EBM and Clinical Support Librarians@UCHC

A blog for medical students, faculty and librarians about their use of evidence based medicine, clinical literature, Web 2.0, sources and search strategies

News, Academic-Health Science Libraries, Collection Management: Ruminations on Reference – Part 2: Using the (Real) or (Virtual) Library Collections

This is Part 2 of a 3-part post about managing and maintaining a core Reference collection, and the people who use resources available from University of Connecticut Health Center.

As a state-funded public institution, and the only medical library in Connecticut open to the general public, Lyman Maynard Stowe Library is staffed 94-hours per week and provides an open-door policy to anyone, with free access to the university’s collection of subscription databases and health science collection.

Reference librarians and public services staff assist many different types of information seeking folks who come in to use the library: college or graduate students from other area institutions, student nurses, nursing faculty or other allied health professionals, hospital patients or out-patients, family members, high school students, trial attorneys, paralegals, medical writers (and anyone else).  Workstations are available for searching subscription databases, journals, e-textbooks, software, etc. or to access the large online collections and databases from UConn’s Homer Babbidge Library (the main library in Storrs, CT).

There are only a few caveats: users must be on-site in order to access the collections (i.e., no remote access with a current UConn ID), and doing medical research (i.e., not playing computer games for hours using a UCHC workstation).  Printing out full-text articles costs seven cents per page.

Some of the people who visit do so without asking for assistance from staff for finding specific information; some do ask for brief instructions on choosing what to search and how to “best” search it.

Other visitors are very motivated to learn the mechanics of searching Medline (PubMed) effectively from a library professional, which is great… generally in 40 minutes we can demonstrate and teach just about anyone how to search effectively, or introduce them to MedlinePlus.gov.

And there are a few who just won’t touch a computer to find the medical information they’re seeking.  There are varied reasons for this: they may not have computing skills, or have physical impairments such as limited vision or hearing, or  low-mobility.  Some would be better served in another language than English.  And some just don’t want to spend the time to learn how to search online.  A few have just received a bad medical diagnosis and are visibly upset… not a good time to start working on a medical research project.  So the print Reference collection is a resource that they can use (without help, if that is their choice).


A different divide for our general library users is temporal in nature. Because the library is open seven days per week from 700am to 1100pm during the week, a “day” staff and a “evening/night” staff is required.  How do we best serve those who come here in the daytime hours (when professional staff is here) versus those who use the collections and physical building during evening, night or during weekend hours (when one evening reference librarian is available)? Recently I asked our evening librarian (whose name is John) for input on updating the Reference collection; his response was: “There are plenty of people use the library between 600pm and 10 pm”.   They typically are UConn MPH graduate students, patients or family members  and anyone who has to visit after their workday is over.

He also noted that many of the after-500pm crowdgoes straight to the Reference books… not to the computer“.


There are standard (anticipated) sets of questions which librarians are accustomed to be asked at Reference.  First to be considered: is this user trying to connect while on-campus as in there in real-life – or are they connecting digitally?  In other words, did they walk through the (real) front door of the UCHC building on their own two feet, or did they use their mouse to click into the library home page?

Does it matter to them?  Does it matter to the librarians Sure! There are more than 4,000 people working in the building every day.  We (i.e. the librarians) aim to serve many different research needs seven days per week.

Here is a list of “composite Reference questions” which public services staff do hear, and answer, on a frequent basis:

  • How do I know if you have it? Users who haven’t visited a library in a long time will find the old card catalog long gone… and may not know about – or embrace the utility of – an online catalog. Many graduate students in the MPH or MSN programs are returning adult learners who haven’t been actively using an academic library in decades.  Some of the faculty are still mourning the disappearance of the card catalog. Knowing how to look, as well as where to look is crucial.
  • One of the most common questions that reference staff answers daily is: I think the library owns this journal or textbook, but where is it?  It could be online, or on the shelf depending on the date of the publication, the choices of the producer of the information, the budget which was available to the library at the time of publication, or it could be available by request from another library (interlibrary-loan). Digital availability is a decision made by publishers who determine what sources to make available electronically as well as basing their fees on market demand, institutional (versus individual) usage and electronic access charges.  It is a fallacy to think that because a journal or book has gone online, it represents a cost-savings for the library.  Many times, the electronic version is more costly than buying a print edition due to hardware management, storage requirements, staff to manage collections and administer systems… none of these are “free”.
  • For Those who do not Compute. It is no longer possible to actually walk into the journals-stacks area to find the volume and issue that is needed, because in many cases, those current issues are now only available digitally.  But there are still plenty of people who do just that.  These users need the librarians’ help to make that leap, and a major concern is that generations of library users are missing essential information because they’ve not learned to effectively employ the tools of the digital library.  These users may not know how to search online.  They may be unaware of the deep investment of digital resources made available to them online.  Some do know about the electronic collections, but don’t possess the technical skills or knowledge base (or confidence) to effectively search online for them.  They are traditional users who still need real books and book-stacks to browse in. This isn’t meant to be “age-discriminatory” because there are many library users who are over 50+ years of age who’ve fully made that leap from in-print to digital format, the so-called “early adopters”.
  • The Digital Natives. Having said the above, I’ve yet to meet and work with any 23-year old student who can’t or just won’t use the digital resources of an academic library.  They grew up with a PC and a mouse in their hands.  Their concern is more likely to be, “If it’s not online, I don’t need it“.  Fair enough – we’ll try to supply it online for you.
  • Those who do compute but are not searching expertly. Here’s a scene playing out in the library lately:  Users who are technologically-savvy but whose first choice (sometimes their only choice) is to use Google or Google Scholar to search our collections while standing in the real library.  Eek! Google-only searchers end up bypassing our integrated collections of databases and limiting their research retrievals to what they can “google” because they are not searching in the “best” places.  Consequently they miss out on accessing a huge body of clinical information.  They would be better served by searching Medline or Scopus or other subscription resources that they are literally standing right next to in this building.
  • Call me. Librarians are generally user-friendly, customer service oriented people whose main goal at work is to connect the user to the information which they require, delivered in an efficient and timely way.  When this model doesn’t work, users can and should initiate a conversation to ask for assistance… this could be via telephone, email, in-person at the Reference desk.  How can we (librarians) help library users – either in the building or off-campus – when they don’t find what they need but then also do not ask for assistance on how to search or which sources are best to answer their research questions?
  • Digital Migration. A journal or textbook may go out of print at any time in favor of digital access only.  As an example, this library pays for access to roughly 1,100 electronic textbooks currently. It is an individual decision by the collection management librarians as to whether to continue to purchase a paper textbook if the digital version is available.  Some core medical textbooks – such as Nelson’s Pediatrics, Hurst’s The Heart and especially, Harrison’s Principals of Internal Medicine – are heavily used in both formats.  It is a judgement call to be made by the librarians, weighing cost versus availability versus expected usage.  Hint: Networked version of standard medical textbooks generally get funding.


Here are a few other things librarians ruminate over.

  • Library users researching topics outside the scope of health sciences and medicine should search the resources assembled by our main library.  Access is only a few mouse-clicks away, including 240+ academic subject databases and a vast journal collection available online.  How many times have I said to someone, “Just go to Storrs”.  The response sometimes is “I don’t want to drive there!”.  (Um.  There’s no need to drive there in a car to access these resources if you are affiliated or are on-site.)
  • A declining gate count doesn’t mean people are using the library less. We as librarians need to provide better statistical reporting and become more effective at explaining and promoting library services to senior managers in a time of budget stressors.  Do university or hospital administrators understand that the number of times that people actually walk in the front door into the real library (what librarians call the ‘gate count’) declines as we become more successful at providing virtual access to periodicals, textbooks, databases and teaching materials?
  • Information literacy is a concern because some of our users coming in the door may not speak or read in the English language well enough to understand what medical information is available here. But lbrarians have found online sources for patient-education materials in Spanish, Polish or other languages… but if those users didn’t ask Reference staff for assistance, it isn’t likely they could find those sources on their own.
  • We never see you anymore. How do library staff measure users’ satisfaction (or lack of satisfaction) with our collections and services, if we aren’t in the same building to interact face-to-face?  How do our remote users ask for help with searching or finding, if they are sitting at their home or office 20 miles from the reference librarians?  Or if they working at 1:oo am, when there’s no staff in the library but they are searching?  What are quantifiable, credible ways to measure the results of remote library users that we don’t get to interact with face-to-face?  This is a long-term issue for library managers.  There are statistics about hits on subscription journal titles or databases, quantified by date and time, but that data is only a part of the answer.


If you’ve read this far… thank you for hanging in there to read what has unexpectedly become something of an essay! The last and final part of the Musings on Reference will appear next week, with a list of open-access documents or reports which I found while looking up “other stuff” for the 2009 Reference collection update.


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