Health sciences librarians' attitudes toward the Academy of Health Information Professionals

Abstract

Objectives: The purpose of the study was to ascertain health sciences librarians' attitudes toward the Academy of Health Information Professionals (AHIP).

Sample: Systematic sampling was used to select 210 names from the list of members of the Midwest Chapter of the Medical Library Association.

Methods: A questionnaire containing open- and closed-ended questions was used to collect the data.

Results: A total of 135 usable questionnaires were returned. Of the respondents, 34.8% are members of the academy and most are at the senior or distinguished member levels. The academy gives them a sense of professionalism and helps them to keep current with new trends. The majority of participants (65.2%) are not members of the academy. Among the various reasons proffered are that neither institutions nor employers require it and that there is no obvious benefit to belonging to the academy.

Conclusions: More research needs to be done with a larger sample size to determine the attitudes of health sciences librarians, nationwide, toward the academy.

INTRODUCTION

The Academy of Health Information Professionals (AHIP), established in 1989, is the latest installment in the Medical Library Association's (MLA's) credentialing program. Medical or health sciences librarianship is a specialized field, and it is incumbent upon those entering this specialty to possess and maintain essential knowledge and skill sets. The academy membership program was designed to contribute to the development of the highest possible professional standards. The purpose of this study was to assess the current attitudes of Midwest health sciences librarians toward the academy.

LITERATURE REVIEW

Throughout its history, MLA's credentialing program has been a work in progress. Concerned about maintaining and improving the quality of health sciences librarianship, MLA promotes education and training to ensure that librarians entering this specialized field possess knowledge and skills relevant to the health sciences environment [1].

Many articles have been written that have called for specialized medical library education, as well as certification and recertification requirements [2–10]. Some articles have addressed the development and importance of quality in continuing education (CE) programs to complement this process [11–13]. The formal education of medical librarians began as early as 1937 at the University of Minnesota Library School with a lecture course on hospital librarianship that included a six-week hospital library internship. The inclusion of medical librarianship courses began to appear as part of selected library school curricula. One example was the course given by Thomas P. Fleming, in 1939, “Bibliographic and Reference Service in the Medical Sciences,” at the School of Library Service at Columbia University [14].

In her presidential address in 1946, Mary Louise Marshall called for a standard program that included certification. She addressed the lack of standards and listed three important factors for attracting qualified persons to medical librarianship, including

(1) recruitment, (2) education, both general and professional, and (3) experience, preferably supervised, as represented by an internship. She further pointed out that as long as the Association had no training program or recognized standards it had no basis for concerted action. [15]

Her message eventually led to the development, in 1949, of the Code for the Training and Certification of Medical Librarians, which consisted of three levels, Grade I (library school training with course work in medical librarianship), Grade II (Grade I requirements and a six-month internship in an approved medical library), and Grade III (an advanced degree or its equivalent in library science) [16]. The code experienced minor changes in 1956 and a major revision in 1964. In lieu of taking a formal library school course, members could now take an examination (and obtain a passing grade) to cover material usually addressed in an approved course on medical librarianship or an internship [17]. Up to this point, certification was permanent, and examinations were optional if the other requirements (degrees and completion of an MLA-approved course in medical librarianship or MLA-approved internship) were met. By 1978, new revisions went into effect. To obtain certification, all members were required to take an examination and meet the educational requirements. In addition, recertification was now required every five years, either by taking the prescribed number of CE courses or by taking an examination to demonstrate ongoing competency [18, 19].

Bell reviewed MLA's credentialing process from its birth to the present day academy program. She summarized each credentialing program—including its code, minimum requirements, levels, and recertification—from 1949 through 1994. She also explained the initial certification process, the competency-based certification examination, the need for requiring recertification, and the eventual development of the academy. In addition, Bell compared the proposed (1988), final (1989), and revised (1994) academy credentialing program. She concluded her article by saying that

The academy and its predecessors have survived not because they have been perfect, not because there is any proof of a correlation between certification or credentialing and economic benefit, but because they have continued to provide an elusive and enticing, albeit sometimes controversial, vision of what is expected of a true professional. [20]

According to Forsman and Nelson [21], in 1995, the MLA Board of Directors established a task force to review the first five years of the academy. The task force developed and utilized three separate questionnaires to poll (1) former academy members (those who chose not to renew), (2) a random sampling of the general MLA membership, and (3) library school deans, leaders of comparable organizations, and prominent information professionals to assess their perceptions of the academy. Of interest to the current study are the results from the first two groups. The response rate from former academy members was 42.5%. The five most common reasons for not renewing their memberships were the amount of time necessary to prepare and submit the application, lack of tangible benefits, lack of value to employers, high cost of the academy, and change in employment status. The response rate of the academy members was low (28%) prompting the authors to suggest that only those who “cared about the academy” responded. From the survey of members, responses revealed that academy membership had little influence on employers and was not often required for job promotion or retention. Members noted, however, that membership “demonstrated personal commitment to the profession,” encouraged “structured professional development,” was considered prestigious, and was “recognized by peers” [22]. As a result of this survey, eight recommendations were presented to the MLA Board of Directors, two of which are relevant to the present study. One was that MLA should take responsibility for keeping track of members' CE credits, attendance at meetings, and service to the association. The other was that MLA should address the issues of the impact of the academy on employers and the use of the academy as a screening tool for employment.

As Forsman and Nelson noted, members have long been concerned about the lack of economic benefits of belonging to the academy. In 2001, MLA conducted its “seventh triennial salary survey to determine economic trends in health sciences librarianship” [23]. The survey was conducted electronically, and the response rate was much lower than in previous years (4,200 were distributed and 645 usable responses were obtained). Relevant to the current study were the salaries of the academy and non-academy members. The mean salary for the academy members was $58,307; for nonmembers, it was $45,373. However, this result, which suggests that membership correlates with a higher salary, may be misleading, because it does not take into account the number of years in practice required for membership and the level of experience or job responsibilities. As the survey pointed out, those with management responsibilities and more years of experience in the field received higher pay.

The purpose of the current study was to ascertain the attitudes toward the Academy of Health Information Professionals of health sciences librarians in the Midwest.

METHOD

Sample

From the membership list of the Midwest Chapter of MLA (n = 430), 213 potential names were selected using the systematic sampling technique. This method involves selecting a random starting point and then “taking every nth element from the list until the total list has been sampled” [24]. Three names were subsequently deleted because their addresses were outside the Midwest region, which includes the states of Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, North Dakota, and Wisconsin. The final sample size included 210 participants.

Data collection

To obtain information about attitudes toward and involvement in the academy, a questionnaire containing both closed- and open-ended questions was developed by the three researchers. All participants were asked to complete the first four questions. If they were members of the academy, they were asked to respond to an additional set of eight questions. Nonmembers were asked to answer a different set of four questions (Appendix). The questionnaire was pretested by nine librarians who were members of the Michigan Health Sciences Library Association or Metropolitan Detroit Medical Libraries Group. Five were members of the academy, four were not. Based on their comments, a small change was made in the format of one question.

After the Human Investigation Committee of Wayne State University approved the protocol of the study, each participant was sent a copy of the questionnaire, a cover letter explaining the study, and a stamped, self-addressed envelope. Follow-up questionnaires and cover letters were sent twenty-one days later to nonrespondents.

The closed-ended questions were analyzed using SPSS for the Macintosh. The open-ended questions were coded and categorized separately, and then jointly, by two of the authors (Baker and Kars).

RESULTS

A total of 153 (72.8%) questionnaires were returned, of which 135 (64.3%) were usable (18 were not included in the analysis because of invalid responses). Of the 135 respondents, only 47 (34.8%) were members of the academy, the remaining 88 (65.2%) indicated they were not currently members of the academy. One hundred and thirty-three (98.5%) held master's degrees, and two (1.5%) had doctoral degrees. The majority of respondents (66 or 49.2%) were between the ages of 46 and 55 years; 32 respondents (23.8%) were between 26 and 45 years; and 36 (26.8%) indicated their ages as 56 to more than 66 years. The respondents were also asked when they graduated from library and information science programs. Their responses, subtracted from the current year (2003), revealed a mixture of both older and more recent graduates (Table 1).

Table 1 Years since graduation from library and information science program

As noted above, members and nonmembers of the academy were asked to respond to different sets of questions. The results of the academy members (n = 47) will be presented first.

Responses of the academy members

The first question asked how long (i.e., years) the respondent had been a member of the academy. While most responses were straightforward, others were more difficult to assess. For example, eight respondents did not include a number, rather they stated that they had been members from “the beginning.” Their responses were coded as 14 years, because the academy began in 1989. Others reported the total number of years that they have been credentialed through the examination process as well as the academy. Thus, the number of membership and credential years ranged from less than 1 year to 33 years (Table 2).

Table 2 Number of years with credentials

The levels at which the respondents joined and their current levels of membership comprised the next two questions. Ten respondents (21.3%) indicated that they joined at the provisional level, but none are still at this level. The majority of respondents hold either a distinguished membership (21 or 44.7%) or a senior membership (19 or 40.4%) (Table 3).

Table 3 Levels of membership

To determine how respondents learned about the academy, they were asked to check any of six possible responses. Space to insert other comments was provided. Attendance at MLA meetings and local health sciences library organizations was the most frequently mentioned source. Table 4 presents the sources of information about the academy in descending order of frequency. Fourteen people credited other sources of information including MLA publicity, materials, a credentialing committee member or a mentor, MEDLIB-L, or the National Library of Medicine (NLM). One person noted the mention of the academy in a job description, while another stated that a library school professor encouraged that person to become a member. Two respondents could not remember where they learned about the academy, and four others explained that they were certified under the examination system and continued with membership in the academy.

Table 4 How respondents heard about the academy*

Because membership in the academy might be a requirement of the job, respondents were asked if the choice to become a member was their own. Of the forty-seven respondents, only one stated that the choice was not that individual's: “An associate dean told me I had to do it. I already had all the necessary points, so it was a matter of putting together my portfolio (which was a pain).”

One question asked who paid for the membership. Thirty-nine respondents (83%) indicated the use of personal funds. Four others (8.5%) checked the response “I paid from the library budget,” and another four (8.5%) indicated “my employer paid.”

The respondents were asked about the benefits of belonging to the academy. Eleven response categories were provided, as well as a space for comments. The most common responses were the academy provided members with a sense of professionalism and encouraged them to take CE courses and to keep current with new technology and trends. Slightly more than half of the respondents indicated that their employers valued the academy or that membership demonstrated their commitment to MLA. Of the forty-seven respondents, only one respondent's salary had increased because of membership in the academy. No respondents felt that being a member of the academy gave them job security or contributed to promotion. Table 5 outlines the statements and responses in descending order of frequency.

Table 5 Benefits of belonging to the academy*

Only four respondents provided comments in the “Other” category. One of them stated that it “encourages me to take on responsibilities I might not otherwise pursue,” while another mentioned using it in the tenure and promotion process. One respondent felt that membership in the academy “demonstrates a commitment to the field/specialty of medical librarianship” and might be “helpful when looking for a job.” Lastly, one respondent wrote, “other organizations recognize its value.”

Responses of the nonmembers of the academy

The respondents who indicated they were not members of the academy (n = 88) were asked if they were in the process of applying for membership. One person did not respond to the question. The majority (71 or 80.5%) of respondents were not applying for membership; 16 others (18.4%) responded affirmatively to this question.

Another question inquired about previous membership in the academy. Of the eighty-eight respondents, seventy-eight (88.6%) had never been members of the academy, while ten (11.4%) indicated they had been members. Of the ten, only three planned to reapply or were in the process of applying for membership. Time constraints and cost of membership were some of the reasons given for allowing membership to lapse. Others mentioned that they saw no benefit to employment or their current job. On this theme, one respondent stated, “after twenty years of filling out forms, I realized no one cared.” A comment by one respondent revealed dissatisfaction with the process of applying for the academy, stating “countersignature by supervisor—which profession does not rely on self-reporting?”

Similar to the question for the academy members about the benefits of belonging, nonmembers were given thirteen possible reasons for choosing not to belong to the academy. Space was provided for their own comments. The results, ranked in descending order of frequency of response in Table 6, revealed that over half of the respondents were not members because neither their institutions nor their employers required it. An equal number of respondents (47 or 53.4%) indicated no obvious benefit to belonging to the academy. Similarly, forty-seven (53.4%) respondents did not think membership would improve the quality of service they provide. Half of the respondents indicated that the academy did not contribute to job security, while slightly less than half (42 or 47.7%) did not think the academy contributed to job advancement. Half of the respondents indicated that the process was too cumbersome. Fewer respondents were concerned about the expense of membership or indicated problems concerning CE courses.

Table 6 Reasons for nonmembership in the academy*

Forty people provided additional reasons for not belonging to the academy. Many of these echoed, emphasized, or explained their earlier responses. For example, five respondents mentioned that the academy process was too cumbersome or time consuming.

The return on investment is not high enough to warrant all the effort and paperwork required to belong to AHIP. My time is at a premium and I feel that I have better ways to use my time.

Too cumbersome a process to apply for mere provisional membership. I am waiting until I have enough years in the field to qualify for full membership. I see absolutely no benefit in spending the time & money to be a “provisional member.”

Eleven respondents' comments centered on themes of “non-relevancy of AHIP to their jobs or no benefits or value to belonging.” A few examples of their comments are provided.

Now that I am a [recent] academic librarian, the AHIP is of some minor value to me for my promotion and tenure, although again, it means nothing to the medical school that the library is a part of. It means something only to librarians. [emphasis in original]

Irrelevant to my academic [health sciences] library setting…I have to do the same CE and other professional activities that I would for AHIP to keep my job, but the credential does not seem to be worth the time to fill out the forms and the cost of the application.

I have gladly taken all the CE courses and gone to [Midcontinental Chapter of MLA] MCMLA or MLA conventions that come my way and are pertinent to my work, so being in AHIP is not part of the equation.

My organization will even pay for the certification. I just feel it is a Mickey Mouse exercise that proves nothing for a librarian in practice for more than thirty years.

Time-related factors seem to pervade many respondents' comments. One respondent cited age as a factor: “If I was younger, I would be more interested. I have two masters and am just tired of taking classes.” Seven respondents mentioned heavy job responsibilities as deterrents to pursuing the academy membership. Another category concerned length of time in the profession. Four respondents stated that they were going to join or were in the process of joining, while six mentioned that they were new to the field and do not have the required number of years in service. Another aspect of time related to part-time employment. One respondent wrote:

I was unable to apply for the first ten years I worked as a hospital librarian because I worked less than full time. That ticked me off since I felt I was 100% professional. By the end of ten years, I no longer want AHIP.

Comments about CE courses or credits were provided by eight respondents. One respondent's institution did not require CE courses. Four respondents valued CE courses as helping them to keep current, but, as one stated, taking CE courses was “not unique to AHIP.” Another's institution “values education, just not certification.” Two respondents mentioned money. The institution of one respondent pays for CE credits, while the other stated that because “our travel budget was totally frozen . . . I don't have the money to travel to meetings to earn credits.” Finally, one respondent noted that “MLA CE courses are limited in location as well as scope.”

The final category of comments focused on problems with the academy process. Examples of problems included the following items:

Too much emphasis on participation in the national or regional organizations.

MLA conferences are expensive.

Publication requirement is unreasonably hard for those who work full time.

Dislike of emphasis on MLA-sponsored professional activities for point accumulation. It feels very self-serving of the organization.

Lack of knowledge about how to apply; lack of a mentor to assist with process; lack of communication; quality of information [about the academy].

The similarity of five statements on both the members' and nonmembers' sections of the questionnaire allowed for some comparison of responses. While fourteen (29.8%) members felt that their membership in the academy improved the quality of service they provide, forty-seven (53.4%) nonmembers indicated that their nonmembership had no effect on the quality of service they provide. The majority of the academy members (37 or 78.7%) stated membership gave them a sense of professionalism, whereas fewer than half of the non-academy respondents (36 or 40.9%) indicated the opposite. In addition, over half of the academy members (25 or 53.2%) indicated that membership was valued by employers, while just over a quarter of the non-academy respondents (24 or 27.3%) indicated that their employers did not value it. Interestingly, no academy member indicated that the academy provided job security or contributed to job advancement, and half of the non-academy members agreed.

Comments, attitudes, and suggestions about the academy

Two open-ended questions were included on the questionnaire to encourage respondents to provide more in-depth comments. The first question focused on credentials for health sciences librarians. Sixty respondents (46.9%) agreed that more credentials were needed, while sixty-eight others (53.1%) replied negatively. Five respondents were unsure. One hundred and nine respondents provided a variety of comments on this question that were divided into five different categories (A–E), as outlined below. The second open-ended question asked all respondents for additional comments about the academy. Thirty-four respondents provided additional comments, discussed below under the heading “Other Comments.” The responses to both questions provided considerable insight into members' and nonmembers' attitudes and were so rich that a number of representative ones are included for each topic.

A: Types of courses.

Eleven respondents commented that the master's of library and information science is sufficient. One respondent felt that “current MLS graduates seem to have the needed focus on technology required today.” Another one echoed this, saying that “the basic skills and knowledge acquired in library school qualify a graduate to perform in any library setting.”

Seventeen respondents suggested types of courses that would be helpful to health sciences librarians. Only one suggested that library directors might need a master's of business administration. Other courses mentioned included: undergraduate degree in science, subject knowledge of medicine or biomedicine, medical terminology, critical nature of information, biology, chemistry, psychology, information sources, information technology, and information systems and management. Certification for four specific areas was mentioned: evidence-based medicine, consumer health, media services, and database management.

B: Types of librarians who need credentials.

Respondents (n = 19) were divided on who needs other credentials. A couple mentioned that all librarians needed credentials.

I think all librarians need credentialing, not just health sciences librarians. There are too many professionals who don't keep current or who don't give back to the profession, and credentialing, although certainly imperfect, is one way to promote continuous self-improvement.

Some respondents thought that hospital librarians should have more credentials, while others disagreed. Similar comments were found for academic librarians. According to a few respondents, the need for more credentials depended on the type of library (e.g., larger institutions) or on the position (e.g., staff librarians, systems librarians). A few examples of comments are provided.

It depends on the environment and your responsibilities. I have a large staff . . . and three libraries to direct. It is more important that my staff be credentialed and trained with the latest searching techniques—my responsibilities are more fiscal and systemwide issues. MLA and NLM accreditation is not necessarily helpful. I often rely on [the Special Libraries Association] SLA for that perspective.

In a hospital setting, I think it is important to have a credentialing program because many other hospital professionals have credentialing programs for their specialties and this gives us greater credibility.

It depends on the type of library. Academic libraries are less likely to need additional credentials.

For academic health sciences librarians with faculty status, the steps leading to success in the promotion and tenure process are enough.

C: Continuing education/self-improvement.

Both members (n = 14) and nonmembers (n = 9) commented on the importance of keeping current through continuing education. Opinions differed on the specific requirements of the academy. Some examples of comments will illustrate the opinions on required CE courses.

I think that credentialing is a good idea, but there should be a uniform CE-core that people can opt out of. Right now, most courses have to be approved MLA CEs, which is great, but I think there should be a set group of courses or topics that members should have competency in, then there could be more flexibility for renewing members or those applying to the next levels.

I feel that the current program of credentialing works to some extent. It proves to your employer (should they care) that you are professionally active, i.e., taking CE courses, serving on committees, writing and publishing, etc., and therefore, keeping current in your field.

A program of formal continuing education is important for any profession and certainly members of the medical profession continue with [continuing medical education] CME credits. I believe the librarians should do the same.

Two comments demonstrated the importance of CE but stressed the need for a self-directed program rather than the current MLA requirements.

A strong individualized program of continuing education to learn new concepts and skills used in the library/workplace is more valuable than “credentials” beyond the first professional degree.

I feel that I must be responsible for the direction of my own professional development as it relates to the needs of my clientele. I do not wish to be dictated to regarding the shape that development takes.

D: Credentialing.

Twenty-seven comments were categorized under this heading. Many respondents saw value in credentialing. In a health sciences environment, as one respondent wrote:

Credentials in addition to degrees are standard. Nurses, physicians, and other technical staff earn certification or licensing. For librarians to be further respected, these types of certifications are necessary.

In addition, credentialing gives librarians prestige and credibility, as another respondent noted:

Just as an MLS (or a BA, MA, or PhD) ensures a certain level of proficiency, I feel the credentialing program helps say an individual has a background in health science librarianship—it isn't foolproof but is something to go on.

Others see credentialing as good but not necessary, because “librarians function effectively without them.” Furthermore, another respondent did not “get the sense that it's viewed like the accreditation health professionals get from their professionals societies.” Some respondents mentioned the type of credentialing programs that should be emulated, such as “the program adopted by physicians and nurses” or “something more recognizable such as Fellow MLA.” One respondent suggested “something similar to the credentialing that medical records people need” from the American Health Information Management Association (AHIMA), because this credential was required by their employers and had an effect on both salaries and status in the hospital. Another suggestion was that there be “two tracks for credentialing.” One track would be for academic and special librarians whose needs differ from those of hospital librarians. The other track for “non-academic librarians should recognize the need for management skills and assist them in obtaining skills through traditional and non-traditional means.”

Some remarks (n = 13) focused on the credentialing process. Respondents suggested that the process should be made easier: “I would like to see something similar to AHIP but simpler. I don't think the different levels (member, senior, distinguished) are necessary.” Another respondent stated, “AHIP is a valuable tool but the paperwork is cumbersome and the politics, awful. Your mentor could make your life miserable.” Others mentioned that, as hospital librarians, they had difficulty meeting some of the requirements including keeping track of CE units, publishing, doing committee work, or conducting research.

The old credentialing examination also received mention. One respondent had “learned a great deal studying for the exams” and that while the “present system has many good features, there is no shared knowledge base.” The other respondent would “prefer a combination of an exam with some elements of the current system.”

Finally, that credentials were not rewarded in their institutions concerned some respondents. A few examples of their comments are provided.

Some institutions value further credentials…This can translate to greater respect for the individual librarian. However, some institutions may not value this sort of credentialing and some may even see it as an effort to get a higher salary or be seen as “special.”

Credentialing can be of value if salaries could rise as a direct correlate, but mostly this type of credentialing seems more related to status.

I don't believe credentialing will improve librarian's status or salaries as many argue. Credentialing programs such as AHIP are usually started as a way to increase income for the professional associations who do the credentialing.

E: Academy of Health Information Professionals.

The academy as it is currently constituted seemed to “work well” for at least nineteen respondents. One reason was that it was seen as a “distinction and internationally valued credential that attests to knowledge, skills, and achievement.” It was also an appropriate program that “gives credit for a variety of activities and professional service.” One respondent noted that because “it is monitored by MLA, there is quality control.” The academy also helped mid-career librarians who are changing from another type of library “to come up to speed on issues relevant to the health sciences library field.”

On the other hand, fourteen respondents stated that there was no need for the academy, because health sciences librarians can function well without having the initials behind their names. Two respondents mentioned they knew great librarians who were not members of the academy and bad librarians who were. One respondent wrote that it “is currently pretty meaningless. It has more to do with your ability to attend national meetings than competency.” The academy was not seen as improving status, salaries, or perceptions that “health professionals and students have of a librarian's ability to provide quality service.” Finally, the academy was not needed for many jobs, nor was it “used widely as a job applicant screening criteria.”

Twelve respondents commented on the fact that the academy is not known by people outside the profession and does not carry much weight with them. It is not “viewed like the accreditation health professionals get from their professional societies.” According to these respondents, employers “are not aware that it is available” or “do not give any ‘credit’ for it; it's not perceived as valuable or desirable.” One respondent thought that it could “actually be a barrier to promotion” in an academic library setting.

Other comments

As noted above, both members and nonmembers were asked for other comments pertaining to the academy that were not addressed in any of the previous questions. Ten academy members and twenty-four nonmembers provided additional comments. Many of the themes described above—such as relevancy to the type of working environment, no direct benefits, cumbersome application process, and relevancy to outsiders— were reiterated. One academy member aptly summarized the comments of a number of others:

Unfortunately, until AHIP is truly supported at the work site, it probably cannot succeed. I encourage our grad students and beginning librarians and serve as an AHIP mentor, but there is no financial differential or support here, and our job ads may not mention AHIP at all. Also, people view the process as overwhelming.

The need to market the academy was mentioned by four respondents. For example, one knew very little about the academy, while another felt there was a “general lack of information concerning the academy. AHIP needs to be more forthcoming in providing details of the membership process.”

DISCUSSION

The results reveal that the majority of the librarians in the Midwest Chapter of MLA are not members of the academy. Their reasons for not belonging include that employers or institutions do not required it; there are no obvious benefits, such as job security or advancement; and nonmembership does not affect the quality of service they provide to clients. Finally, they feel that the process is too cumbersome and suggest that if MLA were to keep track of members' CE units, activities, or attendance at meetings, the process would be easier.

Members, on the other hand, see their membership as providing a sense of professionalism and commitment to MLA, as well as encouragement to keep current. They also point out that their membership is valued by employers; however, less than half of them indicate that it is recognized by peers in their institution. Furthermore, the members indicate it is not rewarded by salary increases or by job advancement or security.

Both members and nonmembers feel personally responsible for maintaining their professional status through CE courses, but opinions differ on the stringency of MLA's requirements. Conducting research, publishing articles, and attending national meetings are seen by some hospital librarians as barriers to becoming members because of time and budget constraints. Suggestions included the need for a more flexible program of requirements and, possibly, different requirements for hospital and academic librarians.

While very few respondents admit that they know little about the academy, more reveal a lack of knowledge about who should belong to the academy, hospital or academic librarians. To address this issue, respondents suggest the need for more marketing of the academy to employers and MLA members.

CONCLUSIONS

The sample size was small and limited to health sciences librarians in the Midwest. Therefore, the results cannot be generalized to the entire membership of MLA. Although the results of this study add to the body of knowledge about the academy, more independent research with a larger sample size needs to be done to determine how MLA members nationwide view the credentialing process.

APPENDIX

Health sciences librarians and credentialing

Throughout its history, the Medical Library Association has offered various credentialing programs to librarians. We are interested in learning about your attitude toward and involvement in the Academy of Health Information Professionals (AHIP). It will take you approximately five to ten minutes to answer the questionnaire.