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curriculum integration

ByElizabeth H. Wood, M.S.L.S.

Computer

Services Librarian University of Southern California NorrisMedical Library

LosAngeles, California 90033 Janet L. Morrison, M.L.S.*

InformationServices LaneMedical Library

Stanford University Medical Center Stanford, California 94305

PhillipR. Oppenheimer, Pharm.D. Associate Dean forProfessional and StudentAffairs

University ofSouthern California School of Pharmacy

LosAngeles, California 90033

Forpharmacy studentsto provide optimal and complete

pharmaceutical care, it isvital that theydevelop drug information skills. Atthe University ofSouthern California, the School of Pharmacy and the Norris Medical Library have establishedan

interactiveeducational program. Library programs support an

increasingly complex progression of information retrieval, evaluation, organization, application, and communication. Librariansare

systematicallyinvolved inall four years of coursework for the doctor ofpharmacy degree. Training and experience in computer literacy

and online database searching are included inthe library components. Description of the educational program covers its

beginningadecade ago,current status,and futurein an environment

ofrapidly advancing technology.

The complexity of the drug information field and the expanding roles of pharmacists as information

resourcesdemand that students be trained

thorough-ly in the skills necessary for handling information.

Prior to entering pharmacy school, many students

lack basiclibraryandinformation researchskills,and

all need instruction toreach necessary levels of bib-liographic and drug information expertise. Students who do notunderstand how to use a librarycatalog

or a printed or online index are at a disadvantage; theycannotbeexpectedtoresearch the

pharmaceuti-caljournal literatureorfindforeign drug information

in anonline database. Health sciences librarianscan

and should train pharmacy students in this entire

spectrumof activities.

Teaching library and literature research skills in

thecurricula ofpharmacyschoolshas been discussed for at least two decades [1-7]. Rather than develop

separate library courses, Sewell et al. describe

inte-gration ofbibliographic skillsinto aseriesof existing pharmacy school courses [8]. At the Norris Medical Library, University of Southern California (USC) Health SciencesLibrary System,aprogramof biblio-graphic and drug information instruction is inte-gratedintothe School of Pharmacy curriculum at all four years of the doctor of pharmacy coursework. There is an additional seminar for pharmacy resi-dents.

Thispaperdescribes the development of the USC *Formerly pharmacy liaison and reference librarian at the

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library's educational program on drug information for doctor of pharmacy students. The discussion cov-ers the beginnings of the program a decade ago, its current status, and itsfuture in a technologically ad-vanced environment.

PROGRAM BACKGROUND

The Norris Medical Library's discussions with the USC School of Pharmacy faculty adecade ago were the beginning of the integrated instructional design process.Faculty explained the need for increased stu-dent learning experiences to build drug information skills. Observationsfrom the librarians and pharmacy

faculty confirmed that students were not skilled in

finding druginformation; neither were students aware of the wide range of medical and pharmaceutical lit-erature.Thefaculty observed deficiencies in students' communication skills and in their ability to relate pharmaceutical and medical knowledge to practical

situations. Previously there had been a brief

orien-tationtothelibrary anditsinformation sources, along with the assignment of simple drug information questions;however, thiswasclearly not enough.

Prior to

entering

pharmacy

school,

many

students

lack basic

library

and

information

research

skills,

and

all need instruction to reach necessary levels

of bibliographic

and

drug

information

expertise.

The literature confirms the need for enhanced training.Astrongstatementaboutdeficiencyin

phar-macy education was found in the 1975 report of the

StudyCommissiononPharmacy [9],which criticized the pharmacy profession's organization and trans-mission of drug information. The reportemphasized

the increasing significanceof druginformation, and the need for changes in pharmacy education and training as pharmacists are called upon to be more sophisticated and knowledgeable. Subsequent

writ-ings have reaffirmed this conclusion [10-11]. Phar-macy students need education and experience in us-ingliterature sourcesanddruginformation systems; thustheybecomemoreeffective andefficientin deal-ing with the analysis and dissemination of drug

in-formation [12]. Today studentsmustalso have

train-ingandexperienceinusingcomputerizedinformation

systems. AsBrodie and Smith state, "Adaptingto the age ofknowledge and technology is not an option; rather, it is an imperative" [13].

The pharmacy education literature contains an abundanceof material about the need for educational programs withinpharmacy curricula that emphasize

drug information skills. Students should be able to apply theoretical knowledge and research methods toproblem-oriented case studies and real-life clinical situations [14]. Pharmacists need to be capable and effective drug information consultants to peers, col-leaguesinother healthprofessions, and patients [15-16]. Of particular importance is the need for experi-enceincommunicating druginformation throughout students' education, not in just one course. Pharma-cists need knowledge about the identification and evaluation of resources, including online information systems. Results of a 1984 survey of pharmacy edu-cational programs suggested that "many of today's pharmacy students may not be receiving sufficient druginformation training .. ." [17].

Toinitiatedevelopment of the USC program a de-cade ago, a core working group was established to interact with the school's Pharmacy Curriculum Council and to devise a model program that would address the recognized needs. The working group consistedofaninstructionaldesignspecialist,a phar-macy faculty member, and the pharmacy liaison

li-brarian. The librarian participated in the develop-ment and implementation of the program by organizing support from the library, later preparing andteaching classsessions. Thegoal of this original program was to develop the drug information and

communication skills of the pharmacy students so

they could fulfill asignificant,uniquerole in health

care through their knowledge and experience. The original intent of the program has changed little during the past ten years. The core working group that initially developed the library program believedintheimportanceof libraries and librarians

asinformationresourcesfor thepharmacyprofession.

They wantedto instill thisoutlook in pharmacy

stu-dents.In a 1985 reportthat includedastudyof

phar-macists' needs for the informationservicesofa med-ical library, the researchers found that younger pharmacists and those working in a hospital setting

weremore likely to usethe library [18]. The authors commented that this trend may bearesultof training and education and that health professionals are be-comingmoredependentonlibraryinformation. The

current program, like the original one at USC, con-tinues to emphasize that pharmacy students need to

gain experience usinglibrary resources;theyneedto

beawareof the valueof using theresourcesavailable and theservicesof librariansaspartnersinthe health

care team.

The originalprogramservedas abasis for the cur-rentprogram. Learningactivitiesatthelibraryduring the firsttwoyearsincludedalecture component but

were largelyexperiential. The identificationanduse ofdrug informationresources weretaught bylecture and demonstration. Students then had direct

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mate-rials. Library assignments for research with written and oral presentations were related directly to par-ticular pharmacy classes. Progressive levels of learn-ing activities with library support durlearn-ing the third and fourth years were designed to build skills for identifying and evaluating druginformation, solving specific patient problems, and communicating this information to immediate colleagues, other health professionals, and patients.

The current program continues to

emphasize

the

retrieval,

evaluation,

organization,

application,

and

communication

of drug

information.

THE CURRENT PROGRAM

During the past decade, the library and pharmacy

school program has evolved in content and method

to include the developments in technology that en-able endusers to do theirownbibliographic search-ing; microcomputers now exist in many offices and clinics. However, the goals of the original program model have remained largely unchanged. The cur-rent program continues to emphasize the retrieval,

evaluation, organization, application, and commu-nication of drug information. The program also

stressesthepharmacyprofession'suseoflibraries and librariansasinformation resources, and waysinwhich librarianscan assist indeveloping studentawareness

of the need for lifelong professional development

andlearning.

Overview

Bibliographic and drug information instruction has been integrated into the classes atall four levels of the existing curriculum. The content provides

step-wiselearningwithincreasingcomplexity throughout

the coursework for the doctor of pharmacy degree.

Each year's work reinforces and builds upon what

wastaught in the previous year.

The progression begins with basic library orien-tation and retrieval of drug information in the first year, then continues with evaluation ofprinted and

computerized tools in the second year. Also in the

secondyear,studentspresent whatthey have learned

to one another insmallgroups. The thirdyear intro-ducesthe application ofdrug information to patient

cases and further builds communication skills. The online database searching taught in the fourth year enables students to become more independent and enhancestheirdrug informationresearch.Computer literacy andcomputerized literature-searching skills are emphasized throughout the program.

Technological advances in both the information retrieval and pharmaceutical fields have altered teaching content and technique. It is now realized that studentsneed computer skillstomaintain

aware-ness of the exploding drug information literature. Whenthey leavepharmacyschool, studentsmustbe able to use electronic forms of communication and computerized databases.

Evaluation

Regularcontactbetween theliaison librarian and the faculty members whose courses have alibrary

com-ponentensures thequality and relevance of the pro-gram. The librarian ensures that these contacts are

made prior to the beginning of each semester and that any changesin personnel or course contentare

reflected in the library program. Topics for student research are revised each year to include recent de-velopments.Examples of topics addedinrecent years include AIDS and genecloning. Duringthese meet-ings, the librarian shares with the faculty the eval-uationsfrom the first- and second-year program

seg-ments and observations made by students at the library. The observations include the numbers and types of questions asked of librarians, the students' apparent familiarity with the printedliterature, and the amount of handbook and index use. Librarians

are currently able to evaluate formally only those partsof the program where librariansadminister the

testsand assignments.Informal evaluation of the

stu-dents' progress occurs as reference librarians help students with assignments. The type and frequency of students' questions indicate where the program needsenhancement orchange.

While both faculty and librarians have indepen-dently observed the students' improved skills, there has beenno thorough, formal evaluation of the pro-gram.The librarians have written their own pre- and posttestsanddiscuss each year how best to organize the work load of teaching and supervision. Faculty and librarians have not shared evaluations in any formal manner. Efforts would be enhanced by the coordination ofevaluationinstrumentsanda follow-upstudy ofpharmacygraduates.

Practical matters

One-on-one and classroominstructiontakeplace both

within the library and atthe pharmacy school close by.Direct NLMMEDLINEsearchingisdonefor a fee by librarians or by users with their own passwords

atdesignated microcomputers. MEDLINE on CD-ROM

is available free for any library user.

Each year's class has approximately 160 students. One pharmacyliaison librarian coordinates the pro-gram butreceives help in teaching and demonstrat-ing from a total of six information specialists. Each

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of these six librarians spends several hours with the first- and second-year students. The librarian who is also the online search coordinator supervises the trainingof the preceptorsinthefourth-year program andspendsseveral hoursinthe spring helping fourth-yearstudents with theirsearches.

First year

The library invites first-year students to a general class on computer literacy. In 1988 about half the students arrived atpharmacy school with some com-puter background. A two-hour session, which in-cludespractical experienceinthe basicsof microcom-puting and word processing, is given to provide minimumlevelsof competence. A further lecture dis-cussesthe library's extensive microcomputer facilities and the availability of drug information via online databases. The popularity of the library's microcom-puter facilities among pharmacy students increases annually.

By the end of the first semester, students should be able to:

* identify and locate library materials by author, title,

orsubject;

* understand howto use printed Index Medicus; * identify bibliographiccitation elements;

* locatejournal holdings at Norris and affiliated li-braries;

* understand the usefulness of onlinebibliographic databases; and

* acquire basicproficiency withanend-user database searching system (CD-ROM).

First-yearstudents havewidelyvaried understand-ingand competence in using libraries and

informa-tion resources. The thrust of the first-year program,

therefore, is to introduce students to the pharmacy

literature and its organization, publication, and

re-trieval, with emphasis on library and information-seeking skills.

Afirst-semestercourseintroducingpharmacy

prac-tice begins witha two-hourlibrary orientation. The pharmacy liaison librarian givesa forty-minute

lec-turedescribing thelibrary'scollections andservices;

thelectureincludesanintroductiontoIndex Medicus andanexplanationof howtofindinformationinthe library by author, title, or subject. A thirty-minute

slide-tape program is then used to describe the

li-brary's layoutand howtolocatelibrary holdings.The

final segment is a demonstration of MEDLINE, the

majorindexto thebiomedical literature,available in

thelibrary online directlyto NLMandonCD-ROM.

Forevaluation, studentsare given pre- and posttests

and an assignment that iscorrected by the librarian

and returned to the students. Results indicate that students doaccomplish the objectives.

Bythe endof the second semester, students should also be able to:

* differentiate types and functions of information re-sources, e.g.,handbooks, indexes, journals;

* understand the process by which pharmaceutical literature is published;

* understand the concept of peer review; and * begin to evaluate drug information by authority, timeliness, and relevance.

Atthe beginning of the second semester, the

phar-macyliaison librarian givesa moredetailed two-hour lecture in the first session of a course on literature evaluation and biostatistics.

This classalso has an assignment. Studentsare

re-quiredto locatejournal articles that demonstrate

re-search methods and prepare a short description for presentationinaclasssession atthepharmacyschool. Themost commoncomplaintamongfirst-year

stu-dents is a request for more supervised CD-ROM searching or more free time

searching

MEDLINE directly rather than the hands-on practice provided

in class. (In 1989, this problem was resolved by the provision of locally-mounted MEDLINE at the

uni-versity,free to all library-card holders and available

atterminals in the library.)

Second year

Library involvementinthe first month of the micro-biologycourse at the beginning of the second year is

more intensivethan thefirst-year program. The pur-poseof the programatthis levelis toprovide practical experience in finding drug or related health

infor-mation on specific, individual topics. The students

mustanalyze their information needs, then select the appropriatesources to meetthem.Librarians discuss appropriate search strategies for handbooks and

in-dexes with small groups of students to help in the choice and evaluation of sources. In addition,

stu-dentscommunicatetheirfindingsinbothsmall-group andlarge class settings.

The class of 160 students is divided into groups of

ten. Each group makes an appointment to come to the library for a two-hour class session. Six Norris librarians share the teaching. Each student is given volumesofIndexMedicus, International Pharmaceutical Abstracts, Science Citation Index, Current Contents, and DrugLiteratureIndex.The librarian assignsadrug top-ic, and the classmembers locate articlesinthe various

indexes.Classdiscussionensues,comparingwhat stu-dentshave found. The librarian then handsout thir-teen different pharmaceutical handbooks. Students

are given a few minutes to find information on the assigned drug topic. The librarian takes two of the

handbooks, demonstrating what each student is ex-pected to present regarding the content, authority,

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timeliness, organization, and scope of the work. In classdiscussion,students compare thehandbooks and contrast the information found in the indexes and handbooks. At the end of the session, each student receives a research topic that requires theuse of

in-dexes and handbooks. A brief presentation is given

in alater antimicrobial therapy class, reiterating the methods and sources usedtolocate the information. Thus, students are gaining experienceinfinding,

or-ganizing, and evaluating drug information, then in

presenting it to others.

At the end of the semester, students are asked to complete an evaluation form regarding the

library

component of the course. They areasked to rate the usefulness of the program as a whole and its effec-tiveness in meetingspecific learning objectives. The mosthighlyratedcomponentsareusuallyinstruction

in the use of Index Medicus and the hands-on expe-rience with the handbooks. Most students rate the program as "very effective" in improving their use

oflibrary information sources and comment on the practicality of the small-groupsegments.

Third year

Activities at this level introduce the application of drug information to patient cases. Two semesters of clinical therapeutics courses concentrate on the

pathophysiology of disease and relatedtherapeutics.

Librarians are not directly involved in teaching in

this year and therefore have no stated goals or ob-jectives for the students. Students participate in clin-ical workshops and work with othersin the evalua-tion ofdrug therapy in preparedcases. In addition,

they are assigned patient-related topics to be pre-sented in class after library research. Related back-ground reading materials, such as copies ofjournal articles, book chapters, and notes provided by

pro-fessors,areplacedonreserve inthelibrary. Students

are expected to do further independent research on theirassigned topics.Althoughlibrarians donottake partintheteaching inthis year,theyarenotifiedby

thefacultyof the topics that have beenassignedand discuss withfacultytheamountofhelpthat students

canexpect whentheycome to thelibrary. Many

stu-dents request computerized literature searches from reference librarians orperform searches themselves usingMEDLINE on CD-ROM.

Through these experiences with individual topics forlibrary research, students become more

indepen-dent learners. Their personal research into practical topics that relate directly to patient care stimulates self-motivation. Presentingfindings builds verbal and

written communication skills. Fourth year

By the end of their fourth year, studentsare

expected

to:

* understand the structure and content ofMEDLINE;

* know howtologontotheMEDLARS systemusing

standard telecommunications software;

* formulate search strategies that include

multiple

concepts such asdisease, drug, and

dosage;

* interact online with the database, limiting searches

by subheadings andcheck tags; and * printorcapture retrieval to disk.

Pharmacists today depend increasingly on

micro-computers. One goal of the library's pharmacy pro-gramistofamiliarize students withmicrocomputers, especially their use for online literature searching.

MEDLINE isdemonstratedinthefirst-year class,and students areencouraged to request online literature searches from librarians throughout their years in pharmacy school. A small fee is charged for these

searches, and no free passwords are available.

In-creasing numbers of students use MEDLINE on

CD-ROM,whichprovides quickandeasy access to a lim-itedpartof the database. Direct online searching with NLM command language, however, provides access to databases other than MEDLINE and enables the user tosearch moreefficientlyandcomprehensively.

To

provide

students with

comprehensive online

searching skills,

preceptors

from

the

clinical

phar-macy

faculty

in

the acute care

therapy

clerkship

teach

fourth-year

students to search MEDLINE

using

NLM command

language.

To provide students with comprehensive online

searching skills, preceptors from the clinical phar-macyfacultyintheacute caretherapy clerkshipteach

fourth-year studentstosearchMEDLINE using NLM command language. The preceptors themselves are trained originally by librarians. Funds for online

chargesare provided by the pharmacyschool. After an initial lecture,students attend a three-hour prac-ticum. The lecture covers the principles of online searching-the use of a controlled vocabulary, Boo-lean operators, and field-specific searching. MED-LINE commands are taught, together witha

descrip-tionofthe database and instructions for logging onto the system. The practicum takes placeinthelibrary's microcomputer classroom. A librarian illustrates

re-trieval ofreferences on a given topic; each student thenduplicates the exercise online. The librarian dis-cussessearchstrategy formulation and compares re-trieval using different strategies; once more, students duplicate the searches. Students are then assigned topics and encouraged to experiment with various formulations. Over the next six weeks, they are en-couraged to make arrangements with their preceptors

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executing searches. Students perform an average of four to six searches each. Further consultation with librarians isavailable as needed.

A further activity for fourth-year students is an elective clerkship at the Drug Information Center (DIC) at the affiliated Los Angeles County General Hospital andatother DICsinthe SouthernCalifornia basin. The DIC and the Norris Medical Library are aware of each other's collections and activities and cooperate in providing information service. As in similar programsdescribed in the literature [19-22], the USC fourth-year students receive practical ex-perience atthe DIC, participating in all ofits

activi-ties.Theyuse variousreference and indexing sources for answeringspecificquestions.Thisclerkship

com-plementsthe drug information component of the li-brary program.

Sixclerkships,each ofsixweeksduration,make up the final year of the curriculum. In all the required

andelectiveclerkships,studentsarerequiredtogive presentations on patient cases in a professional

set-ting. The libraryplaysavital supportive roleduring thistime: librarians guide students in finding

infor-mation for their case conferences, perform comput-erized literaturesearches,andhelpstudentstosearch for themselves on CD-ROM or by direct MEDLINE

access.

Pharmacy residents

The USC Schoolof Pharmacyoffersaone-year post-graduate training program (residency) in specified

clinicalpharmacyareas. Aboutonethirdof the USC residency participants are from other schools. They

havenot necessarily experienced the type of biblio-graphic and drug information program that is pro-vided at USC. A single-session, three-hour library seminar is therefore heldin the fallof each yearfor orientationandreview.Theseminarformat and

con-tent depend largely on the needs of the

particular

group.Orientationtothelibrary'scollections and ser-vices,plusreviewof relevantreference andindexing

sources, are usually included. Discussion and

ques-tions are encouraged. Theseminartypicallyincludes

a demonstration of online bibliographic searching

and comparison of pharmaceutical handbooks.

Li-brarians are available for consultation upon request

atany timeduring the pharmacy residency; further trainingin both computerliteracyand thesearching

of online databases is available through existing li-brary programs.

THE FUTURE

TheTaskForceReport ofCompetencyStatementsfor Pharmacy Practice [23], presented to the American

Association of Colleges of Pharmacy at their annual meetingin 1987, confirms that many responsibilities of pharmacists require skills in the performance of drug information research, application, and com-munication. Researching the medical and pharma-ceutical literature and maintaining access to current drug information, for example, are specifically de-fined as necessary skills for patient care and for pro-vision of drug information to other health care professionals. Library participation in pharmacy ed-ucation can help to develop these skills. It is the re-sponsibility of pharmacy education to build these skills, using the latest technological advances.

Technological developments in computerized drug information systems and advances in pharmaceutical research will demand changes in drug information training programs. Thefollowing developments will affect such programs:

* The drug information literature will continue to expand rapidly with biotechnological research ad-vances; current awarenesswill be critical.

* The pharmacist of the future will increasingly be using computerized drug information systems with direct access to online databases to identify needed drug data and literature.

* Libraries will expand their microcomputer

facili-ties and training programs in basic computer and drug information skills.

* More librarians willact asconsultantstohealthcare professionals for electronic access to the biomedical literature.

Healthscienceseducation isbecomingmore prob-lem-oriented and employing new techniques, such

ascomputer-assisted instruction andinteractive

vid-eo programs, thus changing the traditional roles of

teaching faculty and librarians. Technological

ad-vances areenhancingstudents' learningexperiences and preparing them for professional practice. The NorrisMedicalLibraryprovidesextensive

microcom-puter facilities for both students and

faculty.

Librar-ians usethese facilitiestoteach computerliteracyand demonstrate software for online database

searching

and information management. Thelibrary routinely acquiresself-directedlearningprogramsondiskettes,

laser disks,and videotapes. These programs are

fre-quently patient-oriented. USC pharmacy faculty members have written their own problem-oriented pharmacokinetic modeling programs for student

learning within the library.

Neweducational needsarising fromtechnological advancesshouldcontinuetobeassessed. The library canandwillworkintandemwith thepharmacyschool

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REFERENCES

1.CALLARDJC. The medical librarian'sroleasadjunctfaculty member of acollege withina healthsciences center. Bull Med Libr Assoc 1979Oct;67(4):399-400.

2. MARTIN JA, HOUSE DL JR, CHANDLER HR. Teaching of

formal coursesby medical librarians. J Med Educ 1975Sep;

50(9):883-6.

3.STENSLIECL, ScoTTWF.The medicallibrary:itsfunction

in aclinicalpharmacy program. Bull Med Libr Assoc 1971

Jan;59(1):75-6.

4. LEVCHUK JW. Use ofcompetency-based experiential

in-struction to introduce literature-searching skills to

phar-macy orientation students. AmJ Pharm Educ 1979 May;

43(2):105-10.

5.AMERSONAB.Educatingpharmacystudents about theuse

of the literature. AMJ Pharm Educ 1975Aug;39(3):320-2. 6. HART LL.Techniquesusedinteaching drug information

skills. AmJ Pharm Educ 1975Aug;39(3):322-7.

7.ROWLESB.Basiccourse indrugliterature andevaluation.

Am J Pharm Educ 1978May;42(2):138-40.

8. SEWELLW, SPEEDIEMK,KNAPP DA, CUNNINGHAM P.

In-tegrating library skillsteaching intothepharmacy school curriculum. AmJ Pharm Educ 1980Feb;44(1):65-70.

9.AMERICAN ASSOCLATIONOFCOLLEGESOFPHARMACY.

Phar-macistsfor the future: the report of theStudyCommission

on Pharmacy. Ann Arbor, MI: University of Michigan,

Health Administration Press, 1975:1-161.

10.MILLISJS.Lookingahead-the reportof theStudy Com-mission on Pharmacy. Am J Hosp Pharm 1976 Feb;33(2):

134-8.

11. BRODIE DC. Quo vadis. Am J Pharm 1977 Mar/Apr;

149(2):45-52.

12.WALTON CA. Education andtraining ofthedrug

infor-mationspecialist. Drug Intell Clin Pharm 1986 Apr;20(4):

276-7.

13. BRODIEDC, SMITH WE.Implications ofnewtechnology

for pharmacy education and practice. Am J Hosp Pharm

1985 Tan;42(1):81-95.

14. BECKRJ. Drug information program builds skills. Am Pharm 1980Jan;20(1):54.

15. SMITH DL. Knowledge + skills - apprehension =

ef-fective communication. Can Pharm J 1980 Aug;113(8): 255-8.

16. RUGERJR,DURGIN JM. Drug information: an overview and prospect for thefuture. Drug IntellClin Pharm 1978 Apr;12(4):231-9.

17. KIRSCHENBAUM HL, ROSENBERG JM. Educational pro-gramsoffered by colleges of pharmacy and drug

informa-tion centerswithin the United States. Am J Pharm Educ 1984 Summer;48(2):155-7.

18. ADAMCIKBC,OPPENHEIMERPR, BROWN JF, EAGEN PAET AL. Attitudes and needs of pharmacists relevant to tradi-tionaland practice-based continuing education. Am J Pharm Educ1985 Spring;49(1):22-9.

19. ROSMAN AW, ROMANO JA. Drug information in phar-macyeducation. Drug Inf J 1978Jan/Mar;12(1):11-4.

20. KEITH TD,LAZARUSHL, MCMILLAN DM. Clinical train-ingof hospitalpharmacy residents. Am JHospPharm 1981 Mar;38(3):342-5.

21. PATTERSON LE. A hospital-based drug information

ser-viceand itsroleinteaching future pharmacy practitioners. DrugInf J 1973Jan/Jun;7(1):24-5.

22. LANDAU J, ROSENBERG JM. A required mini-rotation in

adruginformationcenterfor baccalaureate level pharmacy students. AmJPharm Educ 1982 Summer;46(2):158-61.

23. PANCORBO SA,CAMPAGNA KD, DEVENPORTJK,GARNErr

WRETAL. Task force reportof competency statements for pharmacy practice. Am J Pharm Educ 1987 Summer;51(2): 196-206.

ReceivedNovember 1988; accepted March 1989

FROM THE BULLETIN-25YEARS AGO

Random thoughts about medical libraryplanning

By Alderson Fry, Librarian, Medical CenterLibrary, West Virginia University, Morgantown, West Virginia Mostof therestof thistalkisdevoted(andyou mayconsider that word eitherinthesenseof theminister orthe agentprovocateur) to anattack onthe idea thatmostofus mustkeep building bigger and bigger

libraries,or atleast puttingmoreandmorebooksin them.We mustbe concerned(1)withaddingtothat

hugemass of books we haveback in the bowels,or megacolon, of the library or (2)with getting rid of this matter altogether. This latter action will result in saving money, running more efficient libraries,

and,unfortunately forsome ofyou,building fewer libraries.NaturallyIthink it will befortunatefor the restofsociety.

Some of my attitude is easy to illustrate. Thank God for that accretive hi-fi set, the engaging TV, the amiability of the car, and the blessings of medicine in eliminating agreatdealofonly marginal health, thusmaking available energy for something besides reading. They arebreaking the stranglehold of the writer-publisher-critic guild, which would have us believe reading is man's highest pursuit. As Peter Dooley said, "Readin' ain't thinking." And Oscar Wilde said, "Work is the curse of the drinking class." Well, print isthe curse of thethinking class.

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