The electronic environment has created significant role changes for health sciences and science librarians. This presentation will examine how librarians should expand their expertise into the areas of instructional programs, improving access, and advancing scientific communication. Librarians should design both training and instruction programs to help users understand and take advantage of electronic resources effectively. Three types of electronic access will be discussed: full-text with a print counterpart, unique electronic text, and electronic information available on the Internet. Access to electronic information raises a number of important issues: ownership, agreement with vendors, who uses the information, price, and the design or quality of the software systems. Librarians have the skills necessary to evaluate and organize health sciences information on the Internet. Librarians contribute to the growing body of scientific knowledge on the information seeking behavior of users and the evaluation of programs. Decisions for future directions should be based on scientific evidence.
The traditional role of the public services librarian was to supply information to patrons by answering questions at the reference desk or, for more complex questions, to provide an in-depth response which required searching wherever was needed to locate the answer. The first real challenge to this traditional model for reference librarians was “end-user searching”. The emergence of “end-user searching” was greeted with great skepticism, if not outright panic among reference librarians. If users can do their own searching, why do they need reference librarians? A corresponding challenge for technical services librarians came with online catalogs. The technical services librarians have organized material through the use of sophisticated cataloging guidelines and standards. Cataloger experienced a similar panic reaction to the advent of keyword searching in the online public catalogs. If users can locate material on their own with keyword searching, is there a need for all the cataloging refinements?
Both training and instruction are needed to use electronic resources effectively. The idea of librarians providing instruction to users is far from new. In 1937  Eileen Cunningham, famous in the annuals of medical librarianship in the United States, described an experience at Vanderbilt University in which medical students were instructed in the use of the library and given assignments in which they were to locate medical information. Cunningham admitted that teaching students was by no means a universal practice. It was a recent development and she solicited suggestions from others to help develop the instructional program.
By 1975 a survey of academic health sciences libraries in the United States found that 18% of medical schools offered formal instruction to their students on using the literature , but the authors lamented that library instruction was still “ill-defined and poorly organized”. The nature and breathe of these instructional programs offered by health sciences librarians has increased dramatically. By 1996 a similar survey found that 75% of academic health sciences libraries in the United States offered formal library instruction to medical school students. The same study found that 49% of medical schools required students to take curriculum-based courses on information seeking skills .
Health sciences librarians now have a solid place in teaching in the medical school curriculum. The experience with medical schools can be used as a model for similar endeavors in other disciplines and institutions. For example, at the University of Illinois at Chicago a program was begun in which a librarian was assigned as a liaison to each one of the health sciences colleges. Librarians contacted faculty in the colleges and suggested that they teach students how to improve their information seeking skills. Librarians made the case that students needed a knowledge of library resources, how to access these resources, and how to understand the literature. This came at a time when a goal of medical education was to develop life-long learning skills for the students. These contacts have resulted in librarians becoming members of curriculum committees, planning course content, co-teaching with medical school faculty, and working with health sciences faculty on some collaborative research projects.
These endeavors in medical schools have laid the foundation for librarians to further expand their teaching roles. Academic health sciences librarians have begun to broaden their audience beyond students and to teach topics beyond database access. Librarians at Welch Library at Johns Hopkins University offered a course on scientific writing and editing in 1991. Two years after the course was introduced in the library, the School of Public Health asked librarians to design and teach a for-credit course on this topic . Librarians are now investigating the possibility of developing a course to cover topics such as presentation skills. Other examples of librarians moving into new areas include: participation in meta-analysis projects, working in small groups in problem-based learning, contracting services to outside departments, working with faculty to improve teaching effectiveness, and training physicians to incorporate the use of computerized information technologies in their clinical practice .
A survey of faculty at the University of Illinois at Chicago  found that 38.4% of health sciences faculty were interested in taking courses in using library systems and other software packages. The library now regularly offer classes on using personal bibliographic software to faculty. The library houses a computer lab to help faculty use software for classroom instruction, research, or other projects. This lab is staffed and taught by “electronic services librarians”. An all-electronic course called ETrain was designed for faculty to help them understand the basics of accessing the Internet.
Any new programs aimed at training or instruction need to be designed to meet the requirements of the institution and planned with input from the unit which requested the training. Librarians’ teaching role will continue to expand in the online environment. For the foreseeable future there will be a host of patrons who do not understand how to use systems and who will need both formal and informal guidance and instruction.
Librarians can make a tremendous impact in how the systems that operate electronic databases are used. I will discuss librarians role in three types of electronic formats: (1) full-text documents available in both traditional print and electronic format, (2) full-text available in electronic format only and (3) information available over the Internet.
The electronic environment has put us in the position of explaining to our users that we are now going to “rent” electronic material or purchase it on a temporary basis when we already own the exact item in a print format. Issues of ownership of material and information versus only use of that material for a given period of time are important. For example, when the library owns a print copy of an item, the library can copy it and loan it according to standard guidelines, practices, and laws governing copyright. The purchase of electronic information does not have this same assurance.
Contracts sometimes limit who can and who cannot access material we purchase. We need to be involved in the contract negotiations to make sure our patrons are well served. If we have traditionally let the “public” into and use our library, we need to be sure our services are not compromised because the information is electronic. In a sense, full-text journals online is analogous to “close-stacks”. Unless a library user is a member of our institution and has the necessary password or skills to get access to material that person has a limited ability to get information. Vendors are working out these issues and we should work with them to solve access issues. Our role should be not only to continue to serve all those we have traditionally served, but to expand our services to new users.
Publishers now have little ‘tempters’ for some full-text documents. A user can access a full-text database for a period of time for no charge or the publisher may only give access to a section of the journal (letters, editorials, not the research articles) for no charge. Then a fee is added to access the rest of the journal. Price is based on number of factors or formulas: the number of potential users, the number of simultaneous users, the number of accessions, the amount information downloaded or printed, or the ownership of the material in a print format. We need to have a pricing model that makes sense for our particular library.
Users who conduct their own searching use subject headings less than librarians who search. An argument can be made for producers of databases and online public catalogs to pay less attention to subject headings and place more emphasis on designing thesauri that are easy to use. The techniques for accessing a full-text database are very different from the way a traditional index with a controlled vocabulary is accessed. Technical services librarians will need to understand how users navigating a system and develop guidelines, standards, and thesauri designed for full-text material.
The Online Journal of Current Clinical Trials, the first peer-reviewed, totally electronic scientific journal with no paper counterpart, and not issue-based, began publication in 1992 just before Internet access was readily available. To have access to this journal, a library needed a stand-alone computer and its own software. This journal was not widely purchased or accessed. It did receive a boost when Index Medicus selected it as title to index. The journal eventually ran on more readily available software. The most recent indexed article was published in July, 1996. Had librarians been involved in the planning and design of this journal, I am tempted to think that some of these critical issues might have been resolved before publication. Electronic journals, although growing in number have yet to make it into the mainstream of scientific publication; librarians should have a role in how they are shaped.
Librarians are working on the design of electronic information systems and addressing the many issues connected with accessing, implementing, and evaluating these systems. Public services and technical services are beginning to work together to solve the access, storage, retrieval issues brought on in the electronic environment. Many of these roles are extensions of the traditional librarian’s role: the organization of material and access to it.
The third topic of this presentation, advancing scientific commination, is a less traditional role. But it is also the one where librarians have the opportunity to make a significant impact in shaping the direction of the profession.
The Medical Library Association (MLA) has recently developed research policy statement called: Using Scientific Evidence to Improve Information Practice . This document examines our role in research from several perspectives: education, research support, funding, dissemination, recognition, and measurement. All these are areas where much work is needed, but the first important step is to define the problems, support the research endeavors to solve the problems, and reward the work. MLA is now in the process of implementing this policy statement.
Librarians should contribute in meaningful ways to the growing scientific literature on electronic information. Our work and the decisions we make should be based in scientific evidence. We need to gather, analyze, and interpret data which will permit us to reach decisions and change behavior as a result of scientific analysis.
For health sciences librarians there are many interesting questions that need answers. Does access to electronic information make a difference in patient behavior, for example? The consumer health movement in the United States has received much attention in recent years. For the first time evidence has been published, by a study done by health sciences libraries, that consumer health information does make a difference in behavior in patient behavior . As we have seen from the previous example a huge amount of consumer health information is available on the web: what is its value, how is the material evaluated? It is one thing to undertake a project to organize information on the web, it is quite another to evaluate it systematically and to make recommendations based on scientific evidence for how the material should be used.
We need to work with systems specialists; with health care professionals; with international colleagues; all of whom need to answer a variety of questions. These questions range from how to guarantee that an electronic peer-reviewed journal is as good or better than a non-electronic journal to how do we know what is the best way to help users access electronic information.
Training our users, increasing our own computer skills, interacting with those in our parent organization, focusing on vision of that organization, and working to shape our organizations are all part of our new roles.
Some of the things we have touched on are similar to any research undertaking: study, help make things more available, contribute to the scholarly publication process, educate our users, evaluate the literature, filter it in a meaningful way, and base our practice and future undertakings on the evidence we have acquired and what we have learned.