Reporting from Indianapolis

Eleven members of your Midwest Chapter/MLA Executive Board met for a very productive meeting last Friday, March 30 in Indianapolis. Here is my personal take from the proceedings! Be sure to watch for stories in the upcoming mid-May issue of our official chapter newsletter MIDLINE about these items of interest and MORE!

It is worth noting first that chapter finances are in good shape. The chapter has retained the services of a professional accountant, Michelle Dixon, C.P.A. Chapter Treasurer Amy Donahue has been working hard all winter with Michelle to review and re-structure the files and spreadsheets used to keep track of chapter finances and to audit the books for 2010 and 2011.  The books for the 2010 Annual Conference in Madison are “closed” and the conference showed a nice profit, half of which was shared with our co-sponsor, WSHLA. The books for the 2011 Annual Conference in Indianapolis are nearly squared away as well. The chapter will still be using the Acteva services in the short term for online membership payment and conference registration. In the meantime, the Finance Committee is investigating alternatives.

The Professional Practice Committee has been hard at work on the details of the chapter’s new Research Presentation and Poster Awards. These monetary awards recognizing presentation of exemplary research by our members will be given for the first time at the 2012 Annual Conference. Watch upcoming MIDLINE issues for award announcements!

One thread that ran through almost all of the discussion at the board meeting was communication. We considered some concrete measures that the chapter’s Representative at Large Stephanie Schulte and the chapter’s State Liaisons Committee members could pursue to better serve as conduits of information in both directions between the chapter and our sister state health sciences library associations in the Midwest. We talked about how to better use different chapter communications vehicles for keeping our members up-to-date. The chapter website will be getting an extensive informal review and some additions were suggested.

As part of a continuing improvement project, Archivist Mary Hitchcock has been busy working on a draft “policies and procedures” document which was reviewed by the board. The document provides guidance for officers and others working on chapter business on what to keep (and send to the archives) and what not to keep. Work will continue on a better way to archive photographs, particularly digital photos taken at conferences. Anyone interested in helping yours truly with collecting all those photos into a single Flickr account? Seriously, let me know if you want to help! I’ve been procrastinating on this for YEARS.

The board spent a big chunk of meeting time reviewing the answers to the open-ended questions from last year’s Membership Survey. The Membership Committee under the leadership of Membership Secretary Katherine Chew mined your comments, categorizing the comments and suggestions. The board particularly focused at this meeting on continuing education, the annual conferences, and other professional practice issues. The Chair Natalie Reed and the Professional Practice Committee will be working on ideas particularly in the area of continuing education.

And here is one last “heads up” for you! We still indeed are planning to bring revised chapter bylaws up for a vote by the assembled membership at the next Annual Business Meeting in October in Minnesota. Our bylaws need to be brought into “compliance” with the MLA Model Bylaws and need some other various tweaking.

Conference Wrap-Up

We hope you enjoyed the blog coverage of this year’s Midwest Chapter/MLA annual conference. As your intrepid blog editor, I would like to thank our three conference bloggers Amy, Jean, and Stephanie for their great work! This is our fifth year blogging the Midwest Chapter conference and I think it may be the best yet.

We may be finished with the conference blogging, but there are still photos being uploaded to Flickr. As I write this there have been 251 photos tagged midwestmla10 uploaded to Flickr by five photographers. Check them out! Our “official” conference photographer Michael still has some of his fabulous photos to upload. We are in the process of setting up a new Midwest Chapter/MLA Flickr account for those photos. We will let you know when those are posted.

Do YOU have any photos that you took at the conference? Please consider posting them to Flickr and sharing them with all of us!

But wait! There’s more! Presentation slides from many of the conference sessions have already been posted on the conference website on the contributed papers page. Just click on the title of the presentation to see the slides. More will be added as the authors submit them.

Library Advocacy: a Wisconsin example

Session 17 – Eileen Severson, Mary Bayorgeon

I have to admit, I was inspired by this session.  Next week I’ll be doing some advocacy for my senator before the November election, but I’m really considering it practice for sticking up for medical & hospital libraries for the rest of my life.

Eileen and Mary gave an excellent presentation that began with some background info on the requirement for hospital libraries: at one point, New York State threw out the library requirement for hospitals, but as a result, the famous Rochester Study came out.  On the other hand, we’re fortunate here, as there is a Wisconsin Administrative Code for regulating hospitals that requires a health sciences library: DHS 124.09.  Sadly, it hasn’t been enforced.

Some additional info: Wisconin’s COLAND (Library council) advises the state superintendent of public instruction on library issues affecting all types of state libraries.  When hospital library closures prompted Mary to do something, this was the body she was able to approach (she is, in fact, a current member).  In order to be the most persuasive when approaching the superintendent, it was decided that a survey should be sent out.  And while Code 124.09 specified only a requirement for a library and not for staff (124 as a whole deals with all hospital services), the survey asked hospital libraries for information on both.  The survey showed that, I believe, 6 libraries had been closed since 2005.

The survey results were used at a meeting with the relevant administrative bodies last year; attendees also included WHSLA and COLAND representatives along with other various health agencies Mary organized.  In addition to the survey, the meeting preparation included a prepared letter to director of the bureau of health services, division of quality assurance, statements of concern about closures, and references to studies that showed the impact of hospital libraries.  They emphasized how the services provided by a professional librarian save money and argued that hospitals with closed libraries lacked important patient services.

The response was positive and certainly raised awareness…but they found out that the agency enforces federal regulations, and is paid by the federal government.  In addition, it’s a complaint based department, and there had been no complaints, so they hadn’t heard of closures.  They also learned that Code 124 is under revision and was accepting comments.  The trend is less prescriptive in favor of outcome-based requirements

The main outcome of meeting was that the closings were officially recorded as complaints.  And now there is lots of work to do!  They are currently promoting revisions for the code that include a hospital library staffed by a professional librarian.  But the success of this is questionable, especially since the requirements won’t be prescriptive.  What’s needed is an outcome-based requirement that shows a library role.  The public hearing hasn’t happened yet, and Mary/COLAND will get a draft of the proposal beforehand which they’ll use to develop a response.

And so sounds the call for advocacy!  This was a common theme of this meeting, which I’m excited about!

(I apologize for the choppiness of this entry; I think I’m missing some key details about the bodies involved.  Please add any knowledge you might have in the comments!  I’d also love to see Mary’s slides posted…)

The Level of Evidence Used to Answer General Practitioners’ Questions

Session 14: Karen Davies

Karen Davies presented her fascinating research on what level of evidence is most often used to answer general practitioners’ questions, done in the UK.

She started with a couple of thoughts/definitions: first was Venn diagram from Haynes (1996) that showed evidence-based practice as the over-lap of research evidence, patient preferences, and clinical expertise (which, she clarified, does not go away in EBP).  She also raised the question: if you can’t get level 1 or level 2 evidence, is it worth using evidence at all (case studies, e.g.)?  Her response–yes.  She also raised a point I found intriguing: perhaps we should question meta-analysis’s position at the top level, since they’re often inconsistent and even the statisticians can’t agree.  I’m not sure I entirely agree with her, but I definitely think it’s a good point to take into consideration with meta-analysis studies.

She had 2 main research objectives: to determine the highest level of evidence used in answering questions, and also to determine the number of times guidelines are used.  To answer them, she looked at 2 primary care answering services in the UK: ATTRACT and the NLH Primar Care Answering Service.  Their answers are publicly posted online, so it was simply a matter of tallying everything up.

Some results:

  • On average (for both services), only 11% of the answers used top-level evidence.
  • The two services had very different numbers of questions not answered…the sidenote being that there will always be questions for which there is no evidence.  Yet.
  • 42% of the answers referred to guidelines.
  • Very few of the questions were answered using level 2 evidence (clinical trials)

As of now, the NLH service has closed.  Which perhaps underscores Karen’s conclusion that since guidelines are so important, doctors need to know where to find them!

An audience member wanted to know whether there is a difference between UK and US guidelines; Karen’s answer was that she believe the UK is a bit stricter about having obvious “expiration” dates on their guidelines, but she noted that the answering services used US guidelines in many of their replies.

I found this to be a fascinating presentation, and I was very pleased to see that Karen’s slides are posted (.pptx).  Check them out for more results and pretty graphs!

Interesting Times: a library school project with real-life implications

Sadly, I didn’t get a picture of this group, but I did really enjoy their presentation!  So I’ll attempt to share some of what I learned here with the greater Midwest Chapter.

Dr. Catherine Arnott Smith together with Ms. Anan, Ms. Hellwig, Ms. Huggins, Ms. Townsend and Ms. Westby (all currently enrolled graduate students in SLIS’ LIS degree program) presented on their involvement with the American Family Children’s Hospital Family Resource Center (FRC).  The FRC is known as “a consumer health info resource, reading room, and business center.”  It does not, as Dr. Smith originally thought it might, have any connection with the University of Wisconsin’s Ebling Library.

The FRC has a strong mission and an up-to-date collection, thanks to one-time donations, but it also has to contend with poor location and no staff member/librarian to advocate on its behalf.

And, it turns out, the above sentences should be written in the past tense, because (perhaps partially due to the lack of advocate), the FRC has been shut down.

But the students’ project began before the shut-down, and now continues in new directions; they were originally working towards answering the question of “how can the FRC collection remain responsive to its users?”

The first part of the project was a collection analysis, where the students found inconsistencies and which led to a catalog project.  They began to use CIP data to catalog the materials, and to assign MedlinePlus topic headings to help organize the collection into useful lists.  Unfortunately, with the closure, the collection has been dispersed, but the work the students did is a valuable way to think of dealing with small, non-staffed collections.

The students also created and sent out a survey; they spoke in depth about the survey design.  In the end, there were 12 respondents, mostly parents of patients at the American Family Children’s Hospital.  Although it’s not a large sample, some of the interesting findings include the fact that respondents go to doctors and nurses for assistance with health information; very few go to librarians.  Which is not necessarily surprising, but definitely still good to know, and provides a basis from which to move forward.

So the group ended with a challenge for the audience: where do they go from here, and how might they get the FRC back on its feet?  I think they have some of their own plans, but the audience contributed some thoughts, including continued advocacy and outreach through other area health sciences libraries.

Do you, dear readers, have any other suggestions for them?

Dyslexia: health, literacy and libraries

Session 11 (MC/MLA Update):  Margery Katz, MA, JD; Julie A. Gocey, MD

I had the honor of attending this thought-provoking session on Sunday afternoon.  Dr. Gocey started things off by having everyone stand and then asking us to sit down as we responded “yes” to whether we knew an immediate family member affected by dyslexia, a classmate or friend, and finally anyone in our lives.  I was in the middle group, and of course, by the 3rd question, everyone was sitting down.

Some facts:

  • Dyslexia is a term for an unexpected difficulty learning to read (and relatedly, write and spell).
  • ~1 in 5 people have some level of dyslexia (from mild to severe).
  • MRIs show that people affected by dyslexia are unable to use certain key areas of the brain, but they also show neurobiological changes and improvements that can happen with educational treatment.
  • NICHD definition: deficit in phonological component of language, unexpected in relation to other cognitive abilities.
  • What dyslexia is not: reading backwards, a symptom of lower IQ, a life sentence of lower achievement.
  • Untreated dyslexia, however, can result in: poor reading comprehension, poor reading experiences, less vocabulary, and less background knowledge (that would normally be picked up from reading).
  • What is needed to help treat dyslexia is evidence-based reading instruction; often referred to as multi-sensory structured reading instruction.

Dr. Gocey and Margery Katz called on us to all work together, to support early detection, promote adult screening, provide equal access, and to coordinate support from clinics, hospitals, schools, and libraries.  They mentioned that physicians are not routinely trained to identify dyslexia, and that screening is not standardized.  In fact, the lack of access to (as well as insurance coverage for) testing is itself a barrier.  Two bills related to these issues were brought up to the state legislature, and while they both died, there was the positive fact that they got some coverage and conversations did start around the topic.

The results they presented on a librarian survey were perhaps not surprising, although one may have hoped otherwise: just like the general public, librarians show a disconnect in their knowledge of dyslexia.  In addition, most library resources dedicated to disabilities focus on “brick & mortar” problems like building ramps and providing resources for the blind.  This is certainly not a bad thing, but libraries and librarians are missing a big piece of the problem when they don’t address, in addition, reading disabilities (which is, perhaps, ironic).

I went to this session to learn more about a topic I knew little about, and I was not disappointed.  In fact, there was so much information, I wasn’t able to keep up in my notes!  Fortunately for both me and you, the wonderful slides have been posted.  Check them out for lots of links to great resources!

The Resource Library as Host for an eResources Consortium

Neal’s session provided an in-depth look at an e-resources consortium that began a decade ago, and still exists (albeit in a changed form) today.

Session 9 – Neal Nixon

Neal’s session provided an in-depth look at an e-resources consortium that began a decade ago, and still exists (albeit in a changed form) today.

Presenting on an e-Resources Consortium

The consortium, centered around the University of Louisville (Kentucky) Kornhauser Health Sciences Library, began in 2000 when 9 metro-area hospitals and their libraries decided to work together and from the Louisville Medical Center.  A “cooperative spirit” prevailed that made the consortium possible, and certainly contributed to its initial success.

Some Nuts & Bolts (of the early days):

  • Kornhauser, with a committed budget for eresources, was committed to paying its original share and did all the negotiations.  The hospital libraries simply divided the remainder.
  • Key part of the negotiations: the resources were purchased not as site licenses, but as numbers of seats.  In some cases, additional seats weren’t even necessary; the current number was sufficient for all members!
  • Initial resources: MDConsult, Stat!Ref, Ovid.  It became clear that the resources desired were those needed for clinical support, not research.
  • Choosing the databases was the easy part…The difficulties came during the discussions around which collections and journals to subscribe to.
  • Each library sent a representative to make the case.  However, Kornhauser was the “800 pound gorilla in the room” and could make final decisions, since it was doing the negotiations and paying the bulk of the costs.

From these basic facts about the beginnings of the consortium and how it worked, Neal went on to discuss some of the issues.  The first being, not surprisingly, working with IT.  But work they did.  The next big issue (and, in fact, ongoing issue) is that Kornhauser was in charge of billing, which had complications both in actually collecting from the hospitals in the consortium and in dealing with the large amounts of money that then sat in the University’s accounts until the resource bills were paid.  Another interesting feature of Kornhauser’s handling of the accounts was that they then also saw all the statistics…and saw that some of the hospitals weren’t using the resources they paid for!

10 years later, a few things have changed.  Members have come and gone, and the cooperative spirit has changed into a competitive jealousy.  Only 3 of the hospital libraries are left, although some of those that disappeared were simply absorbed by the University.

We’ll start with Neal’s negatives (just so we can end with the positives!):

  • Definitely more work for the Kornhauser staff (billing, negotiations, etc.)
  • Resources didn’t always match the needs
  • What should have been a PR win (cooperation! saving money! providing resources!) often confused and raised questions.
  • Loss of hospital libraries?


  • Really did improve access
  • More clout with the vendors (big contracts means they listened…a little)
  • Helped Kornhauser develop a better understanding of the hospital libraries (UL does not have a connected hospital)
  • Vendors could coordinate training
  • Made it easier for personnel moving between locations: the resources stayed the same!
  • More buying power
  • Allowed Kornhauser to truly fulfill its role as a Resource Library.

All in all, an excellent presentation from Neal.  This was the first time I had really heard about the down and dirty parts of forming a consortia, and it provided both a good generalizable overview with lessons learned as well as an interesting story of the long-term experiences of a specific location.  Thanks, Neal!

(For the entire presentation, visit Neal’s posted slides!)

Conference Memories

Your intrepid blog editor has made her way back to her humble abode in the Buckeye State. It was a great trip! I so enjoyed my time with my fellow Midwest Chapter members. And, of course, I learned a lot.

Some of the interesting and useful things I learned:

  • From Dr. Navsaria – the similarities between the reference interview and the medical patient interview.
  • From Ruth Holst – how the library can act as a “neutral” partner, without a “political agenda” within the organization, effectively spearheading cross-disciplinary endeavors.
  • From Alexandra Dimitroff – the importance of writing survey questions that will meet survey objectives.
  • From Kelly Thormodson – practical tips for improving the delivery of library instruction through teamwork.
  • From Liz Fine – how librarians are and could be engaged with nursing faculty in DNP programs.
  • From Robert Shapiro – shared advice from Dr. Lindberg: “Get out of the library!”
  • During Xiaomei Gu’s presentation – that “Dental librarians rock!” 

Memorable conference moments:

  • The rapt audience listening to Dr. Dipesh Navsaria reading The Three Questions.
  • During the “Ruthapalooza” keynote presentation – remembering how it was “in the old days” when doing it digitally meant using your fingers.
  • Enjoying the company of once-a-year friends – eating breakfast together every morning, swapping stories about the worst cars we’ve ever owned over beer and appetizers, buying jewelry from street vendors, sharing the colorful atmosphere of the farmers market.
  • Mentoring a first-time attendee and attending her excellent paper presentation.
  • The Executive Board working productively as a team during their meeting.
  • Waiting in the Madison airport with two Michigan librarians watching for Air Force One.
  • Barbara Gushrowski screencasting “on the fly.”
  • Having fun with Pete and Carl.
  • Taking photos, photos, and more photos.
  • Did I mention eating, eating, eating, and eating some more?


Of course, for me the most memorable moment was receiving the gavel from outgoing Midwest Chapter President Elaine Skopelja! Ready to go to work for the Midwest Chapter!

HeLP MN Seniors

Session 6

HeLP MN Seniors: an evidence-based health literacy program for seniors

Anne Beschnett, Outreach Librarian, University of Minnesota Health Science Libraries

Anne presented on experiences with the HeLP MN Seniors (“Health Literacy Program for Minnesota Seniors”), a project done through a partnership between the University of Minnesota Health Sciences Libraries and the Minnesota Health Literacy Partnership and funded through an NLM NN/LM subcontract.  Community partners, including Boutwell Landing Senior Living (where the project was pilot tested) were also key to the project’s success.

Anne presenting
Apologies for the low light!

Anne first gave some basic health literacy information, e.g., that low health literacy is associated with poor health outcomes.  She also shared some of the motivation behind this particular project: seniors have lower health literacy than all other age groups, while in 2009, studies showed that 38% of seniors are using the Internet to find health information.  While that number seems low, it was 18% in an earlier year (maybe 2005?), so it’s certainly a growing part of the population.

The purpose of the HeLP MN Seniors project was to create and pilot test health literacy workshops, creating resources and a curriculum that could be used by other health literacy educators throughout the state and beyond.  They created 2 workshops, each 1.5 hours long.  The first workshop focuses on communicating with providers and teaches seniors how to go into medical appointments well-informed and able to ask questions.  It incorporates the idea of “Ask Me 3,” which encourages the patient to leave an appointment with the answers to “What is my main problem? What do I need to do?  Why is it important for me to do this?”  The second workshop is designed to teach seniors how to search for health information on the Internet, and Anne personally became convinced of the need for this course when one of her pupils asked her “why would would anyone put anything bad on the Internet?”

After talking about the workshops that were the end product of the project, Anne talked a little about the whole process with the intent of providing some info for those who are interested in doing something similar.  The project began with a needs assessment using focus groups.  One of the interesting things that came up was that the seniors often felt worried about their friends’ health literacy skills rather than their own; why that might be is an interesting question.  Anne also noted that a side lesson learned at this point was the importance of good facilitators for keeping the conversation on track!  As a result of the needs assessment, current health topics and drug info were added to the curriculum.

The workshops, piloted at Boutwell, had both pre- and post-evaluation questionnaires.  Originally, they had hoped to do multiple choice in order to also measure health literacy levels, but when those took more than 1/2 hour, they switched to a Likert scale.  Questionnaires were given before and after each workshop.  The project team also hoped to have a post-pilot focus group, but when no one attended (the scheduled time competed with some important social activities!), they sent out a survey which had a 55% response rate.  The survey results, mostly positive, led to some changes in the curriculum, including removal of redundant information & unused tips as well as a lot of background info (which was deemed important for the motivation driving the project, but not as important for the seniors themselves to know).  They also made the materials prettier.

The end result is a curriculum, with the full workshop presentations and scripts, along with support materials that provide information on how to customize the content (for instance, making the workshops shorter, which was also helped, for better or worse, with the ending of Minnesota GoLocal).  The team is now in the process of marketing the materials around Minnesota and beyond.

So if you want to step up, step forward, and try HeLP MN Seniors for yourself and your patrons, check out!

Highlights from the Midwest Chapter Meeting

Becca Canton: Membership stands at 400 members, 57 of which are new and 32 student members.

Sue London: Current financial state shows a beginning balance of $50,092.43 and an ending balance of $50,228.07 for a net increase of $135.64

Pam Rees: MLA Chapter Council Report (Each chapter elects 2 representatives every 3 years and they meet annually at MLA) Reminder of deadlines on the MLA awards & scholarship (log onto the MLA website for more details).

Donna Barbour-Talley Annual Meeting Report: 137 registered attendees for this year’s conference.

Future conference locations: 2013 Illinois and 2014 North Dakota.

Liz Fine-Awards & Scholarships

Deborah Lauseng-Nominations and Elections

  • Janna Lawrence, President Elect
  • Katherine Chew, Membership Secretary
  • Stephanie Schulte, representative-at-Large
  • Mary Markland, Potential Candidate for MLA Nominating Committee

Old Business: Effectiveness of the Virtual Board Meeting (worked but had standard technical issues) and plans for future use with different technology.

New Business: New Advocacy Committee started last Friday, Time=Money campaign unveiled (downloadable available through the GMR website in the advocacy section).

AHIP renewal for displaced health sciences librarians is currently not available and of concern to the board. The board is reviewing what to do about this

New Committee Chairs announced and recognition of outgoing officers & chairs.

2011 Indiana Invitation:

Welcome Clare Leibfarth, new president elect.