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63rd IFLA General Conference - Conference Programme and Proceedings - August 31- September 5, 1997

Changing roles of health sciences librarians in the electronic environment: providing instructional programs, improving access, and advancing scientific communication

Ann C. Weller, M.A., A.H.I.P.
Deputy Director,
Library of the Health Sciences
University of Illinois at Chicago
1750 W. Polk St.
Chicago, IL 60615, U.S.A.

email: acw@uic.edu
phone: 312-996-8974
fax: 312-996-9584


The electronic environment has created significant role changes for health sciences and science librarians. This presentation will examine how librarians should expand their expertise into the areas of instructional programs, improving access, and advancing scientific communication. Librarians should design both training and instruction programs to help users understand and take advantage of electronic resources effectively. Three types of electronic access will be discussed: full-text with a print counterpart, unique electronic text, and electronic information available on the Internet. Access to electronic information raises a number of important issues: ownership, agreement with vendors, who uses the information, price, and the design or quality of the software systems. Librarians have the skills necessary to evaluate and organize health sciences information on the Internet. Librarians contribute to the growing body of scientific knowledge on the information seeking behavior of users and the evaluation of programs. Decisions for future directions should be based on scientific evidence.



The electronic environment has created significant role changes for health sciences and science librarians. We must keep abreast not only with constantly advancing technology, but also with the resulting changes in training and access, coupled with the new methods of organizing, storing, and retrieving information. Our traditional expertise with print material has expanded to include knowledge of electronic information. This in turn has changed the types of resources librarians access and the skills and competencies librarians need to work and advance in this environment. We need to understand not only how electronic information systems work, but just as important, we must contribute to their design and management. We have the opportunity of expanding our services and at the same time we are presented with a host of new issues, such as information resources in multiple formats; new approaches to user services; the melding of public and technical services; and perhaps most important for scientific communication the repackaging of information, evaluating systems, and contributing to the growing body of scientific knowledge of electronic systems. In short, we must become managers of the electronic resources and the knowledge contained in them. In this talk I will examine how sciences and health sciences librarians can position themselves to meet these challenges by expanding into new areas of expertise: (1) develop and deliver instructional programs for our users, (2) increase access to the new forms of information, and (3) advance scientific communication.

The traditional role of the public services librarian was to supply information to patrons by answering questions at the reference desk or, for more complex questions, to provide an in-depth response which required searching wherever was needed to locate the answer. The first real challenge to this traditional model for reference librarians was “end-user searching”. The emergence of “end-user searching” was greeted with great skepticism, if not outright panic among reference librarians. If users can do their own searching, why do they need reference librarians? A corresponding challenge for technical services librarians came with online catalogs. The technical services librarians have organized material through the use of sophisticated cataloging guidelines and standards. Cataloger experienced a similar panic reaction to the advent of keyword searching in the online public catalogs. If users can locate material on their own with keyword searching, is there a need for all the cataloging refinements?

Providing instructional and training programs

The initial panic of reference librarians to “end-user searching” was eased with the realization that online searching of any database was not easy. And catalogers also quickly discovered that order was still essential in an online catalog. After one has used a number of different computer software systems, it is hard to remember the confusion one felt when attempting to use a computer for the first time or when trying to make sense of a new software system. How does one navigate from one screen to the next? What are the commands? How do you print, or fix a “frozen” screen (which always happens in the first few minutes of using any new system)? Should librarians teach these skills?

Both training and instruction are needed to use electronic resources effectively. The idea of librarians providing instruction to users is far from new. In 1937 [1] Eileen Cunningham, famous in the annuals of medical librarianship in the United States, described an experience at Vanderbilt University in which medical students were instructed in the use of the library and given assignments in which they were to locate medical information. Cunningham admitted that teaching students was by no means a universal practice. It was a recent development and she solicited suggestions from others to help develop the instructional program.

By 1975 a survey of academic health sciences libraries in the United States found that 18% of medical schools offered formal instruction to their students on using the literature [2], but the authors lamented that library instruction was still “ill-defined and poorly organized”. The nature and breathe of these instructional programs offered by health sciences librarians has increased dramatically. By 1996 a similar survey found that 75% of academic health sciences libraries in the United States offered formal library instruction to medical school students. The same study found that 49% of medical schools required students to take curriculum-based courses on information seeking skills [3].

Health sciences librarians now have a solid place in teaching in the medical school curriculum. The experience with medical schools can be used as a model for similar endeavors in other disciplines and institutions. For example, at the University of Illinois at Chicago a program was begun in which a librarian was assigned as a liaison to each one of the health sciences colleges. Librarians contacted faculty in the colleges and suggested that they teach students how to improve their information seeking skills. Librarians made the case that students needed a knowledge of library resources, how to access these resources, and how to understand the literature. This came at a time when a goal of medical education was to develop life-long learning skills for the students. These contacts have resulted in librarians becoming members of curriculum committees, planning course content, co-teaching with medical school faculty, and working with health sciences faculty on some collaborative research projects.

These endeavors in medical schools have laid the foundation for librarians to further expand their teaching roles. Academic health sciences librarians have begun to broaden their audience beyond students and to teach topics beyond database access. Librarians at Welch Library at Johns Hopkins University offered a course on scientific writing and editing in 1991. Two years after the course was introduced in the library, the School of Public Health asked librarians to design and teach a for-credit course on this topic [4]. Librarians are now investigating the possibility of developing a course to cover topics such as presentation skills. Other examples of librarians moving into new areas include: participation in meta-analysis projects, working in small groups in problem-based learning, contracting services to outside departments, working with faculty to improve teaching effectiveness, and training physicians to incorporate the use of computerized information technologies in their clinical practice [5].

A survey of faculty at the University of Illinois at Chicago [6] found that 38.4% of health sciences faculty were interested in taking courses in using library systems and other software packages. The library now regularly offer classes on using personal bibliographic software to faculty. The library houses a computer lab to help faculty use software for classroom instruction, research, or other projects. This lab is staffed and taught by “electronic services librarians”. An all-electronic course called ETrain was designed for faculty to help them understand the basics of accessing the Internet.

Any new programs aimed at training or instruction need to be designed to meet the requirements of the institution and planned with input from the unit which requested the training. Librarians’ teaching role will continue to expand in the online environment. For the foreseeable future there will be a host of patrons who do not understand how to use systems and who will need both formal and informal guidance and instruction.

Improving access

The first part of this presentation has argued that librarians need to expand their role into instructional programs and we have seen examples of some successful programs. The second topic of this discussion will address the expanding role of librarians in the area of increasing access to electronic information. The electronic environment should not make it more difficult for the average person to access information. Our input in the design of electronic information systems is essential. Using a library has always been a two-step process. First, one needs to identify potentially relevant material and, second, one needs to be able to retrieve that material..

Librarians can make a tremendous impact in how the systems that operate electronic databases are used. I will discuss librarians role in three types of electronic formats: (1) full-text documents available in both traditional print and electronic format, (2) full-text available in electronic format only and (3) information available over the Internet.

  1. Several commercial services now offer full-text electronic versions of print journals [7]. Ovid, a system which currently has several full-text medical journals online (all with a print counterpart), will introduce full-text access to a set of 400 well-known medical and scientific journals next year. How these are designed and priced must have input from librarians. Librarians need to expand their roles to have an impact on how these new systems and products will be packaged and delivered.

    The electronic environment has put us in the position of explaining to our users that we are now going to “rent” electronic material or purchase it on a temporary basis when we already own the exact item in a print format. Issues of ownership of material and information versus only use of that material for a given period of time are important. For example, when the library owns a print copy of an item, the library can copy it and loan it according to standard guidelines, practices, and laws governing copyright. The purchase of electronic information does not have this same assurance.

    Contracts sometimes limit who can and who cannot access material we purchase. We need to be involved in the contract negotiations to make sure our patrons are well served. If we have traditionally let the “public” into and use our library, we need to be sure our services are not compromised because the information is electronic. In a sense, full-text journals online is analogous to “close-stacks”. Unless a library user is a member of our institution and has the necessary password or skills to get access to material that person has a limited ability to get information. Vendors are working out these issues and we should work with them to solve access issues. Our role should be not only to continue to serve all those we have traditionally served, but to expand our services to new users.

    Publishers now have little ‘tempters’ for some full-text documents. A user can access a full-text database for a period of time for no charge or the publisher may only give access to a section of the journal (letters, editorials, not the research articles) for no charge. Then a fee is added to access the rest of the journal. Price is based on number of factors or formulas: the number of potential users, the number of simultaneous users, the number of accessions, the amount information downloaded or printed, or the ownership of the material in a print format. We need to have a pricing model that makes sense for our particular library.

    Users who conduct their own searching use subject headings less than librarians who search. An argument can be made for producers of databases and online public catalogs to pay less attention to subject headings and place more emphasis on designing thesauri that are easy to use. The techniques for accessing a full-text database are very different from the way a traditional index with a controlled vocabulary is accessed. Technical services librarians will need to understand how users navigating a system and develop guidelines, standards, and thesauri designed for full-text material.

  2. The second type of electronic publication I am going to consider is one that is only produced in an electronic version only; with no print counterpart. The Association of Research Libraries has published the 6th edition of the Directory of Electronic Journals, Newsletters and Academic Discussion Lists, which includes 1,688 electronic publications [8]. But when one limits the journals to science, technology, and medicine (or STM) journals, the number drops to about 100 titles. Peer-reviewed, scholarly all-electronic scientific journals are fewer still.

    The Online Journal of Current Clinical Trials, the first peer-reviewed, totally electronic scientific journal with no paper counterpart, and not issue-based, began publication in 1992 just before Internet access was readily available. To have access to this journal, a library needed a stand-alone computer and its own software. This journal was not widely purchased or accessed. It did receive a boost when Index Medicus selected it as title to index. The journal eventually ran on more readily available software. The most recent indexed article was published in July, 1996. Had librarians been involved in the planning and design of this journal, I am tempted to think that some of these critical issues might have been resolved before publication. Electronic journals, although growing in number have yet to make it into the mainstream of scientific publication; librarians should have a role in how they are shaped.

  3. If we look at other formats, the non-traditional, non-journal or non-text-based information, here there is an even greater potential to expand our roles. Librarians have always organized, stored, and retrieved information. Incredible amounts of information are being added to the Internet. Our new role is so clear. The Web needs order. A recent study of Internet use estimates that 37% of households in the United States with Internet access regularly seek out medical information [9]. With an estimated 10,000 sites for consumer health information, there is no lacking in places to look for information. But finding meaningful, accurate information is difficult. If one goes to a search engine on a web browser and enters the term “diabetes”, depending on the browsers, you get up to 65,000 postings, listed (according to the explanation) in “relevance” order. A daunting tasks to sort through. There are a growing number of examples of aids available to help with this task. The National Library of Medicine (NLM), for example, has a Guide to Health Information Resources on the Internet [10]. From NLM’s guide screen one finds about 30 sites; one of which is HealthWeb [11]. HealthWeb was designed by a group of university librarians who have organized consumer health information. If one uses the same example and looks for information on diabetes on HealthWeb, the user is led through a series of choices or “menus”. The user is able to make rationale choices and is more likely to arrive at a place that has needed information than what was found on the web browser. HealthWeb has developed “quality filters” helpful for users. The need to organized Internet information in useful way is critical and librarians have an important new role in contributing to the evaluation and organization of Internet information.

Advancing scientific communication

Electronic databases and especially full-text systems have the potential to forever change the nature of scientific communication. We have seen that librarians have been very successful in moving into the role of training and teaching in the classroom in academic centers. We are teaching life-long learning skills. Our next step should be to evaluate our educational programs and to adopt teaching methodologies consistent with adult learning styles.

Librarians are working on the design of electronic information systems and addressing the many issues connected with accessing, implementing, and evaluating these systems. Public services and technical services are beginning to work together to solve the access, storage, retrieval issues brought on in the electronic environment. Many of these roles are extensions of the traditional librarian’s role: the organization of material and access to it.

The third topic of this presentation, advancing scientific commination, is a less traditional role. But it is also the one where librarians have the opportunity to make a significant impact in shaping the direction of the profession.

The Medical Library Association (MLA) has recently developed research policy statement called: Using Scientific Evidence to Improve Information Practice [12]. This document examines our role in research from several perspectives: education, research support, funding, dissemination, recognition, and measurement. All these are areas where much work is needed, but the first important step is to define the problems, support the research endeavors to solve the problems, and reward the work. MLA is now in the process of implementing this policy statement.

Librarians should contribute in meaningful ways to the growing scientific literature on electronic information. Our work and the decisions we make should be based in scientific evidence. We need to gather, analyze, and interpret data which will permit us to reach decisions and change behavior as a result of scientific analysis.

For health sciences librarians there are many interesting questions that need answers. Does access to electronic information make a difference in patient behavior, for example? The consumer health movement in the United States has received much attention in recent years. For the first time evidence has been published, by a study done by health sciences libraries, that consumer health information does make a difference in behavior in patient behavior [13]. As we have seen from the previous example a huge amount of consumer health information is available on the web: what is its value, how is the material evaluated? It is one thing to undertake a project to organize information on the web, it is quite another to evaluate it systematically and to make recommendations based on scientific evidence for how the material should be used.


We have seen that in addition to our traditional role of providing information and organizing it, we now providing training to teach information seeking skills. We participate in the design of systems. We are significant players in working out some of the complicated access issues. We see new roles for ourselves in gathering data, understand learning styles of adults, collaborating in teaching and research projects, and in the process we are developing our own life-long learning skills.

We need to work with systems specialists; with health care professionals; with international colleagues; all of whom need to answer a variety of questions. These questions range from how to guarantee that an electronic peer-reviewed journal is as good or better than a non-electronic journal to how do we know what is the best way to help users access electronic information.

Training our users, increasing our own computer skills, interacting with those in our parent organization, focusing on vision of that organization, and working to shape our organizations are all part of our new roles.

Some of the things we have touched on are similar to any research undertaking: study, help make things more available, contribute to the scholarly publication process, educate our users, evaluate the literature, filter it in a meaningful way, and base our practice and future undertakings on the evidence we have acquired and what we have learned.


  1. Cunningham, Eileen R. Instructions given to medical students regarding the use of the medical library. Results of eight years’ practical experience. Journal of Medical Education, 1937, November:12(6):376-85.

  2. Martin, Jess A, House DL, Jr., Chandler, HR. Teaching of formal courses by medical librarians. Journal of Medical Education, 1975, September:50(9):883-7.

  3. Earl, Martha F, Quillen, JH. Library instruction in the medical school curriculum: A survey of medical college libraries. Bulletin of the Medical Library Association, 1996, April:84(2):191-95.

  4. Stephens, Patricia A, Campbell, JM. Scientific writing and editing: A new role for the library. Bulletin of the Medical Library Association, 1995, October:83(4):478-82.

  5. Lipscomb, Carolyn E. Applying knowledge and skills: new directions. Bulletin of the Medical Library Association, 1995, October:83(4):453-89.

  6. Curtis, Karen L, Weller, AC, Hurd JM. Information seeking behavior of health sciences faculty: The impact of new information technologies. Bulletin of the Medical Library Association (in press, October, 1997).

  7. Bailey, Charles W., Jr. Scholarly electronic publishing bibliography, Houston: University of Houston Libraries, 1996-97. ( http://info.lib.uh.edu/sepb/sepb.html).

  8. Mogge, Dru W, Ed. ARL Directory of Electronic Journals, Newsletters and Academic Discussion Lists, 6th Ed. Association of Research Libraries, Washington D.C., 1996. (http://arl.cni.org/scomm/edir/dej96pr.html).

  9. Schwartz, John. There’s a world of health information on the Internet, but it’s hard to know what’s reliable. The Washington Post, Tuesday, April 22, 1997, Page Z12.

  10. NN/LM’s Guide to Health Information Resources Around the World. (http://www.nnlm.nih.gov/guides.html).

  11. HealthWeb. (http://www.ghsl.nwu.edu/healthweb).

  12. Medical Library Association. Using Scientific Evidence to Improve Information Practice. The Research Policy Statement of the Medical Library Association, Chicago, IL, 1996. (http://www.kumc.edu/MLA/science1.html).

  13. Pifalo, Victoria, Hollander S, Henderson CL, DeSalvo P, Gill GP. The impact of consumer health information provided by libraries: The Delaware experience. Bulletin of the Medical Library Association 1997, January: 85(1):16-22.