Cunningham Memorial International Fellowship Lisa Kruesi 2008

Contents

Record & Highlights of Library Visits ...... 3

The Annette and Irwin Eskind Biomedical Library Vanderbilt University Medical Center ...... 3

University of North Carolina at Chapel Hill Health Sciences Library ...... 8

Duke University Medical Center Library ...... 11

Connections: Bridging the Gaps May 16-21 2008, Medical Library Association, Annual Meeting, Chicago, USA ...... 15

The Program ...... 18

Endnotes ...... 19

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Cunningham Memorial International Fellowship Lisa Kruesi 2008

The Cunningham Fellowship ran for three weeks. It commenced at the Medical Library Association Annual Meeting, in Chicago on Friday 16 May and continued until Friday 6 June. The program:

Date Event / Institution Location

Friday 16 May - MLA Annual Meeting Chicago, Illinois Wed 21 May

Wed 21 May – Vanderbilt University Medical Center (four Nashville, Tennessee Wed 28 May days)

Thur 29 May- University of North Carolina (three days) Chapel Hill, North Carolina Mon 2 June

Tuesday 3 - Duke University (four days) Durham, North Carolina Friday 6 June

A brief summary of the program aims and findings:

Aims Findings To report on the academic status of the health Academic status varied considerably at each library profession library visited. Overall library appointments differ significantly in the USA to those in Australia. At the Eskind Biomedical Library only the Director has an academic title though there is no tenure or faculty appointments held by other library staff. At the University of North Carolina (UNC) Health Sciences Library staff have faculty status. At Duke University Medical Library staff do not have faculty status or permanent tenure. Similarities and trends of top medical school It was possible to compare staff numbers, library libraries size, reporting structure, services and collections and compare these with the University of Queensland Health Sciences Library Service. Development of online curriculum and the role Whilst at the Duke Medical Library and UNC of the health sciences library in providing Health Sciences Library I was given an insight to content library activities in this area. At Duke I attended a Medical School curriculum committee and met with library staff working with curriculum developers. Fund raising All University visits were able to give me an insight to their fund raising activities.

Access to electronic resources to non-member All three University libraries visited provided groups different examples that I will be able to explore further. Conference planning and management Senior MLA staff and library managers met with me to provide input to ICML 2009 planning.

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Record & Highlights of Library Visits The Annette and Irwin Eskind Biomedical Library Vanderbilt University Medical Center Nashville USA Visit Wednesday 21 - 28 May 2008

Nunzia B. Giuse, M.D., M.L.S., A.H.I.P. (Director, Eskind Biomedical Library & Professor, Departments of Biomedical Informatics & Medicine)

The Annette and Irwin Eskind Library is one of the services of the Vanderbilt University Medical Center Informatics Center, along with Information Systems, Information Technology Integration and Network Computing Services. The Head of the Informatics Center is William W Stead, Associate Vice-Chancellor for Health Affairs & Director, Informatics Center. The Informatics Center has over 400 staff. Approximately 67% of funds to provide the Library service are from the School of Medicine and the School of Nursing and the Hospital Clinics funding the remainder of services.

Strategic direction of the Informatics Center is available from the Vanderbilt website.

In 1996, the Eskind Biomedical Library (EBL) at Vanderbilt University Medical Center initiated the Clinical Informatics Consult Service (CICS). The core mission of the CICS is to facilitate access to and adopt research results within clinical practice.1

Further background to the Library Staff and role of the service: http://www.mc.vanderbilt.edu/biolib/people/nunzia.html http://www.mc.vanderbilt.edu/biolib/research/#CICS http://www.mc.vanderbilt.edu/biolib/research/#HSL

Wednesday 21 May

Breast Cancer Trauma Rounds Patty Lee, Assistant Director

At the Breast Cancer Trauma Rounds physicians’ present patient details; discussing the type of pathology, radiology and raising questions for discussion. The physicians were familiar with the literature on the cases raised and no questions were asked of the Library, as the session I attended.

Thursday 22 May

Trauma Rounds Becky Jerome, Assistant Director

Becky explained the benefit of the information service to the trauma rounds. A bed sores example was given. Becky explained that clinicians were frequently citing an article about the effectiveness

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of a particular bed. Becky tracked down the original article and found it was an advertisement. In this case the clinical information service served as a myth buster!

Examples of search reporting were provided.

Endnote is not used – because they have an internal database that has been developed to store search results, this database is available to clients for retrieving search results.

Standard Components of a clinical informatics consult service (CICS) information packet provided.

Process of filtering search results outlined and documentation provided.

StarPanel & Literature Basket (Oxford House) Nola Vest, Patient Support Services

Nola Vest from the Informatics Center gave a presentation on Medical Record System, StarPanel. She described the development of the system by physicians and informatics experts undertaken fifteen years ago. This web based informatics system, StarPanel, seamlessly integrated all aspects of a patient’s medical care at the institution2. The StarPanel approach took into consideration, as a design principle, that unique patterns of communication represent core activities of each clinical team. 3,4 As a ‘‘central information hub,’’ StarPanel brings into a single interface data needed for outpatient (and most inpatient) clinical decision-making. 5

The EBL recognized that its evidence related services might scale to reach a broader range of clinic and hospital specialties (and care providers) through integration of such services into informatics tools such as StarPanel. This insight, as well as lessons learned from CICS, informed the development of a more mature clinical informationist model that involves capture and delivery of evidence requests via StarPanel. Physicians in VUMC’s Adult Primary Care Center currently use the existing secure, internal messaging feature of StarPanel 6 to send patient care questions directly to EBL librarians via ‘‘information baskets.’’ As part of the question submission process, clinicians select from a list of priority levels reflecting the urgency of the information request.

Overview of Training Program Discussion led by Polly Alexander

Around 64 modules have been developed to train library interns. A group of the modules must be complete before verification of: searching abilities, customer service skills, search filtering techniques, document delivery knowledge, technical services and historical collections expertise. A Health Information Analyst Learning Plan is developed for all Library staff.

The Library has a preference for employing library interns that have trained rather than appointing experienced librarians.

Friday 23 May

VUMC Campus Tour & Neonatal Intensive Care Unit Meeting with Sandi Martin, Assistant Director

My Health At Vanderbilt – https://www.myhealthatvanderbilt.com/myhealth-portal/app As a patient of a participating Vanderbilt doctor or nurse practitioner using My Health at Vanderbilt it is possible to: View lab test results Send and receive secure messages with your doctor's office Request new appointments View your personal medical information

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Pay Vanderbilt bills Read relevant medical information

Visit to Children’s Hospital known as the Monroe Carell Jr. Children’s Hospital at Vanderbilt

It is only a few years old and has some of the following interesting features: • *A Family Resource Centre • Train sets that are elevated and placed at various locations throughout the public area within the hospital (perhaps a painted Brisbane River or Great Barrier Reef might be a suitable substitute for the QCH) • Painted in lilac and other pastel colours throughout the building • A family garden on every floor • Ample facilities for families to sleep over • A Family Information Notebook that can be setup via the web

*The Family Resource Centre is an information headquarters for family and caregivers of children. It includes quiet space, room for infant feeding, meeting room and a small children’s playroom. The Library resources looked very comprehensive they included books, videos, DVDs on health information, customized health information packets prepared by staff, diagnosis and treatment information, parenting information, children’s health and wellness materials, community & national support organizations. In addition they have a Computer Centre for families with Internet connection, health information website recommendations and internet search assistance. All services are free of charge. The facility also includes a toy lending library. Web site details: www.vanderbiltchildrens.com/frc www.finonline.org www.flyingpig.org

Sandi Martin provided an interesting search example. She was asked to undertake an urgent online search prior to a neonatal intestinal operation. It was necessary for the surgical team to remove an intestine and they needed to know how much could be removed before the infant would be dependent upon a colostomy bag. A research paper was found two hours prior to operation that provided the evidence required to determine the amount of intestine that could be safely removed.

Another search was described that was undertaken on locating a birth/delivery room in close proximity to an emergency ward for babies and mothers. The search was undertaken to provide evidence on the importance of proximity which, was used as evidence to help retain a large ward close to the delivery area.

A Pulmonary Medicine Seminar was attended Critical analysis of the following paper was undertaken:

Ibrahim, E. H., M. Iregui, et al. (2002). "Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis." Crit Care Med 30(4): 771-4.

Meeting with Dr John Doulis, Informatics Expert

Vanderbilt is one of a group of American organisations undertaking exemplary projects in informatics, others include: Partners Healthcare (Boston), Regenstrief Institute (Indianapolis), Intermountain Healthcare (Salt Lake City), Duke University (North Carolina) and Columbia University (New York City).

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Informatics projects underway at Vanderbilt:

• Paperless hospital • E-results and e-imaging reviews • Means to track chronic diseases • Virtual Schools (e.g. Botswana School of Nursing) • MyHealth@Vanderbilt • Working with Google Health to develop secure patient information sites • Patient results for analysis

NIH Public Access Policy

A database to inform Vanderbilt clients, on NIH public access format requirements, for journals held by the EBL has been developed by the Library. The database is for internal use only. Such projects are undertaken by Library staff based on needs identified by the Library’s Director, Dr Giuse.

Go Local Demonstration and discussion of the project Go Local: http://www.nlm.nih.gov/medlineplus/golocal/index.html

MICU Rounds

It was a privilege and honour to observe the Intensive Care (IC) ward rounds at the Vanderbilt University Hospital. Prior to the round a listing of house staff on rotation assignment for June was circulated.

When Patty Lee (see the photo taken in the IC unit), Clinical Librarian, arrived at the ward she used a PC at the nurses’ station to download a list of IC patients from the system StarPanel.

Prior to the round I was advised there would be no social chatter and everyone would be totally focused on the patients. There were twelve patients on the round to visit. The Attending Physician briefed the Fellow who was taking over the shift. A physician, commencing her shift, was entering the orders. For each patient their conditions, medications and treatments were summarised.

The cost for a bed in IC is approximately $23,000 per day.

Patients on the round had conditions such as tuberculosis, peptic ulcer disease, septic shock, failed kidney transplant and pneumonia.

There was discussion on establishing a post IC clinic as most patients that leave the ward are never cured and are a heavy burden upon the health system.

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Two questions were raised at the end of the round relating to the use of antibiotics for treating bleeding diverticulosis and evidence for using succinyl choline for intubation to impact intercranial pressure ICP monitoring.

Efficiency and accuracy in provision of the clinical informatics consult service (CICS) was emphasized.

The Evidence Based Medicine Database

A database has been set up to enter queries received and store the packet responses to clinical queries. The database can be searched by clients to retrieve evidence based research search packets. Librarians are able to update previous searches and maintain statistics and data on each search, such as:

Date received Date responded Searcher Search packet Search strategy

Archives, Historical Collections

Mary Teloh, with over thirty years experience at the EB Library, gave me an introduction to the history of medicine collection. It was an absolute pleasure and thrill to view original works by Vesalius, Fleming, Captain James Cook and many others. Mary recommended the following, as THE selection tool for the history of medicine: Morton's Medical Bibliography: An Annotated Check-list of Texts Illustrating the History of Medicine and Scientific and Technical Periodicals of the Seventeenth and Eighteenth Centuries: A Guide

Some of the memorabilia on Eileen Cunningham was layout for my viewing. Eileen was the “lady who had made Vanderbilt’s Medical Library famous around the world.”7 It was very fitting to commence the Cunningham Fellowship, whose namesake was in honour of this outstanding Librarian, at the Vanderbilt EBL.

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University of North Carolina at Chapel Hill Health Sciences Library Visit Thursday 29 May – 3 June 2008

After a flight cancellation, rescheduling, delays and a day spent in transit on Wednesday 28 May I was very pleased to be greeted by Kate McGraw at the Raleigh Durham airport that evening around 9.30 pm. Kate had compiled an action packed three day schedule of meetings and a few social events, which I was very grateful to receive. I was also very pleased to see Kate again, as we had first met in Phoenix, Arizona, at the MLA Meeting in 2006.

The Health Sciences Library

The University of North Carolina (UNC) at Chapel Hill provides information resources and services to five health sciences schools and the UNC Hospitals. The Library is open to the public and users have free access to all the print and electronic collections. The Library serves the needs of health professionals across North Carolina through the Area Health Education Centres (AHEC) Digital Library and supports the needs of the general public for health information via the service NC HealthInfo, a state-wide collaborative database.8 There are sixteen UNC branch libraries. Around 50-70% of funding for the Chapel Hill Health Sciences Library comes from the State the remainder is from development funds.

Health Sciences Library Collaboration Center

The visit began with a Library tour and a meeting with a staff member working at the Health Sciences Library Collaboration Center. The role of the Center is to provide “leading edge visualization and collaboration technologies that can be used across disciplines, campuses and continents; community outreach activities; clinical applications or educational programs”.9

NC HealthInfo

Based on Pew Internet and American Life Project surveys10 it has been found that 80% of all American internet users search for health information online. It was around ten years ago the UNC Health Sciences Library at Chapel Hill commenced provision of consumer health information services. The Library Director, Carol Jenkins at the direction of the Chancellor of UNC wanted to raise the quality of health information access for all NC citizens. In 1999 a proposal was submitted to the National Library of Medicine to establish a more personalised service than the existing MedlinePlus. The Go Local service was then born at the UNC Health Sciences Library. To establish Go Local a developer and two librarians were appointed. The NC Health Information service was launched publicly in 2001, as a means to simplify access to health information for the NC public. Health on the Net (HON) is another service set-up and this is maintained by volunteer librarians. The sites have Academy of Health Information Professionals (AHIP) endorsement.

MLA Meeting Highlights

Staff gave a summary of the MLA Meeting in Chicago highlights to the UNC Library Director, Carol Jenkins. Some of the highlights are included in the MLA meeting notes within this report.

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Clinical Librarianship Services

I attended a talk on Invasive Fungal Infections along with the Clinical Librarian, Karen Crowell. She explained how the Director of the Infectious Diseases Department at UNC invited her, as a library representative to attend the Department’s weekly meetings.

The Director of the Infectious Diseases Department at UNC, Dr Cohen, had just become the new Associate Vice Chancellor for Global Health.

Attending the Department’s meetings has helped Karen to gain an understanding of their work and priorities. She recommended the use of PowerPoint presentations at the sessions and works with the team to save the work to a UNC web site. Karen links references in presentations to full-text available from the Library’s collection. She sets up Medline searches related to topics to keep staff up to date on research areas. She also supports information needs of the gastrointestinal surgeons. A demonstration of Medline saved searches which are embedded in URLs was given.

Support for the Medical School

In the past couple of years the UNC Medical Curriculum has been restructured. They have a one year block based on organs and systems. The objective is to provide an integrated approach to studying how the body works.

For example, the first year course, The Human Body: Molecules to Cells aims to integrate disciplines such as biochemistry, pharmacology, genetics, cell and molecular biology into a cohesive approach to learning the cellular and sub-cellular structures and processes which impact health and disease. More details are available about the curriculum, which has adopted a team based, learning approach is available from: http://www.med.unc.edu/md

The Library has participated in first year of the Medical program to teach information literacy skills within an informatics subject.

Area Health Education Centres (AHEC) Digital Library

With a shortage of clinicians in rural areas the State set up Area Health Education Centres to develop infrastructure and services. Nine regional AHECs were set up in North Carolina; all of the sites organize residency training for medical students and each have a Library. UNC Health Sciences Library applied for a grant and was successful in receiving $200,000 each year for five years to develop an online health information portal.

The portal provides access to OVID’s Medline & EMB package, Cinahl with full text, Statref (full text medical textbooks), Lippincott High Impact journals and five Elsevier journals. A ceiling of 1000 individual users for the system has been set. Healthcare practitioners can join for US$150 each. And institutional members contribute US$7,000 - US$76,000 per year. Authentication for the system was developed in-house. A resource table via the backend of the portal is used to profile what users can access. Statistics on use can be generated by the system. Mary Beth Schell, AHEC Digital Library Manager mentioned it would be far wiser to base price on usage, as this is not always very high.

An investigation of pay per usage has been undertaken recently and shown not to be cost effective. Payment was offered via pay per view at US$25-50 and this was viewed as too expensive.

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Friends of the Health Sciences Library Alumni e-access service via the portal can be set up for US$250 for an individual membership. A thirty day trial is promoted to try out the system. The site content is organised according to health specialities within the groups: databases, journals, books, continuing education and patient education.

A special feature on the home page is a listing the system generates of the top five frequently used resources.

A Microsoft sequel database is used to extract reports and run queries related to usage.

To date there are 14,181 individual members and institutions of the AHEC Digital Library.

Core members of the Digital Library meet once a year and the State supports all of the infrastructure costs.

A federated search engine, Webfeat (Serials Solutions), will be incorporated within the portal.

UNC clinicians working in rural areas can use the portal and all the other UNC Library electronic resources.

Administration Council and Committee on Appointments and Promotions Education Session

I attended the Library Administration Council. This body is responsible for coordination and guidance regarding administrative programs and activities, and other organization-wide areas of infrastructure support; including planning, assessment, fundraising, financial management, human resources, staff development, facilities management, communication and public relations. At the Council meeting staffing, diversity and a forthcoming e-science forum were discussed. Attendance gave me an insight to the organizational and administrative structure at the Library.

At the Committee on Appointments and Promotions (CAP) session I was informed of the faculty status of librarians and their tenure appointments as EPA non-faculty status. Various benefits are derived from this status:

• Voting members of general faculty • Voice in University governance • Opportunity to serve on faculty committees and faculty council • Have access to faculty grievance committee • Provides for peer review • Criteria for review are specified, apply to all, are public and can be changed only by library faculty • Recognizes achievement outside of promotion in position • Benefits package are administered by Faculty Benefits Office

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Duke University Medical Center Library Visit Tuesday 3 – Friday 6 June 2008

Background

The Medical Center Library (MCL) operates independently from the other Duke University Perkins System Libraries, which include nine libraries and an archive service.

The Medical Center Library (MCL) strives to exceed the needs and expectations of their community and is committed to providing a positive service experience. The community includes all those with whom the Library staff interacts, both internally and externally. This includes patrons that visit the Library in person and virtually, co-workers, colleagues, Duke employees, vendors, service personnel, and all other individuals that staff may have contact with on Library-related matters11.

The Associate Dean for Library Services is Ms Pat Thibodeau was a wonderful host. My schedule was organised by the Deputy Director, Mr Rick Peterson, who was overseas during my visit. Rick did an excellent job of creating an interesting schedule for my visit. In addition, I was very grateful as he had organised internet access and allowed me to use his office during his absence.

The visit

For many years the Health Sciences Librarians at the UQ Library have been undertaking the Evidence Base Medicine and the Medical Librarian online course developed by Connie Schardt and her colleagues in North Carolina. Based on the high esteem we have for Connie it was an honour to visit her and colleagues at the Duke University Medical Center Library.

I attended a meeting with Connie and the health sciences librarians to discuss the online EBM quiz, the Library has set up on behalf of the Medical School at Duke.

The Medline quiz had been developed for Year 2 medical students. The quiz starts with a clinical scenario and question. The students are required to translate the scenario in to a PICOT format. It was decided that the right response to the PICOT format required will be provided on submission of the student’s response online. Following this, the student needs to construct a search and recommend three suitable papers that address the clinical question.

Similar to the approach at the UQ Library, Year 1 medical students undertake a library induction/orientation session.

Year 3 at Duke is a research year and the Library is about to succeed in integrating a ten week mandatory EBM course. Connie has worked with a physician to lobby for implementation of the course over recent years.

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Senator Edward Kennedy

During my visit to Duke, Senator Edward Kennedy, was successfully operated on to treat his cancerous brain tumour. Dr Allan Friedman, a top neurosurgeon at Duke, performed the surgery.

Discussion with Connie Schardt and Anne Powers

One Laptop per child

Founder Nicholas Negroponte http://www.laptop.org/vision/index.shtml

OLPC was founded by Nicholas Negroponte with a core of Media Lab veterans, but quickly expanded to include a wide range of exceptionally talented and dedicated people from academia, industry, the arts, business, and the open-source community.

Nicholas is a potential keynote for ICML – to explore how librarians throughout the world can support this program.

The Perkins & the Bostock Library

I gained a number of ideas for library fittings and furnishings whilst visiting the Perkins & Bostock Libraries. Details about the expansion and renovation of the Perkins Library are available: http://library.duke.edu/about/perkinsproject/

As we are investigating new carrels at the Herston Health Sciences Library, I was particularly interested in the stylish version in the Perkins Library.

Carrel power & computer outlet

School of Medicine

The Medical School Curriculum comprises Year 1 of four integrated basic science courses and a practice course; Year 2 Rotations; Year 3 covers 10-12 months of scholarly experience and students can receive a credit for research and coursework they undertake after acceptance to other degree programs, including a MD/MSLS (Medical Science in Library Science) or MD/MSIS (Master Science in Information Science).

Within the Curriculum in second year there are five clinical core sessions where all medical students come together for one week to attend sessions on clinical reasoning, healthcare team visits, interdisciplinary topics, basic science and clerkship skills. These sessions are undertaken in between rotations.

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A Capstone four week course covering internship specific skills, communication skills, financial planning, personal wellness, advanced basic science topics and health care systems is held in the final year prior to graduation.

Pat Thibodeau is a member of the SOM Curriculum Committee and I attended one of their meetings during my visit.

Endnote

Virginia Carden, Administrative Research Librarian, gave me an overview of her role and shared the following useful links with me:

Web intro to 2nd generation tools

Citation analysis: a comparison of Web of Science and Scopus

Tracking institutional authors

Web of Science very useful online tutorials

Evidence Based Medicine

I attended a session with the Health Sciences Librarians were they presented details on new features available in Pubmed, ACP Medicine and Cinahl Clinical Queries (developed by McMaster).

History of Medicine

Suzanne Porter, who trained in the graduate rare books program at Columbia University, has been the curator of the History of Medicine Collection at Duke University Medical Center Library since 1992. Suzanne gave me a tour of this collection and generously presented me with the books: “Foundations for excellence: 75 years of Duke Medicine” and “The physician’s art: representations of art and medicine.”

Duke University Medical Center Library & Archives

My meetings with the archives staff were very fruitful. Adonna Thompson, Director and Archivist, took me to visit the Physician Assistant History Center located at the Research Triangle Park. As the PA profession is being established in Queensland, Adonna altered me to a recent article in the Australian Rural Doctor, April 2008, p.7-14.

On the Friday June 6, Mira Waller, took me to the Archives office off campus. I met with the archivist team, led by the Director, Russell Koonts. The group talked of the Duke 75 Anniversary archive project. They have been archiving images spanning four decades that include individuals, events and buildings.

Russell also expanded on the cytopathology digitization of 10,000 slides, on behalf of the Dr Johnson Centre of Excellence. To date there is 1000 case files with meta data; cards were indexed alphabetically by diagnosis, method and case number. The group used a Jpeg2000 image server to digitize slides. Fedora (also used for UQ espace) is used for in-house digitisation. The group moved from D Space to Fedora Open Source.

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Other examples demonstrated during the session:

New Medspace digitised on behalf of Dean Davison at Duke.

Library Ladies (photo) example demonstrated

Vital is the front end to Fedora

Copyright statement on photos

To date there has been 1,000 visits per month with 9.5 million hits on the site.

Tips \Techniques\Comments

• John East from UQ Library is world famous for his Endnote work. Library staff at UNC and Duke highly praised John’s work and contribution to Endnote services. • Zotero – open source competitor to Endnote • David Rothman’s blog is useful for coverage of 3rd party Pubmed tools • E-science forum with Neil Rambo, who has prepared the e-science white paper recently • Achievement of UNC University Library to raise $36 million in donations. The fund raising effort has been underway since 2002. More details: Windows University Library www.lib.unc.edu vol 16, no. 2, Fall 2007

• http://ebmlibrarian.wetpaint.com/ wiki with lots of resources for teaching and learning EBM; contribution are from lots of libraries; feel free to show and promote to your colleagues; anyone can use the resources and share their materials with the wiki. • Request for wireless at ICML rather than conference bags (note: perhaps we can have some bags available for sale) or get sponsorship for both • Archivists indicate no need to destroy binding to digitise theses, special equipment is available • Cinahl Clinical Queries developed at McMaster now available • Ebsco Host new look; changes to basic search screen

Available for download from the SLA web site - cover page with a University academic to promote the Library

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Connections: Bridging the Gaps May 16-21 2008, Medical Library Association, Annual Meeting, Chicago, USA Available from the HLA bl og : http://hlablogs.blogspot.com/

Some thirty hours and two flights later I arrived at the Hyatt Hotel in Chicago on Thursday 15 May. I cannot remember how many very long queues I’d been in transit so when I arrived at Chicago airport and was standing at the end of another mile long queue I agreed to share a cab. This is worth doing and results in being removed from a queue. Aussie’s must have the sharing spirit, as a chap from WA travelled with me downtown. He was attending the National Restaurant Association conference also on in Chicago. Beautiful tulips lined the streets of this wonderful city.

As the Cunningham Fellow recipient my attendance at the Meeting was funded by the MLA. The MLA over the past three years has provided the booth space to promote the ICML 2009. As hosts of ICML in Brisbane we are enormously grateful for the outstanding support we have received from the MLA.

Friday 16 May I attended a one day workshop Rapid Web-Based Course Development: A Short Course for Librarians presented by Jan Buhmann. What did I learn? By the end of the day I was aware of a few processes and tools that can be used for course development. I also discovered that Camtasia and Survey Monkey are so intuitive that even with jet lag I was able to use them. Why did I do this course? Curriculums are increasingly adopting online formats and I wanted to gain an understanding of what is involved. The course provided a one page listing of instructional design resources and rapid development tools. Let me know if you’d like a copy and I’ll seek Jan’s permission to share the list.

Saturday 17 May the morning was spent setting up the ICML booth. This involves hanging up Australian flags, pinning a large table cloth with a map of Australia to a backdrop curtain, putting out miniature koalas, laying out brochures and getting the larger Koala and Kangaroo raffle prepared. Fortunately the lovely staff at the Majors booth didn’t need their table (already dressed with an attractive skirt) as I’d ordered a table that wasn’t big enough. Last but not least I blew up our inflatable Skippy then the booth was complete. The Exhibition Opening is always on the Saturday evening. Once again I had flown 14,000 km to experience koala frenzy. The MLA delegates just love our wee koalas that can be worn upon a lapel or attached to just about anything. All Australian hands were on deck, including Mary Peterson, Rolf Schafer and Saroj Bhatia from Australia to help promote ICML 2009.

Sunday 18 May at 7 am I attended the Thomson (Reuters) Scientific Sunrise Seminar: Showcasing new translational research resources. The following is a summary of the session taken from the MLA Program: • Investigator Portal: comprehensive research for all stages of disease investigation and therapeutic regimens • BONDplus: public and proprietary sequence, interaction and related interactions information • Thomson Collexis Dashboards custom datasets on therapeutic areas or diseases, providing

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unique data mining, display and predictive potential. Ok, the truth, I attended this seminar as Thomson's door prize was an Apple i-touch though UQ is setting up a Translational Research Institute. I didn’t win the Apple i-touch…grrrr. All the resources are very specialised and are newly released. Are you familiar with Collexis? Watch this space! The Thomson Collexis Dashboard is only available to Web of Science subscribers.

BONDplus is a bioinformatics tool and it was way too early in the morning to digest the complexities of this resource, for more details go to: http://scientific.thomsonreuters.com/bon dplus/

The McGovern Lecture by Andrew Zolli

Andrew Zolli gave an outstanding address on the importance of social networking. He emphasized the importance of knowing and learning about your group's (country, state, city, or institution) demographics to plan and prepare for the changes due to the demographic shift.

Recommended MLA Presentation:

The Bridge Is Out: Better Learn How to Swim—Coping with Budget Cuts—Creative Solutions in Lean Times Corporate Information Services, Hospital Libraries, Leadership and Management Sections; Library Marketing SIG

Using an In-depth Analysis of Individualized Learning to Best Inform a Library Training Program Molly Cahall, Coordinator, Outpatient Clinical Informatics Consult Service (OCICS); Rebecca N. Jerome, Assistant Director Consumer and Patient Health Information Section; Annette M. Williams, Associate Director, Library Operations; Nunzia B. Giuse, AHIP, FMLA, Director; Eskind Biomedical Library, Vanderbilt University Medical Center, Nashville, TN

Purpose: To explore work processes and time management and information organization strategies used by highly efficient clinical librarians. Based on this analysis, investigators will develop a plan for incorporating these strategies into other librarians’ workflow to improve efficiency while preserving high-quality results.

Participants/Setting: Clinical librarians at a large academic biomedical library providing consult services to physicians practicing in the hospital and outpatient clinics.

Methods: A qualitative approach was employed to explore the work processes and strategies used by highly efficient librarians when answering physician requests for evidence from the biomedical literature in response to their complex clinical questions. Methods included: (1) analysis of in-house statistical data for each librarian regarding the number of evidence requests completed and the time spent per request; (2) focus group discussion and one-to-one interviews of work processes, time management, and organization strategies used by clinical librarians with a short response time for completing evidence requests based on in-house data analysis; and (3) analysis of observational data obtained from the focus group and interviews to elucidate pertinent strategies that can be integrated into the primary investigator’s workflow and ultimately the library’s training program to improve the response times of all clinical librarians.

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Results/Conclusion: By exploring the time management and information organization strategies used by librarians with a fast response time, it is expected that integration of these strategies in the librarian’s workflow will lead to improvements in the primary investigator’s personal response time and to the subsequent integration of these strategies into the library’s training program to improve the work efficiency of all clinical librarians.

NLM Presentations

Title URL address Time The NLM Theatre sessions http://www.nlm.nih.gov/bsd/dist_edu.html (which were praised) are archived at: DailyMed https://webmeeting.nih.gov/p81829566/ 19 min

Health Services Research & https://webmeeting.nih.gov/p88051189 27 min Public Health: What's Happening?

LinkOut Update https://webmeeting.nih.gov/p75708954/ 23 min

NIH Manuscript Submission https://webmeeting.nih.gov/p29108561/ 24 min System

NLM Drug Information Portal https://webmeeting.nih.gov/p48476231/ 19 min

NLM Gateway Redesign https://webmeeting.nih.gov/p20517702/ 22 min

PubMed CentralR Update https://webmeeting.nih.gov/p71158499/ 21 min

PubMed Review https://webmeeting.nih.gov/p46566040/ 25 min

The New "Images in the https://webmeeting.nih.gov/p22787929/ 18 min History of Medicine” Software What's New with https://webmeeting.nih.gov/p96532037/ 13 min Environmental Health & Toxicology Resources?

What's New with https://webmeeting.nih.gov/p29104294/ 20 min MedlinePlus & GoLocal

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My Presentations

At each Library visit I gave a one hour presentation, including power point slides and short movie clips on Australia, the US/Australian healthcare system, the University of Queensland Library & the International Congress on Medical Librarianship.

The Program My Cunningham Fellowship ran for three weeks. It commenced at the Medical Library Association Annual Meeting, in Chicago on Friday 16 May and continued until Friday 6 June.

The program developed on my behalf was excellent and my hosts, in particular Patty Lee, Kate McGraw, Connie Schardt and Pat Thibodeau were all extremely generous with their time and support.

My only minor criticism of the program was it covered areas I had nominated of interest and many other areas that librarians wanted to share with me. Schedules were sent to me prior to the visits in most cases, so I did have an opportunity to negotiate the arrangements. Consequently I have gathered details on numerous services and resources without having penetrated my initial program aims very deeply. I take personal responsibility for going off in other learning tangents and these will be very valuable. I was at each of the sites for short periods of time, e.g. Vanderbilt four days; UNC three days; and Duke four days. Travel in between at times, with delays, meant that I was often arriving late the night before an 8 am start at the new site. As I am a seasoned traveller I coped ok with this. I was still suffering with slight jet lag and there were afternoons that I felt extremely tired though all the stimulation of the new places and people helped during these times. Possibly a day in between visits to write up findings and reflect upon some of the experiences would be valuable though I appreciate this can be done during weekends.

Patty Lee made the comment that it would have been preferable for me to have arrived at Vanderbilt on a Monday and stayed for a five day work week.

In hindsight, it would have been beneficial to have stayed at the MLA Meeting until the close and had two days to recover in Chicago before flying to Tennessee the following weekend. As it turned out it took me 30 hours to travel to Chicago from Brisbane, arriving just before midnight Thursday (15 July) evening. I then attended a Continuing Education course on the Friday all day. I then missed the close of the Meeting on Wednesday as I flew to Nashville that morning.

Another recommendation would be to give the recipient a mentor, to help keep them on track with their priorities. It would be valuable for the recipient to stay in contact with another medical librarian not directly involved with the program, even a phone call each week would help.

The support I had from Lisa Fried, Carla Funk, Ray Naegele and other MLA staff was excellent. When I was informed a flight had been ‘refunded’ Lisa was available via the phone to provide support and I was able to purchase another flight and continue on schedule with the program.

The funding for the visit was provided at the commencement of Fellowship. I would recommend in future giving the recipient the money on a travel VISA card (travelex is an example) or transferring the money to a bank account. I found that banks were not always prepared to cash traveller’s cheques and this was very inconvenient. I had three experiences where I was told unless I had an account at the bank they would not cash the cheques. The Bank of America did cash the cheques without question but it was not always possible to locate these branches. Hotels were also willing to accept traveller’s cheques as payment but most times they required a credit card on arrival and on departure they automatically print an invoice charging the credit card.

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Endnotes

1 Mulvaney SA, Bickman L, Giuse NB, Lambert EW, Sathe NA, Jerome RN. A randomized effectiveness trial of a clinical informatics consult service: impact on evidence-based decision-making and knowledge implementation. J Am Med Inform Assoc. 2008 Mar- Apr;15(2):203-11.

2 Giuse NB, Koonce TY, Jerome RN, Cahall M, Sathe NA, Williams A. Evolution of a mature clinical informationist model. J Am Med Inform Assoc. 2005 May-Jun;12(3):249-55.

3 Giuse DA. Supporting communication in an integrated patient record system. AMIA Annu Symp Proc. 2003:1065.

4 Jirjis J, Patel NR, Aronsky D, Lorenzi N, Giuse D. Seeing stars: the creation of a core clinical support informatics product. Int J Healthcare Technology and Management. 2003;5(3/4/5):284–94.

5 Hoot N, Weiss J, Giuse D, Jirjis J, Peterson J, Lorenzi N, et al. Integrating communication tools into an electronic health record. Medinfo. 2004;2004(CD):1646.

6 Ibid

7 Glasgow, Viki L. The Contributions of Eileen R. Cunningham to Medical Librarianship.” Master’s Thesis, University of North Carolina, 1971. Eskind Biomedical Library, p.?

8 UNC at Chapel Hill Health Sciences Library, Strategic Plan 2008-2013, Draft 21 April 2008, Rev 28 May 2008.

9 UNC Health Sciences Library and RENCI flyer [2008] Details available: http://www.hsl.unc.edu/collaboration AND http://www.renci.org/

10 Rice RE. Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys. Int J Med Inform. 2006 Jan;75(1):8-28.

11 Taken from the Duke University Medical Center Library, web site, accessed 13 June 2008. http://www.mclibrary.duke.edu/about/standards

The report has been saved on the UQ Library Network: L:\HumanResourcesManagement\StaffDevelopment\ExternalEvents\2008\MLA08

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