My colleague Linda Williams sent me this note and has allowed me to share it with you:
I’ve just finished reading Fire upon the Deep by Vernor Vinge. The heroine is Ravna Bergsndot, a librarian of the sort that I think we hope to inspire with our MLA course on diagnostic errors and the role of the librarian (see pg 13). I think that using Ravna’s personality, her intellect, and her library skills analogously to what we see librarians doing to improve diagnostic problem solving would be an interesting educational strategy. For some of our audience, when we suggest being part of patient rounds or attending case conferences or morbidity-mortality rounds, it may seem twenty light-years away from where they now work.
To illustrate over-confidence and confirmation bias:
Pg 178 " ‘Look under the surface, Pham. I think you'll find a whole lot of nothing.’ A dream of competence, too closely confronted.”
To make a point about the specialized, essential knowledge that a librarian brings to diangnostic decision making:
Pg. 182 Ravna realized this was not just a favor. She was the best person for this job. She knew humans, and she knew archive management. ...They would need an effective onboard database and strategy program....It was up to Ravna to decide what library materials to move to the ship, to balance the ease of local availablitlty against the greater resources that would be accessible over the ultrawave from Relay.
If emphasizing what it takes to be a librarian – especially when it is time to confront physicians about their own human limitations:
Pg 55 Looking back, Ravna Bergsndot saw it was inevitable that she become a librarian. [She] still wanted adventure. And there was a way to see into everything that humans in the Beyond could possibly understand: Ravna became a librarian.
To demonstrate the value of librarians being right in the thick of action:
Pg 56 So it was that Ravna Bergsndot ended up more than twenty light-years from home, at the network hub of a million worlds.
The book is hugely entertaining and wonderfully written. And in the end Ravna saves the world from destruction. In a way we’re asking librarians to be superheroes, too. There is one other quote that I’d forgotten about until now. She brings a bunch of children out of cold sleep knowing that she will have the responsibility of nurturing them. It is the kind of nurturing that I see us doing for the next generation of physicians. They are certainly more malleable than those who completed their training years ago. Some are learning to use meta-cognition and reflective practice to guard against confirmation bias and improve diagnostic skills. Those are the ones who will be eager to have a librarian on the patient care team.
Join us in May at MLA to learn more. Check out the speaker teams' article (pg 6) that came out in 2010 on how librarians can partner in healthcare to "tackle" Dx error.
Piece of my mind. Stories doctors tell. - Moniz T, Lingard L, Watling C. JAMA. 2017;318:124-125.
5 days ago