BRIEF COMMUNICATIONS little assistance. The next step was to request a MEDLINE search from the Health Sciences Library of the University of Virginia Medical Center. A trained search analyst formulated the search, which was available almost at once and resulted in the retrieval of seven references. Two of them were directly applicable to the case in question. They were a paper by E. M. Evans et al., entitled "Metal Sensitivity as a Cause of Bone Necrosis and Loosening of the Prosthesis in Total Joint Replacement" in the Journal of Bone and Joint Surgery (B) (November 1974); and one by P. G. Laing entitled "Compatibility of Biomaterials" in Orthopedic Clinics of North America (April 1973). A third article, an editorial in the November 1974 issue of the Journal of Bone and Joint Surgery (B) on "Metal Sensitivity," was also found to be relevant but incomplete. On the basis of the literature search, it was concluded that there was a relationship between rejection of orthopedic appliances and allergy to metals commonly responsible for hypersensitivity to jewelry. Moreover, the citations suggested the substitution of titanium, an uncommonly used metal, when metal allergy may be important. This information was transmitted immediately to the orthopedic surgeon. Surgery was performed as soon as a titanium appliance was received from the manufacturer. This experience demonstrated that the rapid retrieval of information through the MEDLINE system enabled the medical team to provide the best possible care without unnecessary delay and uncertainty. Although clinical circumstances permit consultation with local physicians, especially in a teaching-hospital setting, there remain a significant number of circumstances in which the particular information can be found only through a quick search of the relevant biomedical journal literature. It is in such circumstances that computerized retrieval by subject headings or title words becomes important. In short, with the MEDLINE terminal at hand and with a welltrained library staff, it is possible to tap the well of world medical authorities. In conducting a rapid MEDLINE search the library team became members of the health-care team. As this experience proved, more than one source of information was uncovered, including both British and American sources. The consultant who had been called to assist the surgeon was able to interpret the information supplied and to apply the information to clinical use.

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An Investigation of the Continuing Education Needs of New England Health Sciences Librarians BY CHING-CHIH CHEN, Associate Professor School ofLibrary Science Simmons College Boston, Massachusetts

IN order to determine the continuing education (CE) needs of health sciences librarians, a questionnaire, prepared by the students in my medical librarianship course in the spring of 1975, was sent to various librarians. The libraries chosen for this study were listed in the 1973 Directory of Health Sciences Libraries: the number of questionnaires mailed to each library corresponded to the total number of full-time staff members indicated in this directory. Since medical school librarians' experiences in CE may be different from those of other health sciences librarians, they were studied separately. A one-page questionnaire was formulated to determine general information such as position, length of service, training, and the like. The questions which are being dealt with in this paper were directly concerned with CE: whether CE courses were taken; the name of the course; when such courses should be offered; and whether respondents feel there is a need for such courses. Two hundred and eighty-five questionnaires were sent with a return of 184-111 by those without library degrees and 73 with professional degrees. As for the medical school librarians, there were 39 returns from eight medical schools in the area. Regardless of any previous CE experience, a large majority of the librarians from all groups -professional and nonprofessional, medical school or other health science libraries, at least 82% believed there was a need for CE. In terms of preference for the length and time of the CE courses, there was an overwhelming preference for a one-day course offered on a weekday. The next preferred time was a one-week course with 26 supporters as compared with 131 for the oneday course. Those librarians who expressed a positive need for CE were requested to list the desired courses by priorities. However, it was felt by the investigators that most respondents did not take the priority assignment seriously enough. The total number of different courses mentioned by the Bull. Med. Libr. Assoc. 64(3) July 1976

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respondents was fifty-seven. These courses are ar- to another, particularly between the MLS liranged in the following seven broad areas: brarian and the non-MLS librarian groups. The most desired course of both the medical Audiovisual materials, school librarians and the MLS librarians proved Computer and libraries (mainly MEDLINE and other to be management-although for the MLS lion-line data bases), brarians there were two other courses with the Library administration and management, same number of votes (fourteen), namely, audioviLibrary and its users, Library operations and materials, sual materials, and MEDLARS and MEDBiomedical subject knowledge, LINE-while the non-MLS librarians' priority Other. An unquestionable difference was apparent between librarians with and without MLS degrees. MLS librarians favored courses in the areas of library administration and management, and computer systems and on-line data bases. The non-MLS librarians (38% of the total) indicated a strong need for a course in library operations and materials. Similar contrasts in CE concerns were also found in the study by Rothenberg, Rees, and Kronick [1]. The least desired course area (of those listed) for medical school librarians (4%) and non-MLS librarians (6%, although the category "other" was 5.4%) was biomedical subject knowledge; and for the MLS librarians (5.6%) the least popular course area of those listed was the library and its users. To better understand the desires of the health sciences librarians it may be helpful to study the ten most desired individual courses identified by the respondents of the survey. The top ten courses received nine or more entries in the returns, and these courses accounted for 62% of the total 387 entries, while the other 47 courses accounted for only 38%. As a whole, the five most favored courses are: Management, Audiovisual materials (general), Reference sources update, Cataloging and classification, MEDLARS and MEDLINE.

The next five courses are: Budget, Systems analysis, Library automation, Audiovisual materials (cataloging), Selection policies.

These last five courses ranked substantially lower than the five most desired courses (from thirtyfour to twenty-three fewer votes). The ranking of these courses differs substantially from one group Bull. Med. Libr. Assoc. 64(3)July 1976

was cataloging and classification, with second choices of audiovisual materials (twenty tallies), and reference sources update (nineteen tallies). The medical school librarians' second priority was for a course covering aspects of MEDLARS and MEDLINE.

CONCLUSION Ideally, each individual librarian should view CE as a lifelong process and the responsibility should be his or her own. As one medical school library respondent stated [2]: "My CE is continuous, but is rarely in the form of organized courses." However, in most cases, individual commitments are not adequate. Effective, wellplanned, and carefully coordinated CE programs are badly needed. The effort in this kind of program planning for meeting the CE needs of health sciences librarians should be jointly shared by all concerned-health sciences librarians, library administrators, library educators, the MLA, and regional and local professional groups. Although this survey confirms findings of some earlier studies [1, 3-5], it also adds new dimensions in terms of the problems and issues related to CE today. While only a small percentage of New England health sciences librarians refuted the importance of CE, the survey investigators sensed a general feeling of frustration and concern about the lack of coordination in CE efforts for health sciences librarians; the limitation in pertinent course offerings; the incompatibility of CE course contents to the needs, level of education, and background of the participants; the tardiness in providing new but badly needed courses; and many other things. The ideal course formats would be for one-day sessions delving into management, administration, and computers for the MLS librarians. For the non-MLS librarians, courses dealing with library materials, operations, and cataloging seem to be in most demand. (Of course, these two groups of subjects are not mutually exclusive.) All these problems should be real challenges to all of us! 323

BRIEF COMMUNICATIONS I have deliberately avoided any discussion of the potential problems and issues confronting health sciences librarians in the area of CE and recertification. Discussion of these problems would require a separate article. Many of the questions were raised and discussed at great length at the Kansas and San Antonio annual meetings of MLA, and have appeared in several issues of MLA News. Similar questions and issues have confronted other professionals such as physicians [6] and lawyers [7, 8]. REFERENCES 1. ROTHENBERG, LESLIEBETH; REEs, ALAN M.; AND KRONICK, DAVID A. An investigation of the education needs of health sciences library manpower. Part IV: Characteristics of manpower in health sciences libraries. Bull. Med. Libr. Assoc. 59: 31-40, Jan. 1971. 2. STONE, ELIZABETH W. Quest for expertise: a librarian's responsibility. Coll. Res. Libr. 32: 432-441, 1971. 3. KRONICK, DAVID A.; REES, ALAN M.; and ROTHENBERG, LESLIEBETH. An investigation of the education needs of health sciences library manpower. Part V: Manpower for hospital libraries. Bull. Med. Libr. Assoc. 59: 392-403, July 1971. 4. STONE, ELIZABETH W. Factors Relating to the Professional Development of Librarians. Metuchen, N.J., The Scarecrow Press, 1969. 5. REES, ALAN., et al. Feasibility Study for the Continuing Education of Medical Librarians. Cleveland, Ohio, Case Western Reserve University Press, 1968. 6. U.S. DEPT. OF HEALTH, EDUCATION, AND WELFARE. OFFICE OF ASSISTANT SECRETARY FOR HEALTH AND

SCIENTIFIC AFFAIRS. Report on Licensure and Related Health Personnel Credentialing, June 1971. DHEW Publ. no. (HMS) 72-11. Washington, U.S. Govt. Print. Off., 1971. Chap. IX. Continuing education (p. 57-63). 7. Lawyers may be required to renew licences. Mass. Lawyers Weekly 3: 1, Jan. 27, 1975. 8. Questions about mandatory continuing legal education. Mass. Lawyers Weekly 3: 1, 12, Jan. 27, 1975.

Determination of Overlap in Coverage of Excerpta Medica and Index Medicus through SERLINE BY JOYCE L. DOLCOURT, Library Assistant ROBERT M. BRAUDE, Librarian Denison Memorial Library University ofColorado Medical Center Denver, Colorado

IN 1954 one aspect of the Welch Medical Library Indexing Project, entitled Survey of World

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Medical Serials and Coverage by Indexing and Abstracting Services, was issued by Himwich et al. [1]. This study attempted to determine the coverage of biomedical periodical titles by the existing indexing and abstracting services. It also sought to determine the coverage of individual journal articles by these services. A composite list of journal titles was constructed using the published lists of the journals indexed or abstracted by Quarterly Cumulative Index Medicus, Current List of Medical Literature, and Excerpta Medica. The lists from Index-Catalogue, Biological Abstracts, and Chemical Abstracts were checked for titles relevant to medical interests; these titles were added to the composite list. Bibliographic data for each title were then collected and coded on IBM cards, using the collections of the Armed Forces Medical Library, the Welch Medical Library (Johns Hopkins University), and the Library of the American Medical Association. Once compiled, the data were sorted for combinations of code information producing various results; among these was the overlap in coverage by indexing and abstracting services. Since 1954 no attempt to update the information on the overlap in coverage of Excerpta Medica and Index Medicus has been published. Overlap in coverage does appear to be a current problem, however, for James Wood et al. reported on a study conducted by the Chemical Abstracts Service, Engineering Index, Inc., and the Biosciences Information Service of Biological Abstracts, that determined the overlap in the journal titles monitored by these three services

[2]. Determination of the overlap in coverage of indexing and abstracting services is not a mere academic exercise. These tools represent a substantial portion of the serials budget. With troubled finances, with reduced library budgets, with decreased purchasing power for the U. S. dollar because of inflation and devaluation, librarians are all too aware of increased prices for traditional reference tools. For example, in 1970 Excerpta Medica cost $1,239 while Index Medicus cost $63. In 1975 Excerpta Medica had raised its price to $5,166 compared to $173 for Index Medicus. With rising costs a factor, this study was undertaken not only to update that portion of the Welch Medical Library report dealing with overlap in the coverage of Excerpta Medica and Current List of Medical Literature (the predecesBull. Med. Libr. Assoc. 64(3)July 1976