Assessing the Information Needs
      of Health Professionals:
    An Annotated Bibliography
Compiled and Annotated by

   Laura A. Baird, M.S.
           Edited by

Faith A. Meakin, Susan Bailey, Jean P. Shipman

National Network of Libraries of Medicine,
    Southeastern/Atlantic Region
                         i
  University of Maryland at Baltimore
     Health Sciences Library
     " Baltimore, Maryland
           1991
■■& ' 
       RETURN TO
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    MEDICINE 
Assessing the Information Needs
      of Health Professionals:
    An Annotated Bibliography
This annotated bibliography was compiled for the purpose of identifying
literature relevant to health professionals' information-seeking behaviors,
information needs, and information-gathering skills.
       Compiled and Annotated by

           Laura A. Baird, M.S.


               Edited by

Faith A. Meakin, Susan Bailey, Jean P. Shipman
National Network of Libraries of Medicine
     Southeastern/Atlantic Region

  University of Maryland at Baltimore
       Health Sciences Library
        Baltimore, Maryland
              U991 
"The National Network of Libraries of Medicine, Southeastern/Atlantic Region
is supported through a contract with the National Library of Medicine, contract
no. NOl-LM-l-3502"-T.p.  verso.
This annotated bibliography is published by the National Network of Libraries
of Medicine, Southeastern/Atlantic Region to fullfill contract requirements with
the National Library of Medicine. Suggestions, comments, or questions concern-
ing this bibliography and any inevitable omissions or new incorporations may be
addressed to  the National Network of Libraries of Medicine, Southeastern/
Atlantic Re,gion staff.

                                                ^i4x
                                               2\<p3<k
                                                mi
National Library of Medicine Cataloging in Publication.
         Baird, Laura A.
            Assessing the information needs of health professionals : an annotated
            bibliography/compiled and annotated by Laura A Baird ; edited by F.aith A.
            Meakin, Susan Bailey, Jean P. Shipman. ~ Baltimore, Md.: National Net
            work of Libraries of Medicine, Southeastern/Atlantic Region, University of
            Maryland at Baltimore, 1991.

ISBN 1-880491-00-1

             1.  Health Manpower-abstracts 2.  Information Services-utilization--
             abstracts 3. Libraries, Medical-utilization-abstracts I. National Network
             of Libraries of Medicine, Southeastern/Atlantic Region.  II. NationalLibrary
             of Medicine (U.S.) III. Title 02 NLM: Z 674.4 B163a (P) Cit.  No.9110321
Copyright © 1991, University of Maryland at Baltimore.

All rights reserved. No part of this book may be translated, reproduced or
transmitted in any form or by any means, electronic or mechanical, including
photocopying, without permission in writing from the copyright owner. 
ACKNOWLEDGMENTS
I wish to thank Lisa Ann LoVullo, Regional Medical Library outreach coordina-
tor, for sharing her knowledge and experiences in bibliography development, for
proofreading the manuscript, and for her insightful suggestions. I am grateful
to the Interlibrary Loan Department of the University of Maryland at Baltimore
Health Sciences Library for their accurate, expeditious, and assiduous assis-
tance in obtaining the text to many of the references. I wish to express my
appreciation to the Information Services Division of the University of Maryland
at Baltimore Health Sciences Library for the use of their computer facilities and
their attentive assistance in answering many questions. 
 
TABLE OF CONTENTS
Introduction

Scope

Content

Arrangement

Search Strategy

Online Literature Sources Screened

Style

List of Key Terms

BibHography, Alphabetical Order by Author

BibHography, Chronological Order by Year

Appendix A: Pertinent Articles and Reviews of the
            Literature Before 1985

Appendix B: General Readings on Information Needs

Author Index 
 
INTRODUCTION
The practice of medicine, medical education and biomedical research all rely on
information.   In  1989, an Outreach Planning Panel  was convened  by the
National Library of Medicine (NLM) to examine methodologies for meeting
information demands of practitioners in all health fields and in all environ-
ments. Their report, Improving Health Professionals' Access to Information, was
submitted to NLM's Board of Regents and has become the cornerstone of a new
outreach effort.  The  report outlines methods for responding to information
needs of all health professionals  regardless of institutional affiliation, geo-
graphic location or specialty. This current outreach initiative has expanded the
role of the  health science Hbrarian and increased the importance of defining
information needs so appropriate programs and services may be implemented.

Collecting, organizing and disseminating information has long been  the
objective  of  health science  librarians.  And, in  order to meet  the
information needs of health professionals, librarians  must understand
their information-seeking behaviors and skills. The purpose of this bibliography
is to provide a thorough overview of work that has been done in the area of health
professional information needs assessment. Citations included are references to
literature in both health and information science.

The bibHography is intended for health professionals, teachers, students, and
members of the library and information  science community  who want to
understand the information needs of health professionals. It is our hope that it
wiU be used to make further scholarly contributions to the burgeoning field of
health professional information needs assessment.


                                SCOPE

Information need is a difficult concept to identify, isolate, define, and assess, and
the information needs of all health professionals have not been widely examined.
Most of the research has focused primarily on physicians, while the information
needs of allied health professionals, such as medical technicians, occupational
therapists and nutritionists, have often been overlooked.

This bibliography was compiled to include literature that assesses the informa-
tion needs, preferences, and seeking strategies of all health care  professionals.
It is a review of the English language materials published since 1985, however
a few earlier works are included due to their merit.  The various methodologies
used in studying health professionals' information needs are  noted in the
annotations.
i 
CONTENT
Only literature which states or impHes the concept of "information-seeking
behaviors," "information needs," or "information-gathering skills" of various
health professionals, as defined in this bibliography, is included. Judgments as
to the reliability of the methods used and the validity of the findings reported did
not enter into the selection of citations. The body of the literature is heavily
weighted in journal articles.  Scholarly monographs on the subject are rare and
further scholarly research pubHcations are needed.

Because  of the overwhelming amount of literature available and slight differ-
ence in scope, works in which the prim.ary focus is on continuing medical
education or medical informatics have been omitted. Foreign language mate-
rials have also been excluded.

A literature search on "information needs" or "information-seeking behaviors"
revealed that while these subjects have been written on extensively, no generally
accepted definitions exist. The terms "information use," "information gathering,"
"information  seeking," "information needs," "information  behaviors," "user
needs,"  and "information skiUs" are all used interchangeably by different
indexing sources. Therefore, a List of Key Terms is included to assist in better
understanding some of the terminology used in the annotations.


                           ARRANGEMENT

The body of the bibliography is arranged alphabetically by author. Multiple
citations by a single author are listed in reverse chronological order. Following
the annotations, the citations are Hsted chronologically by year. Two appendices
are included:  citations published before 1985 (Appendix A) and a Hst of general
works in the field of information needs assessment with no particular focus on
type of user (Appendix B). Authors Hsted in the appendices are not included in
the Author Index which follows. Authors are listed with their corresponding
citation (not page) numbers in the Author Index.


                         SEARCH STRATEGY

The foUowing types of materials were consulted when searching for works in this
field: audio-visuals, books, conference publications, continuing education courses,
dissertations, grants, journal articles, reports, unpublished materials, bibliog-
raphies, footnotes and many onHne  databases. While many different databases
and database systems were searched for relevant material, half of the references
were identified using the many MEDLARS databases.
ii 
ONLINE LITERATURE SOURCES SCREENED
Books in Print
Conference Papers Index
Current Contents Search™
Dissertation Abstracts Online
EMBASE
ERIC (Educational Resources Information Center)
GPO PubHcations Reference File
GRANTS database
HEALTH PERIODICALS DATABASE™
Information Science Abstracts
LIBRARY LITERATURE online
LIBRARY AND INFORMATION SCIENCE ABSTRACTS online
Magazine Index™
MEDLARS® databases: AVLINE®, HEALTH®, MEDLINE®, CANCERLIT®,
 CATLINE®
NTIS online
CINAHL® (Nursing & Allied Health Literature Index onHne )
OCLC™ Online Computer System
PsycINFO® (Psychological Abstracts online)
Readers Guide to Periodical Literature
SCISEARCH®
SOCIAL SCISEARCH®
SOCIOLOGICAL ABSTRACTS online
                              STYLE

Literature citations in this bibliography are formatted according to the National
Librarv of Medicine Recommended Formats for Bibliographic Citation.1 This
bibliographic format is based on the ANSI citation style.
      1. Patrias, K. National Library of Medicine Recommended Formats for Bibliographic
Citation. U.S. Department of Health and Human Services. Public Health Service. National
Institutes of Health. Bethesda,MD. 1991 April.
ill 
LIST OF KEY TERMS
Information need
Knowledge craved, demanded or required.
Information seeking
The process by which users identify and choose
information. Part of a problem-solving process
which varies according to an individual user's
need.
Information-seeking skill  The natural or acquired ability, competence, or
                            proficiency to obtain the information sought.
Information-seeking
behavior
User need
Information gathering
Health professionals
Information services
Characteristics exhibited during the process
of identifying and choosing information to
satisfy a need.

Condition in which something (information) is
necessary or desirable and is required or wanted.

Activity of bringing together or accumulating
the materials which are desired or needed.

Including, but not Hmited to: addiction
counselors, allied health professionals,
dentists, dietitians, health professionals in
group practices, health professional internists
and students, medical technologists, mental
health counselors, nurses, occupational
therapists, personnel in private health care
organizations, pharmacists, physical
therapists, physicians, public health
employees, radiological technologists,
social service personnel, and social workers.

The utility, assistance, or aid provided in
receiving information.
iv 
Assessing the Information Needs of Health Professionals:
               An Annotated Bibliography
1. Abate MA, Jacknowitz AI, Shumway JM.  Pharmacists' use of online
information sources. Morgantown (WV): West Virginia University, 1991. Grant
R01-LM-0-5189.

This grant will study community pharmacists', clinical pharmacists', and
senior pharmacy students' attitudes  toward and use  of online information
sources to answer drug information questions. The study will evaluate and
compare online  access  to  health  information through the  use of Grateful
Med and BRS Collea.gue and will analyze the information needs of pharmacists
as well as potential barriers  to the widespread use of  computer databases
by these professionals  in  West Virginia.  It  will also address how online
computer systems  can best be  integrated into their  daily  routines.
Descriptive and statistical methods  will be used  to  interpret the study's
data.

2. Abate MA, Jacknowitz AI, Shumway JM. Information sources utilized by
private practice and university physicians. Drug Information Journal 1989; 23:309-
19.

The  object of this study was  to determine which drug  information sources
private practice  and university-affiliated  West Virginia physicians used
over a three-year period. An initial interview and a drug information sources
utilization survey were administered. Of 196 physicians surveyed, on the average,
each received approximately 3.3 drug-related questions a day and spent 16 minutes
searching for information to .answer the questions. Physicians Desk Reference
(PDR) was the most popular source of drug information used. Hospital libraries and
pharmacists were rarely consulted as a source of drug information. Similarly, none
of the  respondents reported using online literature searches as an information
source. The findings also indicate that the physicians in private practice utilized
pharmaceutical manufacturers' promotional literature and sales representatives
as a source of drug information more often than the university-affiliated physicians.
Recommendations are made for physicians to take advantage of the vast number of
onHne information databases and drug information sources currently available to
them.

3. Abate MA, Shumway JM, Jacknowitz AI,  Sinclair G.  Recording and
evaluating end-user searches on a personal  computer. Bulletin of $he_ Medical
Librarv Association 1989 Oct;77(4):381-3.

The authors recapitulate the results of a one-year study  designed to record and
evaluate  end-user searches performed using BRS Colleague and Dialog Medical
Connection to access online health information. Using PROCOMM, a method was
1 
developed to automatically record all aspects of computer searches performed by
the study .group in an unsupervised setting. The primary purpose for studying
the searching behaviors of clinical pharmacists, physicians in private practice and
their nurses, was to examine the drug information needs and information-seeking
behaviors of these private practice health care professionals. Some proposals for
the future use of information retrieval systems are presented.

4. Beckman M. The importance of measuring library effectiveness. Bibliotheca
Medica Canadiana 1987;8(4): 180-9.

This paper was  presented as the keynote address at the first annual
meeting  of the  Ontario  Hospital Libraries Association held at the  Women's
College Hospital, Toronto, Ontario, on October 28, 1986. Beckman addressed the
importance of measuring and evaluating library effectiveness. To measure library
effectiveness, she emphasized two actions: identification of library users' informa-
tion needs and provision of effective library/information services.  She reported
physicians meet their information needs by consulting the following sources (in
order of use): collections, colleagues, experts in the field, and libraries. Availability,
accessibility, reliability, relevance, timeliness, portability, and environment are
seven variables she identified that are used to determine the effectiveness oflibrary/
information services.

5. Bonham MD. BIREME: Latin American and Caribbean Health Sciences In-
formation Center. Bulletin of £he_ Medical Librarv Association 1990 Apr;78(2): 119-
23.

BIREME (Biblioteca  Regional de  Medicina)  is a  regional information center
based at the Paulista School of Medicine in Sao Paulo, Brazil,  and functions
as  the headquarters for a cooperative network that provides services  to
meet the information needs of health professionals in 18 Latin American
and Caribbean countries. Existing for more than 20 years, BIREME initially used
onHne databases, such as MEDLINE, to satisfy information requests. However,
recognizing a need for access to locally available literature in 1980, BIREME started
producing LILACS (Literatura Latinoamericana e Caribe em Ciencias de la Saude),
which incorporates literature published in Latin America not represented in most
commercial onHne databases. The database coverage includes books,  journals,
theses, technical reports and government documents with a special  emphasis  on
tropical diseases. Only 36 of these sources are available on the MEDLINE database.
Indexing for the database is triHngual and includes many public health  concepts.
Through  online access to this database and MEDLINE, Latin American health
professionals can obtain relevant, applicable information to meet their information
needs. In addition to LILACS, this article highlights other services  BIREME
provides for health care professionals.
2 
6. Bowes F 3d.  Response to paper by R. Brian Haynes, M.D., Ph.D.: organizing
and accessing the literature.  Bulletin of the New York Academy of Medicine 1989
Jul-Aug;65(6):691-8.

Bowes, Director of Publishing Operations at the New England Journal  of  Medi-
cine, states that the information needs of health professionals are varied. From the
point of view of those trying to develop information products and tools to meet these
needs, Bowes states "there  needs to be much more market study  of both the
'perceived' and 'true' specific information needs of clinicians." Focusing on some of
the problems of producing new information tools to support the information needs
of physicians, Bowes considers the dilemmas of cost recovery, "true" and "perceived"
information needs, and the  incentives needed to get physicians to adopt new
information tools into their present habits.

7. Braude  RM.  Role of libraries in medical education.  Bulletin  of the. New
York Academy of Medicine 1989 Jul-Aug;65(6):704-27.

This paper was given in the  Role of Libraries in Medical Education Panel at the
Symposium on the Future of Information Systems for the Medical Sciences held on
April 25,  1988. Braude addresses Hbrarians' participation in providing medical
education and their successes in doing so. Two roles Hbrarians of today need to fulfill
are those of educator and information sifter. He recognizes the need to teach infor-
mation  seeking, critical  analysis and information management skills through
curriculum  integration. Braude outHnes several future information needs and
provides methods for responding to them.

8. Brember VL, Leggate P. Linking a medical user survey to management for
library effectiveness: I, the user survey. The Journal of Documentation 1985 Mar;
41(1): 1-14.

In this  article the authors  review  the results of the Oxford  study conducted
by  the  British  Library Research and  Development Department,  Medical
Review Panel. The  Oxford study population  consisted  of 685  clinical
participants from the National Health Service  medical staff and university
medical staff in teaching hospitals and 297 participants from  pre-clinical
university departments to make a total of 982 participants. The objective was to
identify the participants' information needs, information-seeking behaviors, library
use patterns, and attitudes toward libraries in non-rural settings. Data collection
was accompHshed by six different methods to ensure an objective outcome. Methods
included interviews, surveys, direct observation and record analysis. An important
finding was that the information-seeking behavior patterns of participants were
directly related to the amount of time the users devoted to cHnical practice versus
research. The results of the surveys were applied to library management decision
making. Recommendations are made to further study library users'  information
needs in order to provide more effective library services.
3 
9. Brodman E.  The physician as consumer of medical literature. Bulletin of the
USSL York Academy of Medicine 1985 Apr;61(3):266-74.

Brodman divides physicians into subgroups: researchers,urban practitioners, and
rural practioners. She  points out not all physicians' needs are alike and that it is
a difficult task for library and information science professionals to fulfill these
needs. The economics of information access by physicians is also discussed. Finally,
she asks whether physicians with their hectic schedules will utiHze future tech-
nological information tools to their maximum potential.

10. Bruer JT. Response to paper by R. Brian Haynes, M.D., Ph.D.: organizing
and accessing the literature. Bulletin of the New York Academy of Medicine 1989
Jul-Aug;65(6):687-90.

In his response to the Haynes paper, Bruer concentrates on the information needs
of one set of end-users: office-based physicians. He draws heavily on the results of
the Louis Harris Study conducted for the New York Academy of Medicine on the
Future of Information Systems for the Medicial Sciences, and contrasts it with
Haynes' conclusions. Bruer points out that the strategies to help health profession-
als find the best current information recommended by Haynes are in conflict with
what clinicians actually do. Recommendations are made to consider human factors
when designing information products.

11. Bryant SL. Exploiting the information network in support of health
education. Journal of the Institute of Health Education 1987;25(4): 132-9.

In this article, Bryant describes health educators' lack of information-seeking skills
and reasons for their unmet information needs. She claims health educators are
inundated with a wealth of health information that is not aU quality literature.
Health educators are not taught information-seeking skills in the health education
curriculum, and therefore lack the ability to acquire information proficiently. She
suggests that if health professionals' information-seeking skills were improved
dining health education training, they would be better equipped to seek health
information. This would better prepare them to assist the public in understanding
and improving its health. Various information sources that are available to health
educators to meet their information needs are cited.

12. Bryant SL. Bridging the gap between information and health: the role of an
information broker. Health Education Journal  1986;45(3): 180-2.

The establishment of the Health Education/Information Officer  (HE/IO)  post
within the Croydon, Health Education Department (Great Britain) provided an
opportunity to support the information needs of health educators. The duties of the
HE/IO are to provide information services, Hbrary supervision, instruction in the
use of library materials, and to promote public health. This article describes how
4 
the HE/IO developed workable methods for accessing and disseminating informa-
tion which assists in promoting public health in Croydon.

13. Bunyan LE, Lutz EM. Marketing the hospital library to nurses. Bulletin of
the. Medical Librarv Association 1991 Apr;79(2):223-5.

A "marketing audit" of nurses  was conducted  at the Saint Thomas Medical
Center in Akron, Ohio by the medical library staff to determine nurses' informa-
tion-seeking skills  and information needs.  The objective of the audit  was  to
determine how the library could better serve the hospitals' nursing community.
The nurses reported several reasons for not using the library: they had no time to
leave the nursing station, they were unaware they were allowed to use the library,
and that the library was not open during their shift. The survey was sent to 363
registered nurses in  this 400-bed hospital.  The results highlighted a need  to
heighten awareness of library sources. New services, altered techniques for pro-
viding existing services, and promotional tools were established as a result of the
survey.

14. Burger DJI,  van  Brakel PA Information transfer strategies for military
medical practitioners. South African Journal of Librarv and Information Science
1988 Jun;56(2):73-88.

A study was conducted to determine the information needs  of  the military
medical practitioners in the South African Defense Force's Medical Services. An
empirical questionnaire surveyed 1,689 military  medical practitioners. CiviHan
and enlisted practitioners of the  South African Defense Force were studied;
paramedical staff and dentists were excluded. The survey gathered information on
users' personal profiles  and participants' opinions of the medical literature and
medical library  services. An important finding was that this diverse group  of
medical staff had differing information needs, making it difficult for the two  med-
ical Hbraries to  fulfiU all users' needs. The authors make a direct association
between a medical practitioner's background and information needs. Geographical
barriers to libraries and colleagues were also cited as deterrents to  obtaining
information. Information transfer strategies were developed from the  results  of
this research. Recommendations are made to improve library services to meet the
identified information needs. Extension services and enhanced training for both
users and medical librarians are two examples.

15. Burrows S, Ginn DS, Love N, Williams TL.  A strategy for curriculum
integration of information skills instruction.  Bulletin of the Medical Librarv
Association 1989 Jul;77(3):245-51.

This paper describes how the Louis Calder Memorial Library at the  University of
Miami School of Medicine incorporated  an  information-seeking skills instruc-
tion program into the orientation curriculum. Core Hbrary skills, basic informa-
5 
tion tools and subject-specific skills are taught using both printed and computer-
ized information sources. Benefits of using the curriculum integration approach
include: skills reinforcement, improved problem-solving abilities, better critical
thinking, and enhanced communication skills. The problems of achieving curricu-
lum integration of information-seeking skills are also identified and discussed.

16. Cahan MA Grateful Med: a tool for studying searching behavior.  Medical
Reference Services Quarterly 1989 Winter;8(4):61-79.

In a three-month beta test of Grateful Med, version 4.0, the Welch Medical
Library of The Johns Hopkins University School of Medicine studied the informa-
tion-seeking behaviors and information needs of Grateful Med testers. An evalu-
ative questionnaire was completed by 83 users (a copy is included in the article).
Through the use of a  search log built into the software, the staff examined the
search techniques employed by the Grateful Med users. Analysis of the more than
1,300 searches conducted showed that the majority of the Grateful Med searches
were performed in the MEDLINE database; the average search cost was $2.33;
and users downloaded approximately 15 citations per search. The primary conclu-
sion showed that Grateful Med users in the test did not utilize the end-user system
features to their maximum potential.

17. Caras N.  Serving the information and professional development needs of the
allied health professional. North Carolina Medical Journal 1989 Dec;50 (12): 708-
9.

In this article, the North Carolina Area Health Education Centers (AHEC) Library
and Information Services (LIS) Network  is described as providing health care
professionals with information and educational services to support their informa-
tion needs. One of the AHEC staff members, an allied health coordinator, is
responsible for providing educational support services to allied  health personnel
throughout North Carolina. Each of the nine AHEC locations has an allied health
coordinator who, through his or her affiliation with the designated schools of
medicine, serves as a  link to provide outreach information services to rural and
underserved areas. The services and programs provided by the AHEC offer AMA
continuing medical education credit and are accredited to meet legal and profes-
sional requirements.

18. Carmel M. Health information in the  Third World: initiatives and problems.
Health Libraries Review 1989;6:110-11.

Carmel identifies health care problems and health information needs in developing
countries, pointing out that currently health care professionals in  Third World
countries carry a heavy burden of providing quality health care with limited or no
information resources. One method of effectively providing up-to-date medical
information sources has been the Selective Medical Libraries on Microfiche project
6 
implemented by the RockefeUer Foundation.  A second method has been the
inception of the National Focal Point Libraries, set up with the guidance of the
World Health Organization. The author suggests this is just a beginning and that
additional libraries need to be established.

19. Carmel M.  Impact and image: improving the library's contribution.
Health Libraries Review 1986  Jun;3(2):94-100.

This is a paper presented at the  Medical,  Health  and Welfare  Group
Conference in Coventry, Great Britain, July 5 -  7,1985. It addresses the question
of how the library should fulfill the information needs of members of its parent
institution. In fulfilling these  information needs, the Hbrary should focus on
understanding the organization, taking on its priorities, improving its contribu-
tion, and making an impact in the organization.

20. Carmel M.  Users of biomedical libraries.  Health Libraries Review 1986
Mar;3(l):28-34.

This article  gives  an overview of how the  South West Thames Regional
Health Authority, located in Guildford, Britain, conducted a series of
studies into the library  needs of primary  health  care staff.  The results
include research, spanning over a decade, into  user needs in the health care
professions in Britain. Three library use trends were recognized.  First,
clinical information needs in clinical  care have taken precedence over
research  and education. Second,  professional groups, other than  physi-
cians,  have been more vocal in demanding Hbrary services geared to their
needs.  FinaUy, primary and community  health care have emerged as areas
with unique interdisciplinary information  needs.  Additional studies ex-
amined the information needs of community nurses, family doctors, and paramedi-
cal staff in the community. In conclusion, the author outlines how health science
librarians can alter their services to respond to user needs.

21. CD-ROM: providing quick access to volumes of information. Nursing Educators
Microworld 1990 Aug-Sep;4(6):46.

The authors suggest that currently nurses do not have adequate access to information
resources. Yet,  they beHeve  that nurses take advantage of those information
resources readily available to them. This brief article discusses CD-ROM technol-
ogy, a new information source, and the benefits it brings to the nursing community.
CD-ROMs are examined to determine how they  satisfy nurses' information needs
and whether they are cost-effective resources.

22. Childs SM.  General practitioners' use of NHS libraries.  Health Libraries
Review 1988 Jun;5(2):76-92.
7 
The National Health Service in England consists of 14 regions. The South West
Thames Regional Health Authority (SWTRHA) is one of these regions. This paper
is a report on the findings of the SWTRHA Community Health Information Project.
Ten libraries were surveyed to assess the information needs of the community
health care staff.  A comparative study of the various health care professionals'
information needs found that mainly general practitioners, nurses, and visitors use
the National Health Service Libraries  regularly.  Although  the  subject range
included in these groups was broad, many of the information needs were for rare,
obscure or current topics, or for controversial information. The  results of the
research were used to modify and promote regional libraries in order to meet these
information needs.

23. Connelly DP, Rich EC,  Curley SP, Kelly JT.   Knowledge  resource
preferences of family physicians.  The Journal of Family Practice  1990
Mar;30(3):353-9.

The authors conducted an  investigation of 126 family physicians in
community practice.  They examined  the  information-seeking behavior of
these physicians by studying  11 types of knowledge resource preferences.
The  use, value, and cost of contemporary  knowledge resources available in
clinical practice were  investigated through  a self-administered questionnaire.
The study focused on the relationship between the information-seeking behavior
of family physicians and patient care decision  making. The authors stress that it is
important to understand how clinicians decide to seek additional knowledge for
patient care decisions and how they choose among the resources available to them.
Resource cost variables, clinical availability and applicability of the information to
the problem appeared more  influential than factors relating to the quality of the
resource. The most frequently consulted source of information was the Physicians
Desk Reference (PDR) which was used daily. PDR  was also considered the most
readily available resource.


24. Corcoran-Perry S,  Graves J. Supplemental-information-seeking behavior
of cardiovascular nurses. Research in Nursing and Health 1990 Apr; 13(2): 119-27.

This study reports the information  needs and the supplemental information-
seeking behaviors of  cardiovascular nurses in  three metropolitan hospitals.
Supplemental information is defined here as "that which is not available from
memory and could be made  available by computer." Using the Krikelas  model of
information-seeking behavior (ISB) as a structure for  investigating the supple-
mental-ISB of 46 cardiovascular nurses, 175 instances of supplemental-ISB in
four  broad types  of supplemental information were found.  The supplemental
sources included patient-specific data, institution-specific facts, domain knowl-
edge and procedural material. Overall, all of the nurses reported seeking patient-
specific data most often. Institution-specific information  was the second most
sought after supplemental information. The study also examined nurses' reasons
8 
for seeking supplemental information, the external information sources they relied
upon, and the problems  they encountered. The findings  provided  a base for
designing a nursing information system to assist nurses who must make clinical
decisions quickly in complex situations.

25. Cove.ll DG, Uman GC, Manning PR Information needs in office practice: are
they being met? Annals of Internal Medicine 1985 Oct;103(4):596-9.

An investigation into the information needs of physicians in daily practice was
performed by studying the perceived needs of 46 physicians in Los Angeles during
their patient encounters. Three methods  of investigation were used.  After each
patient visit, the physicians completed a forty-item closed response questionnaire.
This was followed by an in-office interview with the physician. At the end of the day,
a closing interview was conducted. An important finding of the self-reported study
revealed that physicians used print sources, such as drug compendiums, most often
to meet their information needs. Computerized information sources and consulta-
tion with other health professionals were reported to be used least often. In contrast,
the results reported in the  interviews revealed that physicians most frequently
refer to other physicians for resource information. Approximately 30 percent of
their  questions were .answered by another physician and 70 percent of their
questions raised  during  patient visits were left unanswered. The  physicians
responded that in their office libraries, their textbooks were outdated and journal
collections too disorganized to consult for answers. The kinds of information
physicians need and the methods and sources available to fulfill these needs are
discussed in detail.

26. Cunningham D, Grefsheim S, Simon M, Lansing PS. Biotechnology
awareness study, part 2: meeting the information needs of biotechnologists.
Bulletin of the Medical Librarv Association 1991 Jan;79(l):45-52.

This article is part two of a study funded by the National Library of Medicine and
conducted by the staff of the Southeastern/Atlantic Regional Medical  Library
Program and the University of Maryland at Baltimore Health Sciences Library. The
purpose of this part of the study was to identify whether the nine health sciences
libraries surveyed sufficiently met the information needs of biotechnologists work-
ing at the affiHated institutions. In the study, Hbrarians were surveyed. The
information sources they used to answer biotechnology questions were compared
to the sources biotechnologists cited as their resource choices. A list  of journals
and online databases in the field of biotechnology is included in the article. The
results revealed that a minimal number of biotechnology questions were asked of
the reference librarians surveyed. The authors conclude there is  a need for in-
9 
creased marketing of information professionals' expertise to the biotechnology
community. For part 1 of this study, see Grefsheim, S.

27. Curley SP, Connelly DP, Rich EC. Physicians' use of medical knowledge
resources: preliminary theoretical framework and findings.  Medical Decision
Making 1990 Oct-Dec;10(4):231-41.

Using  a self-administered questionnaire,  228 internal medicine and
family practice physicians were studied to evaluate their use of, selection of, and
feeHngs about the cost-benefit features of nine knowledge resources. Resources
included general medicine textbooks, computerized bibliographic databases, col-
leagues, medical subspecialty textbooks, Index Medicus. coUeagues in other spe-
cialties, research, clinical manuals, and review articles. The authors' intent was to
understand these physicians' knowledge-seeking behaviors and their reasons  for
seeking specific information sources in clinical problem solving. Overall, they found
physicians refer to clinical colleagues most frequently and use indexing systems
least often. This study also  evaluated the cost-benefit analysis of knowledge
resources.

28. Dalrymple PW.  CD-ROM MEDLINE use and users:  information transfer
in the clinical setting.  Bulletin of the Medical Librarv Association 1990 Jul;78(3):
224-32.

The findings provided here are from a study of health professionals' information-
seeking patterns, using  six versions of  MEDLINE on CD-ROM in  seven
different health care  clinical settings. Participants were not given any training or
assistance at the time of the  study. In hospitals, third and fourth-year medical
students were found to be the most frequent users. In academic medical libraries,
first and second-year medical students were the largest group of users. The
physical location of the CD-ROM terminal made a significant impact on who used
the system. Dalrymple concludes,  that access to information sources must be
"compatible with the information-seeking patterns of health professionals." She
says that as a profession, Hbrarians need to develop information sources that will
prove effective and easy for health professionals to use. She explains her theory of
information-seeking as a communications process, i.e., a process of health profes-
sionals communicating with the information sources they need. The factors associ-
ated with designing and developing information technologies are also discussed.

29. DaRosa DA, Ross D, Folse R.  The way we teach information-seeking
skills.  M£dkalTeachexl985;7(3-4):297-300.

Using a problem-based  approach exercise as part of medical  students'
surgery clerkships at the Southern  Illinois University School of Medicine,
the students assessed their own information-seeking skills  in comparison
to those of an  expert information seeker (librarian).  The authors' study
10 
revealed what earHer  studies suggested, that medical students are not good
information seekers, and that they are in need of additional formal information-
seeking skills training  to support their information needs.  This exercise was a
positive experience for both the medical students and librarians.

30. Dee CR  Information needs of the. rural  physician: a descriptive  study.
[Dissertation!. Florida:  The Florida State University; 1990 Fall. 266 p.

The information needs  and  information-seeking  behaviors  of 12  rural
physicians in Central Florida were studied. Towns with a population of less than
25,000 were considered rural. Rural physicians' information needs, information-
seeking behaviors, prescribing practices, continuing education sources, and use of
technology were studied.  Computerized library networks, end-user searching,
and libraries' delivery of information were also discussed in this dissertation.

31. Demas JM,  Ludwig LT.  Clinical medical librarian: the last unicorn?
Bulletin of the Medical Librarv Association 1991 Jan;79(l): 17-27.

This  paper describes and  evaluates the  clinical medical librarian (CML)
program  and the  impact it has  on the information-seeking patterns of
health care  professionals.  Questionnaires returned  from 79  clinical
medical personnel and 40 medical school  library directors  were used to
study medical school directors' and clinical  department heads'  attitudes
toward the establishment of a CML program. The study examined eight attitud-
inal elements: the participants' feelings toward the implementation of a CML
program;  the influence on information-seeking  patterns of health care profes-
sionals; ethical issues; CML extension services; the costs of the CML program; and,
the effect of implementation on patient care, on education, and on research. The
findings suggest the attitudes of the two groups are quite different. The authors
conclude that there is an increase in health care professionals' information needs
and that if properly structured, the implementation of a clinical medical librarian
program could fulfiU those needs.

32. Elayyan RM.  The use of information by physicians. International Librarv
Review 1988 Apr;20(2):247-65.

Elayyan presents a review of the Hterature on physicians' information needs and
use. The studies included vary in terms of objectives, techniques, populations, scope,
and quality. The author argues that studies on information needs are actually about
information use and that only a few of them distinguish between the two concepts.
This review of the literature is divided into five parts: the concept of information use;
relevant bibliographies and reviews; the use oflibrary-related sources of information
11 
by physicians; the use of non-library related sources by physicians; and, the factors
affecting physicians' information use. Included are 93 references from 1960 to 1989
on the topic of information use.

33. Forsythe DE, OsheroffJA, Buchanan BG,  Miller RA. Expanding the
concept q£ medical information:   an observational  study o£ physicians'
information  needs. Pittsburgh, PA: University  of Pittsburgh,  Intelligent
Systems Laboratory, Computer Science Department; 1990 Aug. 33 p.

The concept and meaning of "information" is discussed in relation to identifying
and interpreting the information needs of physicians. The authors criticize the
methods that have been used to study information needs as inadequate and present
evidence to show that such methods do not sufficiently measure information
needs. This study examines the information needs of academic physicians and
trainees in internal medicine. The basic data-gathering technique, a variant of
participant observation, was  used to study information  needs in four clinical
settings in a university teaching hospital. Use of computerized information sources
to fulfill information needs is discussed.

34. Freedman H. A  survey  of the  use  of Withington Hospital Medical
Library.   Health Libraries Review 1985;2(2):69-78.

A two-part questionnaire  survey was  developed  to assess the use/non-use
of the Withington Hospital Library in England.  The survey population consisted
of staff and  students of this large teaching hospital.  The first  questionnaire
surveyed the library's effectiveness in providing services to the hospital community.
The second survey identified the specific types of information demanded by commit-
ted Hbrary users. Although the necessity of having a library on site was confirmed,
the study suggests that it is not possible for a single hospital library to satisfy all
users' needs. Survey results pointed out the  need  for an  organized  regional
resources  sharing network of health sciences libraries; library promotion among
nurses; and provision of library skills training.

35. The future of information systems for the medical sciences: a symposium. Bul-
letin of the New York Academy of Medicine 1989 Jul-Aug; 65(6): 639-738.

This  special  issue of the Bulletin of ihe_ New York Academy of Medicine is
devoted to papers presented at the symposium and responses to these papers.
Papers from this symposium, as well as  the study itself, are listed separately in
this bibliography. See:  Braude, Bowes, Bruer, Haynes, Huth, Lorenzi and Louis
Harris and Associates, Inc.

36.  Garfield E.   The impact of health information delivery on  the quality
of patient care: whither medical information science? Health Libraries Review
1985;2(4): 159-69.
12 
This article describes several conventional hospital libraries and the role the
libraries play in providing quaHty cost-effective health care services. The purpose
of the hospital library is defined and defended.  Garfield considers the impact of
health information and medical libraries on patient care and the health care system,
and discusses his thesis that "medical information is a requirement for cost-effective
deHvery of health care." Garfield recommends incorporating the teaching of infor-
mation-seeking skills into medical school curriculum.

37. Glockner B. The information needs  of medical practitioners in Western
Australia.  Health Information:  New Directions. Proceedings of the Joint
Conference of the Health Libraries Sections  of the AustraHan  Librarian and
Information Association and New Zealand Library Association; Auckland,  New
Zealand; Nov 12-16,1989:349-358.

Due to the number  of requests for health  science information received at
King Edward Memorial  Hospital Library not related  to  obstetrics or
gynecology,  a  survey was conducted in Western Australia  to study  the
information-seeking behavior of medical practitioners in the Perth metropolitan
area and  doctors practicing in the  country. The objective of the study  was to
determine why rural health professionals were contacting a subject specific library
for general health science information.  Glockner also wanted to identify "reasons
for the medical practitioners' information needs." Studying 100 country doctors and
100 doctors from the Perth metropolitan area, Glockner determined  that the
information needs of rural medical  practitioners in Western Australia were not
being supported by the major medical libraries.  One reason for the lack of support
to rural medical practitioners was lack of funds. Suggestions and recommendations
for supporting the information needs of rural  medical practitioners in Western
Australia  are discussed in detail.

38. Goldstrom R Emerging community staff: who? what? where? NISG News-
letter 1989 Sep;9(3):7-9.

This paper was presented by the Nursing Information Subgroup  at the Library
Association (U.K) meeting on May  18, 1989. This is the report of a study by the
Nursing Information Subgroup providing recommendations to Hbrarians to make
them more aware of the information needs of community nursing staffs. Central
points include: community nurses job functions and how nursing Hbraries can meet
nurses'  needs; the training requirements of community psychiatric nurses; and
the work of practice nurses and community midwives.

39. Goodspeed RB, Goldfield N.  Computer assistance with information needs
in clinical medicine. New York State Journal of Medicine 1988 Apr;88(4): 183-90.

Goodspeed and Goldfield outline the medical information needs of physicians as
patient care, biblio.graphic information, knowledge bases, expert systems,  clinical
13 
databases, and protocol management. Clinical computer programs which support
the medical information needs of physicians are reviewed. The advantages and
difficulties of using computer technology to assist physicians in meeting their
information needs are also discussed. Seven recommendations and key consider-
ations for selecting a computer system to support medical information needs are
offered.

40. Grefsheim S, Franklin J, Cunningham D. Biotechnology awareness study,
part 1:  where scientists get their information. Bulletin cf ihe_ Medical Librarv
Association 1991 Jan;79(l):36-44.

This article  (part  1) reviews the findings of a study assessing the
information needs of researchers in the field of biotechnology. The  study was
funded  by the National Library of Medicine for the purpose of conducting re-
search regarding the establishment of a National Center for Biotechnology Infor-
mation. Using both written and in-depth interview survey methods, the South-
eastern/Atlantic Regional Medical Library staff and University of Maryland at
Baltimore  Health  Sciences Library staff conducted a survey of nine medical
school libraries. The authors evaluate the libraries' resources available to support
biotechnology research.  For part 2 of this study, see Cunningham, D.

41. Gruppen LD. Physician information seeking: improving relevance through
research.  Bulletin of the Medical Librarv Association 1990 Apr;78(2): 165-72.

This paper addresses how libraries can play a significant role in the teaching of
informal continuing education (CE) principles. By teaching information-seeking
skills, librarians can change physicians' information-seeking practices.  Gruppen's
analysis of physicians' information- seeking and advice-seeking behaviors in day-
to-day patient care reveals that their needs are not being met and their strategies
for seeking information are not effective. He suggests that physician characteristics
and practice characteristics influence physicians' preferences for information
sources. He stresses that health sciences librarians need to conduct market re-
search to evaluate the specific information needs of their users.

42. Gruppen LD, Wolf FM,  Stross JK.  Physician practice characteristics
as a context for primary care treatment decision making: a preliminary study.
Academic Medicine 1990 Sep;65(9 Suppl):S9-S10.

In this study, the authors examine how physician practice characteristics affect
their medical decision-making process in the course of patient care. Surveys were
mailed to a random sample of 2,060 internists and family practitioners in Michigan.
Three variables were examined:  1) physicians' confidence in the treatment plan;
2) outside  sources  referred to during  patient care;  and 3) whether they would
continue patient care involvement if they referred the patient out. The results
revealed that physician certification status did influence physicians' information-
14 
seeking behavior. Certified physicians were found to more likely than noncertified
physicians to treat patients without seeking additional information.  The results
suggest "that physician decision-making is influenced not only by physician knowledge
and the  content and nature of the problem, but also by  the  context in which
physicians confront problems."

43. Gruppen LD, Wolf FM,  Van  Voorhees C,  Stross JK.  Information-
seeking strategies and differences among primary care physicians. Mobius 1987
Jul;7(3):18-26.

The objective  of this  study was to identify physicians in  different sub-
specialities to determine whether they had any differences in their information-
seeking behaviors when faced by a difficult problem. Using a multiple  choice
questionnaire, ninety-eight internal medicine physicians and 73 family physicians
were surveyed about their information preferences when they needed to consult
information sources  to  solve patient care problems. The information sources
included were: journals, textbooks, informal consultations with colleagues, consul-
tations with community specialists, and consultations with outside specialists.
Transferring the patient to another physician was  also suggested. The study
indicated that internal medicine physicians prefer consulting the medical litera-
ture, while  primary care family physicians prefer talking with  colleagues and
speciaHsts as their primary source of medical information. Gruppen suggests that
the results of this research should be applied to the development of continuing
medical education courses for physicians.

44. Gruppen LD, Wolf FM, Van Voorhees C, Stross JK Information-seeking
strategies and treatment decision making.  Proceedings of the Annual Conference
on Research in Medical Education 1987;26:203-8.

The focus of this study was to identify the information-seeking strategies primary
care physicians use to supplement their knowledge when confronted by a challeng-
ing problem. The research examined the impacts the office and/or inpatient setting,
the content of the problem, and physician preferences have on physicians' informa-
tion-gathering strategies. Office-based physicians were  found  to use textbooks
more often than inpatient physicians. Overall, the study found that physicians in
different practices use different approaches to answering patient care problems.

45. Gruppen LD, Wolf FM, Van Voorhees C, Stross JK. The influence of prior
experience and confidence on physician preferences for information sources and
continuity of care. Proceedings pi ihe. Annual Conference oji Research in Medical
Education 1986;25:177-82.

In previous studies, Gruppen et al., determined that physicians have differences
in information needs, information-seeking strategies, and preferences. The re-
search presented in this paper examines whether one's experiences as a physician
15 
contribute to differences in information source preferences. A mailed survey using
four clinical vignettes found "there is little evidence for any influence of experience
on the physicians' preferences for information sources."  The authors suggest "that
experience does not alter the physician's strategy or style of accessing additional
information, it just enables him/her to delay or avoid having to seek it." However,
the study determined that physicians with limited experience tend to refer to
external sources rather than printed sources of information to fill their information
needs.

46. Harris-Wehling J, Morris LC, eds. Improving Information Services for
Health  Services Researchers.  A Report to the National Library  of Medicine.
Institute of Medicine. Committee to Advise the National Library of Medicine on
Information Center Services in Health Services Research; 1991. 62p.

In 1989, the U.S. Congress charged the National Library of Medicine with the
development of an information center for health care technologies, technology
assessment and health services research.  The Institute  of Medicine  (IOM)
conducted a twelve-month study  to  identify services that the new NLM
information center should be prepared to provide and to determine broad cost
estimates required to provide those services. This report presents  the findings,
conclusions and recommendations of that study.  Four of the recommendations
relate to improving NLM's infrastructure and one relates to outreach.

47. Haynes RB.  Organizing and accessing the literature.  BuHetin of the New
York Academy of Medicine 1989 Jul-Aug;65(6):673-86.

This paper was presented in the Organizing and Accessing the Literature Panel at
the Symposium on the Future of Information Systems for Medical Sciences. Haynes
reviews evidence concerning the information problems of practitioners and the role
of biomedical literature in addressing their information needs. Haynes states that
"physicians' opinions about their information needs and practices diverge consider-
ably from reality:  clinicians vastly underestimate their information needs and
vastly overestimate their own efforts to meet these needs." His study indicates that
"information needs as 'perceived' by clinical physicians differ markedly from their
'true' needs as deduced from the study of their actual behaviors." Haynes' study also
reveals that there is a lack of evidence to show how the biomedical literature meets
the information needs of health professionals and whether it has any significant
effect on patient care.  He proposes methods for organizing and accessing the
literature to improve its impact on raising the quality of medical care.

48. Haynes RB, Ramsden M, McKibbon KA, Walker CJ, Ryan NC. A review
of medical education and medical informatics.  Academic  Medicine 1989 Apr;
64(4): 207-12.

This article discusses various problems and solutions for deaHng with the informa-
16 
tion dilemmas of health professionals.  Problems cited include keeping up with
technological advances and managing information. Solutions suggested for han-
dling the information overload are the teaching of information-seeking skills in
medical schools and the implementation of computerized systems to handle
medical information. The authors highlight developments in the growing field of
medical informatics and  evaluate potential  solutions for meeting health
professionals information needs. Recommendations suggested by the American
Medical Colleges for Informatics are reviewed.

49. Hewins  ET. Information need and use studies. Annual Review of Informa-
tion Science and Technology 1990; 25:145-74.

The Annual Review of Information Science and Technology (ARIST) has pubHshed
chapters almost every year since 1966 on information needs and use studies. This
series of reviews covers all types of user studies including those of health profession-
als. It includes more than 100 references, covering the period 1986-1989. A section
of this chapter is devoted to the Hterature on information needs in the growing field
of medical informatics.  This section cites many important studies of informa-
tion needs and use studies in the health sciences field, in addition to studies deal-
ing with cognitive processes involved in information need and use studies.

50. Horak EB. Clinical librarianship in an era of end users. Medical Reference
Services Quarterly 1987 Summer; 6(2):65-9.

This article  suggests that certain  aspects of clinical librarianship are being
challenged due to end-user access to information. The author raises the question of
"whether or not the cHnical Hbrarian as intermediary can actually serve end-users,
or,  are the concepts mutually exclusive?" The author implies that, as the librarian
disseminates information, she should also enhance users' knowledge of information
sources. In addition, Horak emphasizes that managers of clinical librarian pro-
grams should be aware of the health care environment and direct their programs
to meet users' needs. Examples of roles for clinical librarians are presented.

51. Hulkonen DA, Mack BR  Physicians' perceptions of library services in a
rural state. Bulletin of the Medical Librarv Association 1986 Jul;74(3):205-9.

In  a study funded  by the National Library of Medicine, the Greater Midwest
Regional Medical Library staff surveyed underserved or unserved rural health
care professionals in hospitals and  clinics in South Dakota to determine their
medical information needs. The study examined three questions:  "1) Did the
perceptions of physicians afifiHated with the underserved and unserved institu-
tions identified in the survey of 1983 vary significantly from the physicians with
adequate resources? 2) Were the underserved/unserved physicians satisfied with
their ability to retrieve information?  3) What was their response to proposed
library initiatives to improve access to  information?" Overall,  unserved and
17 
underserved physicians accessed local, state, and regional libraries infrequently.
They had little if any use of computerized information sources. Many participants
cited reasons for their lack of use of information sources but expressed an interest
in gaining access to library services. Physicians' perceptions of their own abiHties
to acquire information were found to vary significantly. An important finding
revealed that although the physicians had similar responses to the questionnaire,
physicians' institutional affiliation made a difference in their responses.

52. Huth EJ.  The information explosion. Bulletin  of the. New York Academy
Of Medicine  1989 Jul-Aug;65(6):647-61.

In this paper presented by the Information Explosion Panel at the Symposium
on the Future of Information Systems for Medical Sciences, the author suggests that
the medical community is not homogeneous and that its individual specializations
lead to  differences in the kinds of information sought. He  argues that health
professionals' use or non-use of information sources is directly related to a utility/
cost equation. The value of information must be equal to the use of information
divided by the cost of information sought. The utility of information is its credibiHty
and usefulness, and the cost of information is based on how accessible it is in
addition to its monetary cost. Since the information explosion has made it difficult
for managers of  published information, notably librarians, and for academic
medical personnel to find information to suit their needs, Huth concludes that
producers or publishers of information must lower  the  cost of information to
improve its utility.

53. Huth EJ. The underused medical literature.  Annals q£ Internal Medicine
1989Jan;110(2):99-100.

As editor of the Annals of Internal Medicine. Huth identifies obstacles such as
time, cost, inconvenience, effort, and inadequacy as reasons  for the underuse of
the medical literature.  He identifies a critical need for the development of a
system to better link  physicians to the medical Hterature. He argues that the
professional societies are a good source to address the design of new systems to meet
physicians' information needs and suggests expert systems as a further means of
addressing these needs.

54. Ikpaahindi  LN. Information gathering methods of Nigerian veterinary
scientists. Librarv & Information Science Research 1985 Apr;7:145-57.

The hypothesis of the National  Veterinary  Research Institute, Library  and
Documentation Division was that "Nigerian veterinary practitioners do not have
enough information to perform their duties effectively and that, consequently, they
depend on informal communication and invisible colleges for information." Using a
precoded questionnaire, 100  veterinary researchers in Nigeria were surveyed
concerning their  information needs, information-seeking strategies, and their
18 
satisfaction with information found. While an information problem truly exists, the
findings negate the assumption that veterinary scientists depend on their col-
leagues as an information source. In fact, they were found to use their coUeagues
a great deal less than was  presumed.

55. An information digest for health workers in Zimbabwe. Zimbabwe Librarian
1988 Dec;20(2):74-5.

This commentary is a brief background on  health professionals' information
needs in Zimbabwe. The Medical Library of the University of Zimbabwe conducted
two surveys. The  first revealed the information needs of the health professionals
outside the Harare metropolitan area or outside the University of Zimbabwe were
not being met. The second survey found that health professionals who accessed the
University of Zimbabwe medical Hbrary felt that the information services were
"very satisfactory." The Current Health Information Zimbabwe (CHIZ), the inhouse
onHne system which provides access to the National Library of Medicine's MED-
LARS  databases,  is provided free of charge to health professionals, in accordance
with the services provided by the Ministry of Health in Zimbabwe.  Response to this
onHne system has been favorable.

56. Ingram P, McCaleb  J.  Rural community health centers:  the information
network and professional  competence.  North Carolina Medical  Journal 1989
Dec;50(12):701-2.

The North Carolina Area Health Education  Centers  (AHEC) Library and
Information Services (LIS) Program was implemented through the Office of  Rural
Health Services and the National Library of Medicine.  The AHEC goal is to offer
education and information support services to  meet  the information needs of
physicians and allied health personnel throughout North Carolina.  Specific aims
are to assist the rural health care community which has a lack of immediate health
information resources.  It has been suggested that physicians avoid practicing in
rural areas because of a lack of information and support services, professional
isolation, and inadequate facilities available in those areas. The AHEC supports
rural physicians' information needs, offers continuing medical education courses,
didactic lectures, consultation services, hands-on presentations, technical support,
and medical student clinical rotations, in addition to traditional library  and
information services.

57. Kilby SA, Fishel CC, Gupta AD.  Access to nursing information resources.
IMAGE: Journal of Nursing Scholarship 1989 Spring;21(l):26-30.

In this article, the authors discuss the dilemma of access to  current nursing
journal articles and books. They suggest collecting and organizing other types of
nursing information  resources in addition to  the traditional  sources available.
Methods are suggested for gaining control over this information overload.  The
19 
authors stress  that  nurses need to more carefully define and  evaluate their
information needs, understand the importance of the medical Hterature, and obtain
information-seeking skills training in nursing curriculums.  A review and evalua-
tion of nursing Hterature sources is included.

58. King DN. The contribution of hospital library information services to clinical
care: a study in eight hospitals. Bulletin of the Medical Librarv Association 1987
Oct;75(4):291-301.

The Illinois Health Science Libraries Research Group was formed to assess the
hospital library information services' contribution to the quality of patient care.
One hundred seventy-six health care professionals, divided into three groups:
physicians, nurses, and other health professionals, were surveyed in eight hospi-
tals. Five areas were investigated. They included the quality and value of informa-
tion, the impact  information had  on patient care and case management, and
libraries' performance in providing the information. The health care professionals
surveyed did not have any differences in their opinions of the contribution of
information to patient care or its impact on case management. Responses indicated
that information played an important role in patient care decisions.

59. Kochen M, Cohen L, Wulff Y.  Information systems and clinical research by
residents in internal medicine. Methods of Information in Medicine 1985;24(2):85-
90.

The case group  of health professionals studied in this  paper were  internal
medicine residents at the University of Michigan who were required to complete
a research project. For many of the residents, this research project was their first
experience in clinical research.  A questionnaire  was  designed to identify the
residents' current information needs and information-seeking skills. Analysis of
the results showed that residents first turned to experienced colleagues, then to
textbooks in their field, and finally to online databases as sources of information.
The research revealed that  the more experience a physician has, the less time he
spends in the library or depends upon librarians to answer his information needs.

60. Kolner SJ, Dalrymple PW, Christiansen R Teaching skills in medical
information retrieval to medical students.  Journal of Medical Education 1986
Nov;61(ll):906-10.

This article examines the effectiveness of traditional information skills courses
taught by librarians to medical students. The objective of the  project was to
develop an efficient and effective method of teaching information retrieval skills to
second-year medical students. The authors studied 45 second-year students at the
University of Illinois CoUege of Medicine at Rockford who were required to take
a case-oriented, multiple-choice pre-test on information retrieval skills. The tests
were  designed  to evaluate  the  students' use of Index Medicus. computerized
20 
onHne literature searching, the card catalog, and various drug information sources.
Hospital librarians and medical school faculty were also given the test, and the
scores of the two groups were compared. The study revealed that the students
surveyed had deficiencies in information retrieval skills. Students who used a self-
instruction module after the pre-test had significantly higher scores on the post-test
than the students who did not. Based on the results of the study, the authors believe
that "self-paced individual learning modules are effective tools for teaching infor-
mation retrieval skills to medical students."

61. Korale SR The health system and medical information services in Sri Lanka.
Health Libraries Review 1989 Sep; 6(3): 129-40.

This paper describes and evaluates the structure of the health care  system of
Sri Lanka and the information infrastructure that supports it. The government of
Sri Lanka is responsible for the provision of health care services free of charge to
all citizens using both  Western and indigeous systems of medicine. Responding
to a need for a national  health information system, the Ministry of Health has
taken the initial steps in establishing a primary health care information service.
With the assistance of the World Health Organization (WHO), the HELLIS (Health
Literature, Library and Information Services) Sri Lanka was implemented. At
present 18 libraries have joined the network and strive to meet the informa-
tion needs of health care practitioners. The article describes the health informa-
tion  users' groups and delineates  the  deficiencies of the  present  information
services provided to them. The article specificaUy demonstrates the need for better
collections and the "identification of grey Hterature" produced by the many gov-
ernment agencies.

62. Leist JC. Issues in information dissemination and professional competence.
North Carolina Medical Journal 1989 Dec;50(12):694-6.

The  North  Carolina Area  Health Education  Centers (AHEC) Library and
Information Services (LIS) Network provides health care professionals with in-
formation and educational services to support their information needs. The LIS
Network is a cooperative network of health sciences libraries and has been in
existence more than 15 years. The North Carolina AHEC Program has nine Library/
Information Centers with more than 20 specially trained medical librarians.  Each
AHEC is affiliated with one of the four medical schools in North Carolina. LIS is a
unique information resource which links health professionals with information and
resources to support their information needs and  professional competence. The
AHEC program offers AMA continuing medical education courses in coUaboration
with the medical schools to all fields  of health professionals.

63. Levene LA Health educators and library resources. Health Education 1990
Sep-Oct;21(5):25-9.
21 
In this article, Levene discusses the important role a librarian plays in supporting
the information needs of health educators. Levene identifies current and accurate
information as the most common information need of health educators.  Back-
ground information about online pubHc access catalogs (OPACs), online databases,
and CD-ROM technology and their value to health educators are discussed. The
author also identifies and describes basic health science information.

64. Lockyer J,  Jennett P, Parboosingh J, Maes W.  Raising questions in
clinical practice.  Journal of Continuing Education in the Health Professions
1988;8(l):21-6.

Physicians practicing in Calgary and in Southern Alberta who saw at least 25
patients in a typical day were asked to fill out a questionnaire to determine the
number of questions that arise to which they do not have an answer. The family
physicians reported about one question for every five patients. Physicians were
asked to examine the library resources they access and use and to determine
whether there is a relationship between the number of questions raised in practice
and these resources. In phase two of the study, a mailed questionnaire requested
information about office libraries and their use of library resources. A T-test
analysis was used to interpret the answers. The findings from the mailed question-
naire differed from the results in earlier research. The limitations, impHcations,
and biases for the results are reviewed.

65. Lorenzi NM. Response to paper by R. Brian Haynes, M.D., Ph.D.: organizing
and accessing the literature. Bulletin of the New York Academy of Medicine 1989
Jul-Aug;65(6):699-703.

Lorenzi, in response to R. Brian Haynes' paper, agrees that information needs in the
medical professions are not currently being met and that information professionals
must first listen to information requests and then design and develop systems
which will meet these demands. The Integrated Academic Management Informa-
tion System (IAIMS) is one concept that the author suggests could meet some of
these needs.

66. Louis Harris and Associates, Inc. The future of information systems for
the medical sciences. New York: The New York Academy of Medicine; 1987.
271 p.

This study reports the results of a nationwide telephone survey opinion poll of 759
members of the medical community: medical school deans, clinical and basic science
faculty members, residents,  medical students,  health sciences librarians, and
office-based physicians. AU interviews were conducted between September 1986
and January 1987. The objectives of the poll were to identify health professionals'
information needs, evaluate methods for dealing with the  medical  literature
information overload, and examine the  role libraries play in medical education.
22 
Analysis of the data collected led to 13 conclusions. An executive summary is
included in the report and was published in a special issue of Bulletin o£the New
York Academy of Medicine (1989 Jul/Aug:644-46).

67. MacNeil KJ, Algermissen VL, Neill CA Information management skills for
veterinary students. Journal of Veterinary Medical Education 1985 Fall;12(l): 25-
6.

The authors report on the outcome of a course on computer Hteracy in information
management skills taught by the Texas A & M University Medical Sciences Library
faculty. The University Veterinary Public Health Department perceived a need for
second-year veterinary students to learn information management skiUs. The
course taught database content, command language, medical subject headings, and
search relevance. According to the results, the class succeeded in teaching informa-
tion management skills.

68. McCue JD, Hansen CJ, Gal P.  Physicians' opinions of the accuracy, acces-
sibility, and frequency of use of ten sources of new drug information.  Southern
Medical Journal 1986 Apr;79(4):441-43.

Ten drug information sources were compared for their accuracy, accessibility, and
frequency of use to meet the information needs of 49 internists, 42 family practitio-
ners, and 28 surgeons from the Greensboro area in North Carolina.  The sources
included: Physicians' Desk Reference: pharmacology texts; medical  letters; journal
articles; professional meetings; hospital pharmacists; colleagues; community phar-
macists; drug advertisements; and drug company representatives. Written sources
versus verbal sources of drug information and commercial sources versus noncom-
mercial sources were factors considered.  "Commercial sources were thought to be
less accurate than noncommercial sources, but were used more frequently. Written
sources were thought to be more accurate and were preferred over verbal sources of
drug information." Physicians' Desk Reference was  selected as the most highly
utiHzed tool.

69. Meadows B, Hamberg CJ. Health professionals and information: value.
variables, variety. Chicago, IL: Medical  Library Association,  Courses for
Continuing Education; 1988. 27 p.

This a  continuing education  course  (CE 680)  offered by the Medical Library
Association intended for health science librarians. The objective of the course is
to determine and examine health professionals' information-seeking skills, infor-
mation-seeking behaviors, information use, and the value of information to them in
order for health sciences librarians to better meet their cHents'  needs. The course
includes sections on: theory, purpose, and scope; proactive programs;  issues for
further research; and a selective bibHography.
23 
70. Miller RA, Giuse NB. Medical knowledge bases.  Academic Medicine 1991
Jan;66(l):15-7.

This article discusses the importance of medical knowledge bases in the future of
medicine and in the field of medical informatics. The authors describe and review
medical knowledge bases, stressing their capabilities to meet information needs.
They advocate the development and dissemination of medical knowledge bases as
tools for clinical practice, research and education.

71. Milligan GA The information-seeking behaviour of users and non-users of a
computerized bibliographic search service. South African Journal pf Librarv and
Information Science 1986 Mar;54(l):34-7.

The Institute for Medical Literature offers access to the MEDLARS databases of the
National Library of Medicine.  Over a five-year period, 1,400 users accessed the
service, although more than 3,500 users were anticipated.  Therefore, the Institute
conducted an extensive survey through a self-administered questionnaire in order
to better identify users' information needs. Using a prospective survey method, a
study was conducted by the South African Institute for Medical Literature to
evaluate and compare the information-seeking behaviors and information-seeking
skills of users and non-users  of  computerized  onHne search services. Several
variables  of interest were: type of work activity; the age of the user/ non-users;
current awareness methods; use of reference sources; use of colleagues; use of
personal reference collections  and patterns of use. The study found that users
tended to be involved in research, while non-users tended to be involved in patient
care practice.

72. Moore GF. Development of information retrieval skills for freshman medical
students.  Journal of Medical Education 1988 Nov;63(ll):870-2.

In this paper, Moore outHnes a method for helping first-year medical students learn
how to use information resources more efficiently.  He  suggests that previous
studies and library skills courses have not been effective because there is little skills
retention. This course  on information-retrieval  skills utiHzes a specific patient
encounter to teach library skills. As a result, students' information retrieval skills
were shown to improve. A one-year follow-up study revealed that the students had
retained the information retrieval skills learned.

73. Mularski CA, Nystrom E, Grant HK. Developing information-seeking skills
in occupational therapy students. American Journal of Occupational Therapy 1989
Feb;43(2):110-4.

This study describes how the  Ohio State University Library and  Occupational
Therapy Division implemented a library skills course-integrated  instruction
program for students. Both Hbrarians and faculty members are responsible for
24 
executing and evaluating the curriculum-based course. The authors define course-
integrated instruction as the "teaching of library information-seeking skills in the
medical curriculum." They report health sciences students must be able to acquire,
evaluate and apply information effectively. They suggest health sciences students
should be able to use information tools and databases to seek the information they
need. This paper reviews the steps that were necessary to make this course a
success.

74. National Library of Medicine (U.S.) Board of Regents. Improving health
professionals' access £p_ information; report of the National Librarv of Medicine
(U.S.) Board of Regents. Outreach Planning Panel. Bethesda, MD: U.S. Dept. of
Health and Human  Services, National Institutes of Health; 1989 Aug. 28 p.

This report is the result of serious discussion and the diligent efforts of a panel
convened by the National Library of Medicine Board of Regents. Headed by Dr.
Michael Debakey, the  panel's report outHnes the following goals: to increase
awareness of information resources; to provide strategies for removing obstacles to
information access; and to identify mechanisms to insure maximum application of
NLM's information  products and services. The panel found that NLM needs to:
1) address  the individual health practitioners' needs;  2)  network hospitals to
national information sources; 3) provide training  in medical informatics; and 4)
develop a new generation of information products and services.

75. O'Brien D, Procter S, Walton G.  Toward a strategy for teaching informa-
tion skills to student nurses. Nurse Education Today 1990 Apr; 10(2): 125-9.

The library and academic staff of Newcastle upon  Tyne Polytechnic and Sunder-
land Health Authority  developed a comprehensive information skills packet for
student nurses earning an ENB (English National Board) Diploma in the Nursing
Science/ Registered  General Nurse Course. The skills package was developed in
recognition of the increasing need for nurses to develop active and independent
learning skills to support their responsibiHty for life-long learning. The study/
course (ENB Pilot Scheme Course) used a variety of teaching and learning methods
to progressively teach  information referral, information retrieval, information
utili zation, and information evaluation. An important goal of the study was to allow
student nurses to acquire the information skills needed to satisfy their routine
information needs. The value of the course was measured through open-ended
questionnaires, interviews, and student assessments. The findings indicate that
both students and staff felt this method of teaching information skills was benefi-
cial.

76. Osheroff JA, Forsythe DE, Buchanan BG,  Bankowitz RA, Blumenfeld
BH, Miller RA Physicians' information  needs: analysis  of questions posed
during clinical teaching. Annals of Internal Medicine 1991 Apr 1;114(7):576-81.
25 
An anthropologist experienced in participant observation recorded verbatim infor-
mation needs expressed by physicians while caring for patients in four general
medical settings. The objective was to develop educational and technological
approaches to satisfying cHnical information needs. The authors examined the type
of information requested. Findings suggest that information needs can be charac-
terized as consciously recognized, unrecognized and currently satisfied. The au-
thors beHeve that understanding information needs will lead to more effective
patient care.

77. Osiobe SA A study of the use of information sources by medical faculty staff in
Nigerian universities. Journal of Information Science 1986;12(4):177-83.

The  objective of this study was to examine the use of sources of information in
relationship to health professional specialties. The author's hypothesis was that
health professionals used different sources of information depending on their area
of specialty.  The study consisted of a random sample of faculty members of 10
medical specialties from six selected medical schools in Nigeria. The survey study
found the various medical specialities had a "high degree" of similarity in their use
of information sources, proving the author's hypothesis incorrect. The findings
revealed that scientific and technical journals were  the  most frequently used
sources of information. Monographs and texts were found to be the second most
used sources of information. Colleagues and other health professionals were also
cited as frequent sources of information. Reference librarians rated very low as
sources of information, suggesting that perhaps Nigerian librarians should focus
their energies on improving their information services. Osiobe identifies areas that
should be considered during Hbrary budget allocations and suggests recommen-
dations for improved information services in Nigerian medical libraries.

78. Osiobe SA Sources of information for biomedical decision-making.  Methods
of Information in Medicine 1985;24:225-9.

One hundred seventy-seven health professional faculty members at six Nigerian
medical schools were surveyed by questionnaire. The objective was to determine the
frequency with which 20 sources of information were used during research, teach-
ing, patient care, and other tasks. Overall, scientific/technical journals were ranked
the number one source for answering questions arising during research and patient
care. Textbooks/monographs were  the preferred choice for instructional purposes.
Osiobe argues that health professionals' choice of specific information sources is
directly related to the context in which the need occurs.

79. Osiobe SA Use of information resources by health professionals: a review of the
literature. Social Science and Medicine 1985;21(9):965-73.

This is  a review of  the  literature from 1950-1980 on the use of information
resources and the information-seeking behaviors of  health  professionals. The
26 
influence of several variables, such as form and location of practice, specialty and
departmental affiliation, on the use of sources is discussed. The findings revealed
that researchers and academic health professionals use library information sources
heavily compared to practicing physicians who  report low use. Textbooks are
consulted most frequently by medical students and pharmacists. Clinical librarians
were cited as important information resources when available. This article includes
more than 50 references and summaries on the information-seeking and informa-
tion resource needs of health professionals.

80. Palchik NS, Wolf FM,  Cassidy JT, Ike RW, Davis WK. Comparing
information-gathering strategies of medical students and physicians  in diagnosing
simulated medical cases. Academic Medicine 1990 Feb;65(2):107-13.

A study was conducted using patient management problems (PMP) at the Univer-
sity of Michigan  Medical School to examine three medical information-gather-
ing processes: history-taking, physical examinations, and diagnostic studies. The
study sample consisted of 175 second-year medical students.  The medical students
were studied to examine the influence their information-gathering strategies had on
their formulations of the differential and the principal diagnoses of 14 simulated
patient management problems. The clinician responsible for the medical content
of each  PMP was asked  to make a judgement on the relative importance of
information-gathering processes for diagnostic decision making. In general, the
students emphasized diagnostic studies as their preferred information-gathering
choice, while physicians emphasized patient history as the essential element in
gathering information.  These judgments were then compared with the factor
patterns derived from the students' performances as a basis for this study.

81. Patrick W. The hospital library as nurses' library: a modest proposal for pro-
portional representation. Bibliotheca Medica Canadiana 1988;9(3): 151-4.

Patrick points out that two-thirds of Canada's health care professionals are nurses.
Eighty-five percent of Canadian nurses work in hospitals and turn to the hospital
library to meet their information needs. The number of nurses almost doubles the
number of other health care professionals, yet the information sources available to
them are limited. The author suggests the direct outcome of improving nurses'
access to information would be better patient care, resulting in shorter patient stays.
A second point she makes is that better access and support of nurses' information
needs could attract more highly qualified nurses.

82. Pelzer NL, Leysen JM. Use of information resources by veterinary practi-
tioners. Bulletin pf the Medical Librarv Association 1991 Jan;79(l): 10-16.

The authors surveyed randomly-selected veterinary practitioners in 17 states to
determine which information sources met their veterinary information needs. The
veterinarians most frequently preferred books and other practitioners as sources of
27 
veterinary information. Although they have Hmited access to veterinary informa-
tion sources, veterinarians were found to still underuse information resources. The
authors surmise that veterinary medical practitioners are graduating from veteri-
nary medical schools without the information-seeking skiUs necessary to meet their
information needs, and, therefore, do not have the information skills necessary to
find the information. The authors say the trend toward computerization in veteri-
nary practice has not increased the use of onHne information services.

83. Pelzer NL, Leysen JM. Library use and information-seeking behavior of
veterinary medical students. Bulletin pf the Medical  Librarv Association 1988
Oct;76(4):328-33.

The Iowa State University Veterinary Medical Library conducted a survey of the
College of Veterinary Medicine students. The questionnaire focused on four vari-
ables: library use, information-seeking behavior, use of printed and computerized
sources, and clinical practice sources. Course textbooks and class handouts were the
most frequent sources for filling information needs, however many students were
not using journal indexes or abstracts. Students who had reported having previous
bibliographic instruction were not able to use or identify the information sources
any better than the students without previous instruction. An outcome of the study
was that course-integrated information-seeking skill s training for veterinary medical
students is needed before they go into practice in remote locations. Additionally,
computerized information services were seen as a way of reducing the information
isolation typical in many veterinary practices.

84. Premsmit P.  Information needs  of academic medical scientists  at
Chulalongkorn University. Bulletin pf the Medical Library Association 1990
Oct;78(4):383-7.

In  this article,  the  information needs and information-seeking behaviors of
academic medical  scientists in a  developing  country were  examined. The
Chulalongkorn University in Bangkok, Thailand, was selected for the  study.
Using a self-administered questionnaire, 199 basic and clinical scientists reported
on  their use or non-use of Hbraries as information providers, the information needs
they have, and the best sources for information. The scientists reported the need to
identify up-to-date information as the most frequent reason for using the library
resources. The second most important reason was to obtain relevant studies or data.
Finding a research topic was cited as the third most prevalent use. Although the
Chulalongkorn University scientists rely heavily on information from developed
countries, the study concluded that the information needs of scientists in developing
countries are different from those in  developed countries. The major difference is
the high use and regard for the library in less developed countries.
28 
85. Rankin JA, Williams JC, Mishelevich DJ. Information system linking a
medical school with practitioners and hospitals. Journal of Medical Education 1987
Apr;62(4):336-43.

The Georgia Interactive Network for Medical Information (GaIN) is a network of
computers and telephones that Hnk Georgia hospitals with rural Georgia health
care practitioners through the Mercer University School of Medicine in Macon,
Georgia.  The GaIN network was developed by a grant from the National Library of
Medicine in order to provide medical information via computer to meet information
needs. The aims of the GaIN project are to teach information retrieval skills to the
users of the system; to provide timely access to information that is needed in rural
practice; to allow colleagues to talk to one another via electronic mail and telecon-
ferencing; and, to provide access  to the MEDLARS databases and University
resources. Based on their experience with GaIN, the authors make recommenda-
tions for  planning new information networks.

86. Rector RA The information  needs pf nurses specializing in gerontology
[Masters Thesis! Albany, NY: The State University of New York at Albany; 1985.
29 p.

Rector's thesis, submitted in partial fulfillment of an M.L.S. degree, supports the
argument that nurses need access to up-to-date information in medical and nursing
practice in order to provide quality patient care. The author notes that very little
literature on the information needs of nurses was available at the time this article
was written. This study examined the information use patterns of a random sample
of nurses who specialized in working in the field of gerontology in New York state.
The four areas of research interest were general information access, reference
usage, journal usage, and other information needs. Results of a questionnaire
showed continuing education courses, professional conferences, colleagues and
friends to be the most frequent sources of information, in that order. Hospital/
medical Hbraries were the least popular sources of information. Although almost 50
percent of the gerontological nurses had performed an onHne database search at
least once, the remaining 50 percent were not aware of onHne searching services.
The author identifies a need to provide better education to nurses about  how to
access nursing information.

87. Reidelbach MA, Willis DB, Konecky JL, Rasmussen RJ, Stark J. An in-
troduction to independent learning sk ills for incoming medical students. Bulletin .pf
the Medical Librarv Association 1988 Apr;76(2): 159-63.

Library medical school faculty at the University of Nebraska Medical  Center
College of Medicine collaborated on the development of a predominantly unstruc-
tured course for teaching freshman medical students independent information-
seeking skiUs. The objective of the course was to educate freshman medical students
to "retrieve relevant, comprehensive,  authoritative information independently
29 
through optimal use of information resources." The emphasis was on the process of
retrieving information. Students used a self-paced workbook and divided into small
research groups. The workbook contained clinical exercises that the students might
encounter in their second year of medical school. Both pre- and post-tests were used
to evaluate the usefulness  of the course,  which proved effective in teaching
information-seeking skills.

88. Rohde NF. Information needs. Advances in Librarianship 1986;14:49-73.

The author provides a comprehensive overview and critical analysis of the concept
and  study  of information needs during the years  1976-1986.  Focusing on  the
methodology used by the cited authors rather than on their conclusions, Rhode
presents a scholarly discussion of definitions of the terms information and informa-
tion needs. A bibliography of more than 50 references to the Hterature is included.

89. Royaltey HH.  The information needs of health care professionals and con-
sumers in developing countries.  Bulletin of the Medical Librarv Association 1988
Jan;76(l):35-43.

This article discusses the unique differences between the information needs of
health care providers in developing countries and their counterparts in the devel-
oped world. Describing the health care systems organization, funding, and training
of physicians and other health care workers, Royaltey finds that the health care
systems in developing countries are poorly organized, have little financial resources
and  have under-educated health care professionals in comparison to health care
systems in developed countries.  Health care professionals in developing countries
are more diverse in their backgrounds, training, experience and work settings. The
author discusses in detail the  deficiencies, barriers, and  expenses developing
countries' health professionals face in obtaining information.

90. Salasin J,  Cedar T.  Information-seeking behavior in an applied research I
service delivery setting. Journal pf the American Society fpr Information Science
1985 Mar;36(2):94-102.

A nationwide survey of appHed researchers, poHcy makers, and practitioners in the
field of rural mental health, was conducted to identify the information sources,  the
information-seeking behaviors, and the value of the information sources they use.
Partially supported by a grant from the National Institute of Mental Health, the
survey correlated a number of variables describing respondents' activity in mental
health to information-seeking behavior. The findings indicated that physicians had
the fewest questions during their information-seeking episodes (ISE) and used the
fewest number of sources to meet their information needs. Physicians were found
to use colleagues as a source of information much more than the other study groups
and placed a higher value on them as an information source. Nurses, on the other
hand, reported using the largest number of information sources. In general, it was
30 
found that individuals seldom seek information from outside their own organiza-
tion, and that when they do, they consult colleagues.

91. Sandness JG. Use of online databases by practicing physicians.  Symposium
on Computer Applications in Medical Care  1989:456-8.

This article describes and evaluates the use of the American Medical Association's
(AMA) medical information network, AMA/NET.  Low use of the AMA/NET system
prompted the AMA to conduct a study of the use of the AMA/NET system by
practitioners in the Rural Physician Associate Program in underserved areas of
Minnesota. The study found four reasons for low use of the system: "lack of time, lack
of training, lack of awareness, and never used a computer before." Also, the content
of the databases did not meet their information needs.

92. Shumway JM, Jacknowitz AI, Abate MA  Analysis of physicians', phar-
macists', and nurses'attitudes toward the use of computers to access drug informa-
tion. Methods of Information in Medicine 1990 Mar;29(2):99-103.

The  aim of this study was to examine  the attitudes  of health care professionals
toward computerized database sources of drug information. The attitude instru-
ment surveyed 31 physicians, 23 nurses, and six clinical pharmacists affiliated with
a university drug information center. Five attitude areas were studied: attitudes
toward health care and change, attitudes toward professionals' roles and informa-
tion  seeking, and  attitudes concerning end-user  computer use. Differences in
attitudes of the surveyed health care professionals were found in three of the five
areas. The  authors identified a resistance to using commercially available drug
information online databases, and found that health care professionals are in need
of drug information sources that cover the appropriate use of drugs rather than
comparative and evaluative information sources. They suggest computerized drug
information sources could fiU this need.

93. Simon A, Da Silva J, So ares T. Comparative study on information needs  of
hospital and community pharmacists. Journal de Pharmacie Clinique 1987;6(4): 593-
8.

A comparative study of Portuguese hospital and community pharmacists' informa-
tion needs was conducted. The hospital pharmacists had more complex information
needs and  consulted more reference books than the  community pharmacists.
However, the authors found both the community and hospital pharmacists used the
telephone most frequently in answering information needs. Hospital pharmacists
took  more than 30 minutes to answer information questions; community pharma-
cists took less than 30 minutes per question.
31 
94. Stephen-Smith HM. A sonata for librarianship. New Zealand Libraries 1989
Jun/Sept;46(2/3):12-15.

Stephen-Smith compares the information needs of accountants, consulting engi-
neers, lawyers, and pharmacists in order to identify the need for libraries  to serve
these professions. Two studies were  conducted. The first examined  the
information needs of the four study groups. The second survey attempted to prove
that businesses that had libraries were better able to meet professionals' informa-
tion needs. All respondents felt they had information needs that were not met, and
individuals in all four professions were uninformed about library services and had
minimal information-seeking  skills.  Although the engineers and lawyers were
found to use Hbraries more often than pharmacists and accountants, pharmacists
were the only study group who had space allocated for an information coUection in
their office. The study also found that people hoard information and do not share
information sources. The author presents recommendations for improving  the
library system in New Zealand.

95. Strother EA, Lancaster DM, Gardiner J.  Information needs of practicing
dentists. Bulletin of the Medical Librarv Association 1986 Jul;74(3):227-30.

The Louisiana State University Dental Library and School of Dentistry conducted
a study on the information needs, information-seeking behaviors and information
source preferences of practicing dentists throughout Louisiana. A random sample
questionnaire was sent to practicing dentists in Louisiana with a 69 percent return
rate. Keeping up with new developments was reported as the most frequent need
for information. Patient care was the second most frequent reason. The study found
professional colleagues and personal journal collections to be the most often cited
source of information primarily due to convenience and secondarily due to reliability.
This study supports previous research which found that dentists most frequently
used Physicians' Desk Reference (PDR) and colleagues as their sources of informa-
tion. Recommendations are made on how libraries can better meet the information
needs of dentists.

96. Tabor RB. Integrated information for health care. Information Services & Use
1988;8:13-21.

In this article, Tabor discusses the role of the hospital library in the United Kingdom
and the relationship between health care and health information. After examining
the information needs of both  health care professionals  and patients, the author
proposes the development of a sophisticated system capable of meeting the informa-
tion needs of health care professionals in remote locations via computer.
32 
97. Timpka T, Ekstrom M, Bjurulf P. Information needs and information-seek-
ing behaviour in primary health care.  Scandinavian Journal pf Primary Health
Care 1989 Jun;7(2): 105-9.

A comparative study of two groups of general practitioners in Sweden was con-
ducted to analyze their information needs, sources of information, and informa-
tion-seeking behaviors. Colleagues were found to be the most frequent source of
information foUowed by personal textbooks and libraries. Diagnostic information
needs were rated the most prevalent. The authors of this study feel that a re-
organization of the information services in Sweden and more communication
between information providers and users are desirable. The results of the study
were used to design better services and adequate access to information.

98. Unsworth D. In service to meet your research needs. Professional Nurse 1991
Jan;6(4):213-6.

This article describes the Index tp Nursing Research (INR). Produced by the De-
partment of Health, the Index i& Nursing Research, is comprised of nursing re-
search by, for, and about nurses in the United Kingdom. Librarians are responsible
for producing and maintaining the INR, which is regarded as the major information
source to meet nurses' information needs in the UK. Nursing Research Abstracts
is another source of nursing information.

99. Wakeham M. Information skills in nurse education. Nursing Standard 1990
Nov 14;5(8):35-7.

The objective of this  article is to show  the need for integrating information-
seeking skills into the nursing curriculum.  Fifty-three nurses responded to an
information skills questionnaire. More than half the nurses who responded had no
formal training in information-seeking skills. They said that "they had not, in the
areas of information seeking and information use, been well prepared, on the whole,
to do what is asked of them." The author discusses recommendations and conclu-
sions for future integration of library skills into the nursing curriculum.

100. Weitzel R Library services for primary health care. Social Science and
Medicine 1991;32(l):51-7.

Focusing on the role of the Hbrary in primary health care in developing countries,
Weitzel reviews present health information services, types of information needs
and the  role of the library. Ideas for future information technologies are also
discussed. Third World countries face many obstacles in meeting the information
needs of their primary health  care personnel. Information services outreach is
almost impossible in remote rural locations. The author discusses health care
information systems in China, the Philippines, Southeast Asia, and Latin American
and the Caribbean countries and outlines additional Hbrary services and issues.
33 
101. Westermann ML. The health information connection.  Catholic Library
World 1985 Feb;56(7):283-6.

In this article, Westermann discusses the services  of the Regional Medical
Library Program (RMLP). The Regional Medical Library Program is a hierarchical
network of health science libraries throughout the United States that provides
health care practitioners with timely access to health information resources in order
to help meet their information needs. This program was established by the Medical
Library Assistance Act in 1965. The network serves to link health practitioners with
medical information through the use of computers and library networks. The article
reviews the many services of the RMLP and those of the John N. SheU Library at the
Nassau Academy of Medicine in New York.

102. Williamson JW. Education in science information management. The  foun-
dation for quality assurance in the 1990's. Quality Assurance Utilization Review
1990 Nov;5(4):121-6.

In this study, the authors surveyed a random sample of American Medical Associa-
tion physicians and their opinion leaders to determine if they perceive a problem in
identifying and obtaining relevant items from the vast amount of medical literature.
The results show that these physicians do indeed perceive a need for substantial
help in meeting their information needs. Physicians' lack of time was the most
frequent reason cited for unmet information needs. The author suggests there are
three functions involved in the management of scientific information. They include
being able to acquire, evaluate, and apply the scientific information effectively. He
also recommends that  educating professionals to better manage health science
information is the key to improved quality assurance in the future of patient care.

103. Williamson JW, German PS,  Weiss R, Skinner  EA, Bowes F 3d.
Health science information management and continuing education of physicians:
a survey of U.S. primary care practitioners and their opinion leaders.  Annals
of Internal Medicine 1989 Jan 15;110(2):151-60.

The authors address a problem perceived by the Massachusetts Medical Society in
managing scientific information needs and access to information. A self-reported,
two-part study was conducted to identify primary care practitioners and their
opinion leaders' scientific information needs. Their needs included the development
of information-seeking, -dissemination and -use skiHs. The responses from the two
groups were very similar across the board. The volume of scientific literature was
rated "unmanageable" and the usefulness of information was questioned by both
response groups. In addition, both groups rated lack of time to search for informa-
tion and the amount of irrelevant material as primary reasons for unfuHilled
information needs.  The authors conclude that these groups need training to learn
how to meet their information needs.
34 
104. Wood EH, Morrison JL, Oppenheimer PR. Drug information skills for
pharmacy students:  curriculum integration.  Bulletin pf the Medical Librarv
Association 1990 Jan;78(l):8-14.

The expanding role of pharmacists as information resources and the complexity of
drug information indicates a new approach to pharmacy education is needed. This
paper describes the University of Southern California School of Pharmacy's solution
to the problem.  The Health Sciences Library, in conjunction with the School of
Pharmacy, integrated drug information instruction into the four-year Doctor of
Pharmacy program.  Librarians are involved  over the course of the four-year
program. Computer education and online retrieval are components of the training.
The objective of integrated Hbrary education is to instill increasingly more complex
information skills (evaluation, organization, application and communication) in all
levels of pharmacy students. An overview, background and evaluation of the ten-
year-old program are given and some theories on how advances in information
technology will affect the program are presented.

105. Wood FE.  The use and availability of occupational health information:
results of a study. Journal of Information Science 1985;9(4): 141-51.

This article is based on a paper presented  at a meeting entitled, Information
Sources in Occupational Health, held at the London School of Hygiene and Tropical
Medicine. The research for this study was funded by the British Library Research
and Development Department. The objective was to evaluate and identify infor-
mation access, information requirements, and information resources related to or
about the occupational health fields in the United Kingdom. Although most of the
respondents had access to libraries in their organization, two-thirds responded as
foUows: they would rather ask for the information than seek it themselves; they did
not know where or whom to ask; they seldom used reference services; and they used
journals as their main source of information and current awareness. Findings from
this study have led to improvements in providing information sources to meet the
occupational health practitioners' information needs within the United Kingdom.

106. Woolf SH, Benson DA  The medical  information needs of internists and
pediatricians at an academic medical center.  Bulletin pf the Medical Librarv
Association 1989 Oct;77(4):372-80.

A questionnaire was designed to  evaluate  the information-seeking behavior and
information needs of house-staff and faculty at the Johns Hopkins  Hospital in
Baltimore, Maryland. The objective of the pilot study was to assess the physicians'
attitudes and use of information resources including computerized onHne medical
databases. Although the faculty reported a greater use of the MEDLINE onHne
database,  the findings revealed the information needs of both groups were very
similar. Many of the findings agreed with the results of previous studies.
35 
107. Worsley A, Worsley AJ. The nutrition information needs of New Zealand
general practitioners. Nutrition Research 1990:10(10):1099-1108.

Nutrition information and nutrition promotion is a key issue in the New Zealand
government. A survey was conducted of 1,000 New Zealand general practitioners'
use of sources of nutrition information to study general practitioners' nutrition
information needs, the sources of their nutrition information, and views of different
sources of available nutrition information. Sixty-one percent of the general prac-
titioners reported their most frequent information source of nutrition information
was medical journals. Pamphlets were endorsed by physicians as the number one
choice for the form in which nutrition information should be communicated to them
and their patients. Medical school training was reported least helpful. Questions
about nutrition and allergies were reported as the most frequent needs. The study
revealed that general practitioners are lacking in information-seeking skills needed
to obtain nutrition information. Recommendations for future improvements and
investigation are included.

108. Yeoh J. Librarian or educator: into the classroom. Nurse Education Today
1991;11:70-3.

The need for integrating Hbrary instruction into  the nursing curriculum at St
George's Medical School of Nursing in Wandsworth, London, was studied. A Tudor
Librarian post was set up to provide an information skills training, program for
student nurses, faculty,  and staff. The Tudor Librarian works with  the school of
nursing as a member of the teaching staff. The information skills training program
at St George's Medical School has proven successful in teaching students and staff
how to better meet their information needs.
36 
           Assessing the Information Needs of Health Professionals

                        Chronological Order by Year

                                    1991

 1.  Abate MA, Jacknowitz AI, Shumway JM.  Pharmacists' use pf online
    information services. Morgantown (WV): West Vir,ginia University, 1991. Grant
    R01-LM-0-5189.

 2.  Bunyan LE, Lutz EM. Marketing the hospital library to nurses. Bulletin of the
    Medical Librarv Association 1991 Apr;79(2):223-5.

 3. Cunningham D, Grefsheim S, Simon M, Lansing PS. Biotechnology awareness
   study, part 2: meeting the information needs of biotechnologists. Bulletin of the
   Medical Librarv Association 1991 Jan;79(l):45-52.

 4. Demas JM, Ludwig LT. Clinical medical librarian: the last unicorn? Bulletin of
   the Medical Library Association 1991 Jan;79(l): 17-27.

 5.  Grefsheim S, Franklin J, Cunningham D. Biotechnology awareness study, part
    1: where scientists get their information. Bulletin of the Medical Librarv Association
    1991 Jan;79(l):36-44.

 6. Harris-Wehling J, Morris LC, eds. Improving Information Services for Health
    Services  Researchers. A Report to the National Library of Medicine. Institute of
    Medicine. Committee to advise the National Library of Medicine on Information
    Center Services in Health Services Research; 1991. 62 p.

 7.  Miller RA, Giuse NB. Medical knowledge bases.  Academic Medicine 1991
   Jan;66(l):15-7.

 8.  Osheroff JA, Forsythe DE, Buchanan BG, Bankowitz RA, Blumenfeld BH,
   Miller RA Physicians' information needs: analysis of questions posed during
   clinical teaching.  Annals of Internal Medicine 1991 Apr 1;114(7):576-81.

 9.  Pelzer NL, Leysen JM. Use of information resources by veterinary
   practitioners. Bulletin pf the Medical Librarv Association 1991 Jan;79(l):
    10-16.

10.  Unsworth D.  In service to meet your research needs. Professional Nurse 1991
    Jan;6(4):213-6.

11. Weitzel R Library services for primary health care. Social Science and Medicine
   1991;32(l):51-7.
37 
Chronological Order
                                    1990

 1. Bonham MD. BIREME: Latin American and Caribbean Health Sciences
   Information Center.  Bulletin of the Medical Librarv Association 1990 Apr;78(2):
   119-23.

 2. CD-ROM: providing quick access to volumes of information. Nursing Educators
   Microworld 1990 Aug-Sep;4(6):46.

 3. Connelly DP, Rich EC, Curley SP, Kelly JT. Knowledge resource preferences of
   family physicians. The Journal pf Family Practice 1990 Mar;30(3):353-9.

 4. Corcoran-Perry S, Graves J. Supplemental-information-seeking behavior of
   cardiovascular nurses. Research in Nursing and Health 1990 Apr;13(2):119-27.

 5. Curley SP, Connelly DP, Rich EC. Physicians' use of medical knowledge
   resources: preliminary theoretical framework and findings. Medical Decision
   Making 1990 Oct-Dec; 10(4):231-41.

 6. Dalrymple PW. CD-ROM MEDLINE use and users: information transfer in the
   clinical setting. Bulletin of the Medical Librarv Association 1990 Jul;78(3):224-32.

 7. Dee CR Information needs of the rural physician: a descriptive study
   [Dissertation]. Florida: The Florida State University; 1990 Fall. 266 p.

 8. Forsythe DE, Osheroff JA, Buchanan BG, Miller RA  Expanding the concept
   of medical information: an observational study of physicians' information needs.
   Pittsburgh, PA: University of Pittsburgh, Intelligent Systems Laboratory,
   Computer Science Department; 1990 Aug. 33 p.

 9. Gruppen LD. Physician information seeking: improving relevance through
   research.  Bulletin of the Medical Librarv Association 1990 Apr;78(2): 165-72.

 10. Gruppen LD, Wolf FM, Stross JK. Physician practice characteristics as a context
   for primary care treatment decision making: a preliminary study. Academic
   Medicine 1990 Sep;65(9 Suppl):S9-S10.

 11. Hewins ET. Information need and use studies. Annual Review of Information
   Science and Technology 1990;25:145-74.

12. Levene LA Health educators and library resources. Health Education 1990 Sep-
   Oct;21(5):25-9.

13. O'Brien D, Procter S, Walton G. Toward a strategy for teaching information
   skills to student nurses. Nurse Education Today 1990 Apr; 10(2): 125-9.
38 
Chronological Order
14. Palchik NS, Wolf FM, Cassidy JT, Ike RW, Davis WK. Comparing information-
  gathering strategies of medical students and physicians in diagnosing simulated
   medical cases.  Academic Medicine 1990 Feb;65(2): 107-13.

15. Premsmit P. Information needs of academic medical scientists at Chulalongkorn
   University. Bulletin of the Medical Librarv Association 1990 Oct;78(4):383-7.

16. Shumway JM, Jacknowitz AI, Abate MA Analysis of physicians', pharmacists',
   and nurses' attitudes toward the use of computers to access drug information.
   Methods of Information in Medicine 1990 Mar;29(2):99-103.

17. Wakeham M. Information skills in nurse education.  Nursing Standard 1990
   Nov 14;5(8):35-7.

18. Williamson JW. Education in science information management.  The foundation
   for quality assurance in the 1990's. Quality Assurance Utilization Review 1990
   Nov;5(4):121-6.

19. Wood EH, Morrison JL, Oppenheimer PR Drug information skills for
   pharmacy students: curriculum integration.  Bulletin of the Medical Librarv
   Association 1990 Jan;78(l):8-14.

20. Worsley A, Worsley AJ. The nutrition information needs of New Zealand general
   practitioners.  Nutrition Research 1990:10Q0):1099-1108.

                                   1989

 1. Abate MA, Jacknowitz AI, Shumway JM. Information sources utilized by private
   practice and university physicians. Drug Information Journal 1989;23:309-19.

 2. Abate MA, Shumway JM, Jacknowitz AI, Sinclair G. Recording and evalu-
   ating end-user searches on a personal computer. Bulletin of the Medical Librarv
   Association 1989 Oct; 77(4):381-3.

 3. Bowes F 3d. Response to paper by R. Brian Haynes, M.D., Ph.D.: organizing and
   accessing the literature. Bulletin pf the New York Academy pf Medicine 1989 Jul-
   Aug;65(6):691-8.

 4. Braude RM. Role of libraries in medical education. Bulletin of the New York
   Academy of Medicine 1989 Jul-Aug;65(6):704-727.

 5. Bruer JT. Response to paper by R. Brian Haynes, M.D., Ph.D.: organizing and
   accessing the literature. Bulletin pf the New York Academy of Medicine 1989
   Aug;65(6):687-90.
39 
Chronological Order
6. Burrows S, Ginn DS, Love N, Williams TL. A strategy for curriculum integration
  of information skills instruction. Bulletin of the Medical Library Association 1989
  Jul;77(3):245-51.

7. Cahan MA Grateful Med: a tool for studying searching behavior. Medical
  Reference Services Quarterly 1989 winter;8(4):61-79.

8. Caras N. Serving the information and professional development needs of the allied
  health professional. North Carolina Medical Journal 1989 Dec;50(12):708-9.

9. Carmel M. Health information in the Third World: initiatives and problems.
  Health Libraries Review 1989;6:110-11.

10. The future of information systems for the medical sciences: a symposium. Bulletin
  of the New York Academy of Medicine 1989 Jul-Aug;65(6):639-738.

11. Glockner B. The information needs of medical practitioners in Western Australia.
    Health Information: New Directions. New Zealand Library Association, Health
   Library Section Conference Committee. 1989:349-58.

12. Goldstrom R Emerging community staff: who? what? where? NISG Newsletter
   1989 Sep;9(3):7-9.

13. Haynes RB. Organizing and accessing the literature. Bulletin of the New York
   Academy of Medicine 1989 Jul-Aug;65(6):673-86.

14. Haynes RB, Ramsden M, McKibbon KA, Walker CJ, Ryan NC. A review of
   medical education and medical informatics. Academic Medicine 1989 Apr;64(4):
   207-12.

15. Huth EJ. The underused medical literature. Annals of Internal Medicine 1989
  Jan;110(2):99-100.

16. Huth EJ. The information explosion.  Bulletin of the New York Academy pf
  Medicine 1989 Jul-Aug;65(6):647-61.

17. Ingram P, McCaleb J. Rural community health centers: the information network
  and professional competence.  North Carolina Medical Journal 1989 Dec;50(12):
  701-2.

18. Kilby SA, Fishel CC, Gupta AD. Access to nursing information resources.
  IMAGE: Journal of Nursing Scholarship 1989 spring:21(l):26-30.

19. Korale SR The health system and medical information services  in Sri Lanka.
  Health Libraries Review 1989 Sep; 6(3): 129-40.
40 
Chronological Order
20. Leist JC. Issues in information dissemination and professional competence. North
   Caroling! M&dkal Jpjmial 1989 Dec;50(12):694-6.

21. Lorenzi NM. Response to paper by R. Brian Haynes, M.D., PH.D.: organizing and
   accessing the literature.  Bulletin pf the New York Academy pf Medicine 1989
   Jul-Aug;65(6): 699-703.

22. Mularski CA, Nystrom E, Grant HK. Developing information-seeking skills
   in occupational therapy students.  American Journal of Occupational Therapy
   1989 Feb;43(2): 110-4.58.

23. National Library of Medicine (U.S.) Board of Regents. Improving health
   professionals' access to information: report of the National Librarv of Medicine
   (U.S.) Board of Regents. Outreach Planning Panel. Bethesda, MD: U.S. Dept. of
   Health and Human Services, National Institutes of Health; 1989 Aug. 28 p.

24. Sandness JG.  Use of online databases by practicing physicians. Symposium on
   Computer Applications in Medical Care 1989:456-8.

25. Stephen-Smith HM. A sonata for librarianship.  New Zealand Libraries 1989
   Jun/Sept;46(2/3):12-15.

26. Timpka T, Ekstrom M, Bjurulf P.  Information needs and information-seeking
   behaviour in primary health care. Scandinavian Journal of Primary Health Care
   1989 Jun; 7(2): 105-9.

27. Williamson JW, German PS, Weiss R, Skinner EA, Bowes F 3d. Health science
   information management and continuing education of physicians: a survey of U.S.
   primary care practitioners and their opinion leaders. Annals of Internal Medicine
   1989 Jan 15;110(2):151-60.

28. Woolf SH, Benson DA  The medical information needs of internists and
   pediatricians at an academic medical center.  Bulletin of the Medical Library
   Association 1989 Oct;77(4):372-80.


                                   1988

1. Burger D J I, van Brakel PA Information transfer strategies for military medical
  practitioners. South African Journal ofLibrarv and Information Science 1988 Jun;
   56(2):73-88.

2. ChildsSM.  General practitioners'use of NHS libraries. Health Libraries Review
   1988 Jun;5(2):76-92.
41 
Chronological Order
3. Elayyan RM. The use of information by physicians. Tnfornfttional Library Review
   1988 Apr;20(2):247-65.

4. Goodspeed RB, Goldfield N.   Computer assistance with information needs in
   clinical medicine. New York State Journal of Medicine 1988 Apr;88:183-90.

5. An information digest for health workers in Zimbabwe. Zimbabwe Librarian 1988
   Dec;20(2):74-5.

6.  Lockyer J, Jennett P, Parboosingh J, Maes W. Raising questions in clinical
   practice. Journal of Continuing Education in the Health Professions 1988;8(1):
   21-6.

7.  Meadows B, Hamberg CJ. Health professionals and information: value, vari-
   ables, variety. Chicago, IL: Medical Library Association, Courses for Continuing
   Education; 1988. 27 p.

8.  Moore GF. Development of information retrieval skills for freshman medical
   students. Journal of Medical Education 1988 Nov;63(ll):870-2.

9.  Patrick W. The hospital library as nurses' library: a modest proposal for
   proportional representation. Bibliotheca Medica Canadiana 1988;9(3): 151-4.

10. Pelzer NL, Leysen JM.  Library use and information-seeking behavior of
   veterinary medical students. Bulletin pf the Medical Librarv Association
   1988 Oct;76(4):328-33.

11. Reidelbach MA, Willis DB, Konecky JL, Rasmussen RJ, Stark J. An
   introduction to independent learning skills for incoming medical students.
   Bulletin of the Medical Librarv Association 1988 Apr;76(2): 159-63.

12. Royaltey HH.  The information needs of health care professionals and consumers
   in developing countries. Bulletin pf the Medical Librarv Association 1988 Jan;
   76(l):35-43.

13. Tabor RB. Integrated information for health care.  Information Services & Use
   1988;8:13-21.

                                    1987

1.  Beckman M.  The importance of measuring library effectiveness. Bibliotheca
   ]yfpdica Canadiana 1987;8(4): 180-9.

2.  Bryant SL. Exploiting the information network in support of health education.
   Journal of the Institute of Health Education 1987;25(4): 132-9.
42 
Chronological Order
 3. Gruppen LD, Wolf FM, Van Voorhees C, Stross JK Information-seeking
   strategies and treatment decision making. Proceedings of the Annual Conference on
   Research in Medical Education 1987;26:203-8.

 4. Gruppen LD, Wolf FM, Van Voorhees C, Stross JK Information-seeking
   strategies and differences among primary care physicians.  Mobius 1987 Jul;
   7(3):18-26.

 5. Horak EB. Clinical librarianship in an era of end users.  Medical Reference
   Services Quarterly 1987  Summer;6(2):65-9.

 6. King DN. The contribution of hospital library information services to clinical care:
   a study in eight hospitals. Bulletin of the Medical Librarv Association 1987
   Oct;75(4):291-301.

 7. Louis Harris and Associates, Inc. The future of information systems for the
   medical sciences. New York: The New York Academy of Medicine; 1987. 271 p.

 8. Rankin JA, Williams JC, MishelevichD J. Information system linking a medical
   school with practitioners and hospitals.  Journal of Medical Education 1987
   Apr;62(4):336-43.

 9. Simon A, Da Silva J, So ares T. Comparative study on information needs
   of hospital and community pharmacists. Journal de Pharmacie Clinique 1987;
   6(4):593-8.

                                    1986

 1. Bryant SL. Bridging the gap between  information and health: the role of an
   information broker. Health Education Journal 1986; 45(3): 180-2.

 2. Carmel M. Impact and image: improving the library's contribution. Health
   Libraries Review 1986 Jun;3(2):94-100.

 3. Carmel M. Users of biomedical libraries.   Health Libraries Review 1986
   Mar;3(l):28-34.

 4. Gruppen LD, Wolf FM, Van Voorhees C, Stross JK The influence of prior
   experience and confidence on physician preferences for information sources and
   continuity of care.  Proceedings pf the Annual Conference pn Research in Medical
   Education 1986;25:177-82.

5.  Hulkonen DA, Mack BR Physicians'perceptions of library services in a rural
   state. Bulletin of the Medical Librarv Association 1986 Jul;74(3):205-9.
43 
Chronological Order
6. Kolner SJ, Dalrymple PW, Christiansen R Teaching skills in medical
   information retrieval to medical students.  Journal of Medical Education 1986
   Nov;61(ll):906-10.

7. McCue JD, Hansen CJ, Gal P. Physicians'opinions ofthe accuracy, accessibility,
   and frequency of use often sources of new drug information.  Southern Medical
   Journal 1986 Apr;79(4):441-43.

8. Milligan GA  The information-seeking behaviour of users and non-users of a
   computerized bibliographic search service.  South African Journal of Librarv and
   Information Science 1986 Mar;54(l):34-7.

9. Osiobe SA A study ofthe use of information sources by medical faculty staff in
   Nigerian universities.  Journal of Information Science 1986;12(4):177-83.

10. Rohde NF. Information needs. Advances in Librarianship 1986;14:49-73.

11. Strother EA, Lancaster DM, Gardiner J.  Information needs of practicing
   dentists. Bulletin ofthe Medical Librarv Association 1986 Jul;74(3):227-30.
                                    1985

 1. Brember VL, Leggate P. Linking a medical user survey to management for
   library effectiveness: I, the user survey.  The Journal of Documentation 1985 Mar;
   41(1):1-14.

 2. Brodman E.  The physician as consumer of medical literature. Bulletin ofthe
   New York Academy of Medicine 1985 Apr; 61(3):266-74.

 3. Covell DG, Uman GC, Manning PR Information needs in office practice: are they
   being met? Annals of Internal Medicine 1985 Oct;103(4):596-9.

 4. DaRosa DA, Ross D, Folse R  The way we teach information-seeking skills.
   Medical Tpachpr 1985;7(3-4):297-300.

5. FreedmanH. A survey of the use of Withington Hospital Medical Library. Health
   Libraries Review 1985;2(2):69-78.

6. Garfield E. The impact of health information delivery on the quality of patient care:
   whither medical information science? Health Libraries Review 1985;2(4): 159-69.

7. Ikpaahindi LN. Information gathering methods of Nigerian veterinary scientists.
   Librarv & Information Science Research 1985 Apr;7:145-57.
44 
Chronological Order
 8. Kochen M, Cohen L, Wulff Y. Information systems and clinical research by
   residents in internal medicine. Methods of Information in Medicine 1985; 24(2):
   85-90.

 9. MacNeil KJ, Algermissen VL, Neill CA Information management skills for
   veterinary students.  Journal ofVeterinarv Medical Education 1985 Fall;12(l):
   25-6.

10. Osiobe SA Sources of information for biomedical decision-making. Methods pf
   Information in Medicine 1985;24:225-9.

11. Osiobe SA Use of information resources by health professionals: a review ofthe
   literature. Social Science and Medicine 1985:21(9):965-73.

12. Rector RA The information needs of nurses specializing in gerontology
   [Masters Thesis]. Albany, NY: The State University of New York at Albany; 1985.
   29 p.

13. Salasin J, Cedar T. Information-seeking behavior in an applied research I service
   delivery setting. Journal ofthe American Society for Information Science 1985 Mar:
   36(2):94-102.

14. Westermann ML.  The health information connection. Catholic Librarv World
   1985 Feb;56(7):283-6.

15. Wood FE. The use and availability of occupational health information: results of
   a study. Journal of Information Science 1985;9(4):141-51.
45 
 
                 Appendix A

Pertinent Articles and Reviews of the Literature
                  Before 1985
 1. Allen TJ. Information needs and uses. Annual Review of Information Science
and Tpphnplpgy 1969;4:3-29.

 2. Boeck W.   An annotated bibliography  pf studies  in the flow pf medical
information ip practitioners. Part I. 1961; Part II. 1962, Institute of Advancement
of Medical Communication, Bethesda, Maryland.

 3. Crane D. Information needs and uses.  Annual Review of Information Science
and Technology 1971:6:3-39.

 4. Crawford  S. Information  needs and  uses.   Annual Review pf Information
Science and Technology 1978:13:61-81.

 5. Davis R; Baily C. Bibliography of use studies. Drexel Institute of Technology,
1964.

 6. Dervin B; Nilan M. Information needs and uses.  Annual Review of Informa-
tion Science and Technology 1986;21:3-33.

 7. Herner S; Herner M. Information needs and uses in science and technology.
Annual Review  of Information Science and Technology 1967;2:1-34.

 8. Lin N; Garvey WD. Information needs and uses.  Annual Review of Informa-
tion Science and Technology 1972:7:5-37.

 9. LipetzBA  Information needs and uses. Annual Review of Information Science
and Technology 1970:5:3-32.

10. MartynJ. Information needs and uses. Annual Review of Information Science
and Technology 1974;9:3-23.

11. Menzel H.  Information needs and uses in science and technology.  Annual Re-
view pf Information Science and Technology 1966;1:41-69.

12. Paisley WJ. Information needs and uses. Annual Review of Information Science
and Technology 1968:3:1-30.

13. Sherrington AM. An annotated bibliography of studies on the flow of medical
information to practitioners. Methods of Information in Medicine 1965 Mar;4(l):45-
57.
46 
 
                              Appendix B

                 General Readings on Information Needs

 1. Chen CC; Hernon P. Information Seeking: Assessing and Anticipating User
Needs.  New York, NY:  Neal-Schuman, 1982.  205 p.

 2. Bouzza A Information user studies. In:  Kent A.  Encyclopedia of Librarv and
Information Science. New York: Marcel Dekker; 1989;44(9 suppl): 144-64.

 3. Krikelas J. Information-seeking behavior patterns and concepts.  Drexel Librarv
Quarterly 1983;19(2):5-20.

 4. Physicians far the Twentv-first Centurv: Report pf the Project Panel pn the
General Professional Education ofthe Physician and College Preparation for Medi-
cine. (GPEP Report) Washington, D.C.: Association of American Medical Colleges;
1984. 208 p.

 5.  Saracevic T; Kantor P; Chamis AY; Trivison D.  A  study of information
seeking and retrieving: I. Background and methodology.  Journal pf the American
Society fpr Information Science 1988;39(3): 161-76.

 6. Saracevic T; Kantor P. A study of information seeking and retrieving: II. Users,
questions, and effectiveness. Journal of the American Society for Information Science
1988;39(3): 177-96.

 7. Saracevic T; Kantor P. A study of information seeking and retrieving. III.
Searchers, searches, and overlap. Journal pf the American Society for Information
Science 1988;39(3):197-216.

 8. Saracevic T, et al.  Experiments on the Cognitive Aspects of Information Seeking
and Information Retrieving: Executive Summary. Final Report of NSF Grant 85-
05411. New Brunswick, N.J.: Rutgers School of Communications, Information and
Library Studies, 1986. 192 p.

9. Shontz D. Expertise in Information Seeking. Emporia State University [Masters
Thesis].  1987.

10. Varlejs J. Information seeking: basing services on users' behaviors.  Proceedings
ofthe Twentv-fourth Annual Symposium ofthe Graduate Alumni and Faculty ofthe
Rutgers School of Communication. Information, and Librarv Studies. 1986 Apr. 83 p.

11. Wood D. User  studies: a review of the literature from 1966-1970.   ASLIB
Proceedings 1971;23:11-23.
47 
 
Abate MA 1, 2, 3, 92
Algermissen VL 67
Franklin J 40
Freedman H 34
Bankowitz RA 76
Beckman M 4
Benson DA 106
Bjurulf P 97
Blumenfeld BH 76
Bonham MD 5
Bowes F 3d 6, 103
Braude RM 7
Brember VL 8
Brodman E 9
Bruer JT 10
Bryant SL 11, 12
Buchanan  BG 33, 76
Bunyan  LE 13
Burger DJ114
Burrows S 15

Cahan MA 16
Caras N 17
Carmel  M 18, 19, 20
Cassidy  JT 80
Cedar T 90
Childs SM 22
Christiansen R 60
Cohen L 59
Connelly DP 23, 27
Corcoran-Perry S 24
CoveU DG 25
Cimningham D 26, 40
Curley SP 23, 27

Da Silva J 93
Dalrymple PW 28, 60
DaRosa  DA 29
Davis WK 80
Dee CR  30
Demas JM 31

Ekstrom M 97
Elayyan RM 32

Fishel CC 57
Folse R  29
Forsythe DE 33, 76
Gal P 68
Gardiner J 95
Garfield E 36
German PS 103
Ginn DS 15
Giuse NB 70
Glockner B 37
Goldfield N 39
Goldstrom  R 38
Goodspeed RB 39
Grant HK 73
Graves J 24
Grefsheim  S 26, 40
Gruppen LD 41, 42, 43, 44
Gupta AD  57

Hamberg CJ 69
Hansen CJ 68
Haynes RB 47, 48
Hewins ET 49
Horak EB 50
Hulkonen DA 51
Huth EJ 52, 53

Ike RW 80
Ikpaahindi LN 54
Ingram P 56

Jacknowitz AI 1, 2, 3, 92
Jennett P  64

Kelly JT 23
Kilby SA 57
King DN 58
Kochen M 59
Kolner SJ  60
Konecky JL 87
Korale SR 61

Lancaster  DM 95
Lansing PS 26
Leggate P 8
Leist JC 62
Levene LA 63 
Leysen JM 82, 83
Lockyer J 64
Lorenzi NM 65
Louis Harris and Associates 66
Love N 15
Ludwig LT 31
Lutz EM 13

Mack BR 51
MacNeilKJ67
Maes W 64
Manning PR 25
McCaleb J 56
McCue JD 68
McKibbon A 48
Meadows B 69
Miller RA 33, 70, 76
MilliganGA71
Mishelevich DJ 85
Moore GF 72
Morris LC 46
Morrison JL 104
MularskiCA73

National Library of Medicine 74
Neill CA 67
Nystrom E 73

O'Brien D 75
Oppenheimer PR 104
Osheroff JA 33, 76
Osiobe SA 77, 78, 79

PalchikNS80
Parboosingh J 64
Patrick W 81
Pelzer NL 82, 83
Premsmit P 84
Procter  S 75

Ramsden M 48
Rankin JA 85
Rasmussen RJ 87
Rector RA 86
Reidelbach MA 87
Rich EC 23, 27
Rohde NF 88
Ross D 29
Royaltey HH 89
Ryan NC 48

Salasin J 90
Sandness JG 91
Shumway JM 1, 2, 3, 92
Simon A 93
Simon M 26
Sinclair G 3
Skinner EA 103
Soares  T 93
Stark J 87
Stephen-Smith HM 94
Stross JK  42, 43, 44, 45
Strother EA 95

Tabor RB 96
Timpka T 97

Uman GC 25
Unsworth D 98

Van Brakel PA 14
Van Voorhees C 43, 44, 45

Wakeham M 99
Walker CJ 48
Walton G 75
Weiss R 103
Weitzel R  100
Westermann ML 101
WilHamsJC85
WilnamsTL15
WiUiamson JW 102, 103
Willis DB 87
Wolf FM 42, 43, 44, 45, 80
Wood EH  104
Wood FE 105
Woolf SH  106
Worsley A 107
Worsley AJ 107
WulffY59

Yeoh J 108 
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