Two new librarians take on the world of healthcare
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A presentation delivered at the 7th New Librarians Symposium in Sydney, by Steven Chang and Nikki May.
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Two new librarians take on the world of healthcare
- 1. Two new librarians take on the world of healthcare Learning curves and opportunities Steven Chang: Medical Librarian, Western Health (Melbourne) @StevenPChang Nikki May: Health Sciences Liaison Librarian, Flinders University (Adelaide) @NixLib www.flickr.com/photos/jakerust/16226034713/
- 2. One year ago… Nikki: @NixLib ● MLIS completed in 2011 ● Graduate Trainee Librarian Programme at Flinders University (2011 - 2014) ● Liaison Librarian for the Health Sciences (July 2014 - present) Steven: @StevenPChang ● MLIS completed in 2011 ● Research Assistant, university archival digitisation project (2011 - 2014) ● Hospital-based Medical Librarian (April 2014 - present)
- 3. ● Time poor ● Highly variable levels of information literacy ● Hungry for evidence to support clinical practice Our users Students Clinical staff image: NEC Corporation of America
- 4. A window into the world of health librarians ● Expert searching ● Evidence-based practice ● Collaboration ● Medical terminology
- 5. ● Scientific search methodology ● Intimate familiarity with databases ● Advanced search tools o i.e. text mining analysis ● Evaluation of searches Expert searching
- 6. Evidence-based practice ● Levels of evidence - hierarchy ● Critical appraisal of clinical trials ● Study design and methodology ● Systematic review searches ● Evidence into clinical practice: making a difference
- 7. Collaboration ● Proactive outreach initiatives ● Integrating ourselves into non- library teams ● Pushing out beyond the walls of the traditional library
- 8. The ‘embedded’ librarian Nikki ● Embedded in … curriculum o Guest lectures/workshops o Collaboration on topic assessments Steven ● Embedded in … clinical o Clinical Librarian at Western Health o NHS librarians: ward rounds, patient care
- 9. Learning a new language: medical terminology
- 10. Our evolution ● Twitter: meeting each other, plus #MedLibs chat! ● Generous mentors ● MOOCs ● Health Libraries Australia / Health Libraries Inc PD Days ● Raw experience! www.flickr.com/photos/55524309@N05/5377715421/
- 11. One year later ... Nikki (@NixLib) ● Presented at EBP in Optometry Conference ● First student S/R published ● Guest lectures increased by 90% in 2015 ● Co-authoring 3 systematic reviews ● EBLIP S/R protocol in progress ● Completed ALIA CP health Steven (@StevenPChang) ● Launched mobile health information program ● Presented at systematic review and meta- analysis workshop for anaesthetics/ICU ● Annual presenter at Ophthalmology lecture ● Launched Current Awareness service ● Active committee member for Health Libraries Inc ● Writing for Health Inform journal
- 12. Flight paths in health A small sample of the options out there... o Clinical informationist / librarian o Mental health librarian o Health informatics (leaning towards IT) o Academic health faculty librarian o Trainer at a vendor (i.e. EBSCO Health) o Public/consumer health librarian
Notes de l'éditeur
- Nikki: So firstly we would like to introduce ourselves. My name is Nikki May and I am lucky enough to be the Liaison Librarian for the Health Sciences at Flinders University in Adelaide. Flinders University has made a commitment to providing educational oppotrtunities to students who previously may not have had access to uni. With over 27 thousand students, we have campuses across South Australia and the Northern Territory, as well as affiliations overseas in countries such as Indonesia and China. Our campus incidentally also commands one of the best views in Adelaide! Steven: Hii everyone! My name’s Steven Chang and I’m a hospital-based medical librarian at Western Health in Melbourne. We serve 5000 healthcare professionals and I rotate between two workplaces: 1) the ancient, aging Footscray Hospital and 2) brand spanking new Sunshine Hospital. I work in a small team of five people, which is pretty cool because I get to do everything. Which is good and bad! I literally met my co-presenter here less than 48 hours ago for the first time. We met on Twitter and put this presentation together using Google Slides and talking over Skype. Moral of the story: Twitter is awesome! So today there’s a lot of ground we could cover but today we’re mainly going to give you a sense of the average day in the life of a health librarian, reasons why you might want to *be* a health librarian, and some of the career paths to getting here. We hope that by the end of our session, you’ll have some idea of what it’s like as a librarian in the health sciences and the particular, unique skills and features of this field of librarianship. The other thing we want to tease out and contrast is the difference between myself as a hospital-based special libraries person, and Nikki as a university liaison librarian
- Nikki: To give some context to our talk we want to start by going back a year. My study background is in humanities, I have only ever studied one year of biology, in year 8. My work experience was in customer service for a UK train company. So if any of you have ever travelled on the UK rail network you will understand that I, like Sally who spoke yesterday, also have transferable skills in conflict resolution. So you can see that I don't come from a health, or even a science background. 4 years ago I had just finished my Masters course and was working as a casual library assistant for 2 local councils’ public libraries, when I was offered a 6 week part-time casual contract at Flinders University. I did my undergraduate degree at Flinders, and it was the Uni Library and its librarians that had inspired me to become a librarian. So I grabbed this opportunity. I worked 3 jobs that winter, as a casual library assistant in a local public library at weekends. In Special Collections at Flinders during the day, and for the other council library in their toy library in the evenings. With 2 children it was tough going, but I needed the experience and the contacts. It paid off, as I was offered a place on the university's 3 year graduate trainee librarian programme. The programme involves rotating through a number of positions across the University Library branches, in a junior librarian position. This is offered as a full-time continuing position; so permanent employment - which as a new graduate is a dream come true. These programmes, offered by a number of universities are fantastic, and a key entry point for academic library positions. So watch out for them on your local email job list boards - for South Australia this is SALIN, or the South Australian Library and Information Network. My last rotation was in the Medical Library where I was circulation supervisor, readings coordinator, reference librarian and liaison support. This vast experience was key to me being ready to take on a health liaison role myself, when the opportunity arose. Steven: So, my trajectory is kind of one of those Arts graduates who don’t know what to do next who then become librarians stories. I’m sure some of you are familiar with that narrative. I majored in psychology and history, and wrote an Honours thesis in Chinese revolutionary history... ...Then I didn’t know what to do, so studied my Masters of Librarianship. During that time, I started my way from the bottom as a library shelver and eventually became a senior library officer and also became involved in a Melbourne Uni archival digitisation project. I will echo Nikki in saying that I was almost an empty slate when it came to medical knowledge and terminology when I fell into this position. I had done a subject on Healthcare Informatics as an elective in my Masters, but it wasn’t really part of some master plan to end up in a hospital library. So I guess what I’m saying is that if you’re thinking about making a move into health librarianship and you’re feeling anxious about not knowing medical stuff, it’s not the end of the world. Experience in health is a big plus, but you don’t have to be a biomedical whizz to get your foot in the door as a health librarian.
- Steven: So now we’re gonna talk about our users and the clients we get to interact with. At the hospital library, our primary audience are clinical staff. This includes physiotherapists, surgeons, social workers, psychologists and psychiatrists, nurses from a range of specialisations, emergency doctors, the list goes on and on. That variety is a real blessing. To work with such a broad spectrum of clients really keeps you on your toes and you get to meet a huge range of people who are as passionate about healthcare as we are about libraries. Our clients have varying information needs, highly variable levels of information literacy, but all share in common a couple of things. A) They’re very time poor - the stereotype is spot on. But B) They are hungry for evidence to support their clinical practice and development, so they come to the library. Sometimes. It’s an interesting relationship between information specialists and clinical specialists - these people are brilliant, amazing clinicians but they can be pretty mediocre at literature searching, so they stand to gain a lot from a librarian’s intervention. Nikki: My users are primarily students, but also researchers and academics. I am responsible for 10 departments, and their topics, across the School of Health Sciences. This keeps things interesting, but can also be challenging. On any one day I could be running a workshop for Optometry, followed by a lecture to Paramedics, then an orientation for Medical biotechnology students. My students range from brand new undergraduates right up to PhD. There is a high level of stress amongst the students, as often they are very new to searching, many are high achievers, and the nature of their studies has an emphasis on finding high quality evidence-backed resources.
- Nikki: So, what delineates being a health librarian from other specialities across our profession? In our talk today we are going to take a look at some of those points of difference, through a window of our own daily activities.
- Steven: Being very serious and obsessively thoughtful about literature searching is central to health librarianship. We are expected to be experts in teaching and searching databases. At Western Health we often do literature searches for our clients who may not have the confidence, skillset, or time to search for evidence themselves. It’s quite common for us to spend days on end doing these detailed literature searches. They can be very interesting but also very complex, with multi-stranded clinical questions on difficult topics where it takes some real detective work to uncover the evidence. To give you a pair of examples, I’ve worked on searches on… Rare diseases like leprosy and gangrene for a wound care nurse Cognitive therapy vs mindfulness therapy for depression Dynamic leadership theories in healthcare organisations More recently, Incontinence-associated skin diseases for an educator leading a team struggling with post-operative situation The patient care literature searches have been particularly rewarding, but I also enjoy the huge range of research and scholarly literature searches too. Nikki: Rigorous, systematic searching is also paramount in my role. From my perspective though it is more about embedding my students with reproducible, simple methods for searching effectively, and appraising what they find. We start teaching the health databases in week 4 of their undergraduate course, and by their 5th year they are often required to carry out a full systematic review. I know many of you may not have come across the term systematic review before. A systematic review is actually an intense piece of secondary research that attempts to capture all items on a given topic following a structured methodology, they are big in health but are now growing across other disciplines. A systematic review search relies on having used all possible synonyms for a term. To help us with this we use a number of freely available web tools. These tools operate by text mining, and undertaking frequency analysis, on previous located papers, or on clearly defined search topics. I have a libguide on this topic, which I am currently sharing on Twitter. Evaluation of our own searches is also crucial for quality control. In my organisation we share our searches across the health and medical liaison team; we also ask researchers for papers they have previously found, in order to create a ‘gold standard set’, that we can then check to make sure our search has located. This is a suggestion of the the Smart Searching modules, creating by CareSearch and Flinders Filters, links to this are also on my Twitter feed. This is a fantastic set of modules, written in easy to follow steps. So do check it out.
- Nikki: So what is evidence based practice and why is it so important in heath? Essentially evidence based practice is the practice of basing all of your clinical decisions on the ‘best’ evidence, then merging this evidence with your own clinical experience and applying to your patient's individual needs. It is core to every aspect of health and the library has a key role in locating this evidence. So as with teaching searching methods, teaching Evidence based practice also spreads through pretty much all of my topics and I am often asked to add this aspect to my lectures or workshops. Students are taught from the start of their studies to appraise their search results and their located resources, and provide the ‘best’ evidence for their questions by using the highest quality study types, following the hierarchy of evidence. The levels of evidence essentially means that different types of clinical trials are better at answering different types of clinical questions. This was another area where I needed to quickly upskill my own knowledge. Steven: To look at this from a different angle, I’m gonna go off on a small but interesting tangent, something I really like about this field is the way that health librarians have absorbed the evidence-based philosophy from our health sciences subject area and have taken that back into our own profession to translate these methods into library practice, which has given rise to a whole domain known as evidence-based library and information practice (EBLIP whatever you want to call it). This is an approach to librarianship centred on integrating quality library research into what we do and being accountable in practice to the evidence that exists on library practice. This has spawned a proliferation of library journals and conferences like the recent international EBLIP8 conference in Brisbane, where librarians come together to put evidence into practice in libraries in a sort of similar way that occurs in the healthcare field.
- Steven: So now we’re going to talk a bit about collaboration! As a special library in a large healthcare organisation, our survival and sustainability depends on reaching out to clinical departments and collaborating on shared initiatives. The traditional library model of passively waiting for clients to come to us and using our collections is dead. As a small fish in a big pond, we have to boldly promote our skills and our value by integrating ourselves into non-library teams and extending ourselves beyond the walls of the library itself. Some examples of collaboration I’ve been involved in are setting up an annual library lecture for Ophthalmology, jointly delivering a mobile clinical app program with a medical student who’s really obsessed with apps, and launching a partnership with the hospital Research department to deliver systematic review workshops. So if you like forming mutual relationships with people and groups, you’ll probably like health librarianship. Nikki: I am a liaison librarian and therefore collaboration across my schools is key to my position. The school of Health Sciences at Flinders takes a multidisciplinary approach and the departments collaborate closely together and with us. I take on any opportunity to work with any of my topics, researchers or academics. We are also starting to establish collaborative relationships with health research organisations that are affiliated with the University and our schools. Hence, I am currently working with the Cancer Council on a series of Systematic reviews.
- Steven: So what is the “embedded librarian”? It’s basically a metaphor for redefining librarians as partners who are fully integrated into the whole of a team rather than outsiders. For example, at Western Health, we offer a Clinical Librarian outreach service, which is an a huge and exciting trend in health librarianship. Let me offer a really cool example from the UK National Health Service (NHS), where NHS Clinical Librarians play a role as equal and active partners of the healthcare team. And when I say they’re “embedded” into clinical teams, I’m not exaggerating, they literally walk the ward rounds with doctors... with iPads... and they’re lucky and talented enough to be directly involved in patient care by searching and supplying evidence for clinical questions that arise in the hospital wards. This is something I’m ridiculously excited by and a bit of a dream of mine that I want to do one day! Nikki: The embedded librarian is an aspiration of every liaison librarian; to be embedded in the curriculum of your topics. I am lucky enough to have partnered with my major bachelor topic to create course content, design assignment questions, run workshops (for both students and tutors) and deliver the assignment lecture. This is a growing partnership, which I feel is well on the way to becoming embedded. I also guest lecture or run workshops in most of my other topics.
- Nikki: Check out our wordle! My son said it looks messy and confusing … I am glad as that was entirely my point. Medical terminology can look scary and I am sure both Steven and I have been caught out by this before. You are librarians so I'm sure you will follow this up! How many synonyms and acronyms do you think there are for Stroke? There are heaps. Let me know how you get on on Twitter ;-) The language can be intimidating, but there are tools to help. Text mining tools, as previously mentioned, can help you to find many alternative synonyms. But key from my perspective is carrying out effective reference interviews - your users are the experts in their fields and will know most of the terminology themselves. We are the experts at using the resources and efficient searching. Collaboration is key! The more searching you do however, the more the terminology does make sense. Steven: Yeah - I’ve actually come to enjoy navigating the architecture of medical terminology. At first sight it comes across as a confronting jumble of acronyms and long crazy words, but there’s actually a structured method to this madness. It’s a bit like playing lego with interchangeable Latin and Greek prefixes, root words, and suffixes. It makes sense once you put the lego pieces together! Or something. Or some metaphor better than mine.
- Nikki: So how did we get to where we are? What helped? Twitter has been amazing - both Steven and I take part in weekly #Medlibs chats, and I am hosting a chat in August. Medical librarians across the world meet weekly to discuss industry wide issues and share their knowledge. Also just for networking in general, Twitter is a great space to meet like-minded people. Steven and myself actually only met in person for the first time on Friday at the Quay Bar, after agreeing to co-present today on Twitter. Mentors, I cannot emphasis this enough … Find one!!! I am very lucky in that I adopted myself, I didn't give her a lot of choice, a very generous mentor who is always encouraging me to push my boundaries, and supports me when I have panic days. And yes I have heaps!! So, how as newbie, non-sciencey librarian do you learn about study designs, critical appraisal and systematic searching? There are heaps of free MOOCS out there on all aspects of health, and librarianship. In case you haven’t come across them yet a MOOC, or a massively online open course, is essentially a free online mini course. Check out Coursera.com .. you don’t need to do the assessments, just watch the lectures. Stephen and I actually just discovered yesterday that we are both currently doing the same MOOC. Steven: I definitely agree with Nikki that Twitter and online MOOCs have been amazing for my development as a librarian. I’d also like to mention two key associations which have provided excellent support for me. One of these is Health Libraries Australia, which is an ALIA group that publishes HLA News and also runs PD Days across Australia. The other is Health Libraries Inc, which is a Victorian-based association which I’m on the committee for - we run grassroots workshops and networking events as well as an annual Health Libraries Inc conference which is on 23rd October in Melbourne...so if you’re interested in health, you should come! So yeah, with both Health Libraries Australia and Health Libraries Inc - great support networks there to guide both young and experienced librarians through the maze of challenges in the healthcare environment. I’d also like to highlight the value of raw experience - be bold and make mistakes along the way!
- Nikki: My first year has been very challenging, but so rewarding. I feel myself very lucky to be working in the organisation that I am with, and in the challenging, inspiring and supportive health/medical team. I feel I have achieved so much already - but have only just started. This year my workload has grown dramatically, mostly through word of mouth across the school and between the researchers. On a personal note I am currently slowly working towards eligibilty to undertake a phd. And Steven and I are hoping to undertake a systematic review of our own very soon - time allowing. My mantra is to say yes to everything and stretch myself. I guess that's why I am here today too. Steven: So, one year later, we’ve both done lots of cool stuff. I think with the right attitude, the achievements will follow. For me, an intense curiosity about librarianship - both health-specific domains but also libraries in general - has served me really well. As Nathan Connor said yesterday at his keynote, be interested in everything! Curiosity leads to questions, which in a supportive environment leads to insightful answers from people much wiser than ourselves. The other thing I’d like to say is be active rather than passive. Be as active as you can! Even if you’re an introvert. Get into conversations to seek out information needs in your organisation and pitch ideas for projects that meet those needs. Join and contribute to a committee in your field - being part of the Health Libraries Inc committee has given me a bird’s eye view of the field and opened me up to some really critlcal conversations. Offer to write in their journal or newsletter if they have one - great practice, and great exposure for you. Find experienced librarians you respect and read their articles, email them for advice - they’re usually happy to help and I received some great advice from Suzanne Lewis, who was a health librarian who spoke at NLS6 who I emailed, for example.
- Nikki: There are so many options in the health / medical field and this here is just a small selection. With the rise of evidence based practice, and systematic reviews becoming the preferred option for publication acceptance, the opportunities for information professionals in health is rising. Clinicians need on the spot quality information, and with research in health still growing, there are researchers who need support. Steven: Career paths in health librarianship can seem contradictory. On one hand the field is seen as narrow and highly specialised. But on the other hand, there are an enormous variety of options on the edges of health librarianship - healthcare is a huge and complex area and they need highly skilled people who can manage data, search databases, and train users in health information literacy. So remember one of the common threads that’s popped up at NLS7: transferable skills, as Sally Turbitt and others have spoken about, it’s really important! I’m sure you’ll hear this around the traps plenty of times, but heaps of the fantastic, fulfilling roles out there may never have the word “librarian” in them at all! If you’ve got that SEEK.com alert set up, search wider than you usually would! Try “clinical informationist” or “informatics” or look for vendor jobs. Keep an open mind and think outside the box, and remember the boundaries of that crazy box are always shifting!
- Steven: So time is short and lunch is calling, so please feel free to send either of us questions on Twitter or via email or say to hi to us at lunch. We may not have animated GIFs or cute animal pictures, but we hope you found this useful or broadened your view of the trajectories out there. So...thank you for listening.