I Wish to Acknowledge the Help and Support I Have Had in Planning, Carrying out and Reporting

I Wish to Acknowledge the Help and Support I Have Had in Planning, Carrying out and Reporting

1993

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Acknowledgements

I wish to acknowledge the help and support I have had in planning, carrying out and reporting this survey from Roel Tilly, my supervisor, and from Peter Niesten, Fons van den Eeckhout and Trudy Meijers, senior librarians at the University

Library, University of Limburg. I wish to thank also Jeroen ten Haaf and Tony Beard (of the University of North London) for their constructive criticisms and ideas; Marie-Louise Knols for her help in searching online for relevant literature; Sandra Ehrens for her help with translations and for being willing to carryon with" phase two"; Leny Caris for her invaluable help and patience in getting this report into a presentable form; the members of the loans department who have put up with me infesting their office for three months and who have produced numerous docu- ments for me with promptness and efficiency; and--last but not least-- all those survey respondents who have taken the time and trouble to discuss fairly abstruse matters with me in English and who have added much to my understanding of medical information use and of academic librarianship.

Contents

page

Introduction......

1

Background...... 2

1. Library

2

2. Problem-based learning. ...... 3

3. User education. ...... 4

4. Previous surveys and research......

Scope

4

4

Literature review...... 5

Methodology...... 5

Results 6

1. Medical students. ...... 6

2. Health sciences students ~ ~ 7

3. Faculty members. . . . . .

A note on departmental libraries

Conclusions......

15

15

Particular issues for phase two of the survey

...... 18

Other possible investigations for the library...... 18

Appendices

1. List of academic staff interviewed 19

2. Student interview schedule (revised)

...... 20

3. Faculty interview schedule...... 22

Notes...... 24

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Introduction

The University of Limburg (Aijksuniversiteit Limburg = AU is the Netherlands' most recently founded university. The medical school (now Faculteit der Geneeskunde

= FdG) was established in 1975, the health sciences faculty (Faculteit der Gezondheidswe- tenschappen = FdGW) in 1980. The present medical library opened in June 1992 as part of

the new university hospital (Academisch Ziekenhuis Maastricht = AZM) complex. It serves

primarily the needs of the university, although access is permitted to non-university-affi- liated personnel within the AZM. The hospital is situated in the eastern half of the city in a newly-developing commercial and industrial area with very few local amenities. It adjoins a busy dual carriageway and heavily-used railway line.

Throughout the university a relatively novel teaching approach is employed, known as problem-based learning (PBU, imported originally from McMaster University in Canada. The medical curriculum is a six-year programme. The first four years are devoted to understanding disease mechanisms, the final two years are focused on clinical training. The health sciences courses are of the normal four years' duration. A large number of special isms are represented. Following a common first year (known as the crooaedeuse) students divide into three streams: behavioural science, applied social science (which includes those who will ultimately specialised in nursing science, health policy and management, and health philosophy and ethics) and biological sciences. The implications of PBL for the library are discussed further below (p. 3).

The new library is situated within a semicircular building and occupies four floors (see plan appended). It occupies a Wthick arcw around the outer edge; the wcorew of the semicircle is occupied from the first floor up by a large snack bar/refectory. The two are separated by clear glass. The temperature and ventilation within the building are wclimate controlledw. A closed stack, containing older monographs and all bound journal volumes previous to 1987, occupies the ground floor. The main part of the library is on the first floor, and contains the reference collection, printed bibliographies, CD-ROM terminals, loan book stock, current journals, and bound journals from 1987 onwards. OPAC terminals are situated here and on the floor above. The loans desk and information desk are situated centrally near the entrance and exit, with a photocopying area adjacent; neither is enclosed. The upper two floors are given over to a particular form of library provision which relates closely to the Maastricht version of pel, known in Dutch as the studielandschaD. (There is no satis- factory English translation of this term; the phrase usually given as the English equivalent, wlearning resource centreW, is in ordinary usage merely a synonym for wmulti-media libraryW and fails to convey the particular significance of the studielandschaD within the Maastricht pel system. I frequently found myself using in conversation the literal translation Wstudy landscape w; the abbreviation Sl is used in this report). It consists of 1) a separate reference collection of multiple copies of textbooks and other books mostly for undergraduate use, classified, like the stock in the main library, according to the lC system; 2) an audiovisual resource area (AV-ruimte), served by two specialist staff; 3) an anatomy area (anatomie- ruimte), where anatomical atlases and models are available; and 4) a computer-assisted learning area (comDuterruimte). (This is run by another specialist; although it is housed within the library, it is outside its administrative scope and is not considered further here.) The new library brought together resources which had previously been distributed between a number of sites. Health sciences material had been housed within what is now the wFaculteiten Iw building at Peter Debyeplein opposite the hospital entrance, while the medical collection was held at the old university hospital site at St. Annadal. This itself represented an amalgamation of two earlier separate preclinical and clinical libraries. There was also, and still remains, a separate psychiatry library at the Vijverdal mental hospital. Some of the interdisciplinary departments, such as health economics and medical sociology

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need to use material which is held at Bonnefanten, the other university library site in the centre of town (this can be reached within half an hour by bicycle, but is not convenient of access by car or by public transport).

There is no card catalogue; the entire university collection, apart from that of the Jesuit library, is catalogued online. The OPAC includes facilities for searching by subject keyword as well as by classification code; however there is no on-screen subject index and

reference has to be made to folders (kept behind the reference desk) which provide references from keywords to subject codes. In addition the OPAC provides access to the Reaionale Cataloaus Limburo (covering libraries of other educational institutions in the area, also the Maastricht Stadsbibliotheek) and to the catalogues of other selected libraries, mostly university libraries. There are separate sections in the university catalogue for audiovisual materials, theses and sets of statutes (wetsets).

The library receives a budgetary allocation from the faculties for to cover all costs other than accommodation and staff. The total amount is indexed (albeit inadequately) from year to year to allow for inflation. Responsibility for book ordering is divided between the departments and the "WID" (academic/subject librarians) section of the library; each department is allowed to order twenty-five books a year from a total allocation of thirty, while WID orders the remaining five. Journal allocations, with a number of exceptions, are divided equally between the departments. There is no agreed written acquisitions policy.

The library has three CD-ROM terminals providing networked access to MEDLlNE, Excerpta Medica, PsycLlT, ERIC, Current Contents, and Science Citation Index. These are heavily used during the academic year; a reservation system is in force. Tutorials for MEDLlNE, PsycLiT and ERIC are available on these terminals but not elsewhere in the library (a floppy disc containing the MEDLINE tutorial can be purchased by students for f 3,501.

A research network, MAASNET, was set up in 1992. Not all individual academics yet have it, and for reasons of computer security (fears about the possibility of hacking into hospital records) it has not been made available to the clinical departments. It incorporates a number of powerful bibliographic facilities: in addition to the library OPAC, these include access to LC records and to a large numbers of European and North American library catalogues, with connections possible to a number of other services such as BLAISE-LINE. There is the possibility of CD-ROM network access being provided on the system in the near future.

Backaround

1) Librarv

The survey arose from a need felt by the senior librarians to monitor the actual use of the library and also the opinions and attitudes of library users after a year in the new premises, with a view to highlighting problems and improving services. The move had inevitably entailed considerable changes in staff structures and in patterns of service to users as well as in physical locations of facilities. Under the previous arrangements, while access to stock had been relatively problematic, the library staff, particularly in the clinical libraries, had felt able to keep in close contact with the needs of users. This situation was now felt to have been reversed; while access had greatly improved, informal contacts had sharply declined.

The deficiencies of the automated system present a difficulty in monitoring library use; it is not readily able to provide accurate statistics on current library membership by cate- gory of user, and monitoring the circulation of particular categories of stock or individual

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titles requires a great deal of complex and time-consuming manipulation. Statistics are maintained, however, on acquisitions, book loans, interlibrary loans, and stack requests, for each main site. The use of the studielandschaD is also monitored by direct observati- on methods, and here a fall in levels of usage had been observed.

2) Problem-based learnina

The essence of the problem-based learning approach (see above, p.1) is that "passive" forms of information transfer from teachers to students are kept to a minimum--hence, lectures are relatively little used--and that learning activities (i.e. the acquisition of basic- and clinical science knowledge and of problem-solving skills) are focused around particu- lar clinical problems. The system is intended to integrate basic science with clinical knowledge and to develop the facility and motivation for "lifelong" learning, i.e. throughout a student's future professional career. In discussion of these problems in small twice-weekly tutorial groups, students identify "learning issues" for themselves. After studying the relevant literature they report on and discuss their findings. The groups are facilitated by a tutor, who mayor may not be an expert on the subject- matter of the problems. Independent study and the need for co-operative work is emphasised. As will be seen, this has implications for the provision of study space and seating within the library. The basic unit of course structure is the six-week "block". Each block has a particular theme, such as chest pain, fatigue, blood loss etc. The blocks are grouped into general themes within each academic year. Appropriate

practical work (skills training, laboratory sessions etc.) is integrated into the course.(1)

It is important to realise that there is no single entity called "problem-based learning". (A "taxonomy" of different forms of PBl is provided by Barrows: (2)). The form of PBl in use at Maastricht is relatively teacher-centered; it represents a substantial modification of the original McMaster system. The approach to literature use is highly prescriptive, particularly in the earlier stages of the syllabi. For each block, students are provided

with a "block book", which generally contains an extensive reading list. (The existence of block books for two medical course units taught in English allowed me to examine these in detail.) For the health sciences students, collections of literature have been provided until recently (copies of journal articles, etc.) which students have had to photocopy for themselves; this is to save the time, wear and tear on bound journal volumes etc. The collections were formerly very comprehensive (up to 500 pp. of material); following a change in departmental policy (deriving from concern about possible "spoon-feeding" of the students) their size has now been considerably reduced, to around 75-100pp. Students' academic progress is evaluated primarily through MCQ tests. Relatively little written work is expected of students; medical students are not required to write papers other than for their research elective, while health sciences students are required to write one long essay annually only.(3)

Parallel to the teaching faculties, there exists within the university a large department of

educational research and development (onderwiisontwikkelino en onderwiisresearch = 0

& 0), which conducts an extensive programme of educational research as well as being involved in curriculum planning and evaluation. Certain members of this department

have an intense interest in monitoring and investigating students' study behaviour, albeit from the perspective of educational psychology rather than of information studies. Some of their published articles, however, are highly relevant to this survey (see below, p. 4).

The studielandschac was mentioned above as an integral part of the Maastricht PBL system. In both medical and health sciences curricula the SL is seen as a collection of learning resources, available near student study areas and collocated and arranged in a manner that will stimulate critical study of the subject matter. The use of the LC

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classification in the SL functions as a form of introduction to the main library classificati- on. In principle, considerable effort and energy is put into keeping SL resources current and well focused. Library policy regarding the SL is stated in a policy document (12). Each department has a member of staff who has specific responsibility for the SL; every two years they are supposed to weed outdated stock, with the assistance of the library staff, and also check on the condition and availability of books. Because of budgetary constraints the library is not always able to purchase sufficient copies of a required

book, or to replace old editions immediately. The two faculties differ somewhat in their policies of book selection for the SL. FdGW selects a core textbook for each block and expects the students to buy this; copies of the supplementary books are placed in the SL. In the health sciences curricula the SL is envisaged as a place where students look for additional information, differing perspectives etc. beyond the scope of the basic texts. The FdG, by contrast, envisages the SL as a resource area for all kinds of books, and sees one of its purposes as that of providing access to copies of basic textbooks for students to try out and compare before purchasing. Medical students are expected to use the SL, certainly in their early years, as a place to study, whereas for health

sciences students the SL is seen more as a source of references. Since both groups of students use the same resources, these differences can lead to conflict over purchasing of texts, etc.

3) User education

Apart from a one-hour orientation session for students early in their first year, and one- hour classes for students on use of the CD-ROM (which are held once a week for small groups) there is no formalised user education provided by the library. (In addition, library staff will provide brief 1 5-minute introductions to CD-ROM use for individuals). Also there is no written information available about the library other than basic information about services, opening hours etc. In view of the emphasis placed on user education within the libraries of Canadian and American medical schools employing PBL curricula, this was at first sight surprising, not to say anomalous. The perceived need or otherwise for more formalised or explicit user education emerged as an issue within the survey; see below, p.11-12).

4) Previous survevs and research

No previous general surveys of user behaviour or attitudes have been undertaken by the library itself; earlier investigations have focused on specific issues such as catalogue use and inter-library loan requests. In 1989 the two student societies, REFLEX (FdG) and AGORA (FdGW) carried out a questionnaire survey of student opinion about library

stock and services using a Likert scale closed question format. The results of this survey were used by the senior library staff as aid to planning the library provision in the new premises. Some of the 0 & 0 studies have focused on aspects of library and literature use; notably Geerligs in 1990 carried out a detailed investigation of student use of the

SL (4). More recently Dolmans (5) has investigated literature use as part of her study of how learning issues in PBL relate to actual student learning.

SCODe

This survey aimed to be general in scope and to include i) the entire university-related user population; ii) potentially all aspects of user behaviour and opinion. (Obviously detail is sacrificed in such a general investigation.) I received an additional request to include in the second phase (see below, p.5) nursing students, i.e. from the (hospital based) diploma school of nursing based at Vijverdal, the "general" stream of which

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spends time at the AZM and is in a position to use the UB. The user groups to be surveyed thus included undergraduates in both faculties; research students; junior doctors (i.e. specialists in training; "residents" in American terminology); research staff; and lecturers. (Because all senior medical staff have some teaching role within the FdG, these latter are thereby automatically included.) Excluded from the second-phase questionnaire survey, but not from the in-library studies, would thus be hospital administrative, paramedical and nursing staff, and university secretarial and admini- strative staff. The results of the first phase only are included in the present report.