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Health libraries are in the business of collecting print and electronic resources for their users in order to support the effective and timely provision of reference and information services. Despite a decline in reference questions in the digital age, reference services continue to be widely offered in both academic health and hospital libraries right across Canada and the United States.
While traditional library and reference services continue to change, health providers and clinicians continue to require assistance from health and medical librarians, especially in completing literature reviews for grants, clinical trials and systematic reviews. Moreover, every book or journal in a print or electronic collection serves as a critical part of the overall evidence-base. "Evidence" is the sine qua non in 21st century medicine. Some of the most common types of reference books in medicine mirror that of other scientific disciplines: dictionaries, directories, handbooks, encyclopedias and textbooks. Historically, health library users have presented their information needs to health librarians at reference desks, but now can do so via phone and e-mail. Many library users are self-sufficient in their information-seeking activities for the most part thanks to access to information via search engines. However, health librarians are needed for expert searching and to teach the basics of information literacy.
Reference services in the 21st century have changed in new and exciting ways but traditional services are still necessary for the foreseeable future. As health librarians are generally responsible for building print and e-collections, they must take steps to ensure that the information that they collect is authoritative and facilitates the use of evidence in health care. Most medical libraries are found in health settings such as hospitals, medical schools, private industries and medical associations. With so much available information, there is some concern that end users are unable to conduct proper literature reviews and merely accept that what they find in the first list of results on search engines is what is available to them. This is why information literacy is so important in the practice of evidence-based health care and why reference services will also continue to be important.
The role of the health librarian
The major role of health librarians in evidence-based practice is to provide access to reliable, evidence-based information and to assist clinicians in locating and understanding the literature. Information that health librarians find should be the best evidence (see also authority) and contextualized within the larger body of literature in medicine. At a simple level, health librarians are responsible for the interpretation of reference questions, evaluation of information sources and the identification of search engines to supply suitable answers to health professionals and consumers. In that sense, much of the work of the reference librarian in health is focussed on issues of health literacy as well as information literacy. Some reference services focus on the importance of information retrieval but all kinds of newer services in information dissemination such as e-alerting tools, blogs, RSS feeds and podcasts are increasingly used. Health librarians working with clinical teams assist others in locating the best medical evidence and now assume all kinds of new roles in information retrieval such as consultant, advisor and co-investigator.
Traditionally, health librarians have delivered information services by utilizing mostly print collections to meet information needs. As such, they use expert skill and techniques to access, sort, transfer, evaluate, filter, and disseminate information to users. Printed catalogues and bibliographies, the accessibility of online catalogues and multimedia databases, along with organizing national interlibrary loan (ILL) systems, have opened up the range of available resources to health libraries. Despite an increasingly open and extensive corpus of digital information, health librarians continue to provide basic print collections and services to users, tours of the library and, increasingly, subject-specific information tools and advice. Instruction in libraries is greatly expanded by the enormous increases in research worldwide, the expansion of web-based electronic resources, and the quantity of language formats available for media and publication.
Despite an increasingly open and extensive corpus of available electronic information on the web, health librarians continue to provide basic print reference services to their users in medical and health libraries around the world. Health librarians are also typically responsible for providing physical tours of their libraries and, increasingly, how to search online databases, catalogues and subject-specific information sources.
Canadian health librarians face a number of additional challenges in the delivery of reference and information services within their organizations. The fragmentation of our national bibliography, and poor indexing of many of our health researchers' publications, are two challenges that must be overcome to provide information for our users. Many hospital and health libraries across the country offer library workshops on retrieving information efficiently including where to look for Canada-specific studies and data.
Finding (and using) medical and health care statistics is a challenge that most health librarians deal with at some point in their professional work. Health statistics may be defined as "...numerical data that characterize(s) the health of a population and the influences that affect human health" (Friedman, 2005). Health researchers use health statistics in a number of ways to design, implement, monitor and evaluate specific clinical research, health programs and services. It is incumbent on health librarians to help researchers locate these statistics, and to teach how they might be evaluated.