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In which place(s) in Ex. 1a do the following people work? What qualities do they need? Why? Make sentences. • nurse • attendant • surgeon
In which place(s) in Ex. 1a do the following people work? What qualities do they need? Why? Make sentences.
• nurse • attendant • surgeon
• doctor • librarian • mayor
• secretary • police officer
• forensic scientist • detective
• cashier • postal worker
• fire officer • postman
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In which place(s) in Ex. 1a do the following people work? What qualities do they need? Why? Make sen...


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Non-librarian health professionals becoming librarians and information specialists: results of an Internet survey
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Bulletin of the Medical Library Association
Charles R. Fikar, M.D., DABP, M.S.L.S., Library Director and Oscar L. Corral, B.S., Second-Year Medical Student
Objectives: To obtain basic information about non-librarian health professionals who become librarians and information specialists.
Methods: The survey was a Web-based questionnaire. A non-random sample of persons was obtained by posting messages to several large Internet electronic discussion groups. Individuals who met the selection criteria and were willing to participate filled out a Web-based form designed using common gateway interface (CGI) programming.
Results: 118 forms were analyzed. Three subgroups of participants were identified and statistical comparisons among these groups were carried out for many of the quantitative questions. Information concerning reasons they left their original field; factors influencing their choice of the field of library and information science; reactions of family, friends, and colleagues; and interactions with patrons and other information about this group was obtained and summarized. A health sciences background was seen as helpful in the new career as information specialist. Most people were happy with their new profession despite negative reactions from colleagues, relatives, and, occasionally, patrons. Feelings of regret and abandonment of their patients were noted by some. Many persons did not know that peers had made similar career changes.
Conclusions: A health sciences background imparts an expertise in both the vocabulary and subject matter of medicine that non-biomedical individuals would not ordinarily have. Although becoming a librarian may be perceived as a very positive career change for an individual, societal opinion and pressure can make such a career change difficult. Nevertheless, participants in this survey demonstrate a high level of satisfaction with their new careers and are quite happy with their work.
Health professionals change careers for a variety of reasons. The new career may be within the area of biomedicine or in an entirely different arena. Challenging changes made in the delivery of health care by the imposition of new insurance regulations and the advent of managed care have certainly in many instances been contributing factors for individuals to seek a new profession [1, 2]. Information about some of the other reasons health professionals choose to change careers will be presented below. One career alternative available to the non-librarian health professional is that of library and information science, including the subdivision of medical librarianship.
Great changes have taken place in the practice and management of all the health professions in the United States since Congress passed the Health Maintenance Organization (HMO) Act of 1973. Currently, approximately 80% of employees whose employers' provide health insurance coverage are enrolled in some form of managed care plan. In 1988, the percentage was only about 30% [3]. Health professionals were and continue to be faced with changes in their practice style and workplace environment due to changes in the health care delivery system. For some, these conditions are neither conducive to nor compatible with personal career happiness and therefore necessitate a career change. Regardless of the reasons, health professionals leave their chosen initial professions to pursue other careers, not only in nonclinical areas, but also in fields that are non-biomedical.
Societal perceptions of the health care professional who leaves an active, direct patient care career may be problematic to individuals wishing to change their professions. Many physicians who leave medicine may be stigmatized by a society that believes that physicians do not leave their careers unless there is “something wrong” [4]. Other health professionals may be confronted with the same type of societal branding.
The present survey was conducted, because no specific literature on the subject of non-librarian health professionals who become librarians could be found in the English-language medical or library literature. Motivations for a non-librarian health professional to switch to a career in this field were therefore sought. Information about whether individuals were aware that others have made similar career changes, how happy they were in the new profession, and how pleased students were with the new course work (for those still in professional schools) was also requested in this survey. Additionally, the work the individuals did, whether they perceived their background as helpful with present duties and whether there were feelings of abandonment of patients, colleagues, or both, were considered to be important and in need of documentation.
The authors also were curious about the reactions of friends, families, and colleagues concerning this type of career change. Additionally, individuals were asked if they made known their status as a current or former non-librarian health professional to their patrons, colleagues, or both. For those health professionals who still were students, information about their optimism for future job prospects was sought. Information revealed by this survey would be of potential use to health professionals contemplating or undergoing a career change as well as professionals providing career counseling services to such persons.
Historically, non-librarian health professionals have chosen the field of library and information science as either a second career choice or as an additional duty along with their current profession. The idea of the physician or nurse librarian is not a new one. Physicians have been writing and amassing medical information for centuries and, thus, have been librarians of their own personal collections.
Dr. Gabriel Naude, born in Paris in 1600, practiced medicine in France, but his strong love of books and libraries drew him to Rome, where he became a librarian. He is considered the first important theoretician of modern library organization [5]. Dr. Georg Christian Fuchsel, born in 1722, was a German court physician and librarian. He was also a noted geologist [6].
In England, the Royal College of Surgeons in London recognized the need for someone to care for and develop their book and specimen collection. Dr. Robert Willis, a physician and medical historian, was asked to be the college's first librarian in 1827 [7]. In 1836, he began a project to collect “every work of consequence, not already in the library, that was published in the last forty years.” He also compiled an Author Catalogue in 1831 and a Classified Catalogue totaling 1,200 pages in 1843. Dr. Willis was active outside of his library work as well, translating several medical books during this time. His work in building “the finest medical and anatomical library in Europe” was obviously a great contribution to both medicine and librarianship.
Another notable European physician librarian was Dr. William Munk, who was considered an authority on smallpox. In 1857, he was appointed the librarian at the Royal College of Physicians in England and held the position until his death in 1898 [8]. He was given the title Harveian librarian in memory of Dr. William Harvey, the great anatomist and physician of the 1600s. His assuming this position coincides with a change in the library from an “old club library” to a practical medical library. Dr. Munk created the Roll of the Royal College of Physicians in London in 1861, which served as a biographical dictionary of the members of that society. The Roll had not been intended for publication but was found so useful that it was published the year after it was written.
Dr. John Shaw Billings was born in Indiana in 1836 [9]. He joined the Union Army during the Civil War as a physician and was assigned to the Surgeon General's office in 1864. The Army Medical Department, having decided to collect specimens and case reports of the Civil War for a museum and library that would present the war's medical and surgical history, gave Dr. Billings the task of expanding the small library of the Surgeon General's office to accommodate the new collection. He tirelessly built the library to serve the museum and the nation.
In the thirty years he remained at his post, he expanded the original 2,500 volumes in the library to more than 200,000. Although other libraries had excellent printed catalogues to serve as a guide, they only contained journal names and not the articles contained within the journals. Dr. Billings proposed a catalog of the “National Medical Library,” as he called it, which would contain a subject and author catalog of monographs and journal titles. Additionally, and very importantly, he added to this catalog a subject indexing system for all articles in the journals held in the library's extensive and rapidly expanding holdings. The resulting sixteen-volume Index-Catalogue of the Library of the Surgeon General's Office, United States Army (series one), stood as the most complete guide to medical literature in the nineteenth century. The Index Medicus was created as a monthly supplement to ensure that current information would be available. Thus, through Dr. Billings' work, the Index-Catalogue filled in the bibliographical gap of medical writings and made the accumulated literature of the past available.
In the 1890s, American medical schools realized that a comprehensive and well-maintained medical library was essential to a rapidly modernizing medical education [10]. Before this time, physicians had to rely primarily on their own private collections of medical journals. At the Syracuse University College of Medicine (SUCM), Dr. Frank Marlow, professor of ophthalmology, became the librarian in 1890 and was concerned that students were not using the library, because they felt it was unreliable and disorganized. Although Dr. Marlow began the collection and restoration process, the effort and dedication exhibited by Elizabeth L. Shrimpton, M.D., brought the library efficient methods of cataloging, inventory control, and reader services. She received her medical doctor degree from SUCM in 1901. The policies and practices she instituted continue to make the library accessible to the medical community of Syracuse, and for her labors she is known as the first “real” medical librarian at SUCM. Dr. Marlow's plans for the library could not have been completed without Dr. Shrimpton's tireless work.
Nurses who became librarians have also made great contributions to the field of library and information science. Virginia Henderson, born in 1897, graduated in 1921 from the Army School of Nursing in Washington, DC [11, 12]. She continued her education and earned both a bachelor of science and a master of arts degrees in nursing education at Teachers College, Columbia University. She spent fourteen years teaching at Columbia University, where she revised Bertha Harmer's Textbook of the Principles and Practice of Nursing, which was published in 1939. Henderson accepted a position at the Yale University School of Nursing and directed the Nursing Studies Index project from 1959 to 1971. The four-volume Nursing Studies Index was the first annotated index of nursing research. Henderson was named research associate emeritus at Yale University at the age of seventy-five. After this time, her career focused on international teaching and speaking engagements. Her work on many important issues in health care and in promoting nursing research as the basis for nursing knowledge earned her many awards and honors. She has been termed the “twentieth-century Florence Nightingale.”
In order to obtain a sample of non-librarian health professionals who had either completely changed careers to the field of library and information science or were in the process of obtaining a degree in that field, appropriate messages were posted to several Internet electronic discussion lists. Persons still working at both careers were permitted to be in the study, as were persons who had left a program for a specific health profession before receiving their professional health degree or certificate. Internet mailing lists were selected that focused on library and information science for either students or professionals. Local or regional lists and both national and English-language international lists were used.
Medical, academic, and general library mailing lists that had large numbers of subscribers were selected. Persons responding to the posting were sent the Web location of the survey form and given the option of requesting a text copy delivered either by email or postal mail. Postings were sent to the various mailing lists between December 1999 and January 2000. A small number of participants were not members of Internet mailing lists to which the authors posted but were informed about the study by members who saw the posting and knew they met the selection criteria. Three reminder emails were sent to those who had responded to the posting, but who had not completed the survey up to the time the reminder was sent. Responses were received from December 1999 to February 2000. All but five responses were via the Web page form. Two of these responses were returned via the postal system and three as a direct email messages. A supplemental question was sent to all Web-form responders inquiring whether the participants revealed their former health career to patrons or colleagues in their current library and information science positions. The exact wording of this supplemental question is shown in the Appendix.
The research survey form was designed as a Web page using common gateway interface (CGI) programming for many of the questions. Results were sent to the first author upon clicking on the “Submit” button.†
A total of 118 non-librarian health professionals who had either changed careers to the field of library and information science or were engaged in a master's program in that field were identified. Survey forms were completed by 112 (94.9%). Of those who completed the survey, forty-seven (42.0%) were nurses; forty-five (40.2%) were allied health professionals; and twenty (17.9%) were doctors of medicine, dentistry, veterinary medicine, or podiatric medicine. One of the persons completing the survey form as a medical physician completed 5 11/12 out of the six years required for a doctor of medicine degree. This person was the only health professional participant in the survey who did not have a degree in a non-library health discipline. Allied health professionals represented in this study included speech therapists, audiologists, X-ray technicians, physical therapists, pharmacists, laboratory technicians, medical social workers, medical researchers, and others.
The 110 survey participants, who stated the number of years that they practiced, worked in the non-librarian health care field 13.1 ± 8.7 years (mean ± 1 SD) with a range of 0–32 years. The ninety-eight participants, who revealed the number of years that they have been in the library and information science field, worked 6.8 ± 5.9 years (mean ± 1 SD) with a range of 0.2–24 years. Most participants were from the United States with approximately 20% currently residing in Canada, England, Australia, Kuwait, Lebanon, Uruguay, and The Netherlands. For those participants for whom the exact type of library work could be determined, eighty-two of ninety-two (89.1%) were engaged in biomedical librarianship or informatics.
There were twenty-one (18.8%) master's level library and information science students represented among the 112 survey participants. A tabular summary of quantitative data responses is presented in Tables ​Tables1,1, ​,2,2, and ​and3.3. When analyzed by health profession subgroups, there were some differences as noted in the following paragraphs. Subgroup analysis was done only on the following questions:
Do you know others in your profession who made a similar switch?
Do/did you feel you are/were abandoning your patients or coworkers?
Do you think your medical background has benefited or will benefit you in your new profession?
Do you ever regret leaving your previous profession?
Would you ever return to your previous profession?
How optimistic are you about finding a position when you graduate?
How satisfied are you with your decision to change careers?
Do your library colleagues know of your former career in the health professions?
Table 1 Responses to Yes/No survey questions
Table 2 Responses to satisfaction survey questions
Table 3 Responses to optimism survey question
Subgroup comparisons were accomplished using “difference of two proportions” tests [13]. Statistically significant differences were found only for four of the above eight selected survey questions.
The subgroup data for participants who answered “yes” to having regrets about leaving their biomedical careers were as follows: eleven of forty-three nurses (25.6%), two of fifteen doctors (13.3%), and five of thirty-eight allied health professionals (13.2%). There was a statistically significant difference, choosing alpha = 0.10, between the nurses and allied health professionals with P = 0.075. The doctor subgroup comparisons could not be done because of the limited sample size.
The subgroup data for participants who answered “yes” to feeling that they were abandoning their patients were as follows: eleven of forty-seven nurses (23.4%), five of twenty doctors (25.0%), and four of forty-five allied health professionals (8.9%). There was a statistically significant diffe
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