INFORMATICS AND TECHNOLOGY |
Utilization of library outreach services by dental school alumni, 1988–1998
ANN MARIE CORRY, M.A., M.A.L.S.
 |
ABSTRACT
|
|---|
Background. The University of Missouri-Kansas City School of Dentistry Library outreach service includes the Dental Reference Service, or DRS; Loansome Doc service, Career Opportunity Center, or COC; and the Instructional Resources Library, or IRL. The author reviewed usage of services for 1988–1998 to analyze use by alumni and nonalumni and to determine possible trends.
Methods. The author reviewed the UMKC School of Dentistry Library outreach service database from 1988–1998 to determine the total number of contacts for all services, numbers of contacts for each service, overall number of items sent and the number of dental health professionals contacting the services.
Results. The author found that the COC received 55 percent of contacts for the years 1988–1998, while the DRS received 26 percent of the total contacts and the IRL service received 19 percent. The DRS had the highest usage by alumni (80 percent); Loan-some Doc service accounted for 11 percent of the DRS contacts. Total number of items sent in response to all requests was 34,325, of which 22,647 (66 percent) were to alumni. Alumni usage of all outreach services was consistent, ranging from 54 to 63 percent of the total.
Conclusions. It appears that UMKC School of Dentistry alumni are active information-seekers. Several questions, however, remain, indicating that additional research should be done in the area of dental informatics.
Practice Implications. Information-seeking behaviors are an important part of the active clinical practice and may become more important as evidenced-based dentistry becomes more prevalent.
The University of Missouri-Kansas City School of Dentistry Library began an outreach service to dental health professionals in 1973. This outreach service includes the Dental Reference Service, or DRS; the Career Opportunity Center, or COC; and the Instructional Resources Library, or IRL. I previously published an article about the UMKC School of Dentistry Library outreach service.1 Briefly, the DRS provides basic and advanced reference service, photocopy service, Loansome Doc service and book circulation to dental health professionals primarily in Kansas and Missouri. The COC provides career services to practitioners, students, communities seeking dental health professionals, dental clinics and other interested groups. The IRL provides videotapes, slide sets and patient education materials to dental health professionals.
The longevity of the outreach service presents a unique opportunity to obtain a clear picture of the information-seeking behaviors of the dental health professionals who use these services.
In 1991, the UMKC School of Dentistry Library received a National Library of Medicine Outreach grant to teach Grateful Med to dental health professionals in Missouri and Kansas. (Internet Grateful Med and PubMed provide free public access to the National Library of Medicine’s MED-LINE database. Loansome Doc is a program that provides copies of articles to health professionals.) As part of this activity, I trained more than 100 dental health professionals to use Grateful Med and provided them with software, user identification numbers and user passwords. The UMKC School of Dentistry Library agreed to serve as the Loansome Doc provider for participants in the training. After the grant period (1991–1993) ended, I sent two additional mailings to participants to inform them of changes in Grateful Med and the availability of Internet Grateful Med.
A number of studies have investigated the information-seeking behaviors and computer usage of dental health professionals. Dentists and dental hygienists tend to rely on colleagues, personal journal collections and continuing education courses to locate information.2–6 Computer usage studies vary in terms of how many dentists have computers in their practices; these figures range from 60 to 89 percent.7–9 While office functions account for the major portion of computer use, Internet activity is increasing.10 One study noted that 49.5 percent of those surveyed reported using the Internet to locate dental research information.8
The longevity of the UMKC School of Dentistry Library outreach service presents a unique opportunity to obtain a clear picture of the information-seeking behaviors of the dental health professionals who use these services.
|
OVERVIEW
|
|---|
Since the creation of the UMKC Dental Library outreach service in 1973, I routinely have kept utilization data. In 1988, I began a project to collect data on all three outreach services: DRS, COC and IRL. At that time, a change in methodology allowed for the addition of search variables so that data could be sorted by various parameters, including year of graduation. I revised the database and assigned each dental health professional a unique identification number. Each time a dental health professional requested material or services from the UMKC School of Dentistry Library, it was counted as a discrete incident or "contact." This format was selected because a single dental health professional might require service from all three outreach services multiple times per year. Each contact was recorded with the following information: user identification number, year of request, user name, year of graduation (if an alumnus of UMKC), service code, service description, number of items provided (if applicable), transaction date and state of residence. The year of graduation encompassed graduation from dental, dental hygiene and specialty and advanced programs of UMKC School of Dentistry. I did not record year of graduation for non–UMKC dental health professionals. As Loansome Doc requests were received and processed, these data were folded into the outreach statistics as a subset of the DRS.
The resulting database of services and materials provided covers the period 1988–1998. UMKC alumni were grouped by year of graduation. I report the results with alumni and non-alumni usage as a percentage of the overall totals for number of contacts for all services; contacts for the DRS, Loansome Doc, COC and IRL; overall number of items sent and the number of dental health professionals contacting the service.
|
OVERALL LIBRARY OUTREACH SERVICE UTILIZATION
|
|---|
Figure 1
provides overall data from 1988–1998. The COC service received 55 percent of the total number of contacts, while the DRS received 26 percent of the total, and the IRL 19 received percent of the total. Figure 2 shows the total number of contacts and number of items sent to alumni and nonalumni from 1988–1998. In terms of UMKC alumni utilization, Figure 3 shows that the highest number of contacts was recorded for the graduating classes of 1981–1990 (22.3 percent) and the graduating classes of 1971–1980 (18.1 percent).
View larger version (42K):
[in this window]
[in a new window]
|
Figure 1. University of Missouri-Kansas City School of Dentistry Library outreach services to alumni and non-alumni, 1988–1998.
| |
View larger version (39K):
[in this window]
[in a new window]
|
Figure 3. University of Missouri-Kansas City School of Dentistry Library outreach services to alumni by year of graduation, 1988–1998.
| |
|
DENTAL REFERENCE SERVICE UTILIZATION
|
|---|
The DRS component of the outreach service has been in existence since the program began in 1973. Contacts include reference inquiries, requests for photocopies, requests for searches, Loansome Doc requests and book circulation in the greater Kansas City metropolitan area. Figure 4 shows DRS usage from 1988–1998. The number of requests for DRS has remained stable despite increased user access to the Internet and other information sources. I also found that the highest number of contacts was recorded for the graduating classes of 1981–1990 (27.6 percent) and the graduating classes of 1971–1980 (27.2 percent). Of the three services offered, DRS has the highest percentage of UMKC alumni contacts overall (80 percent). Actual numbers fluctuated annually; however, there was little variation in DRS usage from year to year. I separated Loan-some Doc requests from overall DRS contacts and analyzed them. While these requests currently are limited to a few participants, these are very active users who requested 1,085 articles from 1994–1998.
|
CAREER OPPORTUNITY CENTER UTILIZATION
|
|---|
The COC service was developed as an outreach service to provide centralized access to career options both for practitioners and students. However, I only recorded contacts from practitioners. Figure 5 shows COC usage from 1988–1998. As a service, the COC is expanding rapidly. COC contacts accounted for 55 percent of all outreach contacts. I found that the highest number of contacts was recorded for the graduating classes of 1971–1980 (14.2 percent) and the graduating classes of 1981–1990 (14.1 percent). While the COC was used by all graduating class groupings, UMKC alumni usage of the COC service was only 45 percent of the overall total.
|
INSTRUCTIONAL RESOURCES LIBRARY UTILIZATION
|
|---|
The IRL offers free loan of videotapes on dentistry-related topics and patient education materials to dental health practitioners and local educators. Figure 6 illustrates utilization of the IRL service from 1988–1998. I found that the highest number of contacts was recorded for the graduating classes of 1981–1990 (39.6 percent) and the graduating classes of 1971–1980 (17.5 percent). IRL service use peaked in 1990 at 304 contacts, decreased until 1993, at which time it rose to 276 contacts and then consistently decreased after that. Apparently, access to other resources has affected usage of IRL services negatively.
|
NUMBER OF ITEMS SENT
|
|---|
Figure 2
shows the number of items sent out by the library in response to DRS, COC or IRL contacts from 1988–1998. The total number of items sent out during the period was 34,325, of which 22,647 (66 percent) were sent to alumni of the UMKC School of Dentistry. Of the UMKC alumni classes, the highest number of items was sent to the graduating classes of 1981–1990 (26.9 percent) and 1971–1980 (21.1 percent).
|
NUMBER OF DENTAL HEALTH PROFESSIONALS
|
|---|
The number of dental health professionals contacting the UMKC Dental Library outreach services is tracked on an annual basis. Multiple contacts by a single person are recorded to calculate the total number of contacts. However, since a single person might contact one or more of the services several times during the year, I also extracted the actual number of people from the number of contacts made. Figure 7 shows the actual number of dental health professionals who contacted the library from 1988–1998. From year to year, the same people request services. Alumni usage was consistent, ranging from 54 to 63 percent of the total.
View larger version (40K):
[in this window]
[in a new window]
|
Figure 7. Overview of the number of dental health professionals who contacted University of Missouri-Kansas City School of Dentistry Library, 1988–1998.
| |
|
DISCUSSION
|
|---|
From my analysis of this outreach data, it appears that dentists in Missouri and Kansas and alumni of the UMKC School of Dentistry actively seek information at several levels. Several questions remain, however. Even though the numbers seem large, are they a real representation of UMKC alumni information-seeking behaviors? The graduating classes of 1981–1985 appeared as the highest-percentage user group for most services. Usage for this group ranged from 33 to 82 people, depending on the year. Yet, the actual number of UMKC graduates for 1981–1985 was 988 (773 dentists; 124 dental hygienists; 91 receiving specialty or advanced education).11–25 This illustrates the fact that only 3.3 to 8.3 percent of these graduating classes had contacted the UMKC dental library outreach service for information or services.
In 1998, there were 6,701 people listed as UMKC School of Dentistry active and retired alumni. In 1998, only 451 alumni (6.7 percent) contacted the UMKC dental library for outreach services. In contrast, in its last published utilization review, the ADA Bureau (now Department) of Library Services provided 8,563 circulated items and 16,685 photocopied items for the years 1990–1991.26 In 1991, there were 150,762 professionally active dentists in the United States.27 Therefore, the ADA Bureau of Library Services provided information services to less than 2 percent of the professionally active dentists.
Another question I considered was whether nonalumni were more active in seeking information than were UMKC alumni. I found that of the total number of contacts to the UMKC School of Dentistry Library outreach services from 1988–1998, 40.2 percent were made by non–UMKC alumni. Is geographic accessibility more a factor than alumni affiliation in terms of requesting professional support services?
A third question involves the impact of technology on the information-seeking behaviors of dental health professionals. The UMKC dental library outreach service database does not include any information as to the requestor’s type of practice or the level of the practice’s technology. Research has indicated that people who are on the cutting edge of technology are more likely to actively seek information than are those who follow behind the edge.28,29 A recent report on Internet use by dental health professionals indicated that 49.5 percent of the group surveyed were using the Internet to obtain dental research information.8 Dental health professionals using the UMKC dental library as their Loansome Doc resource made only 172 contacts from 1994–1998. Loansome Doc requests represent 11.1 percent of total DRS contacts for this period. This indicates that dental health professionals who use the UMKC dental library outreach services may be less active electronic information seekers than the general dental population, or that they are obtaining hard copies of full-text articles from other sources.
On the other hand, a recent survey of college freshmen showed that these students currently depended equally on the Internet and traditional library sources—a 50:50 ratio.30 They indicated that in the future, they expected to rely more heavily on the Internet and that more full-text resources will be available in the Internet. This trend may reflect the attitude of current and future dental health students and practitioners.
The database of the UMKC dental library outreach services includes information on UMKC alumni users in terms of academic program: dental, dental hygiene and specialty or advanced education. When preparing the output from the database, I requested information for the year of graduation only, not for the academic program. The resulting output does not differentiate between dentists, specialists or dental hygienists in terms of annual utilization. Therefore, the question remains as to whether general dental practitioners are more or less active information seekers than are dental hygienists or specialty practitioners.
A large percentage of the outreach services involve various aspects of the COC service. The COC had a 60 percent increase in use from 1996–1997. This is a reflection of two events. First, a computer program was developed to handle the listings, and all files were entered on a public-access computer terminal located in the dental library. Secondly, dental hygiene position listings were added to the file. Information concerning these two COC changes was made available to alumni at the 1997 UMKC School of Dentistry alumni meeting. Interest in this service is a reflection of the fact that the current dental health professional is more flexible and more fluid in the practice of dentistry than in the recent past.31,32 More dental school graduates are seeking a fifth-year general practice residency,33 and more opportunities are available to dental care practitioners in terms of space sharing, group practices and paid positions. Dentists who began practices in the late 1960s and early 1970s are beginning to think of taking an associate or retiring.34 Also, there is a perceived regional shortage of dental hygienists.35 Many practitioners have dental hygienist openings and are actively seeking either full- or part-time hygienists by listing in the COC. The changing face of dental practice and the high number of dental hygienist positions available may account for the proportionately heavy usage of the COC service.
Research consistently has shown that dental health professionals get information from colleagues, continuing education courses and personal journal collections.2–6 A 1998 study of dental hygienists indicated that those surveyed preferred and used traditional information sources such as discussions with colleagues and journal articles.6 While a great deal of information is readily available in journals, in newsletters and on the Internet, not all of it is of sufficient quality on which to base and document patient care decisions. It has been noted that there is not a clear understanding of how dental health practitioners make clinical decisions and what information they need to do so.36 It is anticipated that future developments in Internet access will include improved technology, Web site development, metasite development, personalization or customizing of access, collaborative filtering and improved information retrieval.36 Evolution of the Internet may improve, enhance and expand the clinical decision-making process for dentistry.
Evolution of the Internet may improve, enhance and expand the clinical decision-making process for dentistry.
Also, the trend toward evidence-based dentistry has gained momentum. Evidence-based dentistry may affect the practice of dentistry, as well as patient expectations, insurance claims and information-seeking behavior.37 Patients are active Internet users and have legitimate questions concerning their dental health and treatment options.37 Dental health professionals no longer will be able to merely ask a colleague for information or claim that a specific procedure works "in my hands."38 Reasons for specific treatments will have to be documented by the dental and medical literature for patients and third-party payers. An excellent review of the evidence-based process and a glossary of terms was published recently.39
|
CONCLUSIONS
|
|---|
In spite of the relatively large database of information on the usage of the UMKC dental library outreach services, many questions still remain.
Dentists are using the Internet in increasing numbers, but they are using it for reasons other than locating dental research information. If they do access MEDLINE or other databases, where are they obtaining the articles?
The UMKC School of Dentistry alumni who graduated from 1981–1990 used the UMKC dental library outreach services more than other groups. Would this be true of equivalent graduates from other dental schools?
Are dentists more active information-seekers than dental hygienists? Does the size and type of dental practice make a difference in information-seeking behaviors? What is the impact of technology on the information-seeking behaviors of dental health practitioners in other geographic regions compared with the Midwest? What impact will evidence-based dentistry have on clinical decision making and information-seeking behaviors of dentists and dental hygienists?
Clearly, there is much research still to be done in the area of dental informatics.
|
FOOTNOTES
|
|---|
Ms. Corry is a dental librarian, University of Missouri-Kansas City, School of Dentistry, 650 E. 25th St., Kansas City, Mo. 64108-2784, e-mail "corrya{at}umkc.edu". Address reprint requests to Ms. Corry.
|
REFERENCES
|
|---|
- Corry AM. UMKC library outreach services. Mo Dent J 1989;69(5):33–5.
- Strother EA, Lancaster DM, Gardiner J. Information needs of practicing dentists. Bull Med Libr Assoc 1986;74(3):227–30.[Medline]
- Norton LA, Yaeger JA. Practices and preferences for learning among Connecticut dentists and University of Connecticut dental alumni. J Conn State Dent Assoc 1992;68(1):28–31.
- Gravois SL, Fisher W, Bowen DM. Information-seeking practices of dental hygienists. Bull Med Libr Assoc 1995;83(4):446–52.[Medline]
- Gravois SL, Fisher W, Bowen DM, Patrick SC. Dental hygienists’ information seeking and computer application behavior. J Dent Educ 1995;59(11):1027–33.[Abstract]
- Covington P, Craig BJ. Survey of the information-seeking patterns of dental hygienists. J Dent Educ 1998;62(8):573–7.[Abstract]
- Weisman G. Dentists brace for the 21st century armed with technology. Dent Prod Rep 1999;33(6):25–33.
- Kehoe B. All systems go. Dent Pract Finance 1999;7(4):55–60.
- Smith C. Change the mindset, say experts! Take computers to the next step. Available at: "www.e-dental.com/content/news/article.asp?DocID={83BCA75C-6853-11D3-9A64-00A0C9C83AFB}". Accessed Nov. 16, 2000.
- Schleyer TK, Spallek H, Torres-Urquidy MH. A profile of current Internet users in dentistry. JADA 1998;129:1748–53.
- American Dental Association. Advanced dental education, 1980–1981: Annual report and admission information—A handbook for graduates. Chicago: American Dental Association; 1981.
- American Dental Association. Advanced dental education, 1981–1982: Annual report and admission information—A handbook for graduates. Chicago: American Dental Association; 1982.
- American Dental Association. Advanced dental education, 1982–1983: Annual report and admission information—A handbook for graduates. Chicago: American Dental Association; 1983.
- American Dental Association. Advanced dental education, 1983–1984: Annual report and admission information—A handbook for graduates. Chicago: American Dental Association; 1984.
- American Dental Association. Advanced dental education, 1984–1985: Annual report and admission information—A handbook for graduates. Chicago: American Dental Association; 1985.
- American Dental Association. 1980–1981 Annual report: dental auxiliary education. Chicago: American Dental Association; 1981.
- American Dental Association. 1981–1982 Annual report: dental auxiliary education. Chicago: American Dental Association; 1982.
- American Dental Association. 1982–1983 Annual report: dental auxiliary education. Chicago: American Dental Association; 1983.
- American Dental Association. 1983–1984 Annual report: dental auxiliary education. Chicago: American Dental Association; 1984.
- American Dental Association. 1984–1985 Annual report: dental auxiliary education. Chicago: American Dental Association; 1985.
- American Dental Association. 1980–1981 Annual report: dental education. Chicago: American Dental Association; 1981.
- American Dental Association. 1981–1982 Annual report: dental education. Chicago: American Dental Association; 1982.
- American Dental Association. 1982–1983 Annual report: dental education. Chicago: American Dental Association; 1983.
- American Dental Association. 1983–1984 Annual report: dental education. Chicago: American Dental Association; 1984.
- American Dental Association. 1984–1985 Annual report: dental education. Chicago: American Dental Association; 1985.
- American Dental Association. 1991 Annual reports and resolutions. Chicago: American Dental Association; 1991:26–7.
- American Dental Association. Bureau of Economic and Behavioral Research. Distribution of dentists in the United States by region and state, 1991. Chicago: American Dental Association; 1992.
- Sarll DW, Holloway PJ. Factors influencing innovation in general dental practice. Br Dent J 1982;153(7):264–6.[Medline]
- Ringrose LC. Factors influencing dental professionals’ uptake of new preventive clinical procedures and materials. J Can Dent Assoc 1987;53(9):695–7.[Medline]
- Lubans J. When students hit the surf. SLJ online. Available at: "www.slj.com/articles/articles/19990901_6516.asp". Accessed May 29, 2000.
- Friedlander DA. The changing face of dentistry. J Can Dent Assoc 1999;65(3):144–5.[Medline]
- Brown LJ, Lazar V. Dentist work force and educational pipeline. JADA 1998;129:1700–7.
- Weaver R. Trends in postdoctoral dental education. J Dent Educ 1999;63(8):626–34.[Medline]
- Brown LJ, Lazar V. Retirement savings of dentists in private practice. JADA 1999;130:1210–8.
- Ward E. Not enough hygienists to go around. Focus MDA 1998;78(4):2.
- Schleyer TK. Clinical decision-making and the Internet. J Am Coll Dent 1999;66(2):29–39.
- Foti SK. Evidence-based care approaches dentistry. AGD Impact 1999;27(3):8–12.
- Robbins JW. Evidence-based dentistry: what is it, and what does it have to do with practice? Quintessence Int 1998;29(12):796–817.[Medline]
- Carr AB, McGivney GP. Users’ guides to the dental literature: how to get started. J Prosthet Dent 2000;83(1):13–20.[Medline]
TOP
ABSTRACT
OVERVIEW
