Developing an academic medical library core journal collection in the (almost) post-print era: the Florida State University College of Medicine Medical Library experience

Abstract

The Florida State University (FSU) College of Medicine Medical Library is the first academic medical library to be established since the Web's dramatic appearance during the 1990s. A large customer base for electronic medical information resources is both comfortable with and eager to migrate to the electronic format completely, and vendors are designing radical pricing models that make print journal cancellations economically advantageous. In this (almost) post-print environment, the new FSU Medical Library is being created and will continue to evolve. By analyzing print journal subscription lists of eighteen academic medical libraries with similar missions to the community-based FSU College of Medicine and by entering these and selected quality indicators into a Microsoft Access database, a core list was created. This list serves as a selection guide, as a point for discussion with faculty and curriculum leaders when creating budgets, and for financial negotiations in a broader university environment. After journal titles specific to allied health sciences, veterinary medicine, dentistry, pharmacy, library science, and nursing were eliminated from the list, 4,225 unique journal titles emerged. Based on a ten-point scale including SERHOLD holdings and DOCLINE borrowing activity, a list of 449 core titles is identified. The core list has been saved in spreadsheet format for easy sorting by a number of parameters.

OVERVIEW

The Internet, once the domain of high-tech academic and government researchers, has only recently begun to fulfill expectations of medical researchers and information seekers in delivering quality medical information to the desktop. Although long a topic for discussion, it has been only within the last two to three years that library users have been able to access a critical mass of literature in high-quality format via Web interfaces or email. In addition, a large customer base is comfortable with migrating to electronic journals completely and a variety of pricing models have been designed to make this possible.

Though professional society publishers are still struggling with the likelihood of individual subscription cancellations if electronic journals are delivered via campuswide Internet protocol (IP) ranges, large publishers are now taking dramatic steps to capture and hold the electronic journal market. These publishers make it more cost-effective for academic libraries to cancel print versions in favor of electronic versions and to create consortia to share electronic journal budgets much as libraries have done in sharing print journal collections via interlibrary loan arrangements. This aggressive strategy by publishers has generated a degree of anxiety among librarians who are concerned that electronic journal subscription rates will increase beyond the limits of affordability once libraries have cancelled print subscriptions.

Questions not asked or necessary to ask in the past are now pressing and require a proactive and responsive approach by the library community. These questions include issues surrounding definitions of core collections and methods for securely archiving costly intellectual property. What does access versus ownership really mean in the twenty-first century library? Has electronic access to the literature changed the way scholarship is conducted? Is an immediately accessible journal viewed differently in terms of quality than one that is more difficult to obtain? What effect are new pricing models and consortium agreements having on the historically independent financial and organizational cultures found in many academic medical libraries?

In this (almost) post-print environment, the Florida State University (FSU) College of Medicine (COM) Medical Library is being developed. Some of the challenges faced by established libraries wrestling with new pricing models for journals do not exist for a library without a history. The opportunity to look at the collection development process anew has been welcomed by the FSU COM.

The development of an effective FSU COM Medical Library collection requires an understanding of the COM curriculum; of the expectations and needs of the faculty, staff, and students of the COM; of the range and depth of the FSU university libraries' collections; and of similar academic medical library collections. The availability of a benchmark core list is highly desirable for developing a journal collection policy, for meeting COM faculty priorities for the collection, for evaluating and providing data for accreditation documents, for selecting vendor e-journal packages, and for negotiating fair and reasonable cost-sharing arrangements with the FSU university libraries. Through a number of efforts described in this article, a core list has been developed that has already proved useful in achieving the objectives noted above and that will continue to inform the Medical Library in future collection efforts. It must be understood, however, that no core list can stand on its own: the intellectual process of weighing unique factors and internal recommendations has been and will continue to be essential throughout the collection development process.

BACKGROUND

The FSU College of Medicine was created by act of the State of Florida legislature in 2000 to educate primary care physicians who will practice in rural and underserved areas of the state. The program places great emphasis on the use of technology to streamline and integrate all phases of the educational process, as well as to prepare students to use technology in their future practices. The students spend their first two years in Tallahassee taking basic medical science and doctoring courses and learning a variety of informatics skills using laptop computers, personal digital assistants (PDAs), electronic medical records, electronic reporting and assessment tools, and information retrieval techniques.

While on the FSU campus during the first and second years, the students are part of student learning communities consisting of approximately thirty students, each having a large commons area with hard-wired computers, digital photocopiers that also serve as laser printers and scanners, a small collection of print reference books and textbooks, and four group study rooms all wired for planned and impromptu teaching opportunities with faculty. The entire COM campus provides wireless access to all medical library resources and educational software. Each student is provided a state-of-the-art laptop and PDA and taught how to use them effectively. The third and fourth years of the curriculum will be spent on regional medical campuses throughout the state, beginning with campuses in Pensacola, Orlando, and Tallahassee. The law creating the College of Medicine mentions specifically that a virtual medical library will be created to serve faculty and students' needs regardless of location.

The FSU COM is a community-based medical school, one of about twenty in the United States in which students train at local medical facilities rather than a university hospital. In the case of FSU, these local facilities are broadly dispersed throughout the state: 200 miles west in Pensacola and 260 miles southeast in Orlando, with more locations to be added in the future. Thus, the Medical Library does not include a local hospital community or faculty and students in nursing or allied health professions as primary users of the library collection. The Medical Library, instead, functions in a large university library system that includes the FSU Main University Library (Strozier), the Dirac Science Library, and the Law Library. These affiliated university libraries house related nursing, basic science, psychology, nutrition, social science, legal, and other print materials sometimes overlapping with the literature of medicine. The university libraries are all within fifteen minutes of the Tallahassee campus of the College of Medicine. In addition, the university libraries subscribe to a significant number of biomedical, bioscience, psychology, nursing, social sciences, and allied health journals in electronic format via both direct licensing and consortium agreements. Most of these are accessible by the entire university.

Approximately $1.4 million was spent in early 2001, prior to the first year of operation of the FSU COM, to develop a preliminary working core collection. The first class of thirty students began that May. These funds were used primarily, but not exclusively, for subscriptions and five years of back issues of 212 journal titles in print format, as well as subscriptions via OVID and MD Consult to a number of electronic journals. This preliminary collection of journals was selected by consulting faculty and COM administrators and other academic medical library directors, as well as by reviewing journals recommended by the “Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library” [1] and journal subscription lists of several academic medical libraries with missions similar to that of the FSU COM.

Upon the arrival of the library director in November 2001, a number of activities critical to providing library service quickly to the growing student body and faculty were conducted. The preliminary collection of print books and journals was processed and moved into a newly renovated temporary library facility, systems were set up for circulation of materials, some additions and refinements were made to the Medical Library Website, and a staffing plan was developed and carried out. At the same time, evaluating the preliminary collection and creating a plan for development of the future collections were imperative. First priority went to the journal collection, because a core book collection already existed from a previous first-year program at FSU that fed into the University of Florida College of Medicine. In addition, books continue to be purchased by the Medical Library based on faculty and Curriculum Committee requests and input.

Additional study is practical and advisable for book purchases, because the nature of electronic book publishing is evolving. Databanks or services—such as Dynamed, InfoRetriever, Stat!Ref, NetLibrary, Harrison's Online, MD Consult, PDxMD, and e-Medicine and applications such as Vital Source—may one day replace or radically change curriculum-based book collections. Further analysis and planning will be conducted as the curriculum is rolled out and as new electronic products are created.

METHODOLOGY

The first task that the Medical Library faced was to gain a complete knowledge of the serial collections available both in print and electronically throughout the several affiliated FSU libraries. During a time when multi-journal packages were added rapidly along with aggregated packages of journals, the FSU collections were changing too fast for catalogers to maintain rigorous bibliographic control. Thus, determining quickly the exact nature and holdings of the collections and evaluating them in terms of quality was difficult. Once knowledge of the FSU medical, biomedical, and behavioral science journal collections was gained, a core journal list specific to serving the FSU COM was developed using a number of quality indicators explained below.

The investigators selected Microsoft Access as the database application most appropriate for the task and, over the course of the analysis, exported the data into a number of spreadsheets for discussion and analysis before continuing with the project. In addition to developing an appropriate core journal list to use in collection development, another important goal was to select the most cost-effective method for purchasing or leasing the journals in the resulting core. To this end, data on offerings and costs for a number of packaged products were added to the database. Furthermore, it was important to determine an approximate value of the university libraries' subscriptions toward developing the Medical Library core. This information would be used to make decisions about packages from publishers, vendors, or both that the Medical Library will purchase for access by the entire university to balance the cost of those that the university libraries have purchased. Such an approach would be both equitable and easy to administer.

The key field used for locating duplicates in the FSU Access database was the international standard serial number (ISSN). Manual corrections were conducted throughout the process to resolve cases in which journals had different ISSNs for print and electronic subscriptions or for journal records lacking ISSNs. Journal titles and ISSNs for the titles indexed in MEDLINE, along with specific journal holdings for FSU both in print and electronic format, were included in the database. This was done partially for collection assessment purposes, to answer the question “How many journal titles indexed in MEDLINE are held by FSU?” It should be noted that the Medical Library solely supports a community-based medical school. Therefore, most nursing, veterinary medicine, dentistry, allied health, and library science journal titles were excluded from the database and the final database-generated core list.

The initial database was loaded with SERHOLD data from eighteen other community-based medical schools in the United States. These SERHOLD data might represent one of the last opportunities for a snapshot of print journal collections in medical libraries given the current trend away from print and toward electronically accessed journals. The SERHOLD data were entered into the database, which was cleaned as much as possible of error from changed titles, incorrect or duplicate ISSNs, and out-of-scope journals such as most dentistry, veterinary medicine, and nursing titles. Because of the large number of records (over 19,000 individual serial records across all 18 libraries for all journals), it was not possible to eliminate all items that might be out-of-scope, to resolve duplicate or similar titles, or to follow through on all journal titles to be sure that the SERHOLD data were correct or complete. For instance, the New England Journal of Medicine was listed as owned by seventeen libraries. When the holdings were checked via the online catalog for the eighteenth library, the New England Journal of Medicine was found in the catalog of the larger university library of which the medical library was a part. For this reason, the investigators built in some flexibility when assigning point values for the number of libraries holding a title.

The database contains more than 4,000 unique titles for the eighteen community-based medical school libraries, once duplicate and out-of-scope titles were removed. The information in the database, sorted by a variety of parameters, provides the number of MEDLINE titles held by the FSU library system available in all formats. It also shows the number of core titles available from vendor packages (EBSCO, ProQuest, MD Consult, and OVID). Though the primary objective in undertaking this project was to identify a core journal collection to develop a quality collection, much more can be mined from this relational database.

Table 1 shows the distribution of unique journal titles by number of libraries holding the titles for the entire list of 4,225 unique titles. The distribution of unique titles by number of libraries holding the titles informed the authors' decision regarding assigning point values. Note that 531 unique journal titles, or 12.6% of the total unique titles, are held by ten or more libraries.

Table 1 Unique journal titles by number of libraries holding the titles

Additional information was added to the database from a number of sources for use as quality indicators. A ten-point system was developed with each item counting as at least one point with some weighted and counting two or three points, for example, if a journal appeared on the “Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library” and was recommended for first purchase, it received three points.

The 140 journal titles on the Brandon/Hill list were selected because of the list's importance to the medical library profession. To get an alternate viewpoint, 265 titles from a list supported by the British Medical Association's Core Collection of Medical Books and Journals by Hague [2] was included. In an effort to focus on clinical medicine and evidence-based medicine, the 102 journal titles scanned for the InfoPOEMs Clinical Awareness System [3] and the ninety-six titles reviewed for the ACP Journal Club [4] were also used.*

Finally, points were given for being highly requested through DOCLINE or for being commonly held by the eighteen community-based medical school libraries in the study. The National Library of Medicine (NLM) provided a ranked order listing of the top 2,000 most requested journal titles between October 2002 and September 2001 [5]. These came from 2.8 million requests from a pool of 20,317 journal titles, thus, the top 10% of the most requested titles. The top 1,000 in this list represented the top 5% of most requested titles. (NLM notes that some of the titles are new and therefore more likely to be borrowed, and some titles that are very old and established may have a large number of requests for old issues. In addition, it should be noted that some of the titles publish more frequently than others and may therefore receive more requests.)

Journal titles included in the SERHOLD data of at least ten of the eighteen community-based medical school libraries (531 total) received one point. Journal titles in the SERHOLD data indicating holdings in at least sixteen of the eighteen libraries (190 total) received two points. The total possible score for a title was ten. Table 2 summarizes the allocation of points.

Table 2 System for assigning points to journal titles

Over the course of reviewing a number of variants of the proposed core list and by consulting with COM faculty about specific titles, a final set of weighted criteria and a cut-off point for inclusion was adopted. Based on the ten-point scale, a core list of 449 medical journals was identified, with each journal receiving at least three points out of ten. Table 3 shows the distribution of point values for all 4,225 titles.

Table 3 Number of journals in each point category (held by six or more libraries or by any of the eighteen libraries studied)

Note that when evaluated by point value, the distribution was similar among the journals held by six or more libraries and among journals held by any of the eighteen libraries down to the three-point cut-off. Beyond that, the gap widened dramatically.

This core was and is being tested by consulting faculty during the journal-selection process for the 2002/03 fiscal year budget. Naturally, additional journal titles specific to the unique mission of the college will be selected as they are identified. For instance, the COM collection will include additional titles in geriatrics and health care delivery to the medically underserved, particularly in rural areas. These journals will be identified with strong faculty input and through review of the entire list beyond the three-point cut-off. However, with these disclaimers, the authors are comfortable with the resulting list as a starting point for discussions, budget negotiations, and collection assessment activities.

Table 4 shows the distribution by journal title appearance on a number of the quality indicators found on the final core journal list. Note that nearly all of the core journals are also on the list of the 10% most frequently requested DOCLINE titles.

Table 4 Journal title appearance on a number of the quality indicators found on the final core journal list

It must be noted that appearance on the lists used as criteria by the investigators does not necessarily capture all of the titles that should be considered for purchase. Obviously, if a journal is held by half of the libraries out of the eighteen library collections studied, it has proved of value to those nine libraries. Table 5 provides some details on the number of journals that do not appear on the core list of 449 titles. An additional 207 titles are held by nine or more libraries, and 144 titles are held by ten or more libraries.

Table 5 Number of journals not appearing on the core list of 449 titles

OUTCOMES

While not infallible, this process accomplished several of the objectives the staff had when we began the project in November 2001. The Medical Library professional staff attained a clearer understanding of the FSU collections and a much better awareness of what a core list can and cannot do in terms of creating a new journal collection. The experience gained by working with faculty and administrators to create shared visions of the journal collection and for delivering services and resources most effectively to users was very important. Three primary outcomes have been identified.

• At the outset, it was unclear what constituted an adequate core collection of journals specific to a community-based medical school. Therefore, the most obvious outcome was the development of a core working list that has played a strong role in an assessment of the value of currently available resources. This assessment made it possible for the investigators to report the total number of relevant print and/or electronic resources to two accrediting bodies, the Liaison Committee on Medical Education (LCME) and the Southern Association of Colleges and Schools (SACS).

• The list of journals and the quality indicators assigned to each journal was used in selecting and deselecting journals for 2003. It was also used for review with faculty. When asked for recommendations for journal subscriptions, the list often provided faculty members with titles they forgot to mention and with information on quality. There is more to do, but initial discussions have confirmed that the cut-off at three points and above is appropriate, with an occasional two-point journal receiving a recommendation by faculty for subscription.

• When publisher and aggregator information on packages (EBSCO, OVID, MD Consult, ProQuest, Science Direct, Kluwer, and Wiley Interscience) was added to the database, the investigators were able to learn more about the real value of each package in meeting the COM's unique needs. Although a package might have a large number of journal titles overall, the number of core titles not already accessible to the COM might be small. The information allowed the investigators to make better-informed purchasing decisions. In agreements with the university library, we were able to identify the titles most appropriate for us to fund. Both the university and COM libraries were able to make cancellation decisions based on the core list. Having a database with complete information empowered us to make evidence-based decisions.

To summarize, we learned about current collections, developed a reasonable core collection, made equitable and cooperative decisions with the university, and found the most cost-effective method for achieving a quality core in 2003. The knowledge gained during this process provided us with the confidence that only good data can provide.

FUTURE DIRECTIONS

Future studies may include a comparison of this core list with holdings of a wider sample of academic medical libraries nationwide. Titles of journals owned by other FSU libraries will continue to be entered into the database to be sure a quality collection is maintained and to determine the percentage of university-purchased core medical journals on an ongoing basis. Prices of a variety of aggregated packages or collections from major vendors will be reviewed annually to ensure that the most cost-effective product is procured for the university at large.

The DOCLINE data appear to be a useful quality indicator, especially for the 5% most frequently borrowed titles. Future study using several variables may yield additional insight into the relationship among interlibrary loan activity, journal subscriptions, and appearance on core journal selection lists.

Table 6 includes the twenty-two journals with a point value of ten to illustrate the method used in determining the core. The complete list of titles appears in the appendix. The spreadsheet that lists the quality filters used and point values assigned for all 449 titles in the FSU COM core is available from the authors on request. This spreadsheet can be saved to the desktop, local data can be added, and the list can be sorted by any parameter. The authors appreciate all feedback on the core collection. Perhaps this core collection might serve as the beginning for an expanded core clinical collection beyond the 140 journals in the Brandon/Hill list.

Table 6 Twenty-two journals with a point value of 10

We conclude with a fundamental observation: this project was as much about process as it was about the actual content of the core list. Each library must communicate with and serve its constituents and function within its organizational and financial context. In gaining knowledge of similar collections, of the nature of specific core lists, of the specific needs and objectives of the FSU College of Medicine, and of the larger FSU university libraries collection, we paved the way for a smooth evolution into the post-print era.

APPENDIX

Core list of titles with total number of points assigned