The evolution of our profession and association from 1998-2023: reflections from four Medical Library Association leaders.

On the occasion of the Medical Library Association's 125th Anniversary, four librarian leaders with a combined 105 years of engagement in MLA collaborated to reflect on the changes in our profession and our association. We draw on an examination of the last 25 years of the MLA Janet Doe Lectures, our own personal histories, and scholarship we produced for MLA publications and presentations. We offer this compilation as an invitation for readers to reflect on their experiences of changes within the profession, inspiration to engage in the issues around our place in society, and a source for additional exploration into researching and learning from our collective history.

Evolving from public health libraries as a place to focus on public health librarian expertise.

Objective: This article describes the evolution of academic public health library services from standalone academic public health libraries in 2004 to centralized services by 2021. Methods: Five public health libraries serving public health graduate programs (SPH) at public and private institutions were visited in 2006-07. Visits comprised tours, semi-structured interviews with librarians and local health department staff, and collecting of contemporary print documents. We compiled and compared visit notes across libraries. In 2022, we reviewed online materials announcing library closure or transition for timing and how services were to be subsequently provided. Results: Libraries and SPH were co-located and most librarians maintained public health expertise though they did not have faculty appointments in their SPHs. Specialized statistical and geographic information systems (GIS) software and data were provided in partnership, often with other system libraries. Only two libraries had strong connections to health departments-one with direct service agreements and another engaged in public health training. Conclusion: Academic public health libraries' relationships with SPHs and health departments did not ensure their existence as standalone entities. Following a national trend for branch libraries, public health information services were centralized into larger health or science libraries. The scope and specialization of librarian expertise continues to be valued with several institutions having librarians dedicated to public health.

Characterizing History of Health Sciences Organizations at Academic Health Sciences Centers.

Questions of how to sustain interest in the history of medicine and broader health sciences (HOM/HS) in a changing institutional environment, and how to collaborate with stakeholders to offer activities to do so, are on the radar for many academic health sciences centers and their libraries. This essay is an initial exploratory study of non-curricular HOM/HS efforts at United States medical schools ranked in the top thirty in primary care or research. In 2019, we collected public information pertinent to any presence of an on-campus HOM/HS community and the group's structure, including funding, activities, and the library's involvement with the group. Seventeen of forty-five institutions in the sample presented information about an institutional HOM/HS group. All posted a mission statement. Their funding varied in nature; some collected fees from members, while others relied on university support. Half were student-led. Most groups hosted regular lecture series, with fifteen groups hosting at least one annually. Six groups sponsored publications or awards. These findings indicate that several institutions with active programs offer potential models and lessons for sustaining HOM/HS communities. Beyond providing a physical or digital space in which HOM/HS groups connect, libraries play an active role in fostering some of these communities.

Interlibrary loan and document delivery in North American health sciences libraries during the early months of the COVID-19 pandemic.

Objective: The study purpose was to understand how early months of the COVID-19 pandemic altered interlibrary loan (ILL) and document delivery (DD) in North American health science libraries (HSLs), specifically the decision-making and workflow adjustments associated with accessing their own collections and obtaining content not available via ILL. Methods: Researchers distributed an online 26-question survey through 24 health science library email lists from January 6-February 7, 2021. Respondents reported their library's ILL and DD activities from March-August 2020, including ILL/DD usage and policies, collection access, decision-making, and workflow adjustments. In addition to calculating frequencies, cross-tabulation and statistical tests were performed to test a priori potential associations. Two researchers independently and thematically analyzed responses to the 2 open-ended questions and reached consensus on themes. Results: Hospital libraries represented 52% (n=226/431) of respondents, along with 42% academic (n=179) and 6% (n=26) multi-type or other special. Only 1% (n=5) closed completely with no remote services, but many, 45% (n=194), ceased ILL of print materials. More than half (n=246/423; 58%) agreed that ILL requests likely to be filled from print remained unfilled more than is typical. Open-ended questions yielded 5 themes on ILL/DD staffing, setup, and systems; 6 on impacts for libraries and library users. Conclusion: Lack of communication regarding collection availability and staffing resulted in delayed or unfilled requests. Hospital and academic libraries made similar decisions about continuing services but reported different experiences in areas such as purchasing digital content. Hybrid ILL/DD workflows may continue for managing these services.

CRediT for authors of articles published in the Journal of the Medical Library Association.

To help ensure that authors of articles published in the Journal of the Medical Library Association (JMLA) receive appropriate recognition for their contributions and to make individual author roles more transparent to readers, JMLA articles will begin including Author Contribution statements using the Contributor Role Taxonomy.

Library involvement in health informatics education for health professions students and practitioners: a scoping review.

OBJECTIVE: The purpose of this scoping review is to evaluate the extent of library or librarian involvement in informatics education in the health domain. METHODS: We searched eight databases from their inception to 2019 for reports of informatics educational activities for health professionals or health professions students that involved library staff or resources. Two reviewers independently screened all titles/abstracts (n=2,196) and resolved inclusion decisions by consensus. From the full text of the 36 papers that met the inclusion criteria, we extracted data on 41 educational activities. RESULTS: The most frequent coded purposes of activities were "teaching clinical tools" (n=19, 46.3%) and "technology" (n=17; 41.5%). Medical students were the most frequent primary audience (34.1%), though 41.5% of activities had multiple audiences. Evaluation was reported for 24 activities (58.5%), only a few of which assessed short or post-activity impact on attitudes, knowledge, or skills. The most common long-term outcome was applying skills in other courses or clinical experiences. Thematic analysis yielded three areas of outcomes and issues for the library and organizational partners: expanded opportunities, technology and resource issues, and value demonstration. CONCLUSIONS: Limited published examples of health informatics educational activities provide models for library roles in informatics education. More librarians should report on their informatics educational activities and provide sufficient details on the interventions and their evaluation. This would strengthen the evidence base about the potential impact of libraries within informatics education.

Exploring interprofessional collaboration and attitudes of health sciences librarians.

OBJECTIVE: This study assessed health sciences librarians' attitudes toward interprofessional collaboration using the Interdisciplinary Education Perception Scale (IEPS) and gathered information on their involvement with interprofessional activities. METHODS: The authors sent a survey to librarians in the Medical Library Association's (MLA's) Interprofessional Education Special Interest Group and Research Section consisting of the IEPS and questions about their prior and current experiences with interprofessional practice and education (IPE). We compared mean IEPS scores between each MLA group and several other demographic factors to assess differences in attitudes. We also compared librarians' IEPS scores with those of previously published health professional students' IEPS scores and thematically analyzed two open-ended questions. RESULTS: Health sciences librarians' scores on the IEPS indicated positive attitudes toward IPE. There were no statistically significant differences between any group. Health sciences librarians' mean IEPS score was similar to the mean score of health professions students from a prior study. The most commonly reported interprofessional activity was teaching or facilitating learning activities for health professions students; fewer served on committees or engaged in non-curricular activities such as grand rounds and book clubs. CONCLUSION: Health sciences librarians in this study reported positive attitudes toward IPE, in line with the majority of other previously studied health professionals. Years of experience, previous health professional careers, and experience supporting IPE as a librarian had little bearing on the responses to the survey. This suggests that health sciences librarians have positive attitudes toward IPE, regardless of whether they directly support IPE programs or participate in interprofessional activities.

Building visualization skills through investigating the Journal of the Medical Library Association coauthorship network from 2006-2017.

OBJECTIVE: The primary objective of this study was to explore different dimensions of Journal of the Medical Library Association (JMLA) authorship from 2006-2017. Dimensions that were evaluated using coauthorship networks and affiliation data included collaboration, geographical reach, and relationship between Medical Library Association (MLA) member and nonmember authors. A secondary objective was to analyze the practice and practical application of data science skills. METHODS: A team of librarians who attended the 2017 Data Science and Visualization Institute used JMLA bibliographic metadata extracted from Scopus, together with select MLA membership data from 2006-2017. Data cleaning, anonymization, analysis, and visualization were done collaboratively by the team members to meet their learning objectives and to produce insights about the nature of collaborative authorship at JMLA. RESULTS: Sixty-nine percent of the 1,351 JMLA authors from 2006-2017 were not MLA members. MLA members were more productive and collaborative, and tended to author articles together. The majority of the authoring institutions in JMLA are based in the United States. Global reach outside of the United States and Canada shows higher authorship in English-speaking countries (e.g., Australia, United Kingdom), as well as in Western Europe and Japan. CONCLUSIONS: MLA support of JMLA may benefit a wider network of health information specialists and medical professionals than is reflected in MLA membership. Conducting coauthorship network analyses can create opportunities for health sciences librarians to practice applying emerging data science and data visualization skills.

Language Consideration and Methodological Transparency in "Systematic" Reviews of Animal Toxicity Studies.

This study evaluated the use of non-English literature (NEL) in systematic reviews (SRs) or meta-analyses (MAs) of animal-based toxicity or communicable disease (CD) studies. A secondary goal was to assess how grant funding, country of primary authorship, or study quality reporting influenced the use of NEL in these reviews. Inclusion criteria and data extraction forms were based on a pilot evaluation of a 10% random sample of reviews that were identified from a PubMed search (2006 to May 2017). This search yielded 111 animal toxicity and 69 CD reviews. Reviews (33 animal toxicity and 32 CD studies) were included when the authors identified their work as an SR or MA, described a literature search strategy, and provided defined inclusion criteria. Extracted data included PubMed indexing of publication type, author affiliations, and grant funding. Language use was mentioned in the methods in 55% of the toxicity SRs and 69% of CD SRs, of which 44% (n = 8) and 41% (n = 9) were limited to English, respectively. Neither the study type, grant funding, nor first author country of affiliation was associated with an increased consideration of NEL. Study quality reporting was more common in SRs that considered multiple languages. Despite guidelines that encourage the use of NEL in SRs and translation tools, SR/MA authors often fail to report language inclusion or focus on English publications. Librarian involvement in SR can promote awareness of relevant NEL and collaborative and technological strategies to improve their incorporation into the SR process.

Distinguishing case study as a research method from case reports as a publication type.

The purpose of this editorial is to distinguish between case reports and case studies. In health, case reports are familiar ways of sharing events or efforts of intervening with single patients with previously unreported features. As a qualitative methodology, case study research encompasses a great deal more complexity than a typical case report and often incorporates multiple streams of data combined in creative ways. The depth and richness of case study description helps readers understand the case and whether findings might be applicable beyond that setting.

Information seeking and evaluation: a multi-institutional survey of veterinary students.

OBJECTIVE: To practice evidence-based medicine, clinicians must be competent in information literacy (IL). Few studies acknowledge the critical role that reading strategies play in IL instruction and assessment of health professional students. The purpose of this study was to understand the information-seeking and evaluation behaviors of doctor of veterinary medicine (DVM) students in regard to scientific papers. METHODS: The authors studied DVM student behaviors across eight programs in North America using a web-based survey of closed- and open-ended questions about finding and evaluating scientific papers, including a task to read a linked scientific paper and answer questions about it. RESULTS: A total of 226 individuals responded to the survey. The sections of a scientific paper that were most commonly read were the abstract, introduction, and conclusions. Students who reported reading a higher proportion of scientific papers were more likely to feel confident in their abilities to interpret them. A third of respondents answered open-ended questions after the paper reading task. Respondents felt the least amount of confidence with one of the final steps of evidence-based medicine, that of interpreting the significance of the paper to apply it in veterinary medicine. CONCLUSIONS: DVM students may lack the skills needed to evaluate scientific literature and need more practice and feedback in evaluating and interpreting scientific papers. Librarians who support DVM students can (1) help DVM students to efficiently evaluate scientific literature, (2) seek training opportunities in alternative modes of teaching and learning IL skills, and (3) partner with veterinary faculty and clinicians to provide students with practice and feedback in information evaluation.

Access to human, animal, and environmental journals is still limited for the One Health community.

OBJECTIVE: "One Health" is an interdisciplinary approach to evaluating and managing the health and well-being of humans, animals, and the environments they share that relies on knowledge from the domains of human health, animal health, and the environmental sciences. The authors' objective was to evaluate the extent of open access (OA) to journal articles in a sample of literature from these domains. We hypothesized that OA to articles in human health or environmental journals was greater than access to animal health literature. METHODS: A One Health seminar series provided fifteen topics. One librarian translated each topic into a search strategy and searched four databases for articles from 2011 to 2012. Two independent investigators assigned each article to human health, the environment, animal health, all, other, or combined categories. Article and journal-level OA were determined. Each journal was also assigned a subject category and its indexing evaluated. RESULTS: Searches retrieved 2,651 unique articles from 1,138 journals; 1,919 (72%) articles came from 406 journals that contributed more than 1 article. Seventy-seven (7%) journals dealt with all 3 One Health domains; the remaining journals represented human health 487 (43%), environment 172 (15%), animal health 141 (12%), and other/combined categories 261 (23%). The proportion of OA journals in animal health (40%) differed significantly from journals categorized as human (28%), environment (28%), and more than 1 category (29%). The proportion of OA for articles by subject categories ranged from 25%-34%; only the difference between human (34%) and environment (25%) was significant. CONCLUSIONS: OA to human health literature is more comparable to animal health than hypothesized. Environmental journals had less OA than anticipated.

Research engagement of health sciences librarians: a survey of research-related activities and attitudes.

INTRODUCTION: The extent to which health sciences librarians are engaged in research is a little-studied question. This study assesses the research activities and attitudes of Medical Library Association (MLA) members, including the influence of work affiliation. METHODS: An online survey was designed using a combination of multiple-choice and open-ended questions and distributed to MLA members. Responses were analyzed using descriptive statistics, content analysis, and significance testing. The authors used statistical tools and categorized open-ended question topics by the constant comparative method, also applying the broad subject categories used in a prior study. Pearson's chi-square analysis was performed on responses to determine significant differences among respondents employed in three different institutional environments. RESULTS: Analysis showed that 79% of respondents read research articles at least once a month; 58% applied published research studies to practice; 44% had conducted research; 62% reported acting on research had enhanced their libraries; 38% had presented findings; and 34% had authored research articles. Hospital librarians were significantly less likely than academic librarians to have participated in research activities. Highly ranked research benefits, barriers, and competencies of health sciences librarians are described. CONCLUSIONS: Findings indicate that health sciences librarians are actively engaged in research activities. Practice implications for practitioners, publishers, and stakeholders are discussed. Results suggest that practitioners can use published research results and results from their own research to affect practice decisions and improve services. Future studies are needed to confirm and extend these findings, including the need for intervention studies to increase research and writing productivity.

Scanning technology selection impacts acceptability and usefulness of image-rich content.

OBJECTIVE: Clinical and research usefulness of articles can depend on image quality. This study addressed whether scans of figures in black and white (B&W), grayscale, or color, or portable document format (PDF) to tagged image file format (TIFF) conversions as provided by interlibrary loan or document delivery were viewed as acceptable or useful by radiologists or pathologists. METHODS: Residency coordinators selected eighteen figures from studies from radiology, clinical pathology, and anatomic pathology journals. With original PDF controls, each figure was prepared in three or four experimental conditions: PDF conversion to TIFF, and scans from print in B&W, grayscale, and color. Twelve independent observers indicated whether they could identify the features and whether the image quality was acceptable. They also ranked all the experimental conditions of each figure in terms of usefulness. RESULTS: Of 982 assessments of 87 anatomic pathology, 83 clinical pathology, and 77 radiology images, 471 (48%) were unidentifiable. Unidentifiability of originals (4%) and conversions (10%) was low. For scans, unidentifiability ranged from 53% for color, to 74% for grayscale, to 97% for B&W. Of 987 responses about acceptability (n=405), 41% were said to be unacceptable, 97% of B&W, 66% of grayscale, 41% of color, and 1% of conversions. Hypothesized order (original, conversion, color, grayscale, B&W) matched 67% of rankings (n=215). CONCLUSIONS: PDF to TIFF conversion provided acceptable content. Color images are rarely useful in grayscale (12%) or B&W (less than 1%). Acceptability of grayscale scans of noncolor originals was 52%. Digital originals are needed for most images. Print images in color or grayscale should be scanned using those modalities.

Librarian readiness for research partnerships.

This study investigated health sciences librarians' knowledge and skill-based readiness to partner on sponsored research involving human participants. The authors developed and deployed, at two time points, a web-based survey on nine indicators of research activities with response choices reflecting the transtheoretical model of stages of behavior change. Librarians with research experience or membership in the Medical Library Association Research Section reported higher levels of having completed indicators. Our results suggest that creating awareness in precontemplation responders could encourage skill development. Mentoring and continuing education could support librarians who are contemplating or preparing to perform indicator activities.

Subject matter expert and public evaluations of a veterinary toxicology course brochure-writing assignment.

Veterinary schools are increasingly developing students' communication skills, with an emphasis placed on practice conveying medical and scientific knowledge to different audiences. We describe how patient-centered written communication has been integrated into the training of veterinary students using toxicology-related preventive materials. Third-year veterinary students were given an assignment to prepare a client-focused brochure related to veterinary toxicology. Since 2010, 148 students have completed this assignment, with an average score of 93.4%. Use of a grading rubric was instituted in 2011 and resulted in a more rigorous assessment of the brochures by the course instructors. In this study, we evaluated a sample (n=6) selected from 10 brochures volunteered for further public and expert assessment. Each brochure was measured for readability and assessed with a rubric for perceived usefulness and acceptability by 12 veterinary toxicologists and 10 or 11 adult members of the public attending a college of veterinary medicine open house. Veterinary toxicologist review anticipated that the brochures would be useful for most clients, and the public reviewers confirmed this assessment. Evaluation of the brochures using set marking criteria and readability indexes showed that students had successfully targeted the chosen audiences. Feedback showed that the general public rated the sample brochures highly in terms of quality, usefulness, and interest. Completion of this study has resulted in revision of the grading rubric, an increased use of brochure examples, and additional instruction in readability assessment and brochure development, thereby improving the assignment as a learning exercise.

Characterizing terminology applied by authors and database producers to informatics literature on consumer engagement with wearable devices.

OBJECTIVE: Identifying consumer health informatics (CHI) literature is challenging. To recommend strategies to improve discoverability, we aimed to characterize controlled vocabulary and author terminology applied to a subset of CHI literature on wearable technologies. MATERIALS AND METHODS: To retrieve articles from PubMed that addressed patient/consumer engagement with wearables, we developed a search strategy of textwords and Medical Subject Headings (MeSH). To refine our methodology, we used a random sample of 200 articles from 2016 to 2018. A descriptive analysis of articles (N = 2522) from 2019 identified 308 (12.2%) CHI-related articles, for which we characterized their assigned terminology. We visualized the 100 most frequent terms assigned to the articles from MeSH, author keywords, CINAHL, and Engineering Databases (Compendex and Inspec together). We assessed the overlap of CHI terms among sources and evaluated terms related to consumer engagement. RESULTS: The 308 articles were published in 181 journals, more in health journals (82%) than informatics (11%). Only 44% were indexed with the MeSH term "wearable electronic devices." Author keywords were common (91%) but rarely represented consumer engagement with device data, eg, self-monitoring (n = 12, 0.7%) or self-management (n = 9, 0.5%). Only 10 articles (3%) had terminology from all sources (authors, PubMed, CINAHL, Compendex, and Inspec). DISCUSSION: Our main finding was that consumer engagement was not well represented in health and engineering database thesauri. CONCLUSIONS: Authors of CHI studies should indicate consumer/patient engagement and the specific technology investigated in titles, abstracts, and author keywords to facilitate discovery by readers and expand vocabularies and indexing.

Googling for a veterinary diagnosis: A replication study using Google as a diagnostic aid.

BACKGROUND: The purpose of this study was to replicate in the veterinary context a BMJ study using Google to assist in diagnosis of complex cases. HYPOTHESIS/OBJECTIVES: To assess percentage of diagnoses identified using Google as a diagnostic aid in veterinary medicine. ANIMALS: None; 13 cases in cats and 17 in dogs published in JAVMA. METHODS: Cross-sectional survey of Google results from searches using keywords generated independently by a generalist and a specialist veterinarian who reviewed the published case history and diagnostic components while blind to the diagnosis. They offered diagnoses and generated up to 5 search strategies for each case. The top 30 Google results for each search were reviewed by the generalist to inform a final Google-aided diagnosis. Both veterinarians' initial diagnoses and the Google-aided diagnoses were compared with the published diagnoses. RESULTS: Google searching led to 52 diagnoses out of 60 possible. Twenty-two (42%, 95% confidence interval [95% CI] 29%-55%) Google-aided diagnoses matched the JAVMA diagnosis. This accuracy rate does not differ significantly from 58% (n = 15/26, 95% CI 38%-77%) identified in the BMJ study. Google-aided results were not statistically different from those achieved unaided by each veterinarian (33%, 95% CI 16%-50%). CONCLUSIONS AND CLINICAL IMPORTANCE: Published information found searching Google using keywords related to complicated or unusual cases could assist veterinarians to reinforce their initial diagnosis or consider other differential diagnoses. Search strategies using words representing either signs or the preliminary diagnoses can yield results useful to confirming a correct diagnosis.

Connecting knowledge resources to the veterinary electronic health record: opportunities for learning at point of care.

Electronic health records (EHRs) provide clinical learning opportunities through quick and contextual linkage of patient signalment, symptom, and diagnosis data with knowledge resources covering tests, drugs, conditions, procedures, and client instructions. This paper introduces the EHR standards for linkage and the partners-practitioners, content publishers, and software developers-necessary to leverage this possibility in veterinary medicine. The efforts of the American Animal Hospital Association (AAHA) Electronic Health Records Task Force to partner with veterinary practice management systems to improve the use of controlled vocabulary is a first step in the development of standards for sharing knowledge at the point of care. The Veterinary Medical Libraries Section (VMLS) of the Medical Library Association's Task Force on Connecting the Veterinary Health Record to Information Resources compiled a list of resources of potential use at point of care. Resource details were drawn from product Web sites and organized by a metric used to evaluate medical point-of-care resources. Additional information was gathered from questions sent by e-mail and follow-up interviews with two practitioners, a hospital network, two software developers, and three publishers. Veterinarians with electronic records use a variety of information resources that are not linked to their software. Systems lack the infrastructure to use the Infobutton standard that has been gaining popularity in human EHRs. While some veterinary knowledge resources are digital, publisher sites and responses do not indicate a Web-based linkage of veterinary resources with EHRs. In order to facilitate lifelong learning and evidence-based practice, veterinarians and educators of future practitioners must demonstrate to veterinary practice software developers and publishers a clinically-based need to connect knowledge resources to veterinary EHRs.

Evidence-based practice in health education and promotion: a review and introduction to resources.

This review examines evidence-based practice (EBP) in health education and promotion with a focus on how academically trained health educators develop EBP skills and how health education and promotion practitioners access the literature to inform their activities. Competencies and credentialing in health education related to evidence-based practice are outlined and sources for evidence-based practice literature in health education and promotion are described. An exploratory questionnaire to consider teaching and resources in evidence-based practice was distributed to faculty and librarians from the top 10 ranked health education doctoral programs. Findings highlighted the integral value of EBP instruction to the curriculum. Growth opportunities in evidence-based health education and health promotion for instructors, practitioners, and librarians include promotion and expansion of online evidence-based public health resources to close the evidence-practice gap.