INSTITUTIONS SERVED

University of Miami Miller School of Medicine • Jackson Health System • Miami Veterans Affairs Medical Center • University of Miami Hospital and Clinics • Bascom Palmer Eye Institute/Anne Bates Leach Eye Hospital • Diabetes Research Institute • Mailman Center for Child Development • Miami Project to Cure Paralysis • National Parkinson Foundation • Sylvester Comprehensive Cancer Center

Aventura Hospital and Medical Center • Baptist Health South Florida (Baptist, Doctor’s, South Miami, Homestead, and Mariner’s Hospitals) • Beckman-Coulter, Inc. • Bobo, Ciotoli, Fulford, Bocchino, & Newman, P.A. • Catholic Health Services (Villa Maria and St. Johns Hospitals) • Coral Gables Hospital • Coral Springs Medical Center • Culmo & Culmo, P.A. • Delray Medical Center • First Marketing Co. • Fishermen’s Hospital • Flight Attendant Medical Research Institute • Florida Keys Area Health Education Center, Inc. • Florida Medical Center • Grossman & Roth • IVAX Corp. • Jupiter Medical Center • KOS Pharmaceuticals • Kendall Medical Center • Kindred Hospital • Krupnick, Campbell, Malone & Roselli, P.A. • Lawnwood Regional Medical Center • Lower Keys Medical Center • Lytal, Reiter, Clark, Fountain & Williams, P.A. • Martin Memorial Health Systems • Mercy Hospital • Miami Children’s Hospital • NABI, Inc. • Northwest Medical Center • Palm Beach Gardens Medical Center • Palms West Hospital • Pan American Hospital • Pinecrest Rehabilitation Hospital • Princess Margaret Hospital • Stanley Rosenblatt, P.A. • Don Russo, P.A. • Sheldon J. Schlesinger, P.A. • Sonneborn, Rutter, Cooney & Klingensmith, P.A. • Stephens, Lynn, Klein, La Cava, Hoffman & Puya, P.A. • University Hospital • West Boca Medical Center • Westchester/Southern Winds General Hospital • Westside Regional Medical Center • Wicker, Smith, Tutan, O’Hara, McCoy, Graham & Ford, P.A.

SUPPORT GROUPS

• Associates of the Louis Calder Memorial Library, Joseph H. Davis, M.D., President • Ralph H. and Ruth F. Gross Medical Library Endowment • Millard Society

AFFILIATED LIBRARIES

Mary and Edward Norton Branch Library, Bascom Palmer Eye Institue • F. Pomerance Library and Resource Center, Department of Psychiatry and Behavioral Sciences • Kennedy Pediatric Library • Departments of Anesthesiology and Otolaryngology Libraries

MESSAGE FROM THE LIBRARY DIRECTOR

The 2003/04-2004/05 Biennial Report highlights the new pathways created during the past two years in the following areas of the Louis Calder Memorial Library and Biomedical Communications department:

• Collection Access, Management and Use
• Archival Digitization Project
• Library as Place
• Evidence-Based Medicine Instruction
• Expert Searching and Information Specialists in Context
• Outreach - 53rd SC/MLA Meeting
• Photography and Graphic Arts

Each of the new pathways reflects the vision expressed in two seminal articles: [1] "2015 - The future of medical libraries", by Donald A.B. Lindberg, M.D., Director, and Betsy L. Humphreys, M.L.S., Deputy Director of the National Library of Medicine, New England Journal of Medicine 352(11):1067-1070; and [2] "Library as place: results of a Delphi study," by Logan Ludwig, Ph.D. and Susan Starr, Ph.D., Journal of the Medical Library Association 93(3):315-326. By 2010-2015:

... "people treasure efficient methods for extracting pertinent information from the fire-hose effect of undifferentiated electronic text (and unwanted commercial offers)." [1]

… "a library continues to be the logical entity to manage this complexity on behalf of the
institution, to make decisions about inevitable and substantial expenditures, to adapt information services to new realities, and to provide essential user training and support." [1]

… "the academic health sciences library … will play a substantial role in archiving locally developed electronic resources." [2]

… "the 'library as place' is still highly valued and heavily used." [1] "most users will primarily come to a health sciences library not for access to information, but for time-saving or value- added information services and places to collaborate and study." [2]

… "more librarians and information specialists are deployed 'in context' … to improve quality, to reduce the risks associated with inefficient or incomplete retrieval of the available evidence, and to do community outreach." [1]

With the continued support of the Leonard M. Miller School of Medicine, its faculty, staff and students, the Library and Biomedical Communications will continue to forge new pathways for the benefit of the School, the Jackson Health System, and the South Florida community.

Henry L. Lemkau, Jr.
Director and Chairman

COLLECTION ACCESS, MANAGEMENT AND USE

During 2003/04 - 2004/05, electronic journals continued to increase in numbers and, for the first time since their introduction in 1996, to forge new pathways of their own. Changes in in-house
management strategies and advances in the open access movement resulted in yet a further significant increase in usage.

ACCESS - By May, 2005, 4,557 electronic journals in the health sciences were accessible to patrons University-wide from both on- and off-campus locations, an increase of 68% over the 2,714 journals accessible in May, 2003. This level of access compares favorably with other U.S. medical school libraries. A significant number of the titles added and approximately one-third of the total available are "open access" titles, i.e., freely accessible immediately upon publication, via PubMed Central, BioMed Central, Public Library of Science and many other websites.

In 2005, the open access movement gained significant momentum. Nucleic Acids Research became an open access title by requiring all authors to pay publication fees for their articles to be freely accessible immediately following publication. PNAS, Springer-Verlag and Blackwell Publishing began offering their authors the option to pay the publication fees of their articles to ensure open access, often associated with increased usage and greater impact factors.

In February, 2005, the NIH issued its "Policy on Enhancing Public Access to Archived Publications Resulting from NIH-Funded Research," which requests and strongly encourages NIH-funded investigators to submit their final manuscript to PubMed Central for posting as soon after the publisher's official date of publication as possible. These 2005 changes could see an increase in public access articles to more than 12% of the articles indexed annually for Medline.

During 2003, the Library's print subscriptions were reviewed in light of the high usage of their online counterparts, the new reasonably sound archival policies of some publishers, and the lack of adequate new budgetary support to permit the continuance of both print and electronic versions of the same title. In 2004, print subscriptions to 230 journals accessible electronically were cancelled, followed by 270 cancellations in 2005. By May, 2005, print subscriptions had decreased by 30% over 2002/03, and only 39% of the 1,245 print titles and 11% of the 4,557 electronic titles were accessible in both print and electronic formats.

MANAGEMENT - In 2005 a new A-Z list of electronic journals was introduced and the in house list, begun in 1997 with less than 200 titles, was retired. Supported by Serials Solutions, Inc., the new list replicates the in-house list and adds rapid updating and addition of links, multiple links to e-journals where available, and searches by words in the title and by ISSNs. Within months of its release, usage was 25,000 searches per month, and the first outsourcing of a management function for the electronic journal collection was deemed a success.

Maintaining the links between electronic journal articles and the corresponding citations in the Ovid Medline and PubMed databases was significantly improved beginning in 2004. Reporting the holdings of electronic journals to SERHOLD, the database used to direct interlibrary loan requests to libraries that have the needed title, was implemented in 2005 and resulted in a significant increase in interlibrary loans filled during the remaining of the year.

USE - Usage of electronic journals for which data are available increased by 44%, from 600,149 PDF or HTML articles in 2002/03 to 861,999 in 2004/05. The 2004/05 usage of e-journals was five times the 180,663 usage of the print literature, a positive
indicator of the high level of accessibility and
acceptability of electronic journals by Library patrons. A 2004/05 usage study documented an 88% decrease in print usage over 1994/95, the eve of the online journal in the health sciences. This decrease reflects a nation-wide trend in print journal holdings and usage at other academic health
sciences libraries.

A cost per document study, conducted in response to the seemingly high cost of site licenses of online journals in the health sciences, documented an average cost per document of $1.16 for 70% of the documents viewed during 2004/05. This low cost per document is seen as a positive indicator of the Library's e-journal collection development policies and practices.

Interlibrary loan activity declined for the fourth consecutive year from a high in 2000/01 of 33,000 filled transactions to a low of 18,970 in 2004/05. During the period of this report, items sent to other libraries declined by 22%, from 24,198 in 2002/03 to 18,970 in 2004/05, due largely to the increase in the number and backfiles of journals accessible electronically. However, the most significant decrease was in items borrowed for patrons, from 4,216 in 2002/03 to 2,012 in 2004/05 (52%) due the vastly enriched electronic journal collection.

Self-service photocopying at the Library declined for the fifth consecutive year from a high of 1,350,000 copies in 1999/00, to 730,500 in 2002/03 to 457,731 in 2004/05, or by 37% during the biennial period of this report. This decline is also attributable to the exponential increase in the number and usage of electronic journals and the dramatic decline in the usage of print materials. As a result, the number of publicly accessible photocopy machines decreased from six to four during 2004 and 2005.

BOOKS

Due primarily to the generosity of Dr. Martin B. Raskin, the Library's rare and historical collections continued to flourish. In September, 2004, the rare books were named the Dr. Martin B. Raskin Rare Book Collection in memory of its greatest benefactor who passed away in August. The historical collection also grew with the relocation of all books in the circulating collection listed as being in the classic Garrison-Morton's Medical Bibliography of important works in the history of medicine.

ARCHIVES AND LOCALLY DEVELOPED ELECTRONIC RESOURCES

The E.M. Papper, M.D., Ph.D. website is the fifth electronic resource developed and maintained by the Library. Others include the PoinTIS (Point-of-Care, Team-based Information System) of comprehensive, up-to-date information on spinal cord injuries and traumatic brain injuries for professionals and patients; the D. Ralph Millard, M.D. and Gross Lecture websites at the 'Special Collections' link; the Internet Catalog under 'Quick links'; and the AIDS Care and Service Provider database at the 'CALLCAT' link on the Library's website.

LIBRARY AS PLACE

Although attendance declined for the first time during the biennial period of this report, from 309,887 in 2002/03 to 211,313 in 2004/05 (32%), as a direct result of online collection usage from non-library locations, usage of the Library's facilities and wireless capabilities implemented in 2004 increased.

• The electronic classroom on the third floor was used daily for online training programs, such as the School's billing system and the molecular biology databases of the National Center for
  Biotechnology Information
• The public access computers throughout the first floor were used continuously by faculty,
  staff and students
• The elegant Emanuel M. Papper, M.D. Reading Room on the third floor was used daily by
  students and faculty as a place for quiet study and scholarship
• The Reference and Education areas on the first floor were used heavily for online
  information instruction

EDUCATION AND REFERENCE

During 2003/04 and 2004/05, the third and fourth years of the School of Medicine's new competency-based curriculum, the Library's Evidence-Based Medicine/Use of the Biomedical Literature component continued to evolve and expand, a major new evidence-based nursing initiative was begun, and the Library's expert searching and informationist role was defined.

EVIDENCE-BASED MEDICINE - At the beginning of 2003/04, a new library faculty member with extensive PubMed searching and instructional experience joined the department and immediately introduced EBM PubMed searching to the second year medical school curriculum. However, the two most significant changes during the biennial period occurred in 2004/05.

The new distance education curriculum for University of Miami Miller School of Medicine students, located at the Florida Atlantic University (FAU) campus in Boca Raton, Florida, began in the Fall, 2004 for 16 incoming freshmen. A faculty member at the FAU library was designated and trained in EBM, Ovid searching, critical appraisal and the Calder Library's evolving curriculum, and a faculty member at the Calder Library was named FAU coordinator to ensure identical instruction in EBM at both campuses.

Simultaneously, the Library's first year curriculum was changed following the creation of a new Doctoring course, which unites the seven longitudinal themes of the curriculum into one course under the direction of the Clinical Skills coordinator. With this change, the EBM curriculum was more fully integrated into Clinical Skills and other themes, such as Complementary and Alternative Medicine, and into the organ system modules, such as Neurological and Behavioral Sciences. As a result, students were able to use their newly acquired EBM searching skills in a meaningful way early in their medical training.

During 2004/05, Library faculty also trained 318 residents, faculty and staff in both Ovid Medline and PubMed searching, evidence-based medicine and EBM resources, MD Consult, NCBI databases, RefWorks, PsycINFO, Web of Science, PowerPoint and other databases and software applications. They offered training at the point of need in electronic journals, the Library's online catalog, remote access, the Internet, PowerPoint and others to 6,515 patrons throughout the UMMSM/Jackson Health System.

EVIDENCE-BASED NURSING - A major new initiative, designed to qualify the Jackson Health System for the Magnet Recognition Program of the American Nurses Credentialing Center and continued to meet the requirements of this program, began with a workshop that included evidence based nursing training in May, 2004. The workshop and subsequent training sessions were team taught by library and nursing faculty. During 2004/05, 21 training sessions on CINAHL (Cumulative Index to Nursing and Allied Health Literature) were conducted, many at the electronic classroom in the Education and Training Department at Jackson Memorial Hospital, and EBM filters for the nursing literature were created for the Ovid CINAHL database. As a result, usage of the electronic nursing literature increased significantly for the first time.

EXPERT SEARCHING AND INFORMATIONIST ROLE - In 2004 the Library addressed the Medical Library Association's Policy Statement: "Role of Expert Searching in Health Sciences Libraries," which resulted from the Institute of Medicine's emphasis on evidence-based practice. Expert searches were defined as a critical component of clinical care and research in settings such as difficult and complex clinical cases, protocol development and review, animal welfare, subject and patient safety, and development of best practice standards and guidelines.

Expert searches were considered, for the most part, as the domain of expert searchers on the Library's faculty. As such, fees for searches designated 'expert' were eliminated.

The knowledge base and skill set required for expert searches are the same as those required for clinical medical librarians and information specialists in context and to provide expert consultation. A Library faculty member's ongoing and valuable work on the School's Animal Care and Use Committee exemplifies the information specialist in context role and involves numerous expert searches.

OUTREACH

CLASSIC - The Library continued to support community-based institutions and corporations in South Florida through its CLASSIC Network, which by May, 2005 numbered 48 members. These members, which appear on the inside front cover of this report, continue to look to the Calder Library for resources in print and electronic formats that are not available locally and for assistance with their educational and online programs and services. 2004/05 marks CLASSIC's silver anniversary. Although members have changed since its inception, the Library is pleased that its first member rapidly renews its membership each year.

53rd ANNUAL MEETING, SOUTHERN CHAPTER/MLA - The Library hosted the 53rd Annual Meeting of the Southern Chapter of the Medical Library Association, October 9 - 13, 2003 at the Omni Colonnade Hotel in Coral Gables. Attended by more than 200 health sciences librarians from six southern states and Puerto Rico and exhibitors from throughout the world, the meeting featured five invited papers, 24 contributed papers, 15 poster sessions, six continuing education courses, eight poolside chats, 27 exhibitors, a mentoring breakfast, and a business meeting. A banquet was held at Vizcaya Museum and Gardens in memory of Mildred C. Langner, director of the Calder Library from 1952 - 1979.

The first invited paper was the 7th Biennial Ralph H. and Ruth F. Gross lecture, presented by Henry L. Lemkau, Jr., Director and Chairman of the Calder Library and Biomedical Communications department since 1979. Mr. Lemkau spoke on the importance of context to history and the corresponding importance of society and medical education to the development, contributions and future of medical libraries in the U.S. This address and the six previous lectures appear at the 'Special Collections' link of the Library's website.

• Filled

• Borrowed

BIOMEDICAL COMMUNICATIONS

The 2003/04 - 2004/05 years were a period of new pathways in staff, services, space and location of the Department's Division of Biomedical Communications. The new pathways were
occasioned by the digital evolution of photographic technology, which saw a major reduction in the demand for conventional film-based services. They were conceived and facilitated by the Division's long time Director's decision to retire in 2005.

Following a year long review, the decision was made in 2003/04 to outsource all traditional, non-digital processing and printing services, to downsize staff, and to relocate the new digital-based photography and graphic units to the informational heart of the medical center. In June, 2004, a new director and assistant director were named, and the previous director served as a consultant until his retirement on May 31, 2005.

In August, 2004, the assistant director and downsized, but highly experienced Photography and Graphic Arts staff were relocated to newly renovated space on the lower level of the Library building, immediately to the right of the elevators. Film processing services were outsourced, and Medical Television staff and services remained at the original location in the Rosenstiel Medical Sciences Building, but reported to the Department of Patient Safety beginning January, 2005.

A new and greatly expanded website debuted in September, 2004 at calder.med.miami.edu/biomed/, the first step of a new marketing initiative for the high quality, state of the art photography and graphic arts services. A new billing program was identified, customized, and implemented effective June, 2005.

During 2004/05, the newly reorganized Photography and Graphic Arts Divisions continued to provide high level, leading edge, cost effective and convenient digital production, processing and consultation services to the medical center and South Florida communities. Digital imaging capabilities were enhanced through the acquisition of state-of-the-art professional cameras and large format high-resolution scanners.

Studio quality, large format poster printing continued to evolve with the acquisition of a new archival quality large format printer in 2005 which resulted in a further increase in large format scientific poster and business presentation design, printing and mounting. With color fastness up to 100 years, the new printer also enables, for the first time, indoor and outdoor signage and fine art pieces on any media: matte, semi-gloss, luster matte, canvas, vinyl, etc.

Publications and Presentations

Burrows, S. A Review of e-journal acquisition, management and use in health sciences libraries. Journal of the Medical Library Association, 94(1), 2006 Jan. (In Press)

Feddern, T. "Developing EBM Instructional Materials for Medical Students," presentation at Annual Meeting, Southern Chapter/Medical Library Association (MLA), October 12, 2003, Coral Gables, FL.

Feddern, T. and Ewers, K. "Towards Creating a 'Care Enough to Know' Evidence-Based Nursing Practice Culture," presentation at 3rd Biennial International Conference on Nursing Best Practice Guidelines, June 2, 2005, Toronto.

Garcia, Y. "Searching Strategies to Support Animal Methodologies Used in Animal Research," poster session at Annual Meeting, Southern Chapter/MLA, October 11, 2003, Coral Gables, FL.

Jones, J.J., Jr. "Strategies for Improving PubMed Evidence-Based Medicine Retrieval," poster
session at Annual Meeting/MLA, May 17, 2005, San Antonio, TX.

Lemkau, H.L., Jr. "HMS Medical Library: Where We Have Been, Where We Are, and Where We are Going," 7th Ralph H. and Ruth F. Gross Lecture presented at Annual Meeting, Southern Chapter/MLA, October 11, 2003, Coral Gables, FL.

Paulaitis, G. "Use of Blackboard to Enhance the Library-Based EBM Component of a New Outcomes-Based Medical School Curriculum," poster session at Annual Meeting, Southern Chapter/MLA, October 11, 2003, Coral Gables, FL.

Other Professional Activities

Arriaga, J. and Feddern, T., co-facilitators, Evidence-Based Medicine/Nursing poolside chat, Annual Meeting, Southern Chapter/MLA, October 12, 1003, Coral Gables, FL.; Curriculum Advisory Committee, UMMSM, 2003-2005.

Bou-Crick, C., co-chair, Mental Health Special Interest Group, MLA, 2003/04-2004/05.

Burrows, S., co-chair, Local Arrangements Committee, Annual Meeting, Southern Chapter/MLA, October 9-13, 2003, Coral Gables, FL.; Curriculum Advisory Committee, UMMSM, 2003-2005.

Garcia, Y. Animal Care and Use Committee, UMMSM, 2003-2005.

Goolabsingh, D., chair, Audiovisual Committee, Annual Meeting, Southern Chapter/MLA, October 9-13, 2003, Coral Gables, FL.

Jones, J.J., Jr., Curriculum Advisory Committee, UMMSM, 2003-05; FAU Coordinator, 2004/05.

Lemkau, H.L., Jr., elected Fellow, MLA, at Annual Meeting, May 24, 2004, Washington, D.C.; Honorary Member, Southern Chapter/MLA, at Annual Meeting, October, 2004, Biloxi, MS.

Lemkau, H.L., Jr., chair, Local Arrangements Committee, Annual Meeting, Southern Chapter/MLA, October 9-13, 2003, Coral Gables, FL.

Powell, E. and Rivera, C., co-chairs, Registration Committee, Annual Meeting, Southern Chapter/MLA, October 9-13, 2003, Coral Gables, FL.

MEDICAL LIBRARY COMMITTEE - 2004/2005

Carl Eisdorfer, PhD, MD, Chair Center on Aging

Ager, Arba, PhD Microbiology and Immunology
Avisar, Eli, MD Surgery
Chandar, Jayanthi, MD Pediatric Nephrology
Chaudhari, Nirupa, PhD Physiology and Biophysics
Estores, Irene, MD Rehabilitation Medicine
Jeffers, Lennox, MD Hepatology
Lucci, Joseph, MD Obstetrics and Gynecology
Mayeda, Akila, PhD Biochemistry and Molecular Biology
Miguez-Barbano, Maria, MD, PhD Psychiatry and Behavioral Sciences
Muller, Kenneth, PhD Physiology and Biophysics
Rine, Rose, PhD Physical Therapy
Swaminathan, Sethuraman, MD Pediatric Cardiology
Tozman, Elaine, MD Medicine
Verma, Ashok, MD Neurology

MEDICAL LIBRARY COMMITTEE - 2003/2004

Carl Eisdorfer, PhD, MD, Chair Psychiatry and Behavioral Sciences

Ager, Arba, PhD Microbiology and Immunology
Brosco, Jeffrey, MD, PhD Pediatrics
Chaudhari, Nirupa, PhD Physiology and Biophysics
Fishman, Lawrence, MD Medicine
Huang, David, MD Radiation Oncology
Kastner-Schmidt, Rainald, PhD Neurology
Mayeda, Akila, PhD Biochemistry and Molecular Biology
Miguez-Barbano, Maria, MD, PhD Psychiatry and Behavioral Sciences
Muller, Kenneth, PhD Physiology and Biophysics
Namias, Nicholas, MD Surgery
Ofengand, James, PhD Biochemistry and Molecular Biology
Roberts, Eugene, PhD Neurology
Swaminathan, Sethuraman, MD Pediatric Cardiology

DEPARTMENT LIAISONS