Daily Archives: May 25, 2007

Notes From The Campaign Trail – Part Three

Editor’s Note: Here is the third post in a series from Scott Walter, ex-ACRLog blog team member, in which he shares his learning experiences as a candidate for ACRL office.

Recruitment and retention in the profession are critical issues for our future, and they are equally important for an organization like ACRL that draws its strength from its members. The key question is often posed as: how can we make sure ACRL remains relevant to the rising generation of professionals?

That’s an important question. That’s a critical question. And, despite my time on the campaign trail, I don’t have “the answer.” What I do have, though, is a better appreciation for the fact that it’s not the whole question. Recruitment and retention are key issues, but the way we talk about those issues often neglects a pretty important group of people – everyone who we have already successfully recruited and retained, but who aren’t done learning, growing, and contributing to ACRL.

This is what I heard: “I know recruitment and retention of new librarians is essential, and programs aimed at those groups are wonderful and need to be supported, but what does ACRL offer to an experienced person still looking to grow?” After hearing enough versions of this question, I began to think that I had made a mistake when thinking about this – I forgot that there should always be “Three Rs”: recruitment, retention, and renewal.

ACRL has wonderful programs that give voice to rising members of the profession and give them an opportunity to contribute to our common work. We need to continue working on these, but we also need to do a better job paying attention to programs aimed at experienced professionals that recognize their need for continued professional development and support their interests in making a wider impact on the Association, e.g., looking at people who have led successful initiatives at the Section or Chapter level and helping them to bring those initiatives to the Division. What does ACRL do to help the experienced professional renew their skills and renew their commitment to our Association? I think we do a lot, but what I heard is that we could do more.

I loved Steven’s characterization of the Giveback Generation Librarian . One lesson I learned on the campaign trail is that people want to belong to a giveback organization. I’d like to hear some ideas about how to make it happen.

The Changing Nature Of Authority: Doctors

Medical doctors have long been considered paragons of authority and expertise in our society. Their authority derives from long, rigorous academic training and is refined through continual clinical practice. We should listen to doctors because they are the best chance we have to get a reliable diagnosis based on the best science available. Or are they?

In What’s Wrong With Doctors, Richard Horton reviews How Doctors Think, a book by Jerome Groopman. The review points out that on average 15 percent of doctors diagnoses are inaccurate (still pretty good compared to the error rate that used to be attributed to reference librarians–was it 55%? what ever happened to that by the way?).

Doctors go wrong in many ways: they misapply evidence-based medicine; their training doesn’t teach them how to learn from mistakes (actually they can’t even admit when they make a mistake); they are susceptible to bribes and misinformation from big pharma; they are prone to a host of cognitive errors that they are unaware of–attribution error, availability error, search satisfying error, confirmation bias, diagnostic momentum, commission bias; they work in a system that rewards hurrying as many patients through as possible; and finally the classic–they don’t listen to patients.

Horton points out that the authority of doctors is no longer sacred and that a better educated public with access to more information is more and more willing to question the gospel. Groopman suggests that doctors should ally themselves with patients in a partnership to guard against error.

But are patients up to the responsibility? A doctor friend of mine told me how the mother of one of his patients told him that she stopped her son’s medication months ago. Why? he asked. Because of something she read on the Internet, she said. He was surprised. What did you read? Was it a study? How was the study done? Are you sure your son’s situation is sufficiently similar to what you read? Do you know the risks associated with discontinuing the medication?

Reading as much as you can about an illness that affects you or a family member–good. Going against your doctor’s advice without consulting your doctor first–not so good.

Learning about an illness is one of the most concrete ways that information literacy skills can be put to use in what we often call “lifelong learning.” We get sick; we’re get scared; we want more information. Has anyone ever taught us how to go about finding information in this situation? Not really, though the more education in general one has the better off one is. Finding and making sense out of medical information has a lot of pitfalls–from filtering out noise on Internet bulletin boards to finding reliable information that’s free and available to understanding how much about medicine is really unknown and uncertain, especially how it applies to your specific situation. It takes a great deal of knowledge even to know what kind of questions to ask your doctor. And who’s got the time to do all this research?

It’s good that we realize that doctors are fallible. Yet this doesn’t imply that by doing a search on PubMed we know more than our doctors. The changing nature of authority requires new skills for both experts and non-experts. Experts (including professors and librarians) have to get used to not having a complete monopoly on information and should have an understanding of where they can and do go wrong. Non-experts need to know where to find reliable or alternative sources of information and how to put this information into context. And both need to figure out how to talk to each other so the right questions get asked and answered at the right time, so that the chances for error are reduced as much as possible, and the chances for finding the truth are increased as much as possible.