Featured Librarian
Learning New Skills as Careers and Library Technology Evolve
Librarians share advice about reskilling for promotions, in-demand technology skills, and the librarian expertise being left on the table.
July 2, 2018

Andrea Twiss-Brooks and Susan Fowler have had interesting and varied careers in library science. Twiss-Brooks joined the University of Chicago in 1993 as a chemistry librarian, later became co-director of Science Libraries, and today is the interim co-associate university librarian and the director of Research and Teaching Support for the entire University of Chicago Library.
Fowler began her career at Washington University in St. Louis (WashU) as a medical librarian and coordinator of systematic review services and now is the library director at WashU’s Brown School, a graduate school of social work and public health.
The two had a wide-ranging conversation with NEJM LibraryHub about moving from hands-on librarian roles into more administrative/supervisory positions; specialized skills medical librarians will increasingly need; and librarian expertise that could be better leveraged by clinicians and researchers.
Q: Each of you started out as librarians doing the day-to-day work of helping people locate information. But eventually, you took on roles that were largely administrative and supervisory, working in subject areas that were new to you. Do you have advice for medical librarians considering similar career moves?
SF: You’re going to have to learn new skills when you make the move from a hands-on role to an administrative one; an obvious one is how to handle a budget. But I also had to learn softer ones like upping my political game, exercising more patience, delaying judgment and big decisions, listening more closely, and remembering more — that translates to taking more notes, in my case.
In terms of subject area, yes, I had to learn new subjects. But as a medical librarian, I was always learning new subjects because medicine changes constantly. The biggest adjustment was adapting to subjects that are not as well organized as medicine. There is no subject as well organized as medicine. The taxonomy and terminology are extremely clear and distinct.
AT-B: I started out as a chemistry librarian. I took on additional subject responsibilities as my career progressed. Now, two of my subject areas are geography and maps, which I know little about. It’s undoubtedly easier to do effective collections development and reference and consultation services if you have the subject area background. But if you don’t, you can use a lot of the skills and knowledge you already have. You figure out how scholarship in a particular field is organized, familiarize yourself with subject vocabularies, and identify the major outlets for the scholarly literature. Then you adjust your strategies for discovery of the literature based on its characteristics.
My career opportunities came organically — an illness, a retirement — and in these types of situations you may say “yes” to a promotion opportunity without being entirely certain of what the new job entails and without much time for advance training.
Q: Did you do anything specific to prepare for your promotions?
AT-B: I gained experience in some of the skills I needed for these new jobs by volunteering to lead committees and work groups in areas where I had interests. Library associations are always looking for people to take on leadership roles. Then you need to be clever about articulating how that experience can translate to the new job you’re applying for.
SF: There are also two excellent leadership programs for academic librarians that I’m familiar with. One is the Leadership Institute for Academic Librarians, which I have done. It’s a week-long summer program at the Harvard Graduate School of Education. The other is the National Library of Medicine/Association of Academic Health Sciences Library’s Leadership Fellows Program, a year-long program that matches fellows — who aspire to director positions — and mentors. Andrea has served as a mentor in that program.
Q: As information technology has evolved in medicine, is there a demand for medical librarians with certain technological skills?
AT-B: There is more demand for librarians — medical and otherwise — with knowledge of programming language, data analysis and visualization, and user experience design. These things have not traditionally been taught in library programs. The University of Chicago wanted to explore hiring system-wide librarians with some of these specialized technology skills. So we created three two-year “residencies” — in Geographic Information Systems (GIS), online learning, and user experience design — targeting early career librarians with these skills. Most candidates were fresh out of library school, but a library degree wasn’t always a requirement.
We did not create a permanent position for an online learning librarian, which I still think is an important role, but is a lower priority for us at this time. The user experience librarian is still doing her residency. She has been a team member on different projects, including improving the library website and streamlining the interlibrary loan service.
The GIS residency was especially successful. Like the other residents, she shared her specialized knowledge with the university community. She held workshops, consulted with students and faculty about using GIS tools, and held a mapathon, where people came together to enhance digital maps of Haiti to assist in humanitarian efforts, using data from sources like aerial photographs. We’ve now created a permanent position for a GIS librarian, redefining an existing map librarian position.
Q: Do you think that medical librarians have a larger role to play in health care, and particularly in patient care?
SF: Yes. Librarians can and should be on patient rounds with the care team. They should be another member of the interdisciplinary care team just like the pharmacist and the nurse practitioner. We have done this at Washington University and it has been successful, but no one is prepared to pay the required salaries to have a librarian on every care team or even a librarian in every hospital unit. For now, we have one librarian integrated at the adult care hospital full-time. She goes on some rounds, which provides her with enough expertise to answer clinical questions.
AT-B: There is some research that shows that when clinical librarians round with care teams, the quality of clinical questions improves and the teams are getting access to more and better information — at the point of care and afterward during clinical follow-up.
SF: I believe that librarians should also play a role in the development of clinical decision support tools. The developers of these tools often don’t understand how medical research is organized. When I attended the American Medical Informatics Association conference, I saw some projects that were replicating Medline and MeSH.
AT-B: I also think that while some health science libraries do offer systematic review services, librarians could be getting more involved with research — in everything from structuring the search strategy to preliminary review of the search results. We can also help with the organization and preservation of data and even provide advice on publishing.
Q: Any final thoughts on the role of medical librarians in medicine, especially in the digital age?
SF: People, including physicians, often think that if you can’t find the answer to a question on Google, it doesn’t exist. I’ve seen physicians go to Google or PubMed and type in a whole list of symptoms and the answer they get back is gobbledygook.
They don’t realize that a librarian could take the list of symptoms and do a search to find the best possible studies that address these symptoms. We have to find a way to communicate our services better to a new generation of information users.
