case KM II (Tuff University)
Down from the Ivory Tower
Call Elizabeth Eaton a pioneer, but she prides herself on being a pragmatist. The director of Tufts’ health sciences library learned in the late 1980s of a new project by the American Association of Medical Colleges (AAMC) in Washington, D.C., and the U.S. National Library of Medicine (NLM) in Bethesda, Md., to explore the use of technology in library information management at medical schools. Her mission: to get Tufts’ foot in the door. The project meant obtaining the backing of two of the nation’s most powerful medical organizations. It also meant money—big money. Eaton wanted Tufts to stake its claim to the hundreds of thousands of dollars in NLM grants.
Eaton got what she was after. Tufts received its first $241,000 grant in 1990. The medical school also chipped in startup funds. To decide how to use the money, she convened a planning team, including members from the health sciences library, the educational dean’s office, IS and administration. The team held a marathon of more than three dozen focus-group sessions with faculty and students to find out how technology could help them teach and learn. From the long wish list, one item leapt out: a library of digital images of laboratory slides that faculty use to teach students how to identify cells, tissues and microorganisms.
Each semester, demand for these slides created chaos, especially just before exams, when hundreds of students would descend on the library to view the only two slide carousels that the university could afford to create. Faculty members were also distraught because over the years many slides—some of them rare and more than a century old—had been destroyed, misfiled or had disappeared from the library altogether.
The decision was unanimous: They would build a digital image library. The team chose to use database technology to build the system—a decision that would prove to be prescient. “One of the most important things that we did was think database in terms of organizing the information,” Eaton says. “Of course, librarians have been thinking that way for a hundred years, so it’s not hard to understand how we got to that point. But a lot of schools didn’t do that.”
Choosing the right technology wasn’t Tufts’ biggest challenge. The greatest hurdle was changing organizational culture. When asked for her opinion about the database, Mary Y. Lee, a physician and the medical school’s dean of educational affairs, told Eaton, “The students will not use the system unless it’s connected to the curriculum.” Eaton now had doctor’s orders: create content, content, content.
And there was plenty of content to be had. In Lee’s office suite towers a 6-foot-high by 4-foot-wide bookshelf, crammed end to end with three-ring binders stuffed with course materials for the first two years of medical school. The keepers of this information trove? The faculty. Handing over their slides to be digitized was one thing, but turning over their course materials was another. “Initially we had a lot of faculty—screaming is too strong a word, but close to screaming at me—saying that I was going to replace them,” Lee says. “I was ruining medical education by replacing them with machines.”
Winning faculty buy-in took a tag-team effort. Lee reassured faculty the system was not intended to replace traditional medical education methods. Metz explained how IT could help alleviate larger economic pressures facing Tufts by reducing costs and increasing efficiency. But Metz closed the deal by telling them the system could improve their effectiveness in the classroom. “In higher education, people have been teaching the same way for centuries,” he says. “The truth is that they’ve been doing it very well. But to point out that a new model of education can work with a higher level of quality—that gets people’s attention.” The team found instructors who had been using the Internet since its early days and were eager to put their material online. Then, other faculty wanted to try the system too. Soon instructors began collaborating to create and integrate course content. “Initially, we had some very strong opponents who became extremely strong proponents after they started using it,” Lee says.
When the site made its debut in September 1997, students raved to their instructors about having around-the-clock access to course material on the Web. “The great thing was being able to look at the slides at home,” says Bullitt, who lives 20 miles from the downtown Boston campus. Using the website as a personal knowledge management system, she organized her course materials into her own folders and made frequent electronic notes. “It’s like having an annotated textbook that I could use anywhere, anytime,” she says.
In a sort of collective “aha!” faculty and students realized that the system could do much more than digitally duplicate textbooks and lab slides. Ideas for new applications and features snowballed. Eaton’s development team worked nonstop to keep up with requests to put content online, including post-course evaluations by students and class schedules.
Despite the momentum—and more grants—the development team recognized that the system could not survive indefinitely on grants alone. So in 1999, the team began drumming up support from Tufts’ veterinary and dental schools, adding some of their course materials to the database as a trial and proposing a budget in which all three schools would support the system.
Today, the system contains approximately 70 percent of the medical school curriculum and a smaller percentage of veterinary and dental school courses. It has evolved from a simple digital image library to a knowledge management system that integrates complex layers and levels of medical information across many disciplines. “It’s more than just throwing a bunch of images into a file,” says Richard Jakowski, a professor at Tufts’ veterinary school. “You have to integrate them with text, put them in the right spot and make them mean something. Otherwise, you’re getting a pop when you can make an atomic bomb.”
