tools, SAM, which is introduced in the book “Teaching Patients with low literacy skills” the lack of some procedures necessary in the development of criterion-referenced measures (like how the measure was constructed and field-tested) was noted. Nevertheless the tool was included into the systematic review, as SAM belongs to one of the most widely used tools of its type [3] for assessment of the health education materials produced in printed form. Only four of the identified instruments: SAM, DISCERN, EQIP and TEMPtEd seem to be finished and are ready to be used by the potential users, the other tools seem to be still in the process of development (SAM + CAM, ELF), were never finished (BIDS) or are not considered to be produced for the broader use (Checklist, EVALPEM). The identified instruments were classified according to their purpose (for e.g instruments developed to assess the health literacy demand of PEMs, instruments assessing general quality of PEMs or their presentation quality), population they suppose to serve (authors or producers of health information materials, healthcare providers, representatives of patient population, librarians etc.) or their type (checklists and rating forms) (table 1).
 It is expected, that this research might help medical librarians to choose the most relevant instruments for assessing the quality of materials that are produced or supplied in the hospitals and public health centers they are working in or cooperating with. Medical Librarians of XXI century must redefine their traditional role and expand their activities also to these areas of health care practice, where their support was so far limited and unknown, but might be necessary needed.