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2010 Cunningham Fellow Marie-Therese Mitri

The few medical libraries that exist in Lebanon are mostly affiliated with specific medical schools and educational institutions.  The Saab Memorial Medical Library (SML) of the American University of Beirut (AUB) is probably the oldest and most developed medical library in Lebanon. It serves AUB Faculty of Medicine and Medical Center, Faculty of Health Sciences, School of Nursing, and the entire AUB community.

The Lebanese American University (LAU) Library is another developed library in Lebanon. It is a general academic library with a print collection of about 350,000 volumes and 2,474 periodicals strongly supplemented by permanent subscriptions to major online databases.  Established in 1934, the mission of the LAU Library is to acquire, organize and disseminate information resources that support the academic curriculum and research needs, and to cater for the intellectual and cultural pursuits of the university community.

I am recently the Reference Librarian of the LAU Byblos Campus Library. My responsibilities include setting and implementing strategies related to the development, maintenance and promotion of the reference services, including the reference collections so as to ensure proper patron serving and safeguarding of assets. I also design and deliver training modules covering OPAC and other electronic resources tailored to the needs of the different user groups.

The School of Medicine enrolled premedical students in September 2006. The first Medicine class actually started in September 2009, M.D. expected in 2013. The Pharmacy School, which was established in 1993, offers a five-year program leading to a Bachelor of Science Pharmacy (B.S. Pharm.) and a six-year program leading to a Doctor of Pharmacy (Pharm. D.). LAU is engaged in an effort to start a medical library to cater for the needs of the students and faculty of its Pharmacy School and its newly established School of Medicine.

I applied to the Cunningham Fellowship hoping to meet new medical librarians and share their varied experiences. The engagement, that I feel will most advance my professional capabilities, is the exposure to the medical libraries in America and the chance to share knowledge with leaders in the medical library field.

Activities and Library Visits

Please find below a summary of my activities starting from May 4, 2010 at the HAM/TMC Library till May 19, 2010 which is the last day of my visit to the Welch Medical Library:

May 04, 2010
I met with Mrs. Deborah Halsted, Senior Associate Director of the HAM-TMC Library, around 11:30am. She introduced me to some of the librarians and gave me a quick library tour. After lunch, I met with Joanne Romano, Licensing & Serials Librarian at the HAM-TMC Library, who informed me about the THSLC which I found brilliant.

Texas Health Science Libraries Consortium (THSLC)
As stated by Joanne, the THSLC is an agreement formed in 1993 between five health science libraries in the Houston-Galveston area. It aims to provide educational, clinical, and research Texas communities an access to the information available in any of those 5 libraries through shared digital library resources and environment.  Although we do have few consortiums in Lebanon such as ILL/DDS consortium and Electronic Resources Consortium, we still need to put more effort towards establishing wider consortium which will encourage other libraries in the region to join. This will help us to meet the needs of our current users and anticipate the needs of the community. If we are lucky enough, we might spread the word in the whole Arabic region and encourage an even wider cooperation and participation within the various Arabic countries.

HAM-TMC Digital Commons
Meeting with Kate Krause, Digital Projects Librarian at HAM-TMC Library, was quite beneficial. I was very interested to know that students and faculty are those who applaud their own theses/dissertations into the repository system called "Bepress/Digital Commons". They also choose the related subjects and keywords from a predefined list. I found this very efficient and time-saving for the librarians at the same time.  The cataloguers on their turn assign the different related subjects according to the NLM subject headings. Those subjects are searchable in the OPAC while the other subjects and keywords assigned by the students/faculty are searchable in the Digital Commons database.  Discussing the search habit of the end-users, Kate noted that most of the end-users search for those theses in Google and not in the Digital Commons database. However, the HAM-TMC Library is usually listed in the first 3 hits on the Google results page. The OPAC is rarely used to locate those theses. This is fairly the case of the LAU's end-users.

May 5, 2010
My second day started by contacting Mrs. Nancy Roderer, director of the Welsh Medical Library/Johns Hopkins University. We had a fairly comprehensive conversation in which I pointed out to the main library activities I am mostly interested in.

History of Diabetes Lecture
I attended a lecture on the history of diabetes which was sponsored by the HAM-TMC Library. Such lectures are definitely beneficial for they help me get acquainted with the medical field and update me on any new research that is being done. Those lectures also provide me with the opportunity to meet some of the faculty members and students of the medical school which will help fostering a good relationship with them.

Finding Electronic Resources Databases' Class
I attended a class session on finding electronic resources databases given by Beatriz Varman, Public Relations Librarian at the HAM-TMC Library. In fact, I have asked Mrs. Halsted, during the communications I had with her before I left my country, to attend such session. I wanted to check how exhaustive such training sessions could be and the way they are being given.  I had a short talk with Beatriz after the class. She informed me that they schedule several training sessions or classes during the academic year, starting from basic to more advanced sessions. What struck me is that those sessions are open for anyone, including students and faculty members. This makes it more difficult for the librarian, having to address several types and levels of end-users.

National Network of Libraries of Medicine South Central Region, NN/LM SCR.
Meeting with Michelle Malizia, the associate director of NN/LM SCR, was very instructive. I was astonished by the service provided through the NN/LM team, i.e. classes, exhibits, workshops, and providing funding opportunities to the region.  The NN/LM mission is "to advance the progress of medicine while improving public health by providing all health professionals and the general public in the South Central Region… with equal access to biomedical information".

I would be extremely happy if something like this could be done in Lebanon as well. I have asked Mrs. Halsted if she can arrange for me a visit to the National Library of Medicine. What I had in mind is to look for the right person in the NLM with who I can discuss the possibility of similar project in Lebanon. Ms. Shana Potash was kind enough to give me a very comprehensive tour on May 20. I had a short conversation with her. However, I feel like I need to sit down and think seriously what is feasible and what is not feasible for Lebanon.

U.T. MD Anderson Cancer Center Research Medical Library's Visit
Esmeralda Calderon, Library Associate at the Research Medical Library, took me in a tour and was kind enough to show me every corner of the M.D. Anderson Library which I found extremely well designed and a welcoming place for the end-users with its wonderful panoramic view.  The M.D. Anderson library combines a wonderful and functional design with dedicated and professional librarians.  Esmeralda detailed the various and specialized services they are providing in order to guide their patrons in finding the needed information that will help them make informed decisions and more importantly to empower Texans with the knowledge needed to reduce the impact of cancer. I find this a very interesting and noble mission. I hope we, at the LAU, can extend our goal to not only educate the LAU patrons but also the whole community.

Esmeralda pointed out to the benefit of the agreement they did with other libraries in Texas which allows Texans to have access to information and library materials available in all participating libraries in the region, which is basically the THSLC.  I had also the chance to browse the print collection, which triggered an interesting discussion on the selection and weeding criteria, as well as the shift from print to electronic format. This is especially vital and one of the most crucial topic of today's libraries. What are the criteria that will help us to make wise weeding decision in order to make room for larger study group space, etc. that will better respond to the new generation's study and work habits?

May 6, 2010
HAM-TMC OPAC and electronic resources
Joanne and I met another time. I wanted to know more about the HAM-TMC OPAC and electronic resources. Upon my request, she pointed to the electronic resources that are most highly used which gave me an idea of the recommended resources for the LAU medical library.  There is one thing I found very interesting while looking at the PubMed/Medline database which is the "FindIt" feature. The HAM-TMC have added this feature which allows the end-users to easily locate the full-text access to any article of interest, be it in print or electronic format, not just in the HAM-TMC Library but also in any library within the THSLC.

Reference Department's Activities
I met with Lisa Berry, Associate Director for Reference and Outreach, and Shannon Basher, Education and Emerging Technologies Librarian. We spoke about the different services provided by the Reference Department through the Help Desk, Ask a Librarian, email service, online tutorials, etc. I was astonished to see that the end-users are becoming pretty much similar in all countries. Despite the continuous efforts from the library part to train its end-users, the attendance could get many times very low.

Presentation about Lebanon and the Lebanese American University
Fellow librarians gathered for the presentation which was scheduled for Thursday. I was happy to see that everybody was extremely excited by the end of the presentation to visit Lebanon. They like the LAU campuses, both Beirut and Byblos and were glad to see many similarities in the services that the LAU and the HAM-TMC libraries provide.

May 7, 2010
Collection Development Department
I spent a couple of hours with Dean James, Associate Director at the HAM-TMC Library. We went over the e-journals collection and emphasized on the core journals for the medical, nursing, and pharmacy majors. He also demonstrated the Access Surgery, the Nursing Consult, Health Source databases, etc. I was able to get a comprehensive list of the databases that are essential for the medical, nursing and pharmacy end-users. We also discussed the difference between Dynamed and UpToDate databases and the cons and pros of each.  Upon my request, he listed the best tools I should refer to in order to make proper selection decision while building and developing the collection. Dean pointed to the importance of the link resolver in accessing the e-journals collection.

McGovern Historical Collections and Research Center
I had a tour at the McGovern Historical Collections and Research Center where Philip Montgomery, Archivist, showed me the very special collection that they have and the preservation and management methods they apply.

THSLC Meeting
A meeting was held at the McGovern Historical Collections between some the THSLC members. I had the chance to attend this consortium meeting.

May 10, 2010
Cataloging Rules

I spend another couple of hours with Dean James. He taught me how to use the NLM cataloging manual, LocatorPlus database, MeSH Browser, NLM Authority Records, etc. He also showed me some online tutorials that might help me to get started.

University of Houston Libraries
I had a tour of University of Houston Libraries. I extremely admired the Learning Commons area with the facilities and services provided. The space is also well designed to provide different type of study and reading areas.

May 11, 2010
Cataloguing Rules

I spent another couple of hours with Dean James to elaborate more on the cataloguing with real examples.

Reference Department
Sheila Green, Partnership and Marketing Librarian, informed me about the kind of things she does in order to market the library services and to partner with the faculty members. In addition to the training sessions she and her other colleagues in the reference department provide on a scheduled basis. I also spend some times with other reference dept. librarians. We discussed the databases that are mostly used, the efforts they put in order to provide their patrons with basic and advanced information skills. They also showed the projects they did for the public consumers, i.e. booths in some places around the city, etc.

May 13, 2010
I gave Ms. Roderer a short overview of what type of patrons we serve at LAU, the LAU future plan for the medical library, and the skills and know-how that I need to develop during my visit.  Ms. Roderer spoke about the Welch Medical Library architectural study, action plan, action planning committee, and their vision of the future library, which is quite innovative and interesting. She plans to reach the Welch Medical Library patrons wherever they are, disregarding of the physical library premises, and therefore they will go over the collection and perform a severe weeding in order to keep just few items following a weeding policy they are now developing. On the other hand, the librarians will try to reach their patrons in their respective location instead of waiting for them to come over to the library when need be.

Clinical Informationist Service
I met with Blair Anton, Associate Director. We discussed the need of the library patrons and the role of the librarians which has become more proactive now in the sense that we need to go to them wherever they are instead of waiting for them to come to the physical library. She informed me about their project to build strong relationship with patrons based on skills and expertise.
In this same spirit, each librarian has been assigned certain schools departments. She will be the contact person for all the faculty members and student of those departments, whenever need be. The librarians first investigate departments and contact key members. Then they conduct needs assessments, attend open department activities, determine physical and virtual venues for active informationist participation, initiate on-site office hours, and hopefully participate in complex project collaborations. Blair was lucky enough to be part of a big project with 2 other faculty members.
Digital Library Services and discuss collection development

Sue Woodson, Associate Director, informed about their decision to keep 20% only of their collection in print format and to replace the rest in electronic format. This triggered a discussion on the weeding criteria, whether for journals or monographs, especially the reference resources for not the same criteria could be applied considering that the later cannot be checked out and therefore it is extremely difficult to identify their usage statistics.

May 14, 2010
Public Health and Basic Science Informationist Services

Claire Twose, Associate Director, took me in a tour of the Johns Hopkins School of Public Health and Basic Science. Claire was lucky that the School of Public Health and Basic Science were co operant enough to spare her with an office within their premises where she spends a couple of hours twice a week. This is part of the project that Blair informed me about, which is to build close relationships with the faculty members of the respective school in order to market the library's services and resources. The more visible the librarians are, the more the patrons will make use of the library resources and services, and the more the librarians will get involved in their research complex.

Hypothesis-driven data exploration
I attended a lecture given by Dr. Jian Wang who works for Biofortis organization. He described how the web search paradigm embodies hypothesis-driven data exploration, how the beliefs about the hypothesis articulated during search make the way for pharma and academia into study design and analysis. This is basically what the Biofortis software does to make their search activity an easier and more efficient one.

RefWorks Lecture
Christina Wissinger, Clinical Informationist, had planned to give a demonstration about RefWorks. Unfortunately nobody showed up and I have been told that this is not the first time that they schedule for such demonstration or training session and got 0 attendees. I was not surprised for we are facing similar situations at LAU. As nobody showed up, Christina demonstrated to me the RefWorks features and tools including tips on working collaboratively, and how to move from Reference Manager or EndNote to RefWorks.

NLM Cataloging
Sue Woodson and Kathy Danko, Manager/Material Processing, explained some of the NLM cataloging rules. We went through the subject heading and the call number manuals.

May 17, 2010
Education Committee Work and Liaison Activities

Victoria Goode, Clinical Informationist, took me in a tour around the Johns Hopkins Medical Institution and the different library departments. She then explained the real work of the Education Committee, which is to define education and training needs of the JHMI user community. Its goals include among others, establishing more opportunities for curriculum integration and offering programs in multiple formats.

Advanced Technology and Information Systems (ATIS)
Dongming Zhang, Associate Director of ATIS, informed me of the various and innovative projects his department is embarking. He also explained how the different portals work and the advantage of such portals. Dongming is a very creative person. I was impressed by the wonderful new ideas that he's got.

Internet Service Committee
I met with Lisa Song, ATIS Chair, whose job is to foster and promote the communication and collaboration between ATIS and other library departments. We discussed the relation between the ATIS and other library departments which is very productive. Lisa provides also suggestions and recommendations for information technology developments and services. I found this committee very efficient especially at a time when libraries are becoming in a way virtual or electronic. I will surely look into having similar committee at LAU Libraries.

May 18, 2010
Welch Service Center and Staff Development Committee

Stella Steal, Associate Director/Welch Service Center and Chair, Staff Development Committee, informed about the staff planning project which Welch Library has already started implementing. They have merged the 3 service points, which are the reference desk, circulation desk, and the reserve into one service point which is now Welch Service Center (WESC). The aim was to improve the service by reducing the service points.

The staff development committee is involved in several projects. One of them is to provide the library staff with opportunities for continuing education, and developing a survey in order to find out how the staff wants to learn, etc. This committee takes in charge the orientation for new employees, etc. I admire the human side of this committee which genuinely tries hard not to loose any of their staff but on the contrary provides them with new opportunities through continuing education and staff development.

Internal Communications Committee and Liaison Activities
I met also with Katie Vizenor, Public Health and Basic Science Informationist and Chair of the Internal Communications Committee. In addition to her duties as informationist which involves developing good relationships with the respective faculty for in-depth collaboration, Katie has undertaken several projects, being the Internal Communication Committee Chair, in order to develop an intranet portal where all the Welch Staff can communicate, share documents, be aware of the work done by each informationist, etc. This committee helps to boost the staff moral by organizing events and gathering and at the same time developing some leadership character among the staff in order to be a good facilitator and speaker.

Assessment Committee
Being the chair of the Assessment Committee, Lori Rosman who is also a Public Health Informationist, showed me the reports they generate for the different activities and departments. Those reports give a good snapshot of the library activities. They help to inform the library staff of what is going on, how much the databases are being used, which one is the most or the least used, etc. They are sometimes used to support a project or a plan, i.e. the brave decision of the director to get rid of the print collection because of its rare use, except for the historical collection and some titles which are not found in electronic format, etc.

May 19, 2010
Finance and Administration overview and space planning

Will Bryant, Associate Director/Finance and Administration, showed me the Welch Budget plan. We discussed the budget shrinking and the Welch Library plan to repurpose the traditional library and therefore the impact it has on the staff plan.

Communications, Informationist Services and Research Committees
I met with Catherine Craven, Communications, Informationist Services and Research Committee's Chair. She talked about the project the committee is undertaking, i.e. the photo campaign in order to promote the library moto "Wherever You Are". The committee's aim is to promote the Welch Library and to raise awareness. In this same spirit, it promotes the training session classes and other library services by posting news, creating a library facebook account, blog, twitter, etc.

Searching Evidence Based Resources Training
I attended a training session tailored for nurses. In this session, Stella trained the attendees on how to search evidence based resources by demonstrating several databases search interface and explaining the Boolean operators, etc. I was pleased to see the wonderful interaction she got with the nurses especially when she was able to locate highly relevant articles to a topic they were discussing on that same day with their instructor. There is no doubt that a successful training session would be one that tackles examples related to the trainees' interest.

Mobile Computing Committee
Christina Wissinger, Clinical Informationist, and Chair of the Mobile Computing Committee, and I discussed the efficacy of the new mobile tools, i.e. ipad, iphone, etc. The big question was how much those tools may be of help in providing library service to the patrons.

Conclusion
The Cunningham Fellowship came at the right time in my professional career that I could not have better planned. The LAU has just inaugurated its medical school in Byblos campus, where I work, and a medical library is firmly in the making. The exposure and intimate interaction with fellow librarians at the HAM/TMC Library and the Welch Medical Library/Johns Hopkins Medical Institutions enabled me to see a new dimension of group dynamics and professional relationships. I have learnt that Job specialization, which to some extent is lacking in LAU mainly due to scarcity of recourses, enables focusing on the subject matter and allows for better concentration and superior results.

Recommendations for Improving the Program
It is not unusual for librarians preparing for a career in medical librarianship to come from institutions, like LAU, that are at the early stages of developing a medical library, and therefore those librarians have limited or no chance to get practical experience in the field of their specialization.Although in my situation the 2 weeks of observation were extremely enriching, I strongly believe that they could have been greatly enhanced with a further period of practical experience.  I would therefore highly recommend extending the program in order to allow for practical training to augment firsthand experience and provide not only the knowledge and skills necessary for medical librarians to embark into the medical librarianship field, but also the practical experience and skills that go with it.