IB of Acupunturists


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  • In the course of our literature review, one thing became abundantly clear: there is a dearth of articles written about the information behavior of acupuncturists. We spent several hours trolling the University of Washington library site using a variety of search terms in order to track down relevant papers.
  • Once we found relevant articles, we discovered three key concepts running through the research.
  • The most helpful article we found was by David J. Owen and Min-Lin E. Fang. The main purpose of their paper was to investigate and describe information seeking behavior of health professionals seeking information about complementary alternative medicine, which is what acupuncture falls under. It is based on a quantitative and qualitative survey of University of California, San Francisco, health professionals who were seeking CAM-related information.
  • In Esther Suter’s paper she and her colleagues determined that the physicians, residents, and medical students whom they contacted had a growing interest in learning about CAM, but they admitted that they had little actual knowledge.This article sets the tone for our presentation: people are interested, but there isn’t much information out there.
  • AlejandroCleraco’s paper discusses what clinicians need to know w/r/t clinical acupuncture research. His findings reveal that the system for imparting information related to acupuncture research is sorely deficient. Not only is it hard for practitioners to find the research, it’s also difficult to determine what exactly the practitioners need and perceive from said research.
  • James Haug asks the question “What sources of information do physicians use to answer questions arising in their clinical practices?” His findings? When his article was written in 1997 – which precedes the explosion of the Internet and the vast amount of information available on the world wide web – it seems that physicians used books and journals most frequently, with colleagues listed as resources nearly as often.
  • EstherSuter again iterates the importance of colleagues when seeking complementary alternative medicine-related information.
  • David Owen notes that when the health professionals he surveyed were able to find complementary alternative medicine-related information, it turned out that their colleagues were ranked highest in terms of usefulness.
  • Owen points out that a lot of important CAM-related information is relegated to what he terms “gray literature” – things such as trade journals, pamphlets, conference proceedings, and market research reports.
  • Daniel Cherkin points out that though the field is growing in popularity, its validity remains vague. People don’t know where to find out information about practitioners.
  • Brian Bermangoeson to mention “the absence of a gold standard” which sums up nicely the problem: The field of acupuncture lacks a governing body. This deficit has a ripple effect on anyone who may be interested in acupuncture therapy: practitioners who seek information about procedures and clinical research; patients who seek information about treatment or qualified practitioners; people interested in finding out how effective acupuncture is; medical professionals who are curious about eastern medicine… There is no information clearinghouse that can help answer the many questions about acupuncture.
  • This part of the presentation discusses the methodology used to research the information behavior of acupuncturists.
  • Our team is made up of two people in Seattle, WA, and two people in Portland, OR, so we focused on acupuncture practitioners in those two cities. Our research included a survey, three indepth interviews, and a review of literature.
  • We created an online survey for acupuncture practitioners to fill out using WebQ in our Catalyst tools. The survey was composed of 14 simple questions, including multiple choice, write-in, and ranking the usefulness of various information sources.
  • The survey was administered to acupuncture practitioners at the OCOM, SIOM, SHAC, and an estimated 10 individual practitioners. We’d like to ensure you that no kitties were harmed during the creation of this presentation.
  • MUSIC CUE: (Gong). Welcome to the Fieldwork section . In this section we will be combining survey in interview information.
  • In the fieldwork discussion I’ll be going over Sources of Information, frequency and quality of information, and open survey questions. Dispersed throughout the field work slides will be comments from interviewees that correlate with the data.
  • IB of Acupunturists

    1. 1.
    2. 2. The Information World of Acupuncturists<br />LIS 510 Team 6 – Autumn 2009<br />Jessica Bottomly<br />Jack Falk<br />Kathy Mar<br />Lisa Tegethoff<br />
    3. 3.
    4. 4.
    5. 5.
    6. 6.
    7. 7.
    8. 8. Acupuncture in the mainstream?<br />Much early prejudice to overcome<br />3.1 million US adults and 150,000 children treated with acupuncture in past year – 2007 National Health Interview Survey<br />Estimated 20,000+ licensed acupuncturists in US – American Cancer Society<br />
    9. 9. Explore….<br /><ul><li>http://www.acupuncturenow.com/acupuncturenow.htm(brief video overview of acupuncture)
    10. 10. http://nccam.nih.gov/health/acupuncture(National Institutes of Health)
    11. 11. http://www.mayoclinic.org/acupuncture(Mayo Clinic)
    12. 12. http://www.acupuncture-schools.us(click “The NIH Consensus Study”)</li></ul>Pause<br />
    13. 13. Literature Review<br />Information World of Acupuncturists<br />
    14. 14. A dearth of articles written about the information behavior of acupuncturists. <br />A few of the search terms we used:<br />acupuncture + behavior acupuncture + information needs<br />acupuncturist + behavior acupuncturist + information needs<br />acupuncture + information acupuncture + seek<br />acupuncturist + information acupuncturist + seek<br />
    15. 15. Three key concepts<br />
    16. 16. Key Concept #1:<br />Acupuncture practitioners find it difficult to locate the information they seek.<br />
    17. 17. Key Concept #1:<br />“Most importantly, our results showed<br />that they frequently did not find <br />the information they sought.”<br /> -- Owen et al.<br />
    18. 18. Key Concept #1:<br />“Many physicians are reluctant to <br />endorse CAM and are concerned <br />about the lack of evidence <br />to support CAM.”<br />-- Suter et al.<br />
    19. 19. “Currently there is poor understanding <br />of what practitioners perceive about, <br />and need from, reports of <br />acupuncture research.”<br />-- Claraco et al.<br />Key Concept #1:<br />
    20. 20. Key Concept #2:<br />Acupuncture practitioners find their colleagues to be one of the best sources of information.<br />
    21. 21. Key Concept #2:<br />“[I]nformalconsultation with colleagues plays <br />a vital role in medical communication, <br />and…rivals books and journals for first place among preferred information sources.”<br />-- Haug<br />
    22. 22. Key Concept #2:<br />“Physicians indicated that they rely <br />mainly on peer-reviewed journals <br />and colleagues for information.”<br />-- Suter et al.<br />
    23. 23. Key Concept #2:<br />“Of the sources they accessed for information, 46% of the respondents found their colleagues to be “somewhat” or “very useful.”<br />-- Owen et al.<br />
    24. 24. Key Concept #3:<br />The field of acupuncture would benefit from a central repository of verified information.<br />
    25. 25. Key Concept #3:<br />“[I]mportantinformation can often only <br />be found in the ‘gray literature,’ such as <br />trade journals, pamphlets, conference proceedings, and market research reports.” <br />-- Owen et al.<br />
    26. 26. Key Concept #3:<br />“Despite the growing popularity of CAM, little is known about the licensed health professionals who provide them, the patients they treat, the services they provide...”<br />-- Cherkin et al.<br />
    27. 27. Key Concept #3:<br />“There is no consensus in the <br />acupuncture texts.”<br />-- Berman<br />
    28. 28. Methodology<br />The methodology used to research the information behavior of acupuncturists<br />
    29. 29. Our research included: <br /><ul><li>a survey
    30. 30. in-depth interviews
    31. 31. a review of literature</li></li></ul><li>Survey<br />We created an online survey for acupuncture practitioners to fill out. <br />14 simple questions <br /><ul><li> multiple choice
    32. 32. write-in
    33. 33. ranking the usefulness of various information sources</li></li></ul><li>The survey was given to participants from:<br />The Oregon College of Oriental Medicine <br />The Seattle Institute of Oriental Medicine<br />Seattle Healing Arts Center<br />And an estimated 10 individual practitioners<br />
    34. 34. Results were then parsed for: <br /><ul><li> Quantitative data
    35. 35. Potential patterns
    36. 36. Similarities
    37. 37. Differences
    38. 38. Anomalies
    39. 39. Points of interest</li></ul>Basic statistics, such as means and histogram tables, were used to describe the data. <br />We’ll discuss stats at length later in this presentation.<br />
    40. 40. Interviews<br />Our team administered standardized, open-ended interviews with three acupuncturists<br />Each interview was conducted using the same set of 20 questions<br />The questions were mainly experience- and behavior-related, with a smattering of other types (e.g., background/demographic, opinion, knowledge)<br />The interview questions were designed to go into more detail than the survey was able to provide<br />
    41. 41. The interviews:<br /><ul><li>Demonstrate the information seeking behavior of acupuncturists in more detail
    42. 42. Provide insight that might not be obvious from a survey alone
    43. 43. Bring up some key points that could be considered problematic in the field</li></li></ul><li>Fieldwork<br />Information World <br />of Acupuncturists <br />Survey and Interview<br />
    44. 44. Fieldwork<br />Survey<br />Sources of Information<br />Frequency and quality of information<br />Open survey questions<br />Corresponding Interview Comments<br />
    45. 45. Sources of Information:Categorical Questions<br />Colleagues, Databases, Journals, Librarians/Library, News/media/popular press, Personal Files, Textbooks, the Internet, and Other<br />Participants constrained to categories<br />
    46. 46.
    47. 47.
    48. 48. “Probably the way I get most of my information is my colleagues or coworkers.”<br /> “Usually, other practitioners.” <br />
    49. 49.
    50. 50.
    51. 51. “I don&apos;t pay too much attention to journals.”<br /> “I don&apos;t…There is a journal that I don&apos;t subscribe to, but that I get. It&apos;s called Acupuncture Today. They blanket-mail it to every licensed acupuncturist about once a month.”<br />“…the naturopathic stuff. I really like Thorne Research. They have a really good journal…”<br />
    52. 52.
    53. 53. “The library at OCOM, even if we’re reluctant to go back, we all use it. They have lots of research and magazines and old texts…you would never own because they are expensive, or in Chinese.”<br />“There are a lot of journals out there, but the Library has them so if I need one, I can find it there.”<br />“In the allopathic world, I hear stories of medical students who tear out the pages in the medical textbooks in the library so that only they can learn it, other people can&apos;t learn it. “<br />
    54. 54.
    55. 55.
    56. 56.
    57. 57.
    58. 58. “…Otherwise, I have a couple of really good textbooks that I go to.”<br />
    59. 59.
    60. 60. Frequency and Quality of Information<br />How often?<br />How much time?<br />Successful?<br />How many resources?<br />Constrained responses in all but time response<br />
    61. 61.
    62. 62. The last time you looked for acupuncture-related information approximately how much time did you spend in number of minutes?<br />Average 40 minutes<br />Large spread<br />Dispersed<br />Larger amounts relative to the spread<br />
    63. 63.
    64. 64.
    65. 65. Open Survey Questions<br />Posed in order to find unpredicted trends<br />Participants were allowed to freely respond without prompting<br />
    66. 66.
    67. 67. “You can do an herbal track, so if you&apos;re talking about herbs and internal conditions”<br />“…there’s a road block and I can’t find anything.”<br />“…Western-style research [is] like, ‘Is acupuncture more helpful or is this drug more helpful’ and that doesn’t tell us really anything….[we need] more studies where ‘We tried these 2 herbal formulas’ or ‘We tried these 2 types of treatments’ ”<br />
    68. 68.
    69. 69. “I learn about their suffering, and their conditions of life. My patients are my teachers; I learn what works.”<br />“I learn what works and what doesn&apos;t work from my patients.”<br />“[I learn] more than you could ever imagine [from my patients].”<br />
    70. 70.
    71. 71. “The seminars are the places that you most often see the acupuncturists together.”<br />
    72. 72.
    73. 73.
    74. 74. The Information World of Acupuncturists<br />http://perezbebe.files.wordpress.com/2008/02/acupuncture.jpg<br />An IB Model<br />
    75. 75.
    76. 76. Influences: Krikelas<br />Information Seeking Model<br />
    77. 77. Influences: Belkin<br />Anomalous State of Knowledge<br />
    78. 78.
    79. 79.
    80. 80. Influences: Bates<br />Berrypicking<br />
    81. 81.
    82. 82. Influences: Leckie et al.<br />Professionals Information Behavior<br />
    83. 83. Concepts<br />Variables<br />
    84. 84.
    85. 85.
    86. 86.
    87. 87.
    88. 88.
    89. 89.
    90. 90.
    91. 91. Implications<br />and suggestions for further investigation<br />
    92. 92. Key Findings<br /><ul><li>Colleagues play a vital role</li></ul>Historical precedent<br /><ul><li>Practitioners have trouble finding info</li></li></ul><li>Medical acupuncture (MDs)<br /><ul><li>Shorter training than L.Ac.(Yeh et al , 2008)
    93. 93. Professional support
    94. 94. Training
    95. 95. Licensure
    96. 96. Quality control
    97. 97. Board certification</li></li></ul><li>Medical acupuncture (MDs) and<br />Licensed Acupuncturists<br /><ul><li>Issues within mainstream medicine (Crumley, 2006)
    98. 98. Convergence of conventional medicine and Traditional Chinese medicine?</li></li></ul><li>TCM: a very young profession (in the US)<br /><ul><li>No central regulatory organization
    99. 99. No central research organization
    100. 100. Challenges to acceptance of acupuncture research
    101. 101. Differences between Chinese and western traditions</li></li></ul><li>Why is it hard to find information? <br /><ul><li>Complex information seeking
    102. 102. Acupuncture (needle insertion)
    103. 103. Herbs
    104. 104. Western medicine
    105. 105. Naturopathic supplements
    106. 106. Drug interactions</li></li></ul><li>Why is it hard to find information? <br /><ul><li>“Gray literature”
    107. 107. Much is in Chinese, not translated
    108. 108. Many relevant journals not indexed in medical databases</li></li></ul><li>Making better use of information<br /><ul><li>A central repository for research
    109. 109. A consortium of acupuncture schools
    110. 110. A professional organization for librarians at acupuncture and related schools
    111. 111. Better indexing in MEDLINE etc.
    112. 112. Increased reliance on seminars, moderated forums, etc.</li></li></ul><li>Colleagues<br />Clinical Trials<br />Patients<br />Conferences<br />Observation<br />Prior Experience<br />Pamphlets<br />Central Information Repository<br />Websites<br />Textbooks<br />Online Texts & Journals<br />Marketing Collateral<br />Databases<br />Journals<br />Blogs<br />Research Papers<br />
    113. 113. For further investigation….<br /><ul><li>Information sharing with patients
    114. 114. Information sharing with colleagues
    115. 115. Examination of general “backgrounder” materials about the field as a whole</li></li></ul><li>