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1.

Objective:

A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.

Methods:

Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors'' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.

Results:

When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.

Conclusions:

Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers'' advisory practices, are suggested.

Highlights

  • Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.

Implications

  • Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
  • Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
  • An understanding of the patient''s potential epistemological community can make the librarian''s recommendations more appropriate for the individual user.
  相似文献   

2.

Objectives:

The research identified the publication types and ages most frequently cited in the infectious diseases literature and the most commonly cited journals.

Methods:

From 2008–2010, 5,056 articles in 5 infectious diseases journals cited 166,650 items. Two random samples were drawn: one (n = 1,060) from the total set of citations and one (n = 1,060) from the citations to journal articles. For each sample citation, publication type and date, age of cited item, and inclusion of uniform resource locator (URL) were collected. For each item in the cited journal articles sample, journal title, publication date, and age of the cited article were collected. Bradford zones were used for further analysis.

Results:

Journal articles (91%, n = 963) made up the bulk of cited items, followed by miscellaneous items (4.6%, n = 49). Dates of publication for cited items ranged from 1933–2010 (mean = 2001, mode = 2007). Over half (50.2%, n = 483) of cited journal articles were published within the previous 5 years. The journal article citations included 358 unique journal titles.

Discussion:

The citations to current and older publications in a range of disciplines, heavy citation of journals, and citation of miscellaneous and government documents revealed the depth and breadth of resources needed for the study of infectious diseases.

Highlights

  • Literature on infectious diseases is multidisciplinary, encompassing medical specialties, public health, and the medical sciences.
  • Infectious disease publications cite journal articles more than 90% of the time. Cited journal articles greatly range in age at citation: more than a quarter were over 10 years old.
  • Infectious disease citation patterns resemble clinical medicine citation patterns more than public health citation patterns.

Implications

  • Infectious disease professionals need access to general medicine titles as well as infectious disease, immunology, virology, microbiology, and public health literature.
  • Librarians serving infectious disease researchers and practitioners should provide access to older materials, especially journal back files, to support the cyclical needs of their patrons.
  相似文献   

3.

Objectives:

Standards for evaluating evidence-based medicine (EBM) point-of-care (POC) summaries of research are lacking. The authors developed a “Critical Appraisal for Summaries of Evidence” (CASE) worksheet to help assess the evidence in these tools. The authors then evaluated the reliability of the worksheet.

Methods:

The CASE worksheet was developed with 10 questions covering specificity, authorship, reviewers, methods, grading, clarity, citations, currency, bias, and relevancy. Two reviewers independently assessed a random selection of 384 EBM POC summaries using the worksheet. The responses of the raters were then compared using a kappa score.

Results:

The kappa statistic demonstrated an overall moderate agreement (κ = 0.44) between the reviewers using the CASE worksheet for the 384 summaries. The 3 categories of evaluation questions in which the reviewers disagreed most often were citations (κ =  0), bias (κ = 0.11), and currency (κ = −0.18).

Conclusions:

The CASE worksheet provided an effective checklist for critically analyzing a treatment summary. While the reviewers agreed on worksheet responses for most questions, variation occurred in how the raters navigated the tool and interpreted some of the questions. Further validation of the form by other groups of users should be investigated.

Highlights

  • Few critical appraisal tools have been evaluated with inter-rater reliability testing.
  • The ways that users of evidence-based medicine (EBM) point-of-care (POC) tools interpret how to appraise an evidence summary—particularly when defining the grading of evidence, currency, and bias—may vary even when a standard evaluation sheet is used.
  • The Critical Appraisal for Summaries of Evidence (CASE) worksheet had a moderate level of inter-rater reliability, similar to previous evaluative studies of critical appraisals tools.

Implications

  • Medical librarians can develop tools useful for librarians, students, and clinicians to guide them in appraising clinical evidence summaries.
  • The CASE worksheet can be a valuable tool to consider the quality of individual evidence summaries and to see patterns of overall quality in EBM POC tools.
  相似文献   

4.

Objectives:

Through interviews with the National Library of Medicine''s MedlinePlus Go Local collaborators, an evaluation team sought to identify process characteristics that are critical for long-term sustainability of Go Local projects and to describe the impact that Go Local projects have on sponsoring institutions.

Methods:

Go Local project coordinators (n = 44) at 31 sponsor institutions participated in semi-structured interviews about their experiences developing and maintaining Go Local sites. Interviews were summarized, checked for accuracy by the participating librarians, and analyzed using a general inductive methodology.

Results:

Institutional factors that support Go Local projects were identified through the interviews, as well as strategies for staffing and partnerships with external organizations. Positive outcomes for sponsoring institutions also were identified.

Conclusions:

The findings may influence the National Library of Medicine team''s decisions about improvements to its Go Local system and the support it provides to sponsoring institutions. The findings may benefit current sponsoring institutions as well as those considering or planning a Go Local project.

Highlights

  • Many project coordinators said they underestimated the level of work their National Library of Medicine (NLM) MedlinePlus Go Local projects would require, but most expressed dedication to the project and optimism about project sustainability.
  • An institutional record of community service or outreach and a director who was supportive of the project were important factors in the progress and sustainability of Go Local projects.
  • Go Local projects brought recognition to some sponsoring institutions from their parent institutions or their communities and provided opportunities to establish better relations with other libraries and institutions.
  • Go Local projects ran more smoothly when a person, even a temporary hire, with dedicated time for the project was in charge during the initial building phase. Volunteer assistance has been difficult to motivate and sustain.

Implications

  • NLM''s Go Local proposal guidelines accurately identify the factors that institutions should pay close attention to when planning a Go Local project.
  • NLM should emphasize continuity plans to address project coordinator turnover.
  • NLM should develop a more formal orientation plan for new project coordinators to assist program continuity at the sponsoring institutions.
  相似文献   

5.
6.

Objective:

This paper examines the development and evaluation of an automatic summarization system in the domain of molecular genetics. The system is a potential component of an advanced biomedical information management application called Semantic MEDLINE and could assist librarians in developing secondary databases of genetic information extracted from the primary literature.

Methods:

An existing summarization system was modified for identifying biomedical text relevant to the genetic etiology of disease. The summarization system was evaluated on the task of identifying data describing genes associated with bladder cancer in MEDLINE citations. A gold standard was produced using records from Genetics Home Reference and Online Mendelian Inheritance in Man. Genes in text found by the system were compared to the gold standard. Recall, precision, and F-measure were calculated.

Results:

The system achieved recall of 46%, and precision of 88% (F-measure = 0.61) by taking Gene References into Function (GeneRIFs) into account.

Conclusion:

The new summarization schema for genetic etiology has potential as a component in Semantic MEDLINE to support the work of data curators.

Highlights

  • Semantic MEDLINE streamlines information retrieval by succinctly expressing the meaning of sometimes complicated text and summarizing output according to a user''s needs.
  • Semantic MEDLINE identifies genes noted in biomedical text as associated with a disease process.
  • Semantic MEDLINE can potentially simplify secondary database curation.

Implications

  • Library information retrieval services can potentially benefit from automated applications such as Semantic MEDLINE.
  • Use of such automated applications can facilitate the library''s work in interdepartmental collaborative endeavors, thus reinforcing the library''s core value in its parent institution.
  相似文献   

7.
8.

Objective:

The research analyzed evaluation data to assess medical student satisfaction with the learning experience when required PubMed training is offered entirely online.

Methods:

A retrospective study analyzed skills assessment scores and student feedback forms from 455 first-year medical students who completed PubMed training either through classroom sessions or an online tutorial. The class of 2006 (n = 99) attended traditional librarian-led sessions in a computer classroom. The classes of 2007 (n = 120), 2008 (n = 121), and 2009 (n = 115) completed the training entirely online through a self-paced tutorial. PubMed skills assessment scores and student feedback about the training were compared for all groups.

Results:

As evidenced by open-ended comments about the training, students who took the online tutorial were equally or more satisfied with the learning experience than students who attended classroom sessions, with the classes of 2008 and 2009 reporting greater satisfaction (P<0.001) than the other 2 groups. The mean score on the PubMed skills assessment (91%) was the same for all groups of students.

Conclusions:

Student satisfaction improved and PubMed assessment scores did not change when instruction was offered online to first-year medical students. Comments from the students who received online training suggest that the increased control and individual engagement with the web-based content led to their satisfaction with the online tutorial.

Highlights

  • First-year medical students at Mount Sinai School of Medicine responded positively to an online PubMed tutorial and skills assessment created by librarians.
  • Students who took the online tutorial passed the PubMed skills assessment at the same high rate as students who attended in-class training led by librarians.
  • Feedback suggests that students preferred the individual control of the web-based content and the ease with which the online training fit into their crowded schedules.

Implications

  • Interactive online training encourages students to direct their own learning experience and can lead to greater student satisfaction.
  • Medical students of the Millennial generation may prefer flexible, self-paced assignments that can be completed at times and locations convenient to them.
  • Medical librarians can create online tutorials to successfully engage and instruct the next generation of medical students.
  相似文献   

9.

Objective:

The objective of this study was to analyze bibliometric data from ISI, National Institutes of Health (NIH)–funding data, and faculty size information for Association of American Medical Colleges (AAMC) member schools during 1997 to 2007 to assess research productivity and impact.

Methods:

This study gathered and synthesized 10 metrics for almost all AAMC medical schools (n = 123): (1) total number of published articles per medical school, (2) total number of citations to published articles per medical school, (3) average number of citations per article, (4) institutional impact indices, (5) institutional percentages of articles with zero citations, (6) annual average number of faculty per medical school, (7) total amount of NIH funding per medical school, (8) average amount of NIH grant money awarded per faculty member, (9) average number of articles per faculty member, and (10) average number of citations per faculty member. Using principal components analysis, the author calculated the relationships between measures, if they existed.

Results:

Principal components analysis revealed 3 major clusters of variables that accounted for 91% of the total variance: (1) institutional research productivity, (2) research influence or impact, and (3) individual faculty research productivity. Depending on the variables in each cluster, medical school research may be appropriately evaluated in a more nuanced way. Significant correlations exist between extracted factors, indicating an interrelatedness of all variables. Total NIH funding may relate more strongly to the quality of the research than the quantity of the research. The elimination of medical schools with outliers in 1 or more indicators (n = 20) altered the analysis considerably.

Conclusions:

Though popular, ordinal rankings cannot adequately describe the multidimensional nature of a medical school''s research productivity and impact. This study provides statistics that can be used in conjunction with other sound methodologies to provide a more authentic view of a medical school''s research. The large variance of the collected data suggests that refining bibliometric data by discipline, peer groups, or journal information may provide a more precise assessment.

Highlights

  • Principal components analysis discovered three clusters of variables: (1) institutional research productivity, (2) research influence or impact, and (3) individual faculty research productivity.
  • The associations between size-independent measures (e.g., average number of citations/article) were more significant than associations between size-independent bibliometric measures and size-dependent (e.g., number of faculty) bibliometric measures and vice versa, except in the case of total National Institutes of Health (NIH) funding.
  • The factor coefficients, or loadings, for total NIH funding may associate more with the quality of research rather than the quantity of research.
  • The removal of twenty outliers, fourteen highly productive or influential medical schools and six medical schools with relatively low research profiles, changed the results of the analysis significantly.
  • This study''s broad institutional bibliometric data sets cannot be extrapolated to specific departments at the studied medical schools.

Implications

  • Librarians, administrators, and faculty should use several methodologies in tandem with bibliometric data when evaluating institutions'' research impact and productivity.
  • Health sciences librarians should not make use of university rankings materials lacking strong methodological foundations.
  • This study''s bibliometric data may provide a starting point or point of comparison for future assessments.
  相似文献   

10.
11.
12.

Purpose:

This lecture discusses a philosophy of educating health information professionals in a rapidly changing health care and information environment.

Discussion:

Education for health information professionals must be based upon a solid foundation of the changing paradigms and trends in health care and health information, as well as technological advances, to produce a well-prepared information workforce to meet the demands of health-related environments. Educational programs should begin with the core principles of library and information sciences and expand in interdisciplinary collaborations. A model of the health care environment is presented to serve as a framework for developing educational programs for health information professionals.

Conclusion:

Interdisciplinary and collaborative relationships—which merge health care, library and information sciences, and other information-related disciplines—should form the basis of education for health information professionals.

Highlights

  • Educational pathways for the creation of future health information professionals are charted through the discussion of four major roads.
  • A model of the health care environment sets the framework for building educational programs for health information professionals.

Implications

  • The presented pathways can inform educational decision making at all levels, including the need to revisit the accreditation bodies of programs educating health information professionals.
  • The National Library of Medicine is encouraged to create a workforce center to identify the needs of the profession.
  • Interdisciplinary and collaborative partnerships are vital to produce quality graduates who are prepared to handle the complexities of the health care and information environment.
  相似文献   

13.
14.

Objectives:

The research objectives were to (1) describe the current and future roles of hospital librarians and the challenges they face and (2) find evidence supporting the hypothesis that librarians are essential to hospitals in achieving the organizations'' mission-critical goals.

Method:

The authors used results from a previous research study that identified the five organizational mission-critical goals important to hospital administrators and then searched the literature and solicited examples from hospital librarians to describe the librarian''s role in helping hospitals achieve these goals.

Results:

The literature supports the hypothesis that hospital librarians play important roles in the success of the hospital. Librarians support quality clinical care, efficient and effective hospital operations, continuing education for staff, research and innovation, and patient, family, and community health information needs.

Conclusion:

Hospital librarians fulfill many mission-critical roles in today''s hospital, providing the right information at the right time in a variety of ways to enhance hospital and medical staff effectiveness, optimize patient care, improve patient outcomes, and increase patient and family satisfaction with the hospital and its services. Because hospital librarians and their services provide an excellent return on investment for the hospital and help the hospital keep its competitive edge, hospital staff should have access to the services of a professional librarian.

Highlights

  • A review of the literature supports the hypothesis that services of the professional librarian result in:
    • enhanced staff effectiveness,
    • optimized patient care,
    • improved patient outcomes, and
    • increased patient and family satisfaction with the hospital and its services.

Implications

  • Because hospital librarians and their services provide an excellent return on investment for the hospital and help the hospital keep its competitive edge, hospital staff should have access to the services of a professional librarian.
  相似文献   

15.

Objectives:

The research sought to determine if first-year medical students consulted and cited resources specifically highlighted during library instructional sessions.

Methods:

Students attended a library resources instructional session. Resources that pertained to the students'' assignment were demonstrated and discussed. The students created a report including citations from relevant literature. The citations were analyzed and categorized as: a resource discussed at the instructional session, a resource found on the course LibGuide, a library resource, course material, or some other resource. All citations were subcategorized as print or electronic.

Results:

Three years (2008–2011) of data analyzing 2,983 citations showed that 49.55% of all citations were from resources discussed during library instructional sessions; 21.86% came from resources with links on the course LibGuide; 77.51% were from library resources; and 90.68% came from electronic resources.

Conclusion:

Students cited resources specifically highlighted during library instructional sessions for their assignments. The percentage of all citations coming from resources highlighted during the instructional sessions or found on the course LibGuide indicates that library instruction had an impact on the students'' work.

Highlights

  • Review of the literature shows that instruction about library resources accompanied by clear guidelines on scholarly research methods and resources provided by course instructors have the biggest impact on the quality of cited materials in student bibliographies.
  • Graduate medical students cited library resources more frequently than nonlibrary resources for their assigned coursework.
  • Graduate medical students cited materials and resources specifically highlighted during library instructional sessions for their assigned coursework.

Implications

  • Instruction about library resources tailored to medical students'' assignments impacts the resources that the students consult and cite for their assignments.
  • Using the information gathered from citation analysis to modify teaching plans can impact the effectiveness of library instructional sessions.
  相似文献   

16.

Objective:

The objective of this study was to validate an assessment instrument for MEDLINE search strategies at an academic medical center.

Method:

Two approaches were used to investigate if the search assessment tool could capture performance differences in search strategy construction. First, data from an evaluation of MEDLINE searches from a pediatric resident''s longitudinal assessment were investigated. Second, a cross-section of search strategies from residents in one incoming class was compared with strategies of residents graduating a year later. MEDLINE search strategies formulated by faculty who had been identified as having search expertise were used as a gold standard comparison. Participants were presented with a clinical scenario and asked to identify the search question and conduct a MEDLINE search. Two librarians rated the blinded search strategies.

Results:

Search strategy scores were significantly higher for residents who received training than the comparison group with no training. There was no significant difference in search strategy scores between senior residents who received training and faculty experts.

Conclusion:

The results provide evidence for the validity of the instrument to evaluate MEDLINE search strategies. This assessment tool can measure improvements in information-seeking skills and provide data to fulfill Accreditation Council for Graduate Medical Education competencies.

Highlights

  • The University of Michigan MEDLINE Search Assessment tool can be used to assess search skills in residency education.
  • Five elements were identified as critical elements in the development of an effective MEDLINE search strategy: inclusion of all search concepts, appropriate use of Medical Subject Headings, appropriate use of search limits, successful combination of all concepts, and search efficiency.

Implications

  • This validated assessment tool can serve as an effective means to measure improvements in residents'' information-seeking skills and provide data to fulfill Accreditation Council for Graduate Medical Education competencies.
  相似文献   

17.

Objective:

The research sought to establish a rubric for evaluating evidence-based medicine (EBM) point-of-care tools in a health sciences library.

Methods:

The authors searched the literature for EBM tool evaluations and found that most previous reviews were designed to evaluate the ability of an EBM tool to answer a clinical question. The researchers'' goal was to develop and complete rubrics for assessing these tools based on criteria for a general evaluation of tools (reviewing content, search options, quality control, and grading) and criteria for an evaluation of clinical summaries (searching tools for treatments of common diagnoses and evaluating summaries for quality control).

Results:

Differences between EBM tools'' options, content coverage, and usability were minimal. However, the products'' methods for locating and grading evidence varied widely in transparency and process.

Conclusions:

As EBM tools are constantly updating and evolving, evaluation of these tools needs to be conducted frequently. Standards for evaluating EBM tools need to be established, with one method being the use of objective rubrics. In addition, EBM tools need to provide more information about authorship, reviewers, methods for evidence collection, and grading system employed.

Highlights

  • Eleven of the fourteen previous evidence-based medicine (EBM) tool evaluations were based on clinicians evaluating tools based on their perception of the products'' ability to answer a clinical question.
  • EBM tools'' evidence summaries are not updated as often as products claim.
  • Although many EBM tools claim to be evidence based, only 74% of the 70 evaluated treatment summaries included graded evidence.

Implications

  • To offer the best tools for users, medical libraries should evaluate EBM resources regularly, including the quality of the evidence provided.
  • Medical librarians have a role to play in evaluating the quality of EBM products and can develop assessment tools to aid in this evaluation.
  相似文献   

18.

Objectives:

The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs.

Methods:

A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008.

Results:

Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access).

Conclusions:

When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.

Highlights

  • Medical textbooks were the most popular information source for family physicians'' (FPs'') clinical decision-making purposes, and medical journals were the most popular information source for the purpose of updating FPs'' general medical knowledge.
  • FPs considered medical textbooks to be the most reliable (trustworthy) source, colleagues the most physically accessible, and continuing medical education the most relevant and intellectually accessible.
  • The lowest ranked information sources across all four attributes were personal digital assistants, mental health professionals, pharmaceutical sales representatives, and other decision aids.

Implications

  • The most popular information sources for clinical decision-making purposes among FPs were sources characterized as reliable and generally physically accessible.
  • This study suggests the need for further research into interventions that target information access barriers in FPs'' practice settings and the promotion of reliable evidence for FPs'' clinical decision-making purposes.
  相似文献   

19.

Objectives:

The study updates Schloman''s 1997 study, “Mapping the Literature of Health Education.” The authors identify an updated list of core health education journals and determine the coverage of these journals by electronic indexes.

Methods:

Citations from four source journals for the years 2006 to 2008 were analyzed using the established methodology of the “Mapping the Literature of Allied Health Project.” The cited journals were divided into three zones of productivity by using Bradford''s Law of Scattering.

Results:

There were 19,907 citations in 602 source articles. Journal articles were the most commonly cited format type. Of the 1,896 journal titles cited, 20 (1.1%) made up the core journals. Together, the fields of medicine, health education, and psychology accounted for 85.0% of the journals in the core. Self-citation was found to be a common practice in the source journals. Scopus had the broadest journal coverage of the indexes examined.

Conclusions:

The results of this study provide a new picture of the health education literature: The volume has grown significantly, cites older materials, and relies less on sexual health journals and more on psychology journals.

Highlights

  • Three of the four health education journals in this study showed a statistically significant increase in the number of journal articles published since 1993.
  • The majority of core journals in the field are from medicine (35.0%), health education (30.0%), and psychology (20.0%), with the largest change in core journal make-up being an increase in psychology journals.
  • Scopus provided the most thorough coverage of the cited journals, followed by MEDLINE, Social Sciences Citation Index, and CINAHL Plus with Full Text.

Implications

  • Reference librarians should instruct users on more sophisticated ways to manage the growing volume of the health education literature.
  • Collection development librarians may need to purchase and retain older materials to support health education research.
  • Librarians should purchase and direct patrons to a variety of databases to completely cover the literature of medicine, health education, and psychology.
  相似文献   

20.

Objectives:

Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians'' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes.

Methods:

Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors.

Results:

The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost.

Conclusions:

All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians'' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

Highlights

  • Despite the many technological advances in the education arena, librarians prefer face-to-face instruction (direct interaction with instructors and other participants, hands-on experience, focused learning). This creates a dilemma as increased budgetary constraints are a barrier to attending face-to-face professional continuing education (CE) classes.
  • Librarians in all age groups preferred the traditional classroom style of face-to-face instruction to web-based methods.

Implications

  • Instructors and course designers face a challenge in incorporating the perceived advantages of face-to-face instruction into the more affordable modalities of online instruction.
  • As cost becomes more of a factor for attending professional CE classes, web-based asynchronous and synchronous modalities offer important, less expensive, alternatives.
  相似文献   

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