Category Archives: Education

Communication

Communication is the topic du jour. And it has been for a little while too. I’m reading old posts from Laika’s MedLibLog and it was this post from 2008 about an article in NEJM called Etiquette-Based Medicine that got me thinking.  The author, Dr Michael Khan, wrote that patients don’t complain about clinicians not being empathic or not understanding them, they complain about clinicians not looking at them, not smiling or not introducing themselves. As a patient, I haven’t had the bad luck to be stuck with a clincian who stared at a computer screen throughout my visit (yet…), but I imagine with would be annoying and probably disconcerting for many people. So many people seem to be more and more addicted to looking at computer screens than communicating with others in real life. How often do you bump into someone who is walking with their head down focusing on their screen? And worse yet, not even apologise? Last week I went to  Stephen K Amos’ gig at the Melbourne International Comedy Festival and one of the things he commented about was communication – “talk to people!” This was in context of being sent a break-up text via mobile phone. Then he merged that into talking to young people about sex. Lots of young people in the audience and young adults he talked to before his performances revealed that their parents weren’t giving them the ‘facts of life’ talk. Amos didn’t have one either from his parents (I did and I bet he is younger than me). Even though it may be awkward and/or embaressing, talk to people! Leave the screens and communciate in real life. It is how we have relationships.

ALIA National Advisory Committee – 8th Aug Meeting

ALIA is the national body representing librarians, information specialists, library technicians, and information science academics in Australia. I recently joined the Health Libraries Australia special interest group as an executive member (my membership became active in July after I finished my term as Chair of the Information Resources Group (HTAi)), and I thought that I should attend the Victorian NAC meeting. It was held at the university were I did my undergraduate degree and I hadn’t been back (apart from a reunion) since. Boy had the library changed! I didn’t recognise it. Of course, a lot can happen in a library over 20 (gasp!) years. The meeting was to discuss the ALIA discussion paper ‘Future of the Profession‘ and to solicit ideas from Victorian ALIA members. Two issues stood out for me – one that keeps on reoccuring again and again and the other a new one to me but valid and applicable in all types of libraries. The reoccuring one is Visability. The other is the superficiality of information trends and technology. How do you deal with these issues? I almost groaned aloud when the discussion leader said that a public librarian in Perth had been ‘caught’ going to Google for an answer to a question. I would have turned it into an educational opportunity – show people how to search for the answer using the tools that they use frequently! What would you have done?

MLA13 and ICML – Day 2 pt2

After lunch, it was time for the first International Clinical Librarian Conference session: Quality Assurance for Clinical Librarians, Informationists, and Embedded Librarians. My co-blogger wrote this post summarising the session. It was a good session but tight – speakers just had 15 minutes to speak. Aldrich talked about establishing yourself as a Clinical Librarian. If you haven’t had a predecessor, I would imagine it would be fairly daunting. The most important thing is to walk about the place like you belong. Don’t expect to be introduced but introduce yourself. Interact with your consituents, encourage questions and take advantage of down time by visiting them in medical/nursing lounges (I have reservations about this last tip).  Have some searches pre-prepared – this will be easier once you get to know the issues encountered. Be there, be visibile!  The next session was a report of the early phase of a research study by Bartlett and colleagues using the Value Study in order to further explore the value of medical libraries in Canada. Canada is unique in that the health system, although publicly funded, differs from province to province. One thing that is evident from the Value Study is that it is very difficult to establish a direct corelation between medical librarian input and patient care outcomes. It will be interesting to hear of the results. Bartlett’s presentation reminded me of a Krafty post about demonstrating value. I tend to agree with Kraft’s contention that organisations are only interested in how your services benefit them, not how some study in another part of the country etc etc. My co-blogger wrote that the most controversial session was the UpToDate talk given by Jane Surtees from the UK. Librarians have a love-hate relationship with UTD and I think this might stem from the type of marketing UTD does – bypassing libraries altogether. I didn’t realise that some of the aggressive audience response left Surtees in tears. Being aggressive is unjustified.  It was a very valid presentation because 1) UTD is pricey and 2) because of this, value has to be demonstrated in real terms to organsations who are working with reduced financial resources. Surtees mentioned that survey participants said that UTD helped them avoid unnecessary imaging tests. Imaging tests are expensive and generally overused with little information gained [Rao VM, Levin DC  Ann Intern Med. 2012; 157(8): 574-576.]. On the subject of overuse or interventions to avoid, NICE has a searchable database of Do Not Do information culled from their suite of guidelines. Next up was Victoria Goode from Welch Medical Library who presented on their team’s Value study. They used the Critical Incident Technique using a survey method that included some open-ended questions. Although only 10% of a population of 7000+ returned surveys, information proved to be valuable in improving services in key areas. Visibility was an issue (people didn’t know about the informationist service), off-site access was a problem, growing areas of information needs were not catered for (statistics, bioinformatics) and ways of working were revealed. The Welch Library have used these results to create specialist information portals, kickstart new collaborations, streamline access and think about marketing.  The final presentation in this session was given by the team at Vanderbilt University Medical Center Library, represented by Rachel Walden. This presentation was of great interest to me not only for the collaboration and guideline aspects but also because of the disinvestment aspect. There are lots of technologies in use that are ineffective, not cost effective or down right harmful. Guidelines can be used to address this somewhat. However, it has to be remembered that guidelines found on NICE for example are broad and do not address specific local needs and priorities – this is where organisations are encouraged to adapt them for their own area. I was very interested in the Choosing Wisely website which is basically a list of low value technologies. Adam Elshaug writes a lot on this topic; The Value of Low-Value Lists | Low Value Practices – An Australian Study. Walden stressed that it is important to document everything and that includes notes on low search results. Include disclaimers and limitations.  The quality of evidence has to be agreed on by the whole team – very important if you are working collaboratively in developing guidelines.  Lastly, stand up for quality! I had to laugh when Walden said it was very tempting to say ‘that’s rubbish!’ when a clincian points you to a guideline you know is low in quality – tell them it is low quality because … I like to think of it as an educational opportunity and a chance to demonstrate expertise.

Straight after this was the second part of The Role of Librarians in EBM, so I rushed over to the room it was in – it didn’t take long as it was almost next door! I blogged about this session for the MLA13 conference blog.  This was the last session of the day for me. After the session, I went down to the Exhibitors Hall to look around, and I caught up with a colleague who told me about some nifty badges she picked up (Data Queen!). Of course, I went to look at them, but I can’t remember who the vendor was now. Went back to the hotel room and blogged, then out for dinner.