Narrative information sources for medicinal care and the implications for LIS

For those who have been following up on my blog for some time, you might already be aware that I am interested in narrative research. Well recently, my university staged a lecture where an author, Dr. Vincent Lam, presented on the topic "Narrative in Medicine – Why We Need Stories in an Age of Evidence". The event was held in the University Hospital | Auditorium A, Room B3-246.

So I attended the lecture by Dr. Vincent Lam staged at my university's hospital. Unfortunately, due to my mix up with the time, I arrived when the lecture was already in progress. Nevertheless, I was still able to get what I needed to hear and even got the opportunity ask Dr. Lam a question. In the next few paragraphs, I outline some of my take away points from Dr. Lam's talk. 

Before outlining what I got from the talk, it is important to indicate my particular interest in the narrative turn in patient care and medicine. I particularly see this new emphasis on narrative based information sources as being important to libraries and information science. This narrative turn in the medical sciences has implications for librarianship, especially in terms of how we go about serving health related information sources. I also see the importance in this for those working as hospital librarians, as they too need to consider supplying biographical or narrative sources to health care providers. (Now back to Dr. Lam's talk.)

Dr Lam indicated that during the encounter between a patient and a health practitioner, the patient brings a story. Usually, the story is "something happened to me". Lam suggests that the health practitioner is then expected to hear and listen carefully to the client's story, and then to use his or her special knowledge and tools to explain the story. Lam also suggests that the health provider is also expected to tell the patient "what will happen next". As such, Lam suggests that doctors and health practitioners have a role to play as story interpreters as well as storytellers. In his words, "doctors are story interpreters" and "third party storytellers", offering story interpretations and storytelling to patients like the shamans and spiritual doctors of the age before modern medicine.

Dr. Lam also argued that health care providers can also benefit from being educated in the literary arts. He cited a study that indicates that reading literary fiction promoted empathy. In general, Lam stated that reading tough, difficult and challenging books was good for medical professionals as it would enable them to become more empathetic. This is needed as medical professionals tend to rely a lot on statistics and hard scientific numerical facts that make them less empathetic and understanding of their clients' needs. 

He said that sometimes doctors need to put down their scientific spectacles in treating patients, and see the world through a different set of eyes. Lam suggests that it is really "easy to miss something about your tools because that is what you work with". It is always good to get outsider perspectives. And narrative information from patients who experience illness are as important as the scholarly or evidence based medical literature for this.

Lam also makes the point that patients rarely present information about what is happening to them in an easy form for doctors to use to make a diagnosis. Patients often do not use the medical terms and jargon when presenting their health problem. Instead, doctors have to collect, interpret and put the fragments of information presented by the patient together into a medical narrative, in order to make sense of it and to arrive at a diagnosis. Hence, in this regard, doctors also need the skill of understanding patient narratives and being able to convert such narratives into a medical narrative.

At the end of his talk, I asked him about his position on doctors reading autobiographies,watching YouTube videos and reading blogs of those who experience illness. His response was "very valuable" and that doctors should read these to supplement their scholarly readings.

My question was motivated from my recent discovery of a Masters thesis in the University of Western Ontario's institutional repository entitled:

Women's Stories of Breast Cancer: Sharing Information Through YouTube Video Blogs  - Jenna Kressler, Health and Rehabilitation Sciences, MSc http://ir.lib.uwo.ca/etd/2095/

This interesting thesis title seems to suggest that a blog is not a medium,but a way of presenting information (genre). Hence YouTube Video blogs! (Or vlogs). The article also touches on the storytelling idea for sharing health-related information. The author also used narrative analysis to conduct her research, similar to the type of analysis that I am doing for my research on blogs and tweets. Finally, she conducted her analysis on the personal narratives of women victims and/or survivors of breast cancer.

Conclusion:

The narrative turn in medicine could spell hope for the value of the humanities in academia, Medicine is realizing and awakening to the idea that narrative and storytelling skills are important to its practice. Further, librarians have a role to play in serving medical practitioners with not just scholarly and scientific literature, but also biographies and other personal narratives of the persons that experience illness. Finally, librarians also have a role in not just providing the published sources of narratives, but also considering social media sources such as blogs and YouTube videos. Curating these may also be valuable to medical practitioners who need to supplement their professional understanding of illness with a deeper understanding of the patient's side of the story.

My December 2013 update on my research

So I have presumptuously began collecting and analysing data for my research. This is despite the fact that I have not yet given the revised proposal draft to my committee for approval. (Keeping my fingers crossed that it is better now and almost worthy of approval). Any way, I just want to share in this post briefly an update about some of my thinking as it relates to my current research and possibly future direction.

The general gist of my research has to do with constructing a profile of those who tweet and blog about library consultants and library consulting and analysing from these tweets and blog posts the presentation of the library consultant identity. In essence I hope to examine and analyse the identity of library consultants and library consulting as discussed and formulated in blogs and tweets. My approach is to use mixed methods, collecting both quantitative attributes and analysing qualitatively the narratives that I see emerging. In the end, I hope to tell 'a story' on library consultants and library consulting pulling the various strands of data together.


I have also been reading Simon Down's (2006) Narratives of enterprise. In my view, Down (2006) presents a good ethnography of how entrepreneurs craft their identity that may be relevant for my thesis on the crafting of the library consultant identity. However, after completing the reading, I realised that the book has had a profound impact on my own existentialism.


In some regards, Down is like me. He is an academic who has had a previous life as an entrepreneur. He also wrestles with his own self-identity as an academic who still feels the calling to an entrepreneurial identity. He also finds himself critical of entrepreneurial narratives as they tend to be anti-social. His work has got me wondering if the entrepreneurial and enterprising identity can be compatible with good moral values.


These ideas also relate to what I am findng about librarians' views on library consultants who charge for their services. A Judas or betrayal to the profession theme is emerging even though I haven't really started the 'deep' analysis. So far I have seen two particular tweets that summarise this perspective. One tweet in 2008 where a librarian remarked [not verbatim to protect anonymity] 'Am I the only person disturbed by this listing of paid library consultants?' In a more recent tweet, another librarian remarked that 'what library consultants should be doing is lobbying businesses to create more librarian positions' [again not verbatim]. From these tweets, it seems to me that there is a sinister picture being painted about library consultants who charge for their knowledge, expertise and services.


Yet this is also contrasted by other tweets and blog posts, where there is an event where library consultants offer free library consulting services (ASCLA, 2013). Or a tweet by a librarian praising another person for being a 'good library consultant' [not sure though if the person doing the consulting was paid though].

So far, the story being told about library consultants and library consulting on blogs and tweets is an intriguing one, where most times they are portrayed as villains, both by librarians or even the public who express outrage at the fees charged or money spent on them. Yet, there is seemingly praise for those who engage in no-paid library consulting services. However, I can't disclose all my ideas here, but just some of the preliminary notes and perceptions that I am forming of the data as I go through. For more, you've got to read the thesis when it is done or follow up on my future publications.


References:

Association of Specialized and Cooperative Library Agencies [ASCLA] (2013). 'Consultants give back: Free 30-minute sessions in Chicago co-sponsored by ASCLA and PLA'. [blog post]. Retrieved from
http://ascla.ala.org/blog/2013/05/news-consultants-give-back-free-30-minute-sessions-in-chicago-co-sponsored-by-ascla-and-pla/

Down, S. (2006). Narratives of enterprise: Crafting entrepreneurial self-identity in a small firm. Chelteham, UK: Edward Elgar Publishing.

 






 

Creating a good organizational story for preserving institutional memory

I have not blogged for a long time now about organizational or institutional storytelling. This has been due to the fact that while organizational storytelling is still one of my interests, it has moved to the periphery of my research at the moment. Currently, I have been thinking more about libraries, library education, library consultants and social media. However, on September 5, 2013, I got the opportunity to apply my interest in organizational storytelling at a meeting of a student club, of which I was one of the founding members, I was assigned the task to tell a newcomer about the student club. However, it was on the next day, after waking up in the quiet of the morning that I reflected on what I did and extracted these key principles.

Principles for creating an organizational story

1. Occasion for storytelling - Linde (2009) argues that for an institution to engage in organizational storytelling, it needs to create an occasion for storytelling. It is at an occasion for storytelling that we engage in what Boje (2008) dubs reflexivity (which in my words simply means reflecting on an organization's past or history). In my circumstance, the trigger for the occasion for organizational storytelling was the occasion of answering a newcomer's question about the organization, the student group. As we undertook the task of socializing the new member, we conveyed to the member the organization's history, something that we never had to do before seriously, on seeing that the club was only 2 years old.

2. Structure the narrative - From a summer course on storytelling I learned how to better create a story structure. One of the most popular means of doing so is by using a timeline. So for my student group, I created a timeline dating back to when we first began to the present. This involved dating the timeline based on the tenure of the leaders of the student club.

3. Identify the main characters or actors- According to Gabriel (2000), all good stories have characters that are portrayed in a particular light. As such, in creating a well-written or oral organizational story, one must always identify main characters. Many such characters end up being the leaders of organizations (Gabriel, 2000). Hence for my case, I identified the leaders of the student group as the main characters. As a group we began to characterise these leaders, developing descriptions of each leader to describe their personalities and idiosyncrasies that they brought to the group or organization, and how they impacted the group or organizational culture of the student club.

4. Identify key events - With the timeline and the leaders plugged into the timeline, the next aspect is to identify key events happening to the student club during the reign or tenure of each of our leaders. 

5. Provide a moral for the story -  This is where I extracted a piece of "wisdom" or advice about the organization based on its past. This "wisdom" is usually a summary in a sentence or few that gives meaning to the organization's past or puts the past in some perspective. Organizational storytelling experts like Gabriel (2000) and Linde (2009) discuss the fact that stories rarely just communicate dry facts, but also opinion or interpretation. From my interpretation and experience, the moral of these stories tend to provide for new members a perspective or lens for understanding the past events and viewing the events meaningfully as well as for use for future reference in interpreting the present and future reality.

This concludes my reflections of what I did as I facilitated the student club in creating and developing its organizational story. I am hoping though, that a year from now, I can use what I have learned to create a course on this topic. (See a previous blog posting about my ideas related to such a course in Corporate online storytelling: for libraries?).

References:

Boje, D. M. (2008). Storytelling organizations. Los Angeles: Sage. 

Gabriel, Y. (2000). Storytelling in organizations :Facts, fictions, and fantasies. Oxford ;; New York: Oxford University Press. 

Linde, C. (2009). Working the past :Narrative and institutional memory. Oxford ;; New York: Oxford University Press. 

An introduction to my narrative information source analytical framework

In my previous blog post, I made mention of my shifting focus to study library consultants. My study however, will still retain a focus on the study of blogs and tweets (or Twitter) as sources of information as well as social information spaces. It is on the point of categorizing information sources that I want to blog about in this post. Specifically, I want to discuss my framework for information source analysis of blogs and tweets

I have created a theoretical or analytical framework for analysing the types of information sources that exist in blogs and tweets  that differs from the traditional categories of people and documents in much of library research literature. Instead I propose a method that classifies information into types of narratives, rather than into types of media/channels. In this sense, narrative information sources can transcend media and is increasingly applicable to the online and social media world, where the lines between storage medium and communication with people are blurred. In this framework, narrative refers to an account of either an event or an experience. This account can be told in varied ways where a person can either attempt to tell the account in a factual and objective way or can perform the account in an interestingly and aesthetically pleasing way to interest in one's audience (sacrificing some of the facts for emotional effect) (Gabriel, 2000).


In my model narrative information sources fall into four main types or genres:

• non-fiction (or objective) narrative information sources
• fictional (or imagination based) narrative information sources
• reality-based, but subjective narrative information sources and
• interpretative or referral narrative information sources

Non-fiction narrative information sources - is my term to cover categories of narratives such as those that exist in academic journals, newspapers, magazines and other documents that aim to be objective and present different viewpoints of an event or different experiences, or even the coverage of a single event or experience supported by fact gathering. The intention and purpose of non-fiction narrative information sources is to be accurate and objective in its reporting of an event or experience.


Fictional narrative information sources - is my term used to cover the set of narratives that are based on imagination or even re-imaging one's world or reality (real event or experience). In this account of an event or experience, the creator may use imaginary characters, create an imaginary world, embellish and reconstruct reality or experience in ways that violate what we know about the real world or simply be creative with their event or experience in order to make it interesting and appealing to their audience's imagination and emotions. Sometimes fictional narrative information sources (like parables) aim to instruct others about real world events or experiences.

Reality-based narrative information sources - for me are those narratives that are based on one's memory, viewpoint, or personal experience. These include biographical sources, auto-biographical sources, opinions and viewpoints, views or advice that comes out of knowledge that one possesses due to personal experience or the acceptance of the experience of others.


Finally, interpretative or referral narrative information sources - is the term I ascribe to the category of narrative information sources that point to or refer to other sources, interpret other sources, provide viewpoints on other sources, or summaries commentaries or reviews. These sources are essentially based on and provide information (whether opinion or facts) about other narrative information sources.

In conclusion, this is the framework that I hope to use when conducting my analysis of tweets and blog postings. However, it is still in the beta or development stage, and I welcome your comments on it. Nonetheless, my preliminary beta test analyses have made me excited about the framework. In my next upcoming post, I hope to blog about how I have been finding this analytical framework useful and effective in understanding blogs and tweets as business information sources. Stay tuned this blog for more exciting details.

References:

Gabriel, Y. (2000). Storytelling in organizations: Facts, fictions, and fantasies. Oxford: Oxford University Press.

Narrating the library catalogue revisited

This post emerges as reflection on discussions with various persons about the library's reader advisory services and how the OPAC can help in this process. If you have been following this blog for a while, you will recall that I have been working on papers as well as presentations on how one can narrate (or use storytelling techniques) to present OPAC results. From the varied interactions with persons on this subject, my thoughts on this subject matter has evolved considerably.

A fellow PhD, after attending a presentation on my thoughts on the idea of using storytelling in the OPAC, mentioned to me that  many catalogues are adding readers' recommendations and advisories. For example, she noted Toronto Public library, sending me this example. She further suggested that by using readers' recommendations and advisories, librarians do not have to be responsible for the content; instead the content will be supplied by the system and the users or readers that generate it. She further pointed out that summaries and reviews incorporated in OPACs can be retrieved from APIs (e.g., Amazon, or some other sites). I have also personally attested to this myself in a previous blog posting, whereby using readers' reviews from goodreads.com, I was able to construct some picture of what a particular book was about. The same is true for Amazon.

In these cases, user generated reviews, stories or narratives about what a book or document is about, are already to some extent being incorporated into library OPACs  as alternatives information sources to inform or signal to other readers the potential content one can expect to find in a book. This is important, because for some books, like graphic novels, one needs to be made aware in advance, what one might see (or not see). However, I will get back to this point in another post, in which I hope to tackle graphic novels in libraries as a separate reflection.

Narrating the OPAC presentation

So I completed my presentation at NCompass Live Tech Talk with Michael Sauers. Feedback from the show as well as from my oral presentation at my faculty got me thinking about the viability of using agent characters to help introduce users to content in the OPAC and guide them to even more useful content. Some of those ideas I will think about further as I prepare and refine my thoughts further for the presentation at Canadian Association for Information Science in June, 2013.

In the mean time, you can view the slide presentation here

NCompass Live: Narrating the OPAC: How Can Storytelling and Narrative Analysis Improve the User-Friendliness of the Online Public Access Catalogue from Nebraska Library Commission

Or alternately, you can watch the recording of my presentation here:

The Infographic as storytelling medium

I read an interesting article by Dylan C. Lathrop on Infographics as media for combining data visualisation with human narrative or storytelling. Lathrop is an insider in the infographics industry, and in his article, provides a history of the medium dating back to the 1920s to the present. Lathrop also discusses the affordances of infographic for narrative or storytelling, arguing that while companies want to tell the stories or narratives of traditional business documents with infographics, not all business narratives can be told with this medium. As I read his article, I couldn't help but appreciate this documentation of the medium and how its features constrain how one can tell a story.


References:

Lathrop, D. C. (2013, March 19). We've reached peak Infographic, and we're no smarter for it. Harvard Business Review Blog Retrieved from:
http://blogs.hbr.org/cs/2013/03/weve_reached_peak_infographic_and_were.html