Publications by Dr. Perryman
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Item AAU library directors prefer collaborative decision making with senior administrative team members(University of Alberta, 2017-06-29) Perryman, Carol L.Objective – To understand academic library leaders’ decision making methods, priorities, and support of succession planning, as well as to understand the nature, extent, and drivers of organizational change. Design – Survey and interview. Setting – Academic libraries with membership in the Association of American Universities (AAU) in the United States of America and Canada. Subjects – 62 top administrators of AAU academic libraries. Methods – Content analysis performed to identify most frequent responses. An initial survey written to align with the Association of Research Libraries (ARL) 2014-2015 salary survey was distributed prior to or during structured in-person interviews to gather information about gender, race/ethnicity, age, time since terminal degree, time in position, temporary or permanent status, and current job title. 7-question interview guides asked about decision processes, strategic goals, perceived impacts of strategic plan and vision, planned changes within the next 3-5 years, use of mentors for organizational change, and succession planning activities. Transcripts were analyzed to identify themes, beginning with a preliminary set of codes that were expanded during analysis to provide clarification. Main results – 44 top academic library administrators of the 62 contacted (71% response rate) responded to the survey and interview. Compared to the 2010 ARL Survey, respondents were slightly more likely to be female (55%; ARL: 58%) and non-white (5%; ARL: 11%). Approximately 66% of both were aged 60 and older, while slightly fewer were 50-59 (27% compared to 31% for ARL), and almost none were aged 40-49 compared to 7% for the ARL survey. Years of experience averaged 33, slightly less than the reported ARL average of 35. Requested on the survey, but not reported, were time since terminal degree and in position, temporary or permanent status, and current job title. Hypothesis 1, that most library leaders base decisions on budget concerns rather than upon library and external administration strategic planning, was refuted. Hypothesis 2, that changes to the academic structure are incremental rather than global (e.g., alterations to job titles and responsibilities), was supported by responses. Major organizational changes in the next three to five years were predicted, led by role changes, addition of new positions, and unit consolidation. Most participants agreed that while there are sufficient personnel to replace top level library administrators, there will be a crisis for mid-level positions as retirements occur. A priority focus emerging from interview responses was preparing for next-generation administrators. There was disagreement among respondents about whether a crisis exists in the availability of new leaders to replace those who are retiring. Conclusion – Decisions are primarily made in collaboration with senior leadership teams, and based on strategic planning and goals as well as university strategic plans in order to effect incremental change as opposed to wholesale structural change.Item Assessing the future: Developing information technology skills for new staff roles in academic medical libraries(2007) Perryman, Carol L.; James, R.; Lackey, C.S.; Peterson, R.Item Assessment related skills and knowledge are increasingly mentioned in library job postings(University of Alberta Learning Services, 2015-03) Perryman, Carol L.Objective – The authors sought to determine whether existing definitions of assessment agree with assessment-related skills sought in job postings, and to identify key assessment-related skills, needs for training, and trends in assessment.Item Before we change the game: The sense-making practices of hospital librarians(2012-05) Perryman, Carol L.Item Beginning the professional discourse: Incorporation of EBLIP concepts and tools into the LIS curriculum(2011) Perryman, Carol L.; Cahill, Maria; Jeng, Ling HweyExamines the use of evidence-based practice in library education by three professors.Item Credit due: Multiple author attribution for interdisciplinary informatics research groups(Medical Library Association Research Section, 2018) Perryman, Carol L.Objective: To understand issues related to multiple authorship in interdisciplinary working groups, and to identify best practices for authorship attribution for a multidisciplinary group. Problem: Research groups comprised of individuals from diverse disciplines need to identify their own internal agreement and process for authorship attribution. Methods: Limited literature review Findings and conclusions: Resources are described and considerations for interdisciplinary working groups are suggested.Item Diagnoses, drugs, and treatment are the main information needs of primary care physicians and nurses, and the internet is the information source most commonly used to meet these needs(University of Alberta Learning Services, 2014-09) Perryman, Carol L.Objective – To improve information support services to health practitioners making clinical decisions by reviewing the literature on the information needs and information seeking behaviours of primary care physicians and nurses. Within this larger objective, specific questions were 1) information sources used; 2) differences between the two groups; and 3) barriers to searching for both groups. Design – Literature review. Setting – SCOPUS, CINAHL, OVID Medline, and PubMed databases. Subjects – Results from structured searches in four bibliographic databases on the information needs of primary care physicians and nurses. Methods – Medical Subject Heading (MeSH) and keyword search strategies tailored to each of four databases were employed to retrieve items pertinent to research objectives. Concepts represented in either controlled or natural language vocabularies included “information seeking behaviour, primary health care, primary care physicians and nurses” (p. 180). An initial yield of 1169 items was filtered by language (English only), pertinence to study objectives, publication dates (2000-2012), and study participant age (>18). After filtering, 47 articles were examined and summarized, and recommendations for further research were made. Main Results – Few topical differences in information needed were identified between primary care physicians and nurses. Across studies retrieved, members of both groups sought information on drugs, diagnoses, and therapy. The Internet (including bibliographic databases and web-based searching) was the source of information most frequently mentioned, followed by textbooks, journals, colleagues, drug compendiums, professional websites, and medical libraries. There is insufficient evidence to support conclusions about the differences between groups. In most research, information needs and behaviours for both groups have been discussed simultaneously, with no real distinction made, suggesting that there may not be significant differences even though a few studies have found that nurses’ emphasis is on policy and procedures. Barriers to access include time, searching skills, and geographic location; for the last, improvements have been made but rural practitioners continue to be adversely affected by limited access to people and resources. Conclusion – Both primary care physicians and nurses seek information on diagnosis and treatment. The Internet is of increasing utility for both groups, but all resources have advantages and disadvantages in identifying evidence based information for use in practice. Further research is required to support access and use of evidence based resources, and to explore how focused, evidence based information can be integrated into electronic health record systems.Item Differences between library instruction conference attendees and their institutional affiliations in the United States and Canada are discernible(University of Alberta Library, 2006) Perryman, Carol L.A review of: Willingham, Patricia, Linda Carder, and Christopher Millson-Martula. “Does a Border Make a Difference? Library Instruction in the United States and Canada.” Journal of Academic Librarianship 32.1 (Jan. 2006): 23-34. Objective – The primary intent of this study was to identify differences among library instruction conference attendees and their institutions between the United States and Canada. The overall hypothesis was that there would be areas of measurable distinction between the two countries. The authors tested nine hypotheses: #1, that the largest number of survey respondents would be employed at large institutions; #2, that statistically, the majority of well-developed instructional programs are found at universities rather than colleges; #3, that beginning programs are more often found at four-year institutions; #4, that program development and technological issues predominate among instructional foci in the early twenty-first century; #5, that more experienced librarians are more likely to attend library instruction conferences; #6, that LOEX (originally an acronym for Library Orientation Exchange) is perceived as the most valuable conference in library instruction; #7, that the impact of conference attendance upon library program development is only moderate; #8, that conference theme and reputation are the two greatest factors contributing to attendance; and #9, that the majority of conference attendees are from the United States. Design – Historical research, and an e-mailed survey. Setting – Libraries and library instruction conferences in the United States and Canada. Subjects – One hundred thirty-two librarians who were attendees at one of three library user instruction conferences: LOEX, LOEX of the West, and WILU (Workshop on Instruction in Library Use). Methods – First, a brief historical review was conducted on the influence of social, economic, and political events on the development of library user instruction, the creation of conferences focused on library instruction in from the United States and Canada, and national surveys looking at institutional support for instructional development. Next, a survey instrument consisting of fifteen demographic and attitudinal questions was sent via e-mail to all 508 attendees of major library instruction conferences (LOEX and WILU for 2001, and LOEX of the West for 2000) in the United States and Canada. Responses from the 132 returned surveys were tabulated and used to evaluate their linked hypotheses. Main results – Of the nine initial hypotheses, five were supported, and the remaining four were either partially supported or rejected. Supported hypotheses included: #1, that most participants in the top library instructional conferences came from institutions with >5,000 student populations; #2, that the majority of fully developed instructional programs were in universities; #5, that librarians with greater seniority were more likely to attend instructional conferences; #7, that conference attendance has only a medium impact on program development at participants’ home institutions; and #9, that most conference attendees come from the United States. Partially supported hypotheses were: #4, that factors most highly rated by participants were program development and technology, and #8, that conference theme and reputation are ranked higher in terms of influence in attendees’ decision to participate in the conferences. Rejected hypotheses included: #3, that “beginning programs are typically found at four-year institutions,” #4, that “program development and technology rank as the two most important instruction-related issues” (note that hypothesis #4 is both rejected and partially supported), and #6, that “LOEX is considered the most valuable conference.” Conclusion – The authors confirmed their overall hypothesis that significant differences exist between the United States and Canada regarding library instructional programs. Although the two countries developed at very different rates prior to the 1960s, technology and cross-border sharing has meant that they are now developing along parallel paths. The authors suggest several avenues for further study including the need to consider attendees over a greater time span, the differences in responses between younger and more senior participants, and questions about the real differences between library instructional programs in Canada and the United States.Item Does a social network based model of journal metrics improve ranking?(University of Alberta, 2007) Perryman, Carol L.A Review of: Bollen, J., Van de Sompel, H., Smith, J.A., & Luce, R. (2005). Toward alternative metrics of journal impact: A comparison of download and citation data. Information Processing and Management, 41:1419-1440. Objective: To test a new model for measuring journal impact by using principles of social networking. Research questions are as follows: Can valid networks of journal relationships be derived from reader article download patterns registered in a digital library’s server logs? Can social network metrics of journal impact validly be calculated from the structure of such networks? If so, how do the resulting journal impact rankings relate to the ISI impact factor (IF)? Design: Bibliometric, social network centrality analysis Setting: Los Alamos National Laboratory (LANL), New Mexico Subjects: 40,847 full-text articles downloaded from a large digital library by 1,858 unique users over a 6 month period. Methods: Full-text article downloads from a large digital library for a six-month period were examined using social networking analysis methods. ISSNs for journals in which the retrieved articles were published were paired based upon the proximity of use by the same user, based on the supposition that proximal downloads are related in some way. Reader-Generated Networks (RGNs) were then tested for small-world characteristics. The resulting RGN data were then compared with Author-Generated Networks (AGNs) for the same journals indexed in the Institute of Scientific Information (ISI) annual impact factor (IF) rankings, in the Journal Citation Reports (JCR) database. Next, a sample of the AGN-derived pairings was examined by a team of 22 scientists, who were asked to rate the strength of relationships between journals on a five-point scale. Centrality ratings were calculated for the AGN and RGN sets of journals, as well as for the ISI IF. Main results: Closeness and centrality rankings for the ISI IF and the AGN metrics were low, but significant, suggesting that centrality metrics are an acceptable impact metric. Comparison between the RGN and ISI IF data found marked differences, with RGN mirroring local population needs to a much higher degree, and with a non-significant correlation between the ISI IF and RGN ranking, while AGN and RGN centrality rankings show significant centrality and closeness and betweenness correlations. RGN network ranking identified highly localized foci of interest for the LANL, as well as “interest-bridging” subject areas pointing to possible emerging interests among the scientists. Conclusion: The study results appear to successfully demonstrate an alternative to existing journal impact ranking that can more validly and accurately reflect the practices of a local community. The authors suggest that the social network-derived methodology for identification of impact rankings avoids biases intrinsic to ISI IF as a result of frequentist metrics collected from a global user group. Although the authors resist the idea of generalizability due to the local nature of their data, they suggest that the methodology can be successfully used in other settings, and for a more global community. Finally, the authors propose the automated creation of an open-source RGN whose data could be localized for smaller communities, with potentially large implications for the existing publishing industry.Item Evaluation of self-ratings for health information behaviour skills requires more heterogeneous sample, but finds that public library print collections and health information literacy of librarians needs improvement(University of Alberta Learning Services, 2016-03) Perryman, Carol L.Objective – To understand public library users’ perceptions of ability to locate, evaluate, and use health information; to identify barriers experienced in finding and using health information; and to compare self-ratings of skills to an administered instrument. Design – Mixed methods. Setting – Main library and two branches of one public library system in Florida. Subjects – 20 adult library users purposively selected from 131 voluntary respondents to a previously conducted survey (Yi, 2014) based on age range, ethnicity, gender, and educational level. Of the 20, 13 were female; 11 White, 8 Black, 1 Native American; most had attained college or graduate school education levels (9 each), with 2 having graduated from high school. 15 respondents were aged 45 or older. Methods – Intensive interviews conducted between April and May 2011 used critical incident technique to inquire about a recalled health situation. Participants responded to questions about skill self-appraisal, health situation severity, information seeking and assessment behaviour, use of information, barriers, and outcome. Responses were compared to results of the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA) test, administered to participants. Main Results – On a scale of 100, participants’ S-TOFHLA scores measured at high levels of proficiency, with 90% rating 90 points or above. Self-ratings of ability to find health information related to recalled need were ”excellent” (12 participants) or “good” (8 participants). Fourteen participants did not seek library assistance; 12 began their search on the Internet, 5 searched the library catalogue, and 3 reported going directly to the collection. Resource preferences were discussed, although no frequency descriptions were provided. 90% of participants self-rated their ability to evaluate the quality of health information as “good” or “excellent.” Participants selected authority, accuracy, and currency as the most important criteria of quality evaluation; however, other important criteria such as editorial review of content were not mentioned. Participants rated their ability to use health information as either “excellent” (17) or “good” (3). Conclusion – Use of health information enabled health behaviour change for participants, although conflicting information tended to increase anxiety. Barriers to success in all areas of inquiry include difficulties with terminology, collection limitations, asking a librarian for assistance, and lack of awareness of resources. Librarians should improve their health literacy skills in order to advise on all aspects of health information seeking, evaluation, and use. Collaborative efforts are suggested, such as special libraries and public library efforts, and health professional workshops or seminars offered to public library patrons.Item Evidence-based Librarianship: TLA Pre-conference workshop(Texas Woman's University, 2013-04-23) Perryman, Carol L.Slides and handout for half-day preconference workshop. This 4 hour hands on interactive session introduced evidence-based practice to multi-type librarians, primarily focused on question building and critical evaluation of information. Two evaluative instruments were created for and tested during the workshop.Item Evidence-based practice: A revolution in library project management(2007) Perryman, Carol L.; Thibodeau, PatriciaItem Exploring virtual librarianship: Second Life Library 2.0(Taylor & Francis, 2008-10) Perryman, Carol L.In April 2006, Alliance Library System and Online Programming for All Libraries partnered to start the Second Life Library 2.0 in the online world Second Life and in August 2006 purchased an island on the Teen grid of Teen Second Life. Second Life is a virtual world, a descendant of multiplayer online games. Educational institutions have recently been drawn into Second Life's robust economy and vibrant cultural life. The Second Life Library 2.0 works with librarians from around the world and with other educational partners such as TechSoup, WorldBridges, and the New Media Consortium. Second Life Library 2.0 provides “traditional” library services such as ready reference, book discussions, and search assistance, but, at heart, it explores what it means to be a virtual library in a virtual world.Item Finding our foundation: Analysis of the LISA database for research retrievability(e-LIS, 2006) Perryman, Carol L.; Lu, DihuiObjective: The primary objective of this study is to examine the Library and Information Science Abstracts (LISA) database to determine if research literature can consistently be retrieved by using keywords identifying the research methodologies used. Question: For the journals named, are articles identified as ‘research’ able to be consistently retrieved by using keywords related to research methodology? Methods: Citations from the top 10 Library and Information Science journals for 2001 as identified by Koufogiannakis, Slater & Crumley (2004) were obtained, then a filter developed by Catherine Beverley (2004) was used independently to identify research articles. The resulting sets of citations were compared, then the two datasets were analyzed in order to consider retrievability and fit for assigned keywords from the LISA database. Results: Although it would need to be tested against a random set of citations rather than the purposive sample tested here, our analysis suggests that retrieval using the descriptor terms alone may succeed in only 31.5% ± 5.2% of attempts, with a 95% confidence interval. Conclusions: The LISA thesaurus is not consistent or sufficiently comprehensive to serve the needs of researchers. Recommendations for the improved retrievability of LIS research literature from the database are made.Item For non-expert clinical searches, Google Scholar results are older with higher impact, while PubMed results offer more breadth(University of Alberta Library, 2013) Perryman, Carol L.Objectives – To compare PubMed and Google Scholar results for content relevance and article quality Design – Bibliometric study. Setting – Department of Internal Medicine at Texas Tech University Health Sciences Center. Methods – Four clinical searches were conducted in both PubMed and Google Scholar. Search methods were described as “real world” (p. 216) behaviour, with the searchers familiar with content, though not expert at retrieval techniques. The first 20 results from each search were evaluated for relevance to the initial question, as well as for quality. Relevance was determined based on one author’s subjective assessment of information in the title and abstract, when available, and then tested by two other authors, with discrepancies discussed and resolved. Items were assigned to one of three categories: relevant, possibly relevant, and not relevant to the question, with reviewer agreement measured using a weighted kappa statistic. The quality of items found to be ‘relevant’ and ‘possibly relevant’ was measured by impact factor ratings from Thomsen Reuters (ISI) Web of Knowledge, when available, as well as information obtained by SCOPUS on the number of times items were cited. Main Results – Google Scholar results were judged to be more relevant and of higher quality than results obtained from PubMEed. Google Scholar results are also older on average, while PubMed retrieved items from a larger number of unique journals. Conclusion – In agreement with earlier research, the authors recommended that searchers use both PubMed and Google Scholar to improve on the quality and relevance of results. Searches in the two resources identify unique items based upon the ranking algorithms involved.Item Further study is needed to define and measure the use of reflective practice in library and information science(University of Alberta, 2008) Perryman, Carol L.A review of: Grant, Maria J. “The Role of Reflection in the Library and Information Sector: A Systematic Review.” Health Information and Libraries Journal (2007) 24: 155-166. Objectives - To identify and review the literature of reflective practice in Library and Information Science (LIS) in order to understand its role, particularly with regard to health libraries. Design - Systematic review Setting - LIS English-language articles indexed in the Library and Information Science Abstracts (LISA) database and published between 1969 and 2006. Subjects - 929 citations retrieved from the LISA database. Methods - The author conducted free text searches in the LISA database for the terms ‘reflective’ or ‘reflection*’ or ‘reflexion*.’ An initial search series was conducted in 2004 in order to retrieve items published between 1969-2003, then in 2007, for articles published between 2004-2006. In all, 929 article citations were retrieved. Exclusion criteria included those articles addressing the facilitation of reflective practices in others, as well as non-English language, and materials predating 1969. After review, 55 articles met the author’s relevance standard. Citation tracking then added 10 articles to the total. From this dataset, full text articles were obtained where possible, if determined on initial scrutiny to be deserving of further examination. Thirteen articles (.013%) were ultimately selected for analysis. These articles were categorized as analytical or non-analytical, with respect to perspective (individual or organizational), and recency of events (retrospective or recent). In addition, a determination was made about whether the articles’ focus was reflection occurring on (in retrospect to) or in (during) practice. Main results - Of 13 articles, 5 were found to be non-analytical, with the other 6 being analytical. Three of the non-analytical items were the reflections of an individual, while the remaining 2 offered an organizational perspective. The non-analytical accounts were found to be mostly descriptive accounts by an individual, mostly retrospective and offering no consideration of implications for LIS practice. Analytical reflective accounts attempt to systematically appraise events from the recent past, and draw conclusions in order to improve future actions. Conclusion – A gradual increase in the use of analytical reflective practice is demonstrated over the period from 1969-2006, although insufficient examples of the practice were found in the published literature. Reflective practice is likely to be beneficial to LIS practitioners, especially when time is spent in considering the implications of lessons learned from practice.Item Information behaviors in an online smoking cessation forum(De Gruyter, 2007-12) Perryman, Carol L.Smoking is a major contributor to morbidity and mortality today, and a focus of attention by primary care practitioners and public health. Few studies take into account the role of community-based information transactions, nor have they examined the information needs of quitting smokers beyond generic patient education pamphlets. A pilot study examines the function and value of information communicated in an online forum dedicated to smoking cessation. Firstly, a Web-based survey was sent to fourteen forum participants known by the author. Twenty questions about medications, decision support sources, the evaluation of those sources, and basic demographic information were asked and the resulting responses were analyzed. Secondly, 371 selected posts from the Web forum were collected to better understand the importance and frequency of specific types of cessation-related information. Several models are discussed in a preliminary attempt to characterize the forum's community-based information behaviors. Survey respondents view the existence of online community-based information resources (in the persons of their community peers) as a major factor in their cessation efforts. Although no attempt was made to generalize findings beyond this initial pilot, gaps were tentatively identified between the support provided by more traditional healthcare practitioners and the information needs experienced by this population. In their provision of a milieu for the exchange of information, online fora may enable support at a depth and quantity unavailable through more immediate channels. Further studies are needed to develop a better understanding of information-related behaviors of this large population.Item The information practices of physical science librarians differ from those of the scientific community: More research is needed to characterize specific information seeking and use(University of Alberta, 2008) Perryman, Carol L.A Review of: Brown, Cecilia M. and Ortega, Lina. “Information-Seeking Behavior of Physical Science Librarians: Does Research Inform Practice?” College & Research Libraries (2005). 66:231-47. Objective – As part of a larger study exploring the information environments of physical science librarians (Ortega & Brown), the authors’ overall objective for this study is to profile physical science librarians’ information behaviours. The authors’ two-part hypothesis was that first, peer-reviewed journals would be preferred over all other sources for research dissemination, resembling the preferences of scientists, and second, that peer-to-peer consultation would predominate for practice-oriented decisions. Design – Mixed methods: survey questionnaire followed by citation and content analysis. Setting – Five internationally disseminated professional association electronic mailing lists whose readership comprised those with interests in science librarianship: the American Library Association (ALA) Science and Technology Section; the American Society for Information Science & Technology (ASIST) Science and Technology Information Special Interest Group; the Special Library Association (SLA) Chemistry Division and its Physics-Astronomy-Mathematics Division; and the American Geological Institute Geoscience Information Society. Subjects – Seventy-two physical science librarians voluntarily responding to an online survey. Methods – A questionnaire was distributed to inquire about physical science librarians’ professional reading practices as well as their perceptions about the applicability of research to their work. Participants were asked to rank preferences among 11 resource types as sources supporting daily business, including personal communication, conference attendance, electronic mailing lists, and scholarly journals. Differences between the mean rankings of preferences were tested for significance by applying the Friedman test with p>0.0005. Journals identified most frequently were analyzed using the Institute for Scientific Information’s (ISI) Web of Science index and Ulrich’s Periodical Index to measure proportions of research and non-research citations, as well as the general topic areas covered by the journals. Next, content analysis was performed for the years 1995, 1997, and 2000 in order to characterize research methodologies used in the previously identified journals according to a previously tested schema (Buscha & Harter). Results from this portion of the study were compared with participants’ responses about journal usage. Main Results – Librarians reported using personal communication (both face-to-face and electronic mailing lists) more frequently as a means of information gathering than professional journals, Web sites, conferences, trade publications, monographs, or ‘other’ resources. Variations in responses appeared to correlate with years in the profession and in the respondents’ time in their current positions, although there are indications that the importance of all information resources to practice and research declines over time. The relative importance of resources is also shown in time spent reading journal literature, less than 5 hours per week for 86% of participants. Conclusion – For the first hypothesis, the authors found that unlike scientists, survey participants did not prefer research publications as vehicles for dissemination of their research results. For the second, librarians ranked peer-reviewed journals third in preference after personal communication and electronic mailing lists as sources of information supporting daily practice, supporting the second hypothesis that respondents would emulate the information use practices of mathematicians.Item Mapping studies(Medical Library Association, 2016-01) Perryman, Carol L.When I first read about evidence-based practice, I had several thoughts. The first was a somewhat horrified question: Does this mean that medical care has not been based on research? The second question was that if we intend to build a better knowledgebase for this and other professions, how could that happen, if the base (existing research) was not itself evidence based? The image of a house built on sand would not leave my mind.Item Medicus Deus: A review of factors affecting hospital library services to patients between 1790-1950(2006-07) Perryman, Carol L.QUESTION: What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? DATA SOURCES: Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. STUDY SELECTION: The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. DATA EXTRACTION: An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. MAIN RESULTS: Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. CONCLUSION: This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved.