Journal of Avian Medicine and Surgery 28(3):251–256, 2014 Ó 2014 by the Association of Avian Veterinarians

Round Table Discussion

Avian Health Information Management in the Digital Age It seems that we lived in simpler times 20 years ago when I graduated from veterinary school. There was the Journal of the Association of Avian Veterinarians and a few other zoological companion animal journals, conference proceedings, and books, but it seemed easy to keep track of print materials on a book shelf. I knew exactly where to look on my shelf to find the information I needed. Simple. Fast forward to today, and it doesn’t take a rocket scientist to realize that each and every one of us is inundated every day by information everywhere we turn. We can access digital content in text, image, audio, and video format anytime we like from laptops, tablets, and smartphones. There are more professional journals and conferences, more books, and more continuing education resources than I can ever remember. More and more content is available online. Because evidencebased avian health information can sometimes be challenging to find, this is of considerable value to avian medicine. Despite being published 4 years ago (an eon of time in the digital world in which we now live), the review article ‘‘Finding avian health information’’ (Paul-Murphy J, J Exot Pet Med. 2010;19(2):151–159) is still an excellent resource for finding print and digital content in avian medicine and for determining which online search engines and other resources to use. Along with the advent of digital content, numerous reference and note management software programs have been developed to help organize ever-growing collections of digital information. I have tried most of them and have settled on Ultra Recall by Kinook to manage my databases, but I wondered how others were managing their print and online content. Contributors to this discussion include Kathryn C. Benson, DVM, 2014 graduate, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA; Jo˜ao Brand˜ao, LMV, MS, resident in Avian and Zoological Medicine, Louisiana State University School of Veterinary Medicine, Baton Rouge, LA, USA; Jennifer Graham, DVM, Dipl ABVP (Avian Practice), Dipl ABVP (Exotic Companion Mammal Practice), Dipl ACZM, Assistant Professor of Zoological Com-

panion Animal Medicine, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA; Michelle G. Hawkins, VMD, Dipl ABVP (Avian Practice), Director, California Raptor Center and Associate Professor, Companion Exotic Animal Medicine and Surgery, University of California Davis School of Veterinary Medicine, Davis, CA, USA; Krista A. Keller, DVM, resident in Zoological Companion Animal Medicine, University of California Davis School of Veterinary Medicine, Davis, CA, USA; Amber Lee, BVSc, resident in Avian Medicine and Surgery, Avian and Exotic Animal Clinic of Indianapolis, Indianapolis, IN, USA; Angela M. Lennox, DVM, Dipl ABVP (Avian Practice), Dipl ABVP (Exotic Companion Mammal Practice), Dipl ECZM (Small Mammals), Avian and Exotic Animal Clinic of Indianapolis, Indianapolis, IN, USA; and Anna Osofsky, DVM, Dipl ABVP (Avian Practice), Carrollton West Pet Hospital, Carrollton, TX, USA. Lauren V. Powers, DVM, Dipl ABVP (Avian Practice), Dipl ABVP (Exotic Companion Mammal Practice), Service Head, Avian and Exotic Pet Service, Carolina Veterinary Specialists, Huntersville, NC, USA, and Adjunct Assistant Professor, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA. Question: How long have you been practicing avian medicine? Dr Benson: I am a 2014 graduate of North Carolina State University College of Veterinary Medicine. Dr Brand˜ao: Approximately 5 years. After graduating, I have done several exotic and zoological medicine internships; Great Western Referrals (Swindon, UK), Tufts University (North Grafton, MA), and the University of Georgia (Athens, GA). I am currently the 3rd-year resident at Louisiana State University. 251

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Dr Graham:

Dr Brand˜ao:

I have been practicing avian medicine for 15 years. I graduated in 1999 and completed an avian/ exotic internship at the University of Georgia followed by a 3-year avian/exotic residency program at the University of California Davis. I started an avian/exotics department at a specialty practice in Seattle and was there 3 years before moving to Boston to work at the Angell Animal Medical Center. I was there 6 years before coming to the Cummings School of Veterinary Medicine at Tufts University.

Currently, most of the printed documents that I get are books, mainly because some of them are older versions that are not available in digital format. I tend to get journals and proceedings in digital format. I still rely on libraries and printed copies of older journals because some are not available in digital format.

Dr Hawkins: 17 years. Dr Keller: I have been practicing avian and zoological medicine for the length of my residency at University of California Davis, 3 years. Before that, I completed an internship in Small Animal Medicine and Surgery at Louisiana State University. Dr Lee: I have been a veterinarian for 3½ years and have been practicing avian medicine exclusively for nearly a year as a resident in Avian Medicine and Surgery. Dr Lennox: 22 years. Dr Osofsky: I have been practicing avian medicine for 15 years. Question: Do you still receive and read print journals, conference proceedings, books, and professional magazines? Dr Benson: During school, I used to receive the Journal of Avian Medicine and Surgery (JAMS) in print up until this year and I also receive the Journal of Exotic Pet Medicine (JEPM) in print. This year, I chose to have access to JAMS online because it was cheaper than having journal mailed. Everything else, I access online.

Dr Graham: Yes. I currently receive JAMS, JEPM, Journal of Herpetological Medicine and Surgery, Journal of Zoo and Wildlife Medicine, and receive conference proceedings for all associated organizations. I also subscribe to Veterinary Clinics of North America: Exotic Animal Practice and Lab Animal. I keep current with textbooks and my library has updated texts covering avian, small mammal, reptile, and zoo species. Dr Hawkins: Some. I still enjoy sitting down with a printed journal and reading through the entire journal, it helps me to remember in which journal and issue I found an article. However, most of my reading of the literature is now from electronic resources. Dr Keller: I do not receive or read printed journals, conference proceedings, or professional magazines. Although I prefer most books in digital format, I do have a few printed books. Because of accessibility, I tend to use the digital copy of the books that I have as both digital and printed sources. Dr Lee: I do still read some print journals such as JAMS and Journal of the American Veterinary Medical Association, but only those which I have a subscription for. Dr Lennox: Yes, some of them. Dr Osofsky: I do still receive print journals. My primary conference each year is the AAV conference and they are no longer providing printed proceedings. I have to admit that I do prefer to have a printed

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copy of the proceedings and I reference them less now that I have to find my thumb drive to open them and review. Question: Do you prefer print or digital content, and why? Dr Benson: I feel like there is value to both digital and print copies, but I prefer hard copies when it comes to reading journal articles and other professional information. Digital copies are beneficial when I am doing research on a topic, or I am looking for a particular piece of information. I prefer hard copies when I find a journal article of interest. I find reading a sheet of paper a lot more comfortable than reading a computer screen, and I find that writing notes and highlighting on the document helps me make connections and understand the material better than when I am reading a digital copy.

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a journal and reading all the way through it. Having said that, in the clinic, when we see a lesion or abnormality that we have not seen before, it is so quick and easy to perform an electronic search and download the papers or a textbook to have on an almost immediate basis. I believe this has greatly improved our response to specific issues and helps us organize our differential list much more quickly in some cases. Dr Keller: I prefer digital content. At first, developing a digital library was out of necessity as the last 8 years of my life has included a lot of traveling in pursuit of my education and moving a large library of textbooks and journals was not possible. Now, I like the feeling of having an entire library of information readily accessible on my computer; I can read from a multitude of textbooks, conference proceedings, and journals anywhere in the world as long as I have my trusty laptop!

Dr Brand˜ao:

Dr Lee:

Digital. It makes it a lot easier to transport. Instead of having kilos worth of paper, I can have everything in the computer, thumb drive, or on a tablet. The advent of the tablets has made it extremely easy to read and transport books and papers. With the current available apps, you can highlight and take notes as if it was a book. I do like the ‘‘feel’’ of a book but it is a lot more comfortable to use a tablet nowadays.

For my residency I am required to read several journals and online access with digital content is easier for me because of the volume of material and also it is easier to find articles because of the key-word search function. I still do like to read printed material so I often print some articles, but I am getting better at reading material online and saving trees. Dr Lennox:

Dr Graham: I prefer print content, especially for conference proceedings. I don’t feel like I have really ‘‘graduated’’ to the digital age and enjoy having printed materials whether it be books, journals, or proceedings. I am much better about flipping through a printed journal to keep up on topics and find myself forgetting to scan through the digital resources as they are not sitting directly in front of me. I realize that many groups are converting to digital-only formats but I am fighting this transition for as long as I possibly can! Dr Hawkins: I am still struggling to make the complete change to digital content because I am slow in making the neural connections to where the content came from as easily as when I am holding

I am currently ambivalent about this. . .at one point I greatly preferred print, as I could highlight and write notes in the margins; however, with all the information I have to manage I now find myself going back to digital sources. I am considering dropping some print sources. Dr Osofsky: I like to use both print and digital content depending on the circumstances. I prefer my journals in print as this allows me to place them strategically around the house or clinic. If I have a moment when my children/nurses/receptionists do not need me, I can read an article. If I am researching a clinical case or working on a publication, I prefer digital content that I can access online no matter where I am (with the exception being textbooks). I always reach for the

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hard copy of a book over the CD version (if available); I suppose I am just used to looking things up in the actual book—I love my Kindle, but I do not like having to (figuratively) thumb back and forth on it! Question: When researching a topic of interest, what online search engines and other resources do you use? Dr Benson: As a student, I commonly used the search engine through the veterinary school library as well as PubMed and ISI Web of Science. Dr Brand˜ao: I think the online search engine I rely on the most is Google Scholar. To a lower extent, I use PubMed and ISI Web of Science. I prefer Google Scholar because it has a very broad search spectrum and does not depend on only one database. Also, it provides direct access to open source documents and some grey literature. PubMed is great but it seems more limited because it only provides information on the MEDLINE database. Another advantage of Scholar over PubMed is that it is very easy to do prospective searches on a particular paper. It lists all the newer articles that have cited a certain paper, which makes it easier to find more recent publications. Furthermore, it provides citations for EndNote. One of the negative aspects of Scholar is that it occasionally provides nonscientific information. Dr Graham: I have access to the Tufts online library so this is my main resource. If our library does not carry an item I need, I can request material through an interlibrary loan through a service called ILLiad. If I am in a hurry, I use Google Scholar. When I am referencing material for a manuscript I generally use PubMed, BioOne, and CAB Abstracts. If I am investigating a specific syndrome or emerging disease I will use Veterinary Information Network (VIN) and reach out to individual veterinarians or pathologists who may be seeing similar cases. Dr Hawkins: PubMed, BIOSIS Previews, ISI Web of Science, CAB Abstracts, Google Scholar.

Dr Keller: The first search engines that I use for all topics are PubMed and BioOne. Due to experience using these search engines I feel very comfortable using the search and advanced search features. These search engines have the added benefit of being freely accessible to anyone. Additional resources that I turn to are ISI Web of Science and Scopus. However, these search engines require a subscription, which is generally limiting to veterinarians outside of academia. Dr Lee: I use Purdue University’s journal search engine primarily because my partner is a student there so I can use his access to their journal database. I also use some free online textbooks from www. exoticdvm.com. Another resource to consider would be have an ‘‘editor’s pick’’ where the reviewers of a journal would choose the best journal articles to highlight certain topics (both new and old) as a kind of spotlight so fellow avian veterinary professionals can read those ground-breaking articles to gain access to that valuable knowledge. This could also be approached by opinion pieces by top specialists who comment or review these articles and talk about why they are important with the new information presented. Dr Lennox: PubMed, Scopus, AAV and AEMV Web sites for conference proceedings, JEPM Web site for JEPM, as well as the Purdue University journal access (perk of being an adjunct professor). Dr Osofsky: Especially with clinical cases, I will often review relevant cases and publications on the topic on VIN; in exotic pet medicine, sometimes ‘‘In My Experience’’ information on VIN is all I can find. I always like to see what other veterinarians are doing to manage cases. If I am working on a publication or need to find the latest research on a topic, I use VIN, PubMed, and the Texas A&M University library search engines. Texas A&M University has a fabulous service for veterinarians in private practice in Texas called ‘‘Get It For Me.’’ This service is free as long as they have the material requested within their library system. The user places an online request

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for the material and it is e-mailed (either as a scanned document or as a link to an online document) within a few days. I feel so lucky to have this service! Question: Is open access (free to all) content important to you? Dr Benson: As a new graduate, the realization of the cost associated with accessing some journals and resources is becoming a growing concern. I’m growing increasingly interested in open access content because it would allow me to get information for free instead of paying for it. Dr Brand˜ao:

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Dr Lee: Open access is very important to me, as a resident studying for my exams. If I or my supervisor did not have access to all the online literature, then I would find it very difficult to study for my board exams as well as looking to the literature to learn when I have difficult or interesting cases. If an organization such as the ABVP could partner with an online search engine such as Web of Science via a paid subscription, and then offer this resource to its residents and diplomates, then this would provide a great learning opportunity. Dr Lennox: It certainly makes things much easier. Dr Osofsky:

Yes! I think it is a great resource. In my case, I have access to academic libraries so I can get a lot of publications, but for someone that does not have academic library resources, it may be difficult to get some of the peer-reviewed papers. I think open access journals allow easy and free access to good literature. But, like traditional journals, it is important to guarantee quality of the peer-review process. Dr Graham: Yes. I realize not everyone has access to a university library and it is difficult to thoroughly research a topic without access to published materials. Open access materials provide a way for all individuals to access this information. Dr Hawkins: Absolutely, as it is simple to point referring veterinarians outside the university to specific papers about their case that they can download on their own. Being in the university, it is not very important to me specifically at this point in my career as I have library access, but for all those that do not have the luxury of having access to an electronic library open access will become very important in the future.

For the most part, I like open access content. It is frustrating to see a tantalizing abstract, but not have access to the full paper. Also, clients have access to all sorts of questionable information online so we may as well allow them access to good information. The one caveat would be something like VIN. I think clinicians might be hesitant to ask questions about cases if they think their clients might be reading their posts; it might detract from their role as the expert (though I have historically printed out my VIN posts for clients since I am usually up front about needing help on tough cases). Question: How do you manage large volumes of print or digital scientific content? Do you use reference management software programs such as EndNote, Mendeley, Zotero, RefWorks, Papers, or other note management programs such as Evernote? Dr Benson: I honestly have not used software programs to manage reference material. What I have done for school and research previously was keep a Microsoft Word document with the citations listed and, retrospectively, I wish I had taken the time to learn about some of the reference software.

Dr Keller:

Dr Brand˜ao:

Open access is incredibly convenient as I am searching for articles to read; however, I do not prioritize publishing in a journal with open access.

I rely heavily on EndNote, both to manage my personal database as well as to generate citations for my publications. I have tried to use some other

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software but I am used to EndNote, so it is easier to use only that one. I also scan my printed papers and add them to my EndNote library. I keep my library in my computer but I do regular backups so I don’t lose the information.

remember to save a copy with your reference data attached to it, it can be very difficult if you need to rearrange any references after the paper has been reviewed. Dr Keller:

Dr Graham: I probably have the most experience with EndNote but have occasionally used Mendeley and Zotero. I have to confess that I have moved away from cataloging volumes of information and generally research as I work on a particular topic. I use dropbox.com and box.com for holding manuscripts that I have scanned and don’t otherwise have easy access to through the library. Dr Hawkins:

I have tried EndNote but did not find it to be useful for me. My downloaded digital scientific content is self-indexed on my laptop. It is a labor to perform the downloading, naming, and filing of the PDF documents, but I find that because I have put so much time into the organization that I have a better grasp of what content I have available to me. Although I may consider using another software system in the future, right now my personal system seems to be working well for me. Dr Lee:

I use EndNote and Mendeley. Mendeley has gotten better about being able to recognize the metadata associated with the paper and so it renames the download with specific author, title, journal, and year data with much more accuracy than previous versions. This naming of the articles is important to me to be able to find papers in the future easily, and has significantly reduced the amount of time I used to spend renaming downloaded articles. You can share your databases, which can be very useful for many reasons; in the university, the residents share theirs with others when they are studying for boards for example. EndNote is very useful as a reference manager database. I use this for reference-building for manuscript writing. You can do electronic searches and download directly into the program, whereas in the past we had to manually type each reference into the database so that is a big time-saving aspect now as well. Many reference managers, including EndNote, have the ability to format your reference list specifically for hundreds of journals, also saving a huge amount of time. The only downside is that many journals request that you ‘‘turn off’’ your reference manager from your manuscript due to interference with editorial software. If you don’t

I have just started writing my case report for my ABVP boards, and in my research came across reviews for some of those reference management software programs. I ended up choosing Zotero and have had some success using it so far. My partner uses Mendeley and he said it is very similar to Zotero, both of which seem to be very userfriendly. Otherwise for my own study purposes I just categorize all of my articles into folders on my hard drive. Dr Lennox: I have not actually heard of any of the above. I will look into it! Dr Osofsky: Sadly, I do not have a general reference library on EndNote; I wish I were that organized. As a resident I had a nicely organized file cabinet full of all the relevant exotics papers. That was 10 years ago and now I have to do online searches to find the papers I need/vaguely recall reading. Thank goodness for the Internet!

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