Using the Evidence to Fight the Flue

It’s that time of the year again – as commuters on the train are sniffing, sneezing and coughing, the Neue Zürcher prints a guest commentary by Johannes G. Schmidt, a GP with an interest in Public Health, as well as Alternative Medicine, about the low efficacy of the flue vaccination. And the old debate between believers and doubters erupts all over again, with several letters to the editor within a good week.

However, one thing is different this time: the Cochrane reviews both sides refer to, are now accessible to all of us in Switzerland, thanks to the national license by the Swiss Academy of Medical Sciences. Let’s see how access to the best evidence will influence public debate!

The National License for the Cochrane Library is here!

From today, the whole of Switzerland has access to the Cochrane Library, thanks to the efforts of and funding by the Swiss Academy of Medical Sciences. Under the aegis of the academy, funding from existing academic and hospital licences were pooled and the total topped up by the SAMS to allow the whole nation access. In the course of the next months, the SAMS will, jointly with medical and cantonal libraries and professional bodies, make healthcare professsionals throughout Switzerland aware of this license and introduce potential users to it in workshops and through other channels.

So far healthcare professionals in countries with a national health service, such as the UK and the Scandinavian countries, have benefitted from library services provided for them by their employer while in all-private systems, such as in Switzerland and Germany, doctors outside of university hospitals are left to their own means – they have access to those few journals they have personal subscriptions for. And I haven’t even mentioned the rich libraries professional bodies offer their members in addition to the NHS resources: the BMA, the RSM and all the royal colleges run extensive library services with a print collection in London or Edinburgh, remotely accessible e-resources, and support through experienced librarians. Evidence Based Medicine can only be practiced where there is access to the evidence, alongside the professional support with information retrieval.

The SAMS has made a first step – and a bold one. We Swiss medical librarians will do our utmost to make it a success. Let’s hope more e-resource licenses will join the Cochrane access in the future!

iPads in Medical Education – Apple Experts Roundtable, Amsterdam, Dec 14th, 2015

Being librarians, we buy or license e-books. Well, some libraries are getting into publishing – through repositories or OJS journal servers. But producing e-books, and competing with textbook publishers like Elsevier and Thieme? Is that any of our business?

Yes, why not? Programs like iBooks Author – a free-to-download programme from Apple – or, as a platform for a whole university press, Open Monograph Press from the Public Knowledge Project, allow all of us to produce e-books, even with multimedia and interactive content. Jochen Bretschneider from Vrije Universiteit Medical Centre in Amsterdam showed how as part of their ‘Mobile Learning Initiative‘ he and his team turn lecture notes into ibooks and enrich them with videoed surgical procedures, interactive elements etc.

We librarians spend huge and probably unsustainable amounts of money on e-books the vast majority of which make no use of the benefits the on-line platform offers (and quite a few even come in infuriating DRM restricted formats). At the same time quite a lot of teaching materials that our academics have created in-house, are dumped in poor formats in remote corners of Virtual Learning Environments or course websites. Wouldn’t it be worth setting a small proportion of our e-book budget aside, to allow our academics to experiment with the e-book format? Some of the content might turn out more useful than the e-books we have been licensing for so many years…

Is the iPad the successor to the printed textbook?

Oliver Obst reported the findings from a large-scale iPad trial in Münster – a project he first mentioned at the 2013 AGMB conference in Berlin, the outcome of which many of us have been eagerly awaiting.

With the transition of journals to the on-line format completed, the Münster ZB Medizin investigated the potential of a similar conversion of student textbooks. A survey amongst students showed strong penetration of traditional (i.e. print) textbooks, complemented with on-line (multiple choice) training materials, lecture notes and on-line textbooks. Students tend to use the lecture notes in electronic format, annotating them and sharing them within their revision groups through cloud services.

The Münster library decided to build on the popularity of the tablet as a learning and revision tool, and piloted loanable, pre-loaded iPads (85 of them!) alongside content bundles for download to students’ personal iPads (70 of those). Students quickly adopted the iPad, even changing their revision habits to make best use of the new tool. The learning tools also integrate with external tools, such as communication or calendar.

So is the iPad the heir to the throne? Oliver Obst’s answer was along the lines that – although each medium was so unique there was never a 100% successor to anything -, the iPad integrates the functions of the textbook with many additional ones. A future device that expands the capabilities of the platform even further, might, indeed, replace the printed textbook for good. However, the big hurdle of making content available, in the form of site-licensed apps, will have to be overcome.

Negotiating licenses for a wide range of healthcare providers

The Spanish province of Andalusia has set up an eHealth service that provides on-line resources to all users across the healthcare system, Laura Muñoz-Gonzales reported. The new service provides an impressive range of service, replacing a large number of institutional subscriptions and delivering better value for money. To my amazement, the project met the support of institutional librarians who had to give up part of their budget towards the centralised resource purchasing!

As far as I can see, the gap in access to a decent range of information resources is widening all the time between countries with a central or national health service, and countries with an all-private healthcare system. The level of information services Laura presented currently has no match in countries with a private healthcare system.

Elsevier out of sync with Elsevier?

Francesca Gualteri reported about her library in a pharmaceutical company’s use of Elsevier’s ‘Mendeley’ to manage the internal literature repository. Interestingly, she mentioned problems with the importing, especially of Elsevier publications. Others in the audience confirmed these issues. I suppose quite a few of the participants at the conference are going to ask the Elsevier reps at their stall about this issue…

Journal Apps

Guus van den Brekel presented an excellent comparison of four journal apps which the university of Groningen evaluated as a way to help academics keep up to date with their literature. How do your users want to read journals? Only in response to a concrete query, doing a database search? Or do they also browse tables of content? And how often do they do the latter – do they rather use RSS feeds from selected journals, or do they browse their favourite journals on a Friday afternoon?

All four apps come from fairly small, innovative companies, not from the big library software providers or publishers. They are:

The app that scored highest in the Groningen evaluation against a set of criteria and attracted a substantial amount of additional usage of the journals, was Browzine. I was glad to hear of this outcome: at Bern university we are currently trialling Browzine, too!

“Open” and the Library

Maria Cassella in her keynote speech at the EAHIL 2014 conference reports that “Open” – i.e. Open Access, Open Data, Open Educational Resources, Open Peer Review, MOOCs (Massive Open Online Courses) – has triggered a centrifugal trend away from the traditional channels of scholarly communication, including the library. This new trend contravenes the previous centripetal tendency of consolidation of all information related services in the library. As academics increasingly are in a position to produce and store data themselves – research data and publications, educational content; using repositories, cloud services and the like -, they use these new channels rather than the library. This could, ultimately, lead to the fragmentation of knowledge.

Librarians, so Maria, need to form partnerships to counter this dangerous trend: with faculty, students, IT. And they should develop new skills and professional roles, such as (as defined by the ALA as ‘core competencies in librarianship’ in 2009):

data librarian
digital cudrator/data curator
scholarly communication librarian
project manager
ontologies specialist
intellectual property rights specialist
bibliometrics specialist
knowledge facilitator
educator

In the discussion, a colleague saw the risk that the wide range of highly specialised tasks could lead to specialisation and fragmentation of the profession of librarians. She was certainly right in the sense that none of us will be able to cover the full range of both our traditional and our new roles as a single person: we will need to split our tasks between several people with different focus. At the same time, as our roles rapidly change and evolve, we will have to keep up with these developments.

A source of endless frustration: e-books

It seemed so simple: instead of shifting piles of printed books every day, libraries would license core textbooks on-line, and students would read them on their own devices. No more queues for core texts during exam preparation, no more anatomy atlasses hidden inbetween Geology, no need any longer to preserve copies of the past edition for the busiest times of year.

But in real life, e-books turned out a nightmare. Why does one e-book from publisher X open on the iPad, while another one doesn’t? Does the viewer which e-books from a certain set from publisher Y require, allow printing chapters? Why is there no viewer for that publishers’ titles for Android? There’s a ‘Download’ button showing which doesn’t do a thing – what’s that good for? How do I get this e-book into Colwiz, for sharing notes with my revision group? Are you sure that’s not possible at all? I’ve got these anatomical images on my tablet now, but isn’t it daft they aren’t three-dimensional?

Especially since iPads have made their entry, students would be prepared to try even core textbooks in the on-line format. But at the same time, students are IT-savvy enough not to put up with all the limitations publishers impose on their content. And this includes not just all the DRM hurdles, but also the limited functionality: students expect e-books to make good use of the capabilities of their tables, from advanced handling of images (zooming, turning by 360º…) to sharing annotations in the cloud. And they certainly won’t put up with e-books that can only be viewed in a special reader, one page at a time…

Overall, e-books have, so far, been a pretty disappointing experience for our readers. It is about time we listen to their frustration, and make it plain to publishers what we expect in return for a share of our budget. We’ve done it with Thieme – they now accept that their former e-book format (which required Flash, i.e. wouldn’t open on the iPad) was a mistake; and, at long last, Thieme e-Books are now available in a Flash-free format. Let’s make sure other publishers, too, begin to take our readers’ needs more seriously!