Innovating Around the Concept of “Library”

By Jennifer J. Salopek

Although it occupies a physical structure made of brick, featuring study carrels and a circulation desk, the Claude Moore Health Sciences Library at the University of Virginia houses much more than books and journals. As it has sought to redefine itself in the digital age, as so many other medical libraries have done, CMHSL has added intangibles to its collection: knowledge, collaboration, experimentation, innovation. Indeed, Director and Associate Dean Gretchen Arnold and her staff have brought a fresh approach to the very definition of “library.”

Arnold has been on staff at U.Va. since 1986. During her tenure, the profession has changed dramatically. “In my early days, library science was made up of many clerical tasks,” she says. “Now, libraries are about knowledge—not just finding it but creating it. This dramatically broadens the possibilities.”

CMHSL’s current mission is to provide all that people in the health sciences at U.Va. require to do their work. Arnold has adapted the library’s service model and infrastructure, and forged collaborations and partnerships, to position the library and its resources at the point of need. “We try to be a node,” she says.

Many medical libraries are undergoing similar adaptations, says Michelle Kraft, senior medical librarian at the Cleveland Clinic Alumni Library and president-elect of the Medical Library Association. A big part of the challenge is fighting misperceptions, she says:

“People still think that libraries may go the way of the dinosaur. They think that everything is online, and that just because you can find something on Google, it’s free. In medicine, the good stuff isn’t always online, and it isn’t always free.”

Even if the good stuff is online, resources must be curated, notes Arnold. Libraries are trying to make their online resources easier to find, striving for a seamless experience. Their websites are the new front doors of the library, and ideally are optimized for mobile access. Medical libraries conduct outreach through social media.

At CMHSL and other medical libraries, keeping pace with changes in health care and medical education is critical. “Medical libraries are getting into big data, applying indexing skills to data management. They often work with the IT staff to develop the EMR and EHR. Many are even working to implement one-stop shopping, integrating evidence-based medicine resources into the electronic record,” Kraft says.

The medical librarians at U.Va. created and set up the initial health system website, acting as an incubator. Staff have applied library principles to big data to formulate best practices for use in data sciences. The library houses a physical and virtual space called BioConnector, a collaboration with the Bioinformatics Core. The physical space offers a place for classes, consultations or group meetings. The virtual space is a hub for training, hosting online tutorials on bioinformatics topics as well as links to other resources. Twice a week, biostatistics experts offer “office hours” for anyone in the Health System on statistics topics. The director of the Bioinformatics Core regularly offers training and consultations on in-depth bioinformatics topics.

U.Va. graduated its first competency-based medical school class in 2014. As Arnold has worked to integrate the library more tightly into medical education, CMHSL has aligned offerings with competencies and student-centered learning. One medical education librarian, Karen Knight, works with U.Va. medical students across all four years of their undergraduate experience. Once they prepare to graduate, Knight offers one-on-one consultations called “One Foot Out the Door,” to familiarize students with the available resources at the institutions where they’ll do their residency. Knight also co-leads instruction in the information competency thread with a member of the clinical faculty and maintains a blog for students.

Overall, Arnold says, you might summarize the changes with a single word: proactiveness.

“We no longer stand behind the reference desk,” she says. “We were challenged to think what we were really about. People have to believe that they can’t do without us. The leadership here is accepting of, and excited about, our new role.”

Articulating value to institutional leadership is a common challenge for medical libraries, Kraft says. “Hospital administrators may not realize how expensive these resources are, and may not realize that we can’t buy in bulk. They often see us as a cost center, so libraries must quantify how we are saving money or helping institutions meet their goals.”

“Medical libraries embraced the change to the digital age almost immediately when it came to understanding that health care professionals needed information wherever they worked: Coming to the library to find important information when this time could be spent taking care of patients made no sense. So when print books and journals became online books and journals, it was an easy transition,” says Arnold.

“Where it became more challenging for some was when non-traditional ways of sharing information came into play. What did Twitter have to do with libraries? Why concern ourselves with data? How do statistical support and bioinformatics relate to the role of the library?” Arnold continues. “At this point (and I think academic medical libraries have been very good at answering this), the question is, What are libraries about? They have always been about knowledge. At their core, libraries have always been about finding knowledge, sharing knowledge, and preserving knowledge.

“It is an exciting time in libraries because we have the opportunity to really leverage our expertise and resources to support the critical missions of our institutions.”

October is National Medical Librarians Month.

See also, “Eight Things You Need to Know About Medical Libraries.”


Jennifer-1990-webJennifer J. Salopek is founding editor of Wing of Zock. She can be reached at or follow her on Twitter @jsalopek.