The Implementation of a Large-Scale Self-instructional Course in Medical Information Resources BY STEPHANIE N. ALLEN*
Lexington, Kentucky J. MAURICE MAHAN, PH.D., Director of Instructional Development and Evaluation, Division of Learning Resources, and Associate Professor of Psychiatry and Human Behaviort
IRENE GRAHAM, Director, Rowland Medical Library The University of Mississippi Medical Center Jackson, Mississippi ABSTRACT The implementation of library orientation and bibliographic instruction in health sciences centers presents some interesting as well as perplexing problems. The Rowland Medical Library at The University of Mississippi Medical Center had to confront and reexamine these problems when faced with the requirement to teach 298 freshman and sophomore medical students in one ten-week quarter. This paper outlines the development and implementation of a large-scale self-instructional approach to library instruction. The package consisted of an audiotape, a videotape, a written program, selfteaching quizzes, a performance test, and a student evaluation. Performance test results and student evaluation data are presented which indicate that this format can successfully be employed to meet course objectives and to be accepted by students.
THE development and delivery of library orientation and bibliographic instruction in health sciences centers present some interesting as well as perplexing problems. Rowland Medical Library (RML) at The University of Mississippi Medical Center has presented such courses for several years and has wrestled with problems of evolution and implementation. However, due to changes in curriculum these problems were again brought into focus when the staff was faced with the problem of teaching 298 freshman and sophomore medical students a required three-clock-hour credit course within one ten-week quarter. This situation, along with the creation of a new * Formerly Head, Instructions and Loans, Rowland Medical Library, The University of Mississippi Medical
Center, Jackson, Mississippi.
tAddress requests for reprints to Dr. Mahan. 302
dental school and increasing enrollments in the medical, nursing, and allied health schools, was cause for concern because of the limited staff time available for tours, lectures, and preparation of teaching programs for each of these different student groups. An examination of past teaching at RML and a review of the relevant literature provided some guidelines for making significant changes in the development, implementation, and evaluation of a bibliographic teaching program for medical students. Bibliographic instruction at RML has traditionally been an integral part of user services. Usually these presentations consisted of tours, lectures, and practical exercises. The guided tours tended to disrupt other library patrons and were difficult to present effectively because of crowded conditions. Lectures were given to small groups of about fifteen students to ensure that instruction was somewhat personalized. The small groups were ideal for teaching but required repetitive lecturing for the staff, often at varying times, to fit student schedules. Optional computer-assisted search demonstrations were poorly attended. Exercises were developed and graded by each lecturer. Final grades were based on a simple pass/fail system. Evaluation by students indicated that the majority felt that the course was worthwhile but given at an inappropriate time in their schedule (the sophomore year). With the press of compacted and accelerated curricula in the various schools, many academic departments no longer allot the time traditionally set aside for the students to perform research on a topic, evaluate the data, and then draw concluBull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES sions. At a time when health sciences professionals most need improved literature-searching techniques for patient care, continuing education, and teaching duties, unfortunately they seem to be receiving less training. The library staff was concerned because, although most health professionals wanted to increase their knowledge, few were familiar with independent study techniques. Thus, as Closurdo has observed, they seemed to find ".. . themselves providing care based on dated information simply because they [did] not know how to independently meet their own informational needs" [1 J. Reason and experience indicated that the library must continue, by whatever methods were available, to ensure that each student acquire the bibliographic skills that would prove valuable to him or her in school, practice, or research. All of these considerations forced the library staff to confront the problem of what to teach and how to teach it. Should individual programs be created for each group, should a single course be designed that attempted to satisfy a part of all user needs, or was it possible to implement a general strategy for instruction that, with minor modifications, could be used for specific user groups? Tradition and bias have largely determined both format and coverage in courses taught by librarians in the past. As a result emphasis has been placed more often on the use of specific tools or libraries, rather than on the more general concept of the library as a major intermediary in the overall communication process. To be effective, RML's instruction had to be developed systematically from the perspective of both the user's and the library's short- and long-term needs. The methods for teaching these desired bibliographic skills had to derive logically from the learning objectives, offer students the opportunity to interact with the library, and provide feedback on student performance. The library staff considered adaptations of various educational strategies and adjunct audiovisual methods that were already in service at other institutions. An overview of many of these efforts at formal instruction by medical librarians was published by Martin, House, and Chandler [2]. While these courses show considerable merit in both format and coverage of material, there are certain limitations in the use of the models on the large scale required by RML. Elective courses
[1-6], although initially creating a more positive environment, rarely reach the audience that needs them the most. As Hall observed, ". . . because of Bull. Med. Libr. Assoc. 67(3) July 1979
the heavy course work demands on student time, learning library skills must be a required activity" [7]. Courses that are detailed and extended over a period of weeks provide excellent background for those entering the research field [2, 3, 8], but the RML teaching staff felt that a required intensive course would neither be acceptable to most health sciences students, because of the time and work load involved, nor fit into the already full curriculum. The importance of establishing patron-librarian rapport through small groups offering personal instruction has been recognized by several authors [2, 6, 7, 9]. Faced with great numbers of students, however, it was necessary to explore other methods that did not sacrifice this goal. Furthermore, even though most of the courses cited in the literature successfully covered specific library policies and procedures and use of library tools, they neglected the broader concept of finding and obtaining information via the Biomedical Communications Network [10-12]. Although Martin, House, and Chandler briefly introduced their classes to the interlibrary loan document delivery system [2], no course has been reported that outlined either the biomedical information-gathering network or the significant role that librarians play as useful intermediaries in this system once school resources have been left behind. The goal of the library staff, then, was to develop a course that was aimed at producing skills that could be used throughout the students' education, as well as in their medical practice. Additionally, the implementation of this course on a large scale would provide an opportunity to develop some further insights into the acceptability and timing of a required course in this area. COURSE DEVELOPMENT The assessment of previous course objectives and student evaluations, as well as the past experiences of other programs, led to the development of six new or modified teaching objectives. These stated that the students should: (1) be capable of locating books, journals, and audiovisual materials by using the card catalog and the computer-produced journal list; (2) be able to utilize properly the services offered by the library; (3) be able to find information on a subject using basic ready-reference tools, indexes, and abstracting sources; (4) be exposed to the use of nonprint media as an information source; (5) be introduced to the overall regional information-seeking and material-obtaining pattern (the
303
ALLEN, MAHAN, AND GRAHAM
Biomedical Communications Network) for future needs when they may no longer be in a medical center environment; and (6) be comfortable working with librarians. An analysis of these objectives by an educational technology specialist resulted in the design of a total self-teaching package, for use in the Introduction to Medical Information Resources course. The package consisted of an audiotape, a videotape, a self-instructional booklet, a practical test, and a course evaluation. The audiotapes and videotapes were included in the package not only because they seemed to provide the best media for presenting certain parts of the course, but to give the students experience in using these materials. The twenty-minute audiotape was developed as a self-guided tour of RML. Three copies of the tape were available, and both sides of each tape duplicated the tour, to avoid the necessity of rewinding. Stations throughout the library were numbered consecutively from one through nine. At four stations students were asked to stop the recorder and carry out simple activities to help ensure that they understood how to locate a book, journal, index, or abstract. The complete tour required about thirty-five minutes to complete. The ten-minute videotape was designed to aquaint the viewers with the Biomedical Communications Network concept and to place RML within this framework. An introduction to the RML reference and circulation staffs and the roles of each was used as a starting point for exposing the students to the network mechanisms for obtaining biomedical information. The graphics on the videotape demonstrated how these mechanisms can be used at the local, regional, national, or even international levels. Emphasis was placed on how this information network can be entered from any basic unit library, regardless of where the future health professional might be geographically located. The self-instructional booklet, entitled Introduction to Bibliographic and Information Services (see Appendix), contained a library guide, which served as a written reinforcement and expansion of the audiotour. Included were library arrangement, policies, and services. The second half of the booklet presented material on the use of basic readyreference tools, indexes, and abstracts and an overview of computer searching and available data bases, as well as a brief summary of suggestions for obtaining material for the preparation of scientific manuscripts. Two self-teaching quizzes were included in the booklet to provide the students with
3`04
an opportunity to review their understanding of each section. A 1 00-point practical test at the end of the course measured the students' ability to apply their knowledge to twenty information-gathering tasks using selected indexes, abstracts, and other library tools. Tasks required students to investigate disease symptoms, the origin of the associated eponymic name, biographical information about the discoverer, properties of drugs used in treatment, statistics about health care facilities, and the availability of residency programs. Further requirements asked students to find additional citations on the same disease using selected indexes and to determine whether the discoverer had written other papers or had been cited by other authors. The students also had to select a topic and delineate the parameters for a computer-assisted literature search. In the process they worked with a reference librarian to define the area of interest and then observed the search at the terminal. The resulting citations were attached to the test answer sheet. A student evaluation form was designed to assess the students' reactions to the various components of the course. It was hoped that the data obtained from the evaluation and that from the practical test would provide insights into the effectiveness and acceptance of the course, as well as possible differences between freshmen and sophomores. Because this was a transition year in the curriculum, the 150 sophomores were scheduled first due to their heavier course load. Forty students were alphabetically assigned each week and could complete the work at their own pace during that time. At registration students received a list of the requirements of this course and its objectives, a schedule, and a procedure for completing the course. Students were asked to report to the library during their assigned week and leave their identification cards while listening to the audiotour and viewing the videotape. Booklets and exercises were then distributed and were to be completed and the tests and evaluations returned by the following week. The week preceding exams at the end of the quarter was designated as the make-up week. Notices concerning a make-up session and the course deadline were posted. RESULTS OF STUDENT EXAMINATION AND EVALUATION The results indicated that the students performed well on the 100-point practical examiBull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES
nation, and that their evaluations of the course were positive. A total of 148 freshman and 150 sophomore medical students took the course. For the total group of 298, the mean score on the practical examination was 93.02, with a standard deviation of 5.96. For freshmen the mean was 92.77, with a standard deviation of 6.10; and for the sophomores the figures were 93.28, with a standard deviation of 5.82. Results of the "t" test [13] for the differences were not statistically different (t = .73, 29 df).
The results of the course evaluation (Table 1) indicated that the students rated the various aspects of the course between "good" and "very good." The course evaluation questionnaires were returned by 133 freshmen and 135 sophomores, for an overall response rate of 90%. The high return rate, perhaps prompted by the anonymity of the course evaluation, provided what may be regarded as an accurate estimation of the students' reactions to the course. In general, the students did not rate the audio-
TABLE I STUDENT EVALUATION OF THE INTRODUCTION TO MEDICAL INFORMATION RESOURCES COURSE
Freshmen Mean S.D. Response
Sophomores Mean S.D. Response
Total Mean S.D. Response
Audiotape: tour of the library* Interest Clarity of presentation Overall effectiveness
3.14 3.62 3.34
.98 .93 .94
3.13 3.62 3.29
.87 .93 .88
3.14 3.62 3.32
.93 .93 .91
Videotape: the Biomedical Communications Network* Interest Clarity of presentation Overall effectiveness
3.11 3.43 3.17
1.04 .90 .98
2.96 3.44 3.06
.97 .83 .94
3.04 3.44 3.12
1.01 .87 .96
Written packet: Introduction to Bibliographic and Information Services* Interest Clarity of presentation Overall effectiveness
3.26 3.54 3.62
1.04 1.03 .94
2.98 3.34 3.35
1.09 1.10 1.01
3.12 3.44 3.49
1.07 1.07 .98
I feel that I learned something from this courset
4.06
.89
3.89
.96
3.98
.93
The two self-teaching quizzes helped me understand the materialt
3.38
1.09
3.12
.97
3.25
1.03
2.20
1.17
2.10
1.25
2.15
1.21
3.86
.90
3.77
.93
3.82
.92
4.14
.83
3.81
.98
3.98
.91
3.78
.78
3.35
.96
3.57
.87
I feel that this course should be supplemented with a formal lecture or discussiont
The instruction packet provided enough information to complete the quiz at the endt I feel that this course will help me with my future clinical and research
needst On a 1-5 scale, with 5 as best, overall rating for this course
*Scale for responses: 1 =poor, 2=fair, 3=good, 4=very good, 5=excellent. tScale for responses: 1 =strongly disagree, 5=strongly agree. Bull. Med. Libr. Assoc. 67(3) July 1979
305
ALLEN, MAHAN, AND GRAHAM
tape, videotape, and written packet very differently, although the videotape was rated slightly lower. It should also be noted that the students strongly believed that they had learned from the course, that this experience would help with their future clinical and research needs, and that there was not a need for supplementary formal lectures or discussions. They also felt that the information provided was sufficient for completion of the practical examination at the end of the course. The students were somewhat less certain about the value of the self-teaching quizzes in the packet as aids to understanding the materials. DISCUSSION AND CONCLUSIONS The delivery of a self-instructional course for nearly 300 medical students in one ten-week quarter was conducted efficiently and with seemingly effective results. By allowing the students to complete the course at their convenience during a specified week, the library was not overcrowded or disrupted by tours or other instructional activities. Except for the answering of occasional questions and conducting of the computer-assisted literature searches, a minimal amount of librarian time was required for the actual delivery of instruction. Although the time for development of the course materials was not trivial, the reusable nature of the materials for future courses makes this investment in time well worth the effort devoted to it. Evaluation of the course between "good" and "very good" compared very favorably with student evaluations of other courses in the preclinical schedule and indicated that the Introduction to Medical Information Resources course should remain in its present form as an integral part of the curriculum. Without these positive attitudes toward the material in the course, it is not likely that the students would continue to apply this knowledge. Because of the unique opportunity provided for comparison of freshman and sophomore students, it was hoped that the evaluations might support an optional time for the course in the curriculum. Unfortunately, but perhaps not surprisingly, a conclusion concerning the best time for presentation could not be drawn from student attitudes or performance. As past experience has shown at both RML and the University of Maryland [6], students are unable to agree upon the most appropriate time. It would seem that the best approach for selecting a time to present such a course would be through consideration of the specific curriculum needs of the program involved and the capabilities of the library staff.
306
The synthesis of instructional components utilized in formal courses taught at RML and at other medical schools into a systematically designed course provides a unique and useful model for the large-scale teaching of library skills. The adaptation of this package for use with other health sciences students is currently being undertaken. The combination of the audiotour, videotape, self-instructional booklet, and test in a selfteaching package helps prepare each individual for future information-gathering activities in any type of library, at any location in which he or she may be working. REFERENCES 1. CLOSURDO, J. S. Teaching library skills. Hosp. Prog. 55: 36-42, Sept. 1974. 2. MARTIN, J. A.; HOUSE, D. L., JR.; AND CHANDLER, H. R. Teaching of formal courses by medical librarians. J. Med. Educ. 50: 883-887, Sept. 1975. 3. TITLEY, J. The medical librarian as a medical educator: the description of a course. In: Davis, K. E., and Sweeney, W. D., eds. Proceedings of the Third International Congress of Medical Librarianship, Amsterdam, 5-9 May, 1969. Amsterdam, Excerpta Medica, 1970. p. 327-332. 4. BORDA, E., AND MURRAY, M. E. Introduction to library services for allied health personnel. Bull. Med. Libr. Assoc. 62: 363-366, Oct. 1974. 5. EATON, E. S. Library orientation methods: J. Hillis Miller Health Center Library program. Bull. Med. Libr. Assoc. 60: 133-137, Jan. 1972. 6. GALLANT, D. E. Mini-course in dental literature utilization. J. Dent. Educ. 37: 33-35, Oct. 1973. 7. HALL, V. B.; KRAUTHEIM, D.; AND HANSRA, B. S. A slide-tape program for beginning pharmacy students: effect on learning. Bull. Med. Libr. Assoc. 65: 443-445, Oct. 1977. 8. LUNIN, L. F., AND CATLIN, F. I. Teaching information and communication in a medical center. J. Med. Educ. 47: 658-660, Aug. 1972. 9. ADKINS, E. F. Library orientation for student nurses: a new approach. Spec. Libr. 61: 21-25, Jan. 1970. 10. JONES, V. A., AND JACKSON, S. J. Toward a biocommunications network. Postgrad. Med. 61: 219226, Apr. 1977. 11. DEPARTMENT OF HEALTH, EDUCATION AND WELFARE. PUBLIC HEALTH SERVICE, NATIONAL INSTITUTES OF HEALTH. MEDLARS: The Computerized Literature Retrieval Services of the National Library of Medicine. Bethesda, Md., 1977. (DHEW Publication no. (NIH) 77-1286.) 12. BisHoP, D. Activities for a regional medical library: a view of priorities by users and librarians. Bull. Med. Libr. Assoc. 63: 247-251, July 1975. 13. WALKER, H. M., AND LEV, J. Statistical Inference. New York, Holt, Rinehart, and Winston, 1953.
Received August 14, 1978; revision accepted January 23, 1979. Bull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES
APPENDIX
CONTENTS OF INTRODUCTION TO BIBLIOGRAPHIC AND INFORMATION SERVICES SELF-INSTRUCTIONAL BOOKLET Preface ......................................1ii Photocopy .............................. 9 Directions for use of this Guide ................................. 10 Interlibrary loan .............................. 1 Selected ready reference tools .............................. Floor plan of the library ...................................... 11 Course objectives .......................................2 Ready reference self-learning quiz ............................. 18 Course requirements ...................3..................3 Glossary ......................................4 How to find a book . .....................................5 How to find a journal .....................6................6 Audiovisuals ......................................7 How to check out books and journals ......................... 8
Bull. Med. Libr. Assoc. 67(3) July 1979
Selected indexes .............................. Selected abstracting services ............................ .. Indexes and abstracts self-learning quiz ..................... Bibliographic reference and search services ............... Suggestions for preparing literature reviews ..............
19 30 45 46 50
307
Lexington, Kentucky J. MAURICE MAHAN, PH.D., Director of Instructional Development and Evaluation, Division of Learning Resources, and Associate Professor of Psychiatry and Human Behaviort
IRENE GRAHAM, Director, Rowland Medical Library The University of Mississippi Medical Center Jackson, Mississippi ABSTRACT The implementation of library orientation and bibliographic instruction in health sciences centers presents some interesting as well as perplexing problems. The Rowland Medical Library at The University of Mississippi Medical Center had to confront and reexamine these problems when faced with the requirement to teach 298 freshman and sophomore medical students in one ten-week quarter. This paper outlines the development and implementation of a large-scale self-instructional approach to library instruction. The package consisted of an audiotape, a videotape, a written program, selfteaching quizzes, a performance test, and a student evaluation. Performance test results and student evaluation data are presented which indicate that this format can successfully be employed to meet course objectives and to be accepted by students.
THE development and delivery of library orientation and bibliographic instruction in health sciences centers present some interesting as well as perplexing problems. Rowland Medical Library (RML) at The University of Mississippi Medical Center has presented such courses for several years and has wrestled with problems of evolution and implementation. However, due to changes in curriculum these problems were again brought into focus when the staff was faced with the problem of teaching 298 freshman and sophomore medical students a required three-clock-hour credit course within one ten-week quarter. This situation, along with the creation of a new * Formerly Head, Instructions and Loans, Rowland Medical Library, The University of Mississippi Medical
Center, Jackson, Mississippi.
tAddress requests for reprints to Dr. Mahan. 302
dental school and increasing enrollments in the medical, nursing, and allied health schools, was cause for concern because of the limited staff time available for tours, lectures, and preparation of teaching programs for each of these different student groups. An examination of past teaching at RML and a review of the relevant literature provided some guidelines for making significant changes in the development, implementation, and evaluation of a bibliographic teaching program for medical students. Bibliographic instruction at RML has traditionally been an integral part of user services. Usually these presentations consisted of tours, lectures, and practical exercises. The guided tours tended to disrupt other library patrons and were difficult to present effectively because of crowded conditions. Lectures were given to small groups of about fifteen students to ensure that instruction was somewhat personalized. The small groups were ideal for teaching but required repetitive lecturing for the staff, often at varying times, to fit student schedules. Optional computer-assisted search demonstrations were poorly attended. Exercises were developed and graded by each lecturer. Final grades were based on a simple pass/fail system. Evaluation by students indicated that the majority felt that the course was worthwhile but given at an inappropriate time in their schedule (the sophomore year). With the press of compacted and accelerated curricula in the various schools, many academic departments no longer allot the time traditionally set aside for the students to perform research on a topic, evaluate the data, and then draw concluBull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES sions. At a time when health sciences professionals most need improved literature-searching techniques for patient care, continuing education, and teaching duties, unfortunately they seem to be receiving less training. The library staff was concerned because, although most health professionals wanted to increase their knowledge, few were familiar with independent study techniques. Thus, as Closurdo has observed, they seemed to find ".. . themselves providing care based on dated information simply because they [did] not know how to independently meet their own informational needs" [1 J. Reason and experience indicated that the library must continue, by whatever methods were available, to ensure that each student acquire the bibliographic skills that would prove valuable to him or her in school, practice, or research. All of these considerations forced the library staff to confront the problem of what to teach and how to teach it. Should individual programs be created for each group, should a single course be designed that attempted to satisfy a part of all user needs, or was it possible to implement a general strategy for instruction that, with minor modifications, could be used for specific user groups? Tradition and bias have largely determined both format and coverage in courses taught by librarians in the past. As a result emphasis has been placed more often on the use of specific tools or libraries, rather than on the more general concept of the library as a major intermediary in the overall communication process. To be effective, RML's instruction had to be developed systematically from the perspective of both the user's and the library's short- and long-term needs. The methods for teaching these desired bibliographic skills had to derive logically from the learning objectives, offer students the opportunity to interact with the library, and provide feedback on student performance. The library staff considered adaptations of various educational strategies and adjunct audiovisual methods that were already in service at other institutions. An overview of many of these efforts at formal instruction by medical librarians was published by Martin, House, and Chandler [2]. While these courses show considerable merit in both format and coverage of material, there are certain limitations in the use of the models on the large scale required by RML. Elective courses
[1-6], although initially creating a more positive environment, rarely reach the audience that needs them the most. As Hall observed, ". . . because of Bull. Med. Libr. Assoc. 67(3) July 1979
the heavy course work demands on student time, learning library skills must be a required activity" [7]. Courses that are detailed and extended over a period of weeks provide excellent background for those entering the research field [2, 3, 8], but the RML teaching staff felt that a required intensive course would neither be acceptable to most health sciences students, because of the time and work load involved, nor fit into the already full curriculum. The importance of establishing patron-librarian rapport through small groups offering personal instruction has been recognized by several authors [2, 6, 7, 9]. Faced with great numbers of students, however, it was necessary to explore other methods that did not sacrifice this goal. Furthermore, even though most of the courses cited in the literature successfully covered specific library policies and procedures and use of library tools, they neglected the broader concept of finding and obtaining information via the Biomedical Communications Network [10-12]. Although Martin, House, and Chandler briefly introduced their classes to the interlibrary loan document delivery system [2], no course has been reported that outlined either the biomedical information-gathering network or the significant role that librarians play as useful intermediaries in this system once school resources have been left behind. The goal of the library staff, then, was to develop a course that was aimed at producing skills that could be used throughout the students' education, as well as in their medical practice. Additionally, the implementation of this course on a large scale would provide an opportunity to develop some further insights into the acceptability and timing of a required course in this area. COURSE DEVELOPMENT The assessment of previous course objectives and student evaluations, as well as the past experiences of other programs, led to the development of six new or modified teaching objectives. These stated that the students should: (1) be capable of locating books, journals, and audiovisual materials by using the card catalog and the computer-produced journal list; (2) be able to utilize properly the services offered by the library; (3) be able to find information on a subject using basic ready-reference tools, indexes, and abstracting sources; (4) be exposed to the use of nonprint media as an information source; (5) be introduced to the overall regional information-seeking and material-obtaining pattern (the
303
ALLEN, MAHAN, AND GRAHAM
Biomedical Communications Network) for future needs when they may no longer be in a medical center environment; and (6) be comfortable working with librarians. An analysis of these objectives by an educational technology specialist resulted in the design of a total self-teaching package, for use in the Introduction to Medical Information Resources course. The package consisted of an audiotape, a videotape, a self-instructional booklet, a practical test, and a course evaluation. The audiotapes and videotapes were included in the package not only because they seemed to provide the best media for presenting certain parts of the course, but to give the students experience in using these materials. The twenty-minute audiotape was developed as a self-guided tour of RML. Three copies of the tape were available, and both sides of each tape duplicated the tour, to avoid the necessity of rewinding. Stations throughout the library were numbered consecutively from one through nine. At four stations students were asked to stop the recorder and carry out simple activities to help ensure that they understood how to locate a book, journal, index, or abstract. The complete tour required about thirty-five minutes to complete. The ten-minute videotape was designed to aquaint the viewers with the Biomedical Communications Network concept and to place RML within this framework. An introduction to the RML reference and circulation staffs and the roles of each was used as a starting point for exposing the students to the network mechanisms for obtaining biomedical information. The graphics on the videotape demonstrated how these mechanisms can be used at the local, regional, national, or even international levels. Emphasis was placed on how this information network can be entered from any basic unit library, regardless of where the future health professional might be geographically located. The self-instructional booklet, entitled Introduction to Bibliographic and Information Services (see Appendix), contained a library guide, which served as a written reinforcement and expansion of the audiotour. Included were library arrangement, policies, and services. The second half of the booklet presented material on the use of basic readyreference tools, indexes, and abstracts and an overview of computer searching and available data bases, as well as a brief summary of suggestions for obtaining material for the preparation of scientific manuscripts. Two self-teaching quizzes were included in the booklet to provide the students with
3`04
an opportunity to review their understanding of each section. A 1 00-point practical test at the end of the course measured the students' ability to apply their knowledge to twenty information-gathering tasks using selected indexes, abstracts, and other library tools. Tasks required students to investigate disease symptoms, the origin of the associated eponymic name, biographical information about the discoverer, properties of drugs used in treatment, statistics about health care facilities, and the availability of residency programs. Further requirements asked students to find additional citations on the same disease using selected indexes and to determine whether the discoverer had written other papers or had been cited by other authors. The students also had to select a topic and delineate the parameters for a computer-assisted literature search. In the process they worked with a reference librarian to define the area of interest and then observed the search at the terminal. The resulting citations were attached to the test answer sheet. A student evaluation form was designed to assess the students' reactions to the various components of the course. It was hoped that the data obtained from the evaluation and that from the practical test would provide insights into the effectiveness and acceptance of the course, as well as possible differences between freshmen and sophomores. Because this was a transition year in the curriculum, the 150 sophomores were scheduled first due to their heavier course load. Forty students were alphabetically assigned each week and could complete the work at their own pace during that time. At registration students received a list of the requirements of this course and its objectives, a schedule, and a procedure for completing the course. Students were asked to report to the library during their assigned week and leave their identification cards while listening to the audiotour and viewing the videotape. Booklets and exercises were then distributed and were to be completed and the tests and evaluations returned by the following week. The week preceding exams at the end of the quarter was designated as the make-up week. Notices concerning a make-up session and the course deadline were posted. RESULTS OF STUDENT EXAMINATION AND EVALUATION The results indicated that the students performed well on the 100-point practical examiBull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES
nation, and that their evaluations of the course were positive. A total of 148 freshman and 150 sophomore medical students took the course. For the total group of 298, the mean score on the practical examination was 93.02, with a standard deviation of 5.96. For freshmen the mean was 92.77, with a standard deviation of 6.10; and for the sophomores the figures were 93.28, with a standard deviation of 5.82. Results of the "t" test [13] for the differences were not statistically different (t = .73, 29 df).
The results of the course evaluation (Table 1) indicated that the students rated the various aspects of the course between "good" and "very good." The course evaluation questionnaires were returned by 133 freshmen and 135 sophomores, for an overall response rate of 90%. The high return rate, perhaps prompted by the anonymity of the course evaluation, provided what may be regarded as an accurate estimation of the students' reactions to the course. In general, the students did not rate the audio-
TABLE I STUDENT EVALUATION OF THE INTRODUCTION TO MEDICAL INFORMATION RESOURCES COURSE
Freshmen Mean S.D. Response
Sophomores Mean S.D. Response
Total Mean S.D. Response
Audiotape: tour of the library* Interest Clarity of presentation Overall effectiveness
3.14 3.62 3.34
.98 .93 .94
3.13 3.62 3.29
.87 .93 .88
3.14 3.62 3.32
.93 .93 .91
Videotape: the Biomedical Communications Network* Interest Clarity of presentation Overall effectiveness
3.11 3.43 3.17
1.04 .90 .98
2.96 3.44 3.06
.97 .83 .94
3.04 3.44 3.12
1.01 .87 .96
Written packet: Introduction to Bibliographic and Information Services* Interest Clarity of presentation Overall effectiveness
3.26 3.54 3.62
1.04 1.03 .94
2.98 3.34 3.35
1.09 1.10 1.01
3.12 3.44 3.49
1.07 1.07 .98
I feel that I learned something from this courset
4.06
.89
3.89
.96
3.98
.93
The two self-teaching quizzes helped me understand the materialt
3.38
1.09
3.12
.97
3.25
1.03
2.20
1.17
2.10
1.25
2.15
1.21
3.86
.90
3.77
.93
3.82
.92
4.14
.83
3.81
.98
3.98
.91
3.78
.78
3.35
.96
3.57
.87
I feel that this course should be supplemented with a formal lecture or discussiont
The instruction packet provided enough information to complete the quiz at the endt I feel that this course will help me with my future clinical and research
needst On a 1-5 scale, with 5 as best, overall rating for this course
*Scale for responses: 1 =poor, 2=fair, 3=good, 4=very good, 5=excellent. tScale for responses: 1 =strongly disagree, 5=strongly agree. Bull. Med. Libr. Assoc. 67(3) July 1979
305
ALLEN, MAHAN, AND GRAHAM
tape, videotape, and written packet very differently, although the videotape was rated slightly lower. It should also be noted that the students strongly believed that they had learned from the course, that this experience would help with their future clinical and research needs, and that there was not a need for supplementary formal lectures or discussions. They also felt that the information provided was sufficient for completion of the practical examination at the end of the course. The students were somewhat less certain about the value of the self-teaching quizzes in the packet as aids to understanding the materials. DISCUSSION AND CONCLUSIONS The delivery of a self-instructional course for nearly 300 medical students in one ten-week quarter was conducted efficiently and with seemingly effective results. By allowing the students to complete the course at their convenience during a specified week, the library was not overcrowded or disrupted by tours or other instructional activities. Except for the answering of occasional questions and conducting of the computer-assisted literature searches, a minimal amount of librarian time was required for the actual delivery of instruction. Although the time for development of the course materials was not trivial, the reusable nature of the materials for future courses makes this investment in time well worth the effort devoted to it. Evaluation of the course between "good" and "very good" compared very favorably with student evaluations of other courses in the preclinical schedule and indicated that the Introduction to Medical Information Resources course should remain in its present form as an integral part of the curriculum. Without these positive attitudes toward the material in the course, it is not likely that the students would continue to apply this knowledge. Because of the unique opportunity provided for comparison of freshman and sophomore students, it was hoped that the evaluations might support an optional time for the course in the curriculum. Unfortunately, but perhaps not surprisingly, a conclusion concerning the best time for presentation could not be drawn from student attitudes or performance. As past experience has shown at both RML and the University of Maryland [6], students are unable to agree upon the most appropriate time. It would seem that the best approach for selecting a time to present such a course would be through consideration of the specific curriculum needs of the program involved and the capabilities of the library staff.
306
The synthesis of instructional components utilized in formal courses taught at RML and at other medical schools into a systematically designed course provides a unique and useful model for the large-scale teaching of library skills. The adaptation of this package for use with other health sciences students is currently being undertaken. The combination of the audiotour, videotape, self-instructional booklet, and test in a selfteaching package helps prepare each individual for future information-gathering activities in any type of library, at any location in which he or she may be working. REFERENCES 1. CLOSURDO, J. S. Teaching library skills. Hosp. Prog. 55: 36-42, Sept. 1974. 2. MARTIN, J. A.; HOUSE, D. L., JR.; AND CHANDLER, H. R. Teaching of formal courses by medical librarians. J. Med. Educ. 50: 883-887, Sept. 1975. 3. TITLEY, J. The medical librarian as a medical educator: the description of a course. In: Davis, K. E., and Sweeney, W. D., eds. Proceedings of the Third International Congress of Medical Librarianship, Amsterdam, 5-9 May, 1969. Amsterdam, Excerpta Medica, 1970. p. 327-332. 4. BORDA, E., AND MURRAY, M. E. Introduction to library services for allied health personnel. Bull. Med. Libr. Assoc. 62: 363-366, Oct. 1974. 5. EATON, E. S. Library orientation methods: J. Hillis Miller Health Center Library program. Bull. Med. Libr. Assoc. 60: 133-137, Jan. 1972. 6. GALLANT, D. E. Mini-course in dental literature utilization. J. Dent. Educ. 37: 33-35, Oct. 1973. 7. HALL, V. B.; KRAUTHEIM, D.; AND HANSRA, B. S. A slide-tape program for beginning pharmacy students: effect on learning. Bull. Med. Libr. Assoc. 65: 443-445, Oct. 1977. 8. LUNIN, L. F., AND CATLIN, F. I. Teaching information and communication in a medical center. J. Med. Educ. 47: 658-660, Aug. 1972. 9. ADKINS, E. F. Library orientation for student nurses: a new approach. Spec. Libr. 61: 21-25, Jan. 1970. 10. JONES, V. A., AND JACKSON, S. J. Toward a biocommunications network. Postgrad. Med. 61: 219226, Apr. 1977. 11. DEPARTMENT OF HEALTH, EDUCATION AND WELFARE. PUBLIC HEALTH SERVICE, NATIONAL INSTITUTES OF HEALTH. MEDLARS: The Computerized Literature Retrieval Services of the National Library of Medicine. Bethesda, Md., 1977. (DHEW Publication no. (NIH) 77-1286.) 12. BisHoP, D. Activities for a regional medical library: a view of priorities by users and librarians. Bull. Med. Libr. Assoc. 63: 247-251, July 1975. 13. WALKER, H. M., AND LEV, J. Statistical Inference. New York, Holt, Rinehart, and Winston, 1953.
Received August 14, 1978; revision accepted January 23, 1979. Bull. Med. Libr. Assoc. 67(3) July 1979
A COURSE IN MEDICAL INFORMATION RESOURCES
APPENDIX
CONTENTS OF INTRODUCTION TO BIBLIOGRAPHIC AND INFORMATION SERVICES SELF-INSTRUCTIONAL BOOKLET Preface ......................................1ii Photocopy .............................. 9 Directions for use of this Guide ................................. 10 Interlibrary loan .............................. 1 Selected ready reference tools .............................. Floor plan of the library ...................................... 11 Course objectives .......................................2 Ready reference self-learning quiz ............................. 18 Course requirements ...................3..................3 Glossary ......................................4 How to find a book . .....................................5 How to find a journal .....................6................6 Audiovisuals ......................................7 How to check out books and journals ......................... 8
Bull. Med. Libr. Assoc. 67(3) July 1979
Selected indexes .............................. Selected abstracting services ............................ .. Indexes and abstracts self-learning quiz ..................... Bibliographic reference and search services ............... Suggestions for preparing literature reviews ..............
19 30 45 46 50
307
