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Objective: The study assessed the coping strategies of MEDLIB-L subscribers during an unexpected disruption in the list's service., Methods: An online survey of MEDLIB-L subscribers was performed following a six-day service outage in August 1999., Results: Respondents' information needs resulted in two distinct coping strategies. Subscribers without a recognized information need or an information need determined to be not pressing coped by waiting out the interruption. Subscribers with pressing information needs turned to alternative methods of resolving these needs., Conclusions: While most respondents missed the list and the assistance that it provided, many did not feel that the outage required significant coping strategies. The outage was viewed as a "minor stressor" and did not require secondary-level assessment of the availability and suitability of alternative resources.

Objectives: The study examines how Loansome Doc services are implemented and used by libraries in the Southeast Region and describe end users' experiences with and attitudes toward Loansome Doc., Methods: 251 active DOCLINE libraries and 867 Loansome Doc users were surveyed., Results: Roughly one half of the libraries offered Loansome Doc services. Of those that did not, most indicated no plans to offer it in the future. The majority had a small number of end users and experienced minimal increases in interlibrary loan activity. Problems were relatively rare. Satisfaction with Loansome Doc was high among all types of libraries. End users were usually physicians or other health care professionals who requested articles for research and patient care. Most learned about Loansome Doc through PubMed or Internet Grateful Med. End users appeared to be largely self-taught or received informal instruction in Loansome Doc. Loansome Doc filled document requests in a timely manner, and end users reported being satisfied with the service., Conclusions: Greater promotion of what Loansome Doc is and how it can benefit libraries can increase the number of participating libraries. While satisfaction of Loansome Doc end users is high, satisfaction could be increased with more help on the PubMed screen, more library training, and faster delivery methods.

Objectives: In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries., Methods: Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys., Results: Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results., Conclusions: ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas.

This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.

The relationship between the development of mediated online literature searching and the recruitment of medical librarians to fill positions as online searchers was investigated. The history of database searching by medical librarians was outlined and a content analysis of thirty-five years of job advertisements in MLA News from 1961 through 1996 was summarized. Advertisements for online searchers were examined to test the hypothesis that the growth of mediated online searching was reflected in the recruitment of librarians to fill positions as mediated online searchers in medical libraries. The advent of end-user searching was also traced to determine how this trend affected the demand for mediated online searching and job availability of online searchers. Job advertisements were analyzed to determine what skills were in demand as end-user searching replaced mediated online searching as the norm in medical libraries. Finally, the trend away from mediated online searching to support of other library services was placed in the context of new roles for medical librarians.

Consumer health information studies in library and information science (LIS) are typically not grounded within a theoretical framework. This article explains the importance of theory to LIS research in general, and the specific value of using theories from other disciplines to study consumers' health information-seeking behavior. The argument is supported with two examples: Miller's psychological theory of blunting and monitoring behavior and Granovetter's sociological theory of the strength of weak ties. These theories can be applied by practitioner-researchers to investigate a variety of research problems.

Background: The goal of this prospective, cross-sectional study was to determine the user demographics of a digital health sciences library (DHSL), motives for use, the nature of users information requests, and success rate in finding answers., Methods: The content of 500 consecutive electronic mail messages (e-mails) submitted to a DHSL were analyzed using a predetermined coding scheme. Data were entered into a database and frequency analysis was performed., Results: The number of information requests from the 500 e-mail messages was 751. The largest sender category was patients and laypersons followed by students, then physicians. Motivations for use were primarily medical advice (42.8%) and patient care (13.8%). E-mail subject areas were mainly medical (61.8%) and technical (20.6%). Answers to information requests were found 54.3% of the time and senders felt the DHSL was valuable (97.8%)., Conclusions: A DHSL is a valuable medical resource. DHSLs must serve the broad information needs of patients and laypersons in addition to health care providers. Developers and managers of DHSLs can use this information to guide future development of DHSL information content and services, as has been done at The University of Iowa.

Unlabelled: Abstracts of scientific papers and posters that are presented at annual scientific meetings of professional societies are part of the broader category of conference literature. They are an important avenue for the dissemination of current data. While timely and succinct, these abstracts present problems such as an abbreviated peer review and incomplete bibliographic access., Methods: Seventy societies of health sciences professionals were surveyed about the publication of abstracts from their annual meetings. Nineteen frequently cited journals also were contacted about their policies on the citation of meeting abstracts. Ten databases were searched for the presence of meetings abstracts., Results: Ninety percent of the seventy societies publish their abstracts, with nearly half appearing in the society's journal. Seventy-seven percent of the societies supply meeting attendees with a copy of each abstract, and 43% make their abstracts available in an electronic format. Most of the journals surveyed allow meeting abstracts to be cited. Bibliographic access to these abstracts does not appear to be widespread., Conclusions: Meeting abstracts play an important role in the dissemination of scientific knowledge. Bibliographic access to meeting abstracts is very limited. The trend toward making meeting abstracts available via the Internet has the potential to give a broader audience access to the information they contain.

The medical specialist emerged as a critical gatekeeper in a study of information sources used by family practitioners in New Zealand. Thirty-four practitioners in the Wellington region were interviewed and their responses examined to ascertain the extent to which five criteria influenced their choice of information sources for clinical decision-making. The criteria were availability, searchability, understandability, credibility, and applicability. Of three major information sources investigated (textbooks, colleagues, and medical specialists), textbooks were consulted most frequently but were rated less valuable than colleagues and specialists as a source of information. The medical specialist was identified as the information source that best meets the five criteria. Thus, specialists play an important role in disseminating information to family practitioners. However, female practitioners included in the study were less likely to approach specialists than were their male counterparts. Physicians made little use of medical libraries to support clinical decision-making. The apparent disadvantage of female practitioners in accessing specialists needs to be addressed by professional associations. Medical librarians seeking to improve the access of family practitioners to recent literature should consider the heavy use made of specialists as a source of information.

In the popular rush to provide electronic consumer health information, particularly via the Internet, one system has been largely overlooked-the free-net. Free-nets are often text-based systems from which users choose topics from "menus." While the World Wide Web can be more graphically appealing, it can also be overwhelming. Medical information resources are available to diverse populations through free-nets, which are convenient, free services. The amount of information and range of topics they offer are vast. A study of Florida's free-nets during a six-month period involved five free-net systems. Survey items included user demographics, interlibrary loan services, attitudes toward providing medical advice, and availability of medical librarian expertise. Comparisons include the number of user queries on medical and health-related free-net menus, user-friendliness, and the type of health information provided.

Background: Listservs offer the potential for participants to engage in a "virtual conference" with experts and colleagues from around the world. However, little research has been done to study the use and effectiveness of this means of communication., Methods: In April 1995, an electronic survey of MEDLIB-L subscribers was conducted to determine demographic characteristics and uses of the listserv., Results: Respondents worked predominately at academic institutions (45%) as members of large staffs (44%) in the United States (82%). The majority had worked as health information professionals for more than ten years. Nearly 90% of respondents read MEDLIB-L at work and most spent fewer than three hours per week doing this. More than half of the respondents read 41% to 100% of the messages distributed by the list, with fewer than 20% reading 91% to 100% of the messages. Respondents reported initiating and responding to reference questions and product information with greatest frequency. There was no relationship between years of experience in the profession and participation in listserv activities except in the category of posting information., Conclusions: This study describes communication activities on MEDLIB-L and the extent of subscriber participation in these activities.

A follow-up outreach project was undertaken to extend and reinforce the work of a National Library of Medicine-funded outreach project conducted in west central Illinois in 1991. The participants included five of the eight original sites as well as additional populations. An evolving partnership with the state's Center for Rural Health expanded the project's geographic area statewide. Evaluation showed benefits of varied training formats, reexposure to end-user searching, and the importance of "readiness." Follow-up training and longer trials for practice searching resulted in greater volume of search and document delivery activity. Varied training formats proved successful in reaching specific groups. Loansome Doc activity throughout the eighteen-month project suggested sustained use of Grateful Med beyond the two-month trial periods. The introduction of Grateful Med/Loansome Doc to unaffiliated health professionals is an important component in equalizing information access. Future information service initiatives are suggested to meet the challenge of building a rural information infrastructure and support system for health professionals.

Information gathered from Grateful Med and Loansome Doc outreach projects, including one involving seven health centers in rural southwest Alabama, raises questions about the effectiveness of such programs. This paper presents a review of the literature on Grateful Med as well as of information access and usage behaviors of physicians, an overview of the Alabama project, and data from other projects. Analysis of the responses and observations of the researchers reveal some strategies for enhancing the outcomes of such projects and improving access to medical care literature by health care professionals at rural sites.

A survey was conducted to solicit data related to health professionals image of librarians. Physicians, residents, nurses, medical students, dentists, pharmacists, physical therapists, and occupational therapists were questioned about their experiences with and opinions of librarians, particularly the skills and characteristics needed by helpful, successful librarians. Health sciences librarians were also questioned about their own professional image and their perceptions of their patrons' impression of librarians. Librarians and health professionals alike ranked good communication as the most important skill for librarians. Computer or technological skills were ranked fourth by librarians but second by health professionals. Although librarians tended to describe themselves in slightly more positive terms than did their patrons, health professionals viewed librarians as approachable, responsive, supportive, and open to change. Health professionals also reported that they received accurate, reliable, and timely information from librarians and that this information was valuable.

Recent trends in medical education include a shift from the traditional, didactic, lecture-oriented approach to a more student-driven, problem-based approach to learning. This trend provides librarians with an opportunity to develop programs to teach information-gathering skills that support and are integrated into problem-based learning (PBL). In 1992, the University of Pittsburgh School of Medicine implemented the initial phase of a curriculum revision that emphasizes PBL. Since that time, Falk Library of the Health Sciences has provided a large-scale, intensive program integrating information-seeking skills and activities into the first-year Patient-Doctor Relationship course, a sequence that initiates medical school. A multimodal approach to information seeking and sources is emphasized, utilizing print and audiovisual materials, computerized resources, and subject experts. The Falk Library program emphasizes the gathering and use of information as central to both PBL and student skills development. An informal, post-course evaluation was conducted to gauge which information resources were used and valued most by students. This article presents evaluation results, including data on the use of information sources and services, and student perceptions of the librarian's role in the PBL sessions.

Increasing numbers of physical therapists are providing evaluation and therapy in their own private-practice clinics. Their move out of the hospital setting has reduced their access to the sources of information designed to support clinical and practice-management decision making. The author designed a survey to determine how often physical therapists in private practice in Vermont use seven sources of information for clinical and practice-management decision making. Survey respondents also were asked to rate the anticipated usefulness of a variety of health sciences library information and research services not currently available to them and to rank access paths to information according to their preferences. The therapists' responses show frequent reliance on personal and office collections of professional literature for clinical decision making but virtually no use of bibliographic databases. Respondents ranked document-delivery services and mediated searches as having the greatest anticipated usefulness for clinical decision making. The limitations of their current information-seeking behavior and their high level of interest in increased access to a wide range of information and research services make physical therapists in private practice of special interest to health sciences librarians who are planning outreach programs.

The goal of this study was to assess the usage frequency, user satisfaction, and quality of literature searchers for a multi-application computer workstation in a university-based general medicine clinic. A computer with medical literature searching, textbook searching, and a decision-support program was deployed in the workroom of the clinic and made available for routine use. Data were collected for ten months. More than three quarters of the study participants used the computer, with use increasing by level of medical training. Despite physicians' known preferences for nonjournal sources of information, literature searching was the application used most frequently, followed by textbooks and decision support. The literature searches were replicated by experienced clinician and librarian searchers using first full MEDLINE and then text-word-only searching, to compare the quantities of relevant references retrieved. Novice searchers retrieved a larger number of relevant references than did the experienced searchers, but they also retrieved more nonrelevant references. For both groups of experienced searchers, the full MEDLINE feature set conferred little benefit over searching with only text words. These searching results call into question the value of traditional searching methods for both novice and experienced physicians.

A study was conducted by the Oakwood Hospital Library in Dearborn, Michigan, to document health information needs and opinions among staff physicians and area health consumers. The study sought to discover which community sources, besides the hospital library, consumers were consulting for health information and how helpful these sources were; what types of health information physicians were providing to patients in their offices; and whether and how physicians and health consumers might differ in their perceptions of health information. Study results, along with suggested opportunities for additional investigation, are presented.

This article presents the results of a survey conducted over the summer of 1992 on the use of information sources by professionals in the field of aging. In particular, factors affecting the use of electronic information sources were investigated. The data provide a demographic profile of North American gerontologists, with a predictably wide range of disciplines and types of practice represented. Several factors were found to have an impact on the gerontologists' utilization of electronic information sources. Respondents who used a larger-than-average number of computer applications were found to make relatively more use of electronic sources, including online searches, CD-ROM indexes, library OPACs, and other databases searched by remote access. Attendance at library workshops was found to increase the amount of end-user searching but not the amount of library-mediated searching. Respondents also reported which databases they used and which they considered most important. MEDLINE was the most frequently mentioned database across all disciplines, including the health and social sciences. Computer databases were ranked least important out of six listed sources of information, and only 5% of respondents reported having used an electronic current awareness profile.

The second part of the biotechnology awareness study focused on health sciences libraries and how well they are meeting the needs of biotechnologists working in the study's nine medical centers. A survey was conducted over a three-month period to assess the demand for biotechnology-related reference services at nine libraries and the sources the librarians used to answer the questions. Data on monographic and current serial holdings were also collected. At the end of the survey period, librarians were asked for their perceptions about biotechnology research at their institutions and in their geographic areas. Their responses were compared to the responses the scientists at the nine schools gave to the same or similar questions. Results showed few biotechnology-related reference questions were asked of the librarians. The recorded questions dealt with a range of biotechnology subjects. MEDLINE was used to answer 77% of the questions received during the survey period. More detailed notes in MeSH and a guide to online searching for biotechnology topics were suggested by the librarians as ways to improve reference service to this group of researchers. Journal collections were generally strong, with libraries owning from 50% to 87% of the titles on a core list of biotechnology journals compiled for this study. All libraries subscribed to the five titles most often cited by the scientists surveyed. Generally, librarians were unaware of the biotechnology-related research being done on their campuses or in their geographic areas.

Veterinary practitioners are often isolated from easy access to information in medical or hospital libraries, making necessary the use of a variety of information resources. A survey was conducted to assess the extent to which various information resources were used within the veterinary profession. Most responding veterinarians were small-animal practitioners who used the veterinary literature, colleagues, diagnostic laboratories, continuing education courses, association meetings, and pharmaceutical representatives as sources of information. Books and other practitioners were the preferred information source in critical-care situations, followed closely by diagnostic laboratories and journals. For keeping up-to-date with current advances in veterinary medicine, journals, books, other practitioners, and continuing education were used. University extension services, veterinary medical libraries, and computer applications to information use were not important resources ot most of the respondents. Many veterinarians indicated that they would use library services if they knew more about them. With the trend toward computerization in veterinary practice, it is possible for libraries to help reduce the information isolation of many veterinary practices.

A model study, funded by the National Library of Medicine (NLM) and conducted by the Southeastern/Atlantic Regional Medical Library (RML) and the University of Maryland Health Sciences Library, attempted to assess the information needs of researchers in the developing field of biotechnology and to determine the resources available to meet those needs in major academic health sciences centers. Nine medical schools in RML Region 2 were selected to participate in a biotechnology awareness study. A survey was conducted of the nine medical school libraries to assess their support of biotechnology research. To identify the information needs of scientists engaged in biotechnology-related research at the schools, a written survey was sent to the deans of the nine institutions and selected scientists they had identified. This was followed by individual, in-depth interviews with both the deans and scientists surveyed. In general, scientists obtained information from three major sources: their own experiments, personal communication with other scientists, and textual material (print or electronic). For textual information, most study participants relied on personal journal subscriptions. Tangential journals were scanned in the department's library. Only a few of these scientists came to the health sciences library on a regular basis. Further, the study found that personal computers have had a major impact on how biotechnologists get and use information. Implications of these findings for libraries and librarians are discussed.

The information needs of scientists in English-speaking countries have been studied and reported in the library literature. However, few studies exist on the information-seeking patterns of scientists in developing countries, and no study has examined the information needs of medical scientists in developing Asian countries. This study investigated the information needs of academic medical scientists at Chulalongkorn University in Bangkok, Thailand. The results indicate that medical scientists have three types of information needs: identifying up-to-date information, obtaining relevant studies and data, and developing research topics. Thai scientists' information-seeking behavior was different from that of scientists in developed countries. The study shows a high use of libraries as information providers; Thai medical scientists rely heavily on information from abroad.

The paper describes some initiatives in the field of grey literature (GL) and the activities, from 1985, of the Italian Library Association Study Group. The major categories of GL are defined; a survey that evaluates the use of GL by end users in the health sciences is described. References in selected periodicals and databases have been analyzed for the years 1987-1988 to determine the number of articles citing GL, the number of GL citations found in selected periodicals, the various types of GL found, and the number of technical reports cited and their country of origin and intergovernmental issuing organization. Selected databases were also searched to determine the presence of GL during those same years. The paper presents the first results obtained.

An analysis of requests for CD-ROM MEDLINE* searches from June to December 1987 at the Medical Library, Chulalongkorn University, was performed. Requests were received from eighty-two places, in Bangkok and the provinces; 97.8% were from government organizations. MEDLINE on CD-ROM was available from 1982 to date. Most users requested searches covering the previous five or six years. Users were surveyed regarding the service: just over 87% found the service user-friendly. In addition, users suggested that the library conduct search training programs, and more than half of the users noted that a single work station could not meet the search load.

It is hypothesized that health professionals in the United States and the United Kingdom are nationally biased in their citation practices. Articles published in the New England Journal of Medicine and Lancet were used to study citation practices of U.S. and U.K. authors. Percentages of cited references to material published in a specific country were calculated for both the New England Journal of Medicine and Lancet. Using a variation of a citation publication ratio based on Frame and Narin's original ratio, an attempt was made to quantify author bias. To calculate these ratios, values from SERLINE* and the British Library Lending Division were employed to find world journal counts. The results suggest that U.S. authors publishing in the New England Journal of Medicine and U.K. authors publishing in Lancet tend to cite material produced in their own countries more than would be warranted by the amount of material produced by these countries. In addition, these authors cited material produced in non-U.S. and non-U.K. countries far less than the amount of material produced by these countries would indicate.

The information needs of practicing physicians in seventeen counties of upstate New York were surveyed by questionnaire. A 45.6% response, or 258 usable replies, was obtained. Computer-aided market analysis indicated that the areas of greatest need for improved information were new developments in specialties and government regulations relating to health care. Sources most frequently used were journal papers, colleagues, and books, in that order. Specialty-related differences occurred with both specific information needs and source use. Degree date, geographical location, and type of practice (hospital, nonhospital, private, and so on), and involvement in research or education were also analyzed in relation to information needs and sources. Implications for library service are discussed.

Dentists, as health professionals, need access to information. As in other health sciences, the increase in the rate and volume of published information has made it more difficult for them to keep up with new developments. Five hundred randomly selected dentists in Louisiana were surveyed to determine what information dentists seek and what sources they prefer. Responses indicated that dentists need information on new techniques in dentistry and that preferred sources are professional colleagues and personal journal collections. Libraries were found to be used only infrequently as sources for information. Implications for planning libraries for applications- and technique-oriented professions are discussed.

Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems.

Hospital health sciences libraries represent, for the vast majority of health professionals, the most accessible source for library information and services. Most health professionals do not have available the specialized services of a clinical medical librarian, and rely instead upon general information services for their case-related information needs. The ability of the hospital library to meet these needs and the impact of the information on quality patient care have not been previously examined. A study was conducted in eight hospitals in the Chicago area as a quality assurance project. A total of 176 physicians, nurses, and other health professionals requested information from their hospital libraries related to a current case or clinical situation. They then assessed the quality of information received, its cognitive value, its contribution to patient care, and its impact on case management. Nearly two-thirds of the respondents asserted that they would definitely or probably handle their cases differently as a result of the information provided by the library. Almost all rated the libraries' performance and response highly. An overview of the context and purpose of the study, its methods, selected results, limitations, and conclusions are presented here, as is a review of selected earlier research.

The Missouri Institute of Psychiatry Library Current Contents Service offers free dissemination of ISI's Current Contents: Behavioral, Social and Management Sciences to 144 mental health professionals employed at twelve locations in the Missouri Division of Mental Health system. The service includes free document delivery of up to 100 articles per subscription. Sixty percent of the participants in the project are sharing copies of CCBSMS with their colleagues. Operation of the service is described, and data on degree of use are analyzed by user professional orientation and hospital location. The most frequently cited journal titles are compared to lists of heavily used titles derived from other sources. These lists of titles are offered as empirical guides to frequently consulted behavioral science journals. After six months experience participants appear to be highly satisfied. Ninetytwo percent responding to an evaluative questionnaire want to continue the service another year.

In 1966, the Indiana University School of Medicine Library became part of a statewide teletype network. Biomedical personnel throughout Indiana may use the resources of the Library by requesting either specific books and articles or bibliographic searches through local public libraries which relay the requests to the School of Medicine Library. All transactions except reference questions receive twenty-four-hour service. The popularity of such a facility is indicated by the fact that 472 identified borrowers used it during the twenty-five months between its inception and December 31, 1968. Over half of the borrowers have used it repeatedly, and as many as 358 transactions have occurred in a single month. The largest group of borrowers consists of practicing physicians. It is felt that the enthusiastic response to the service justifies its continuation and expansion.