COMMENT AND OPINION Observations on the cross*training of health sciences academic and general academic reference librarians The Reference Services Department of University Library Services at Virginia Commonwealth University (VCU) offers a possibly unique work experience through its cross-training program between the general academic library (the James Branch Cabell Library) and the health sciences library (the Tompkins-McCaw Library). The Cabell Library services 16,000 students and faculty on the academic campus; the TompkinsMcCaw Library serves 3,000 students, interns, residents, postdoctoral fellows, and faculty on the Medical College of Virginia (MCV) campus. In brief, the cross-training program, which has been in effect for over two years, involves selected reference librarians and staff attending the reference desk of what may be called their nonbase campus library for between two and six hours per week. The possibility of cross-training between the facilities has been brought about by the particular organizational structure of VCU and its libraries. The university was established by the General Assembly of Virginia in 1968 by merging the former Richmond Professional Institute and the Medical College of Virginia, incorporating a large, comprehensive medical center with a broad range of undergraduate and graduate programs. The university has two designated divisions but operates as one institution with two campuses. The academic campus offers undergraduate and graduate programs in the Schools of the Arts, Humanities, Business, Community and Public Affairs, Education, and Social Work. The MCV campus offers programs in the Schools of Allied Health Professions, Basic Health Sciences, Dentistry, Medicine, Nursing, and Pharmacy. The Tompkins-McCaw Library and the 64
James Branch Cabell Library, as well as learning resource centers and media services on each campus, are all components of university library services and are under one director. The health sciences and the general academic libraries are operated as one library in two locations. Through participation in the cross-training program, one can not only observe but also experience similarities and differences between health sciences and general academic reference work, and can come to know some of the benefits and difficulties inherent in such a program. University and library administrators may find these observations useful if they wish to consider similar cross-training of librarians; both new and experienced librarians may find them interesting if they are approached with the cross-training possibility or are considering changing career directions. A description of the similarities and differences between health sciences academic and general academic reference librarians is in order before mentioning the benefits and difficulties in cross-training. The description here is limited to the librarians' sense of mission; the value they place on various subject areas; differences in their clientele, terminology, and sources of information; and organizational hierarchies and networks. This description is based on observations and perceptions, not on technical studies. From experience it would appear that few reference librarians are without a sense of mission. That sense, aside from financial reward or anything else, is a prime element in keeping the reference librarian coming back day after day. The mission of the health sciences academic reference librarian would
seem to be to educate and assist all those who contribute to the good health of humankind, while the mission of the general academic reference librarian would seem to be to educate and serve the student or seeker after knowledge or information or to open up vistas of knowledge and the techniques for finding it, to enrich the individual for a lifetime. Besides mission, there are other potent energizers of the reference librarian, regardless of area. Included among them are both introverts and extroverts, and individuals with various other personality differences; but almost without exception, they are highly energized by heavy doses of what are usually affirming interpersonal relationships with library users, the satisfaction of intellectual curiosity, or the excitement over a novel bit of information. Reference librarians are a bit of the ham combined with the teacher or helper. All share a high degree of intellectual curiosity, but it would seem that health sciences academic reference librarians rank health-related information as higher in value than any other. The mention of affirming interpersonal relationships leads naturally to the subject of what similarities or differences there may be in the persons, served by these two types of librarians. In general terms, despite the exceptions, the general academic reference librarian will see the young, novice, undergraduate library users, some of whom are openly fearful of a large library facility. To these librarians, such students represent the utmost challenge. These are the still-supple twigs that may be bent to use, to learn, and to enjoy the information-finding process; or they may be easily lost to the process by small expressions of impatience or Bull Med Libr Assoc 78(1) January 1990
Comment and opinion
indifference on the part of the reference librarian. In the health sciences academic library, by contrast, one sees the older, established professional and faculty member, or the graduate student preparing for a health-related profession. These individuals bring to bear on the reference librarians who seek to serve them a greater knowledge of their subject matter in most cases, an intensity of focus, a determination to persist, and the pressures for accuracy, timeliness, and speed that their professions or future professions demand of them. The atmosphere around such individuals may be described as something of a "no-fooling world," which comes to embed itself in the understanding of the health sciences academic reference librarians, who are highly aware of their clients' need to be competent and beyond reproach of their treatment of patients, of the cost of human life or health for their errors, of the potential for lawsuits if they are found to be sloppy or negligent, and of the pressures to publish or perish. What resources do these library users need, and what kinds of questions are they asking? For health sciences academic reference librarians, the answer to the first question is easy: journals. Although other sources might be used, the client would be harmed to the greatest degree without the journals and all the indexing leading to them. Information needs in a rather short time will run from biographical data on an Austrian malaria expert of the nineteenth century, to meetings related to anesthesiology to be held in Florida next month, to an article related to renal transplants and a specific drug, to evidence that a physician practicing in the Richmond area between 1955 and 1960 could have been aware of the potential hazards of XYZ. Although this is certainly diversity of subject matter, it doesn't apBull Med Libr Assoc 78(1) January 1990
proach the diversity in the general academic library. There, within an hour or two, information needs may run as follows: articles on distant point copying; financial data on a small, privately held company in New Jersey; a reproduction of the Egyptian heiroglyphics on a particular monument; criticism of Ibsen's "Ghosts"; and articles on the history of feminism in Latin America. Besides diversity in subject matter, is there something basically different about how one goes about finding needed information? Experience would say, no. The tools for finding information in both libraries are of similar types and their organization does not often vary in ways that would deter use, although new terminology can present at least a temporary obstacle in communications with clientele. Organizational hierarchies and networks are not exactly the same for health sciences academic reference librarians as for general academic reference librarians. Both groups, no doubt, come out of library schools with extensive information as to how they will relate to various networks on the international, national, regional, state, and local levels. However, health sciences academic reference librarians are committed to the delivery of needed information to health care personnel and to the health care consumer, from the metropolis to the boondocks, and operate, as we know, in a hierarchy with the National Library of Medicine (NLM) as the apex; NLM acts as the key to a nationwide datagathering system that connects widespread centers of expertise and forms them into a resource available to all. There is no such equivalent network of hierarchical arrangements in existence for general academic libraries. One does not function well as a health sciences academic reference librarian without understanding the responsi-
bilities and connections of the health libraries hierarchy and the ways in which, for example, the health sciences academic librarian is expected to interact with local hospital libraries. There are obvious benefits to be realized in a cross-training program. It affords administrators flexibility in the assignment of personnel where needed, even if temporarily. It promotes greater knowledge of the total library resources available, resulting in more frequent and appropriate referrals; this benefits library users and improves use of the collections. Crosstraining can stimulate and reinvigorate long-term personnel by exposing them to different subjects and clientele. It can serve as the experience that convinces a librarian that a career change to another library field would be more enjoyable-or conversely, that the initial subject field is, indeed, the one preferred. Undetermined thus far is whether cross-training improves marketability of the librarian in any way. Difficulties in carrying out such a cross-training program could include the contrasts between reference librarians in their sense of mission and in their perceptions of what subject areas are most valuable in society. Those whose sense of mission is most focused and whose devotion to certain subjects and clienteles is most compelling will very likely not be interested in cross-training and, in fact, may actually resent it. Characteristics of clientele in a health sciences academic library can be disconcerting to general academic reference librarians who are more attuned to the characteristics of undergraduates. Although types of reference tools used do not vary significantly, lack of familiarity with terminology can present difficulties in communications with library users. For health sciences academic reference librarians, the nature of the hierarchical network in which they 65
Comment and opinion
are involved is quite demanding and leaves them little time or inclination for involvement in other networks. In conclusion, a cross-training
program can benefit library administrators, be both positive and negative in terms of library users, and serve the desired purposes of some librarians, but not of all.
Mary Ellen Thomas Tompkins-McCaw Library Medical College of Virginia Virginia Commonwealth University P.O. Box 582 Richmond, Virginia 23298-0582
Remembering our history: the roots of knowledge* studies the page for a few moments, then turns to the librarian. "I guess I would rather have a computer search. I don't want to copy all this stuff." Professor Johnson greets a librarian in the corridor of the Medical Center. "Your online catalog is wonderful. I access it from my office, and I never come to the library anymore." Dr. Tim Walsh is a first-year resident. He smiles at the librarian. "Look at this-it's wonderful and I did it myself!" He picks up his printout with 250 citations produced from a CD-ROM database. These are daily occurrences in our institutions, and they are achieved by the advances in technology. There is nothing wrong with the technology: databases allow access to the literature that cannot be achieved through manual searchand he learned from reading how ing; the online catalog provides to use a stethoscope and to take a keyword access to holdings in a university-wide system that the history from the patient [1]. That setting was grand rounds. printed catalog cannot; and CDHere is another: The librarian ROM gives users a chance to exshows a medical student the print- plore the database without online ed Science Citation Index.t "This is charges. The technology is a trethe author you asked about and the mendous asset to librarians who specific paper from 1984," ex- seek information and who help plained the librarian. "The items users to unearth it. The technology listed below are the papers that cit- has increased our capabilities and ed the 1984 paper. Thirteen of productivity; it has enhanced our them-that will give you plenty of image and enriched the scope of relevant articles." The student our jobs. I use it. I like it. And I want every electronic device that Presented May 22, 1989, at the Eighty- helps manage and transfer inforNinth Annual Meeting of the Medical Li- mation and knowledge. What, then, is the problem? My brary Association, Boston, Massachusetts. t Science Citation Index is a registered trade- concern is that these electronic mark of the Institute of Scientific Infor- marvels have become the driving mation. force of our libraries, that we no
One of the places that a physician or scientist can tell a poignant story about a patient or write about personal concerns in medicine is in the JAMA series "A Piece of My Mind." One such "piece" was Michael A. Lacombe's description of a medical student presenting a patient at grand rounds. The student examines the patient with his hands, with a stethoscope; he observes and listens. That his diagnosis is correct astounds the audience, for he has not used the latest techniques and devices to arrive at his diagnosis. His professor chides him for not using the patient's "database," questioning how he could consider diagnosing without the aid of a computer. The student'replies that he had found some old books on physical diagnosis that were not in the database,
*
66
longer determine what we can do more effectively without them or in other ways. We do only what the machine is capable of doing. Consider the three examples: the medical student misses the unique information Science Citation Index offers because searching through the volumes takes time and so she chooses a quick computer search instead; the professor knows only those resources he finds in an inadequate search of the online catalog, but no longer handles or browses through the riches of the library's collection; and the resident retrieves hundreds of citations, wondering why so many seem irrelevant. The machines performed their tasks very well, but the librarians did not provide these users with the best sources and information. Lewis Thomas says, "Medicine is no longer the laying on of hands, it is more like the reading of signals from machines" [2]. Of course, many of these machines help to cure patients and Thomas' concern is not that the change has made the doctor less able to cure the patient, but that the doctor-patient relationship has lost meaning. He adds, The close-up, reassuring warm touch of the physician, the comfort and concern, the long, leisurely discussions ... are disappearing from the practice of medicine, and this may turn out to be too great a loss, for the doctor as well as for the patient [3].
Are we librarians so enamored with our electronic tools that we Bull Med Libr Assoc 78(1) January 1990
James Branch Cabell Library, as well as learning resource centers and media services on each campus, are all components of university library services and are under one director. The health sciences and the general academic libraries are operated as one library in two locations. Through participation in the cross-training program, one can not only observe but also experience similarities and differences between health sciences and general academic reference work, and can come to know some of the benefits and difficulties inherent in such a program. University and library administrators may find these observations useful if they wish to consider similar cross-training of librarians; both new and experienced librarians may find them interesting if they are approached with the cross-training possibility or are considering changing career directions. A description of the similarities and differences between health sciences academic and general academic reference librarians is in order before mentioning the benefits and difficulties in cross-training. The description here is limited to the librarians' sense of mission; the value they place on various subject areas; differences in their clientele, terminology, and sources of information; and organizational hierarchies and networks. This description is based on observations and perceptions, not on technical studies. From experience it would appear that few reference librarians are without a sense of mission. That sense, aside from financial reward or anything else, is a prime element in keeping the reference librarian coming back day after day. The mission of the health sciences academic reference librarian would
seem to be to educate and assist all those who contribute to the good health of humankind, while the mission of the general academic reference librarian would seem to be to educate and serve the student or seeker after knowledge or information or to open up vistas of knowledge and the techniques for finding it, to enrich the individual for a lifetime. Besides mission, there are other potent energizers of the reference librarian, regardless of area. Included among them are both introverts and extroverts, and individuals with various other personality differences; but almost without exception, they are highly energized by heavy doses of what are usually affirming interpersonal relationships with library users, the satisfaction of intellectual curiosity, or the excitement over a novel bit of information. Reference librarians are a bit of the ham combined with the teacher or helper. All share a high degree of intellectual curiosity, but it would seem that health sciences academic reference librarians rank health-related information as higher in value than any other. The mention of affirming interpersonal relationships leads naturally to the subject of what similarities or differences there may be in the persons, served by these two types of librarians. In general terms, despite the exceptions, the general academic reference librarian will see the young, novice, undergraduate library users, some of whom are openly fearful of a large library facility. To these librarians, such students represent the utmost challenge. These are the still-supple twigs that may be bent to use, to learn, and to enjoy the information-finding process; or they may be easily lost to the process by small expressions of impatience or Bull Med Libr Assoc 78(1) January 1990
Comment and opinion
indifference on the part of the reference librarian. In the health sciences academic library, by contrast, one sees the older, established professional and faculty member, or the graduate student preparing for a health-related profession. These individuals bring to bear on the reference librarians who seek to serve them a greater knowledge of their subject matter in most cases, an intensity of focus, a determination to persist, and the pressures for accuracy, timeliness, and speed that their professions or future professions demand of them. The atmosphere around such individuals may be described as something of a "no-fooling world," which comes to embed itself in the understanding of the health sciences academic reference librarians, who are highly aware of their clients' need to be competent and beyond reproach of their treatment of patients, of the cost of human life or health for their errors, of the potential for lawsuits if they are found to be sloppy or negligent, and of the pressures to publish or perish. What resources do these library users need, and what kinds of questions are they asking? For health sciences academic reference librarians, the answer to the first question is easy: journals. Although other sources might be used, the client would be harmed to the greatest degree without the journals and all the indexing leading to them. Information needs in a rather short time will run from biographical data on an Austrian malaria expert of the nineteenth century, to meetings related to anesthesiology to be held in Florida next month, to an article related to renal transplants and a specific drug, to evidence that a physician practicing in the Richmond area between 1955 and 1960 could have been aware of the potential hazards of XYZ. Although this is certainly diversity of subject matter, it doesn't apBull Med Libr Assoc 78(1) January 1990
proach the diversity in the general academic library. There, within an hour or two, information needs may run as follows: articles on distant point copying; financial data on a small, privately held company in New Jersey; a reproduction of the Egyptian heiroglyphics on a particular monument; criticism of Ibsen's "Ghosts"; and articles on the history of feminism in Latin America. Besides diversity in subject matter, is there something basically different about how one goes about finding needed information? Experience would say, no. The tools for finding information in both libraries are of similar types and their organization does not often vary in ways that would deter use, although new terminology can present at least a temporary obstacle in communications with clientele. Organizational hierarchies and networks are not exactly the same for health sciences academic reference librarians as for general academic reference librarians. Both groups, no doubt, come out of library schools with extensive information as to how they will relate to various networks on the international, national, regional, state, and local levels. However, health sciences academic reference librarians are committed to the delivery of needed information to health care personnel and to the health care consumer, from the metropolis to the boondocks, and operate, as we know, in a hierarchy with the National Library of Medicine (NLM) as the apex; NLM acts as the key to a nationwide datagathering system that connects widespread centers of expertise and forms them into a resource available to all. There is no such equivalent network of hierarchical arrangements in existence for general academic libraries. One does not function well as a health sciences academic reference librarian without understanding the responsi-
bilities and connections of the health libraries hierarchy and the ways in which, for example, the health sciences academic librarian is expected to interact with local hospital libraries. There are obvious benefits to be realized in a cross-training program. It affords administrators flexibility in the assignment of personnel where needed, even if temporarily. It promotes greater knowledge of the total library resources available, resulting in more frequent and appropriate referrals; this benefits library users and improves use of the collections. Crosstraining can stimulate and reinvigorate long-term personnel by exposing them to different subjects and clientele. It can serve as the experience that convinces a librarian that a career change to another library field would be more enjoyable-or conversely, that the initial subject field is, indeed, the one preferred. Undetermined thus far is whether cross-training improves marketability of the librarian in any way. Difficulties in carrying out such a cross-training program could include the contrasts between reference librarians in their sense of mission and in their perceptions of what subject areas are most valuable in society. Those whose sense of mission is most focused and whose devotion to certain subjects and clienteles is most compelling will very likely not be interested in cross-training and, in fact, may actually resent it. Characteristics of clientele in a health sciences academic library can be disconcerting to general academic reference librarians who are more attuned to the characteristics of undergraduates. Although types of reference tools used do not vary significantly, lack of familiarity with terminology can present difficulties in communications with library users. For health sciences academic reference librarians, the nature of the hierarchical network in which they 65
Comment and opinion
are involved is quite demanding and leaves them little time or inclination for involvement in other networks. In conclusion, a cross-training
program can benefit library administrators, be both positive and negative in terms of library users, and serve the desired purposes of some librarians, but not of all.
Mary Ellen Thomas Tompkins-McCaw Library Medical College of Virginia Virginia Commonwealth University P.O. Box 582 Richmond, Virginia 23298-0582
Remembering our history: the roots of knowledge* studies the page for a few moments, then turns to the librarian. "I guess I would rather have a computer search. I don't want to copy all this stuff." Professor Johnson greets a librarian in the corridor of the Medical Center. "Your online catalog is wonderful. I access it from my office, and I never come to the library anymore." Dr. Tim Walsh is a first-year resident. He smiles at the librarian. "Look at this-it's wonderful and I did it myself!" He picks up his printout with 250 citations produced from a CD-ROM database. These are daily occurrences in our institutions, and they are achieved by the advances in technology. There is nothing wrong with the technology: databases allow access to the literature that cannot be achieved through manual searchand he learned from reading how ing; the online catalog provides to use a stethoscope and to take a keyword access to holdings in a university-wide system that the history from the patient [1]. That setting was grand rounds. printed catalog cannot; and CDHere is another: The librarian ROM gives users a chance to exshows a medical student the print- plore the database without online ed Science Citation Index.t "This is charges. The technology is a trethe author you asked about and the mendous asset to librarians who specific paper from 1984," ex- seek information and who help plained the librarian. "The items users to unearth it. The technology listed below are the papers that cit- has increased our capabilities and ed the 1984 paper. Thirteen of productivity; it has enhanced our them-that will give you plenty of image and enriched the scope of relevant articles." The student our jobs. I use it. I like it. And I want every electronic device that Presented May 22, 1989, at the Eighty- helps manage and transfer inforNinth Annual Meeting of the Medical Li- mation and knowledge. What, then, is the problem? My brary Association, Boston, Massachusetts. t Science Citation Index is a registered trade- concern is that these electronic mark of the Institute of Scientific Infor- marvels have become the driving mation. force of our libraries, that we no
One of the places that a physician or scientist can tell a poignant story about a patient or write about personal concerns in medicine is in the JAMA series "A Piece of My Mind." One such "piece" was Michael A. Lacombe's description of a medical student presenting a patient at grand rounds. The student examines the patient with his hands, with a stethoscope; he observes and listens. That his diagnosis is correct astounds the audience, for he has not used the latest techniques and devices to arrive at his diagnosis. His professor chides him for not using the patient's "database," questioning how he could consider diagnosing without the aid of a computer. The student'replies that he had found some old books on physical diagnosis that were not in the database,
*
66
longer determine what we can do more effectively without them or in other ways. We do only what the machine is capable of doing. Consider the three examples: the medical student misses the unique information Science Citation Index offers because searching through the volumes takes time and so she chooses a quick computer search instead; the professor knows only those resources he finds in an inadequate search of the online catalog, but no longer handles or browses through the riches of the library's collection; and the resident retrieves hundreds of citations, wondering why so many seem irrelevant. The machines performed their tasks very well, but the librarians did not provide these users with the best sources and information. Lewis Thomas says, "Medicine is no longer the laying on of hands, it is more like the reading of signals from machines" [2]. Of course, many of these machines help to cure patients and Thomas' concern is not that the change has made the doctor less able to cure the patient, but that the doctor-patient relationship has lost meaning. He adds, The close-up, reassuring warm touch of the physician, the comfort and concern, the long, leisurely discussions ... are disappearing from the practice of medicine, and this may turn out to be too great a loss, for the doctor as well as for the patient [3].
Are we librarians so enamored with our electronic tools that we Bull Med Libr Assoc 78(1) January 1990
