Michael Clarke Executive Editor, Pediatrics Online Information & Education Conference 2005

1. Using Print and Online Content: The Information Seeking and Reading Habits of Physicians: A Case Study of Pediatricians Michael Clarke Executive Editor, Pediatrics Online Information & Education Conference 2005

2. 1960s 1970s 1980s 1990s 2000s The Launch of E-Journals Development of Electronic Journals WWW Search Engines HTML PubMed Algorithmic Search XML CrossRef DOIs SGML UNIX Electronic Databases PC Windows Internet Mainframe Computing

3. 2006 2008 2009 2007 2nd Phase of Electronic Journals Development of Electronic Journals Launching online journals and getting 100% of journal content online and searchable Incremental improvements for searching and filtering vast amounts of information 2009 2003 2004 2005 2006 2007 2008 1st Phase of Electronic Journals • Critical mass of legacy archives online • Development of a truly integrated search of all scholarly literature (i.e. Google Scholar)

4. Readers? Methods Used to Analyze Readership Readers? Reader Surveys Usage & Citation Analysis Focus Groups/ User Studies

5. Methods: Reader Survey • Survey design and analysis conducted in collaboration with Professors Carol Tenopir & Donald King • 4,000 surveys sent out by snail mail Spring 2004 • 2 versions, each sent to 2,000 readers • Surveys sent to AAP members • $1 incentive • Return postage paid • 1 follow-up letter

6. Methods: Reader Survey • Version 1: PEDIATRICS Journal Survey • 685 returned questionnaires (34.25%) • Version 2: Critical Incident Survey • 666 returned questionnaires 33.3%

7. Methods: Questionnaires • 2 brief questionnaires (sent to different sample groups of 1000 at different times) • 34% & 31% response rates • Conducted by Research USA • Blinded data collection • Sample of Table of Contents • Purpose was to determine whether specific articles were read in print or online

8. Methods: Focus Groups 2 focus groups were held in May 2004: • Focus Group 1: Researchers • PAS, May 2, 2004, San Francisco • Focus Group 2: Clinicians • AAP Practical Pediatrics Course, May 14, 2004, Sante Fe

9. PEDIATRICS: Vital Signs • Published monthly • “Early Release” articles published on 1st and 15th of every month • Impact factor: 3.781 (1st in field) • Total citations: 25,691 (1st in field) • Original science articles: ~700 annually • 62,000 subscribers (English edition)

10. Pediatrics Print and Online

11. Represent a much greater percent of total readers Journal Subscription Profile Total Subscriptions = 62,000

12. Demographics: Practice Setting of Individual Subscribers Spring Reader Survey

13. PEDIATRICS Electronic Pages • Began in 1997 (first online-only section of a medical journal) • Articles freely accessible (“open access”) from day of publication • Same peer review process as printed articles • Final, edited, redacted version only • 30-40 percent of research articles published in e-pages

14. Pediatrics Electronic

15. Electronic Pages

16. Electronic Abstracts

17. Why do you read PEDIATRICS? (print) • 78.8% Keep current • 36.7% Find specific information • 20.2% Know what my colleagues are up to • 12.0% Learn about other subspecialties Spring Reader Survey

18. What Sections of PEDIATRICS Do You Read Regularly? Abstracts 71% Policy Statements 56% TOC on Cover 39% Articles 32% Commentaries 29% TOC Inside Journal 18% Green Pages 18% Spring Reader Survey

19. What Sections of PEDIATRICS Do You Read Regularly? Abstracts 71% Policy Statements 56% TOC on Cover 39% Articles 32% Commentaries 29% TOC Inside Journal 18% Green Pages 18% “The abstracts in the Green Pages are difficult to read. The green paper makes it harder to read and the abstracts are formatted poorly. I often read on the exercise bike, and I just give up when I get to the green section.” —Focus Group Participant “The abstracts in the Green Pages are difficult to read. The green paper makes it harder to read and the abstracts are formatted poorly. I often read on the exercise bike, and I just give up when I get to the green section.” —Focus Group Participant Spring Reader Survey

20. What Sections of PEDIATRICS Do You Read Regularly? Abstracts 71% Policy Statements 56% TOC on Cover 39% Articles 32% Commentaries 29% TOC Inside Journal 18% Green Pages 18% “I get the journal in the mail. I look at the cover, circle the articles I am interested in, and then set it aside for when I have time to come back to it.” —Focus Group Participant Spring Reader Survey

21. Indicate your agreement with the following statements (print) (Strongly agree = 5/Strongly disagree= 1) • It is easy for me to read 4.08 • It is easy for me to use 4.07 • I like it because it is portable 4.06 • It is convenient for me 3.88 • It is easy for me to find things 2.95 • Using it is time consuming 2.88 Spring Reader Survey

22. Indicate your agreement with the following statements (electronic) (Strongly agree = 5/Strongly disagree= 1) • Can search comprehensively 3.42 • Online features are valuable 3.29 • It is easy for me to find things 3.16 • The navigation makes sense 3.14 • It is convenient for me 3.08 • The interface is cumbersome 2.94 • Using it is time consuming 2.94 Spring Reader Survey

23. Which features of the electronic edition do you use? Advanced searching 14.2% Links to Medline 12.1% Most-Read Articles 8.9% Topic Collections 5.4% E-mail Alerts 4.7% E-Letters 4.7% Free Reference Links 4.5% Spring Reader Survey

24. What electronic features would you be likely to use if added? CME 56% Download Figures to PowerPoint 56% Publish Ahead of Print 41% Full-text & Search on PDA 32% Citation Reporting by Article 27% Usage Reporting by Article 15% Spring Reader Survey

25. What format do you prefer to receive PEDIATRICS in? • 59.3% Print only • 8.2% Electronic only • 33.6% Both print & electronic • 92% Wish to continue to receive print Spring Reader Survey

26. And Yet…PEDIATRICS electronic usage… *projected based on year-to-date statistics

27. Indicate your agreement with the following statements (e-only articles) (Strongly agree = 5/Strongly disagree= 1) • e-articles are reviewed as strictly as print 3.21 • e-articles are as useful as print 2.84 • e-articles are second class 2.71 Spring Reader Survey

28. e-Articles vs Articles, 1999 – 2005 *projected based on year-to-date statistics

29. Most-Read Articles, July 2004 July Questionnaire

30. Most-Read Articles, July 2004 July Questionnaire

31. Top e-Articles, July 2004 July Questionnaire

32. Comparisons: PEDIATRICSReaders to Other Scientists • King and Tenopir have surveyed ~25,000 respondents since 1977 • Medical, physical, and social scientists in all settings • Data from 2001-2004 reported today

33. Univ. medical Univ Scientists All Scientists Soc Sci/Psych Engineers Pediatricians ~322 articles/year ~216 articles/year ~130 articles/year ~191 articles/year ~111 articles/year ~180 articles/year Number of Articles Reader per Year Article Read Spring Reader Survey Compared with Data from King & Tenopir

34. University Faculty 37 % 63 % Form of Reading Pediatricians 16% 84% Medical Faculty Astronomers 20% 25% 75% 80% Spring Reader Survey Compared with Data from King & Tenopir

35. Form of Final Reading: PEDIATRICS Readers 7.5% 92.6% Spring Reader Survey Compared with Data from King & Tenopir

36. Sources of Readings Pediatricians 21.4 % 12 % 16% 72 % Medical Faculty University Faculty Astronomers 16% 21 % 22% 44 % 49% 36% 36 % 62% 16% Spring Reader Survey Compared with Data from King & Tenopir

37. Age of Last Article Read 17 % Scientists Astronomers Pediatricians 13 % 2 % 10 % 17 % 23 % 21 % 64 % 81% 69 % Spring Reader Survey Compared with Data from King & Tenopir

38. Principal Purpose of Reading Spring Reader Survey Compared with Data from King & Tenopir

39. Location when reading Spring Reader Survey Compared with Data from King & Tenopir

40. Conclusions – e-articles • E-articles are read more online because that is the only place they can be found • Perception of e-articles as second-class articles has diminished, but still lingers • “I sometimes wonder, why wasn’t this one printed?”

41. Conclusions – e-articles • Due to rising tide of manuscripts and costs of print/postage, e-only articles are necessary • ~50% in 2005 and as high as 80% in near future • Necessity of reader education on benefits of and reasons for e-only articles

42. Conclusions—PEDIATRICS Readers • Pediatrics has a bifurcated readership: • AAP members who receive print & read primarily print • Non-members who read the online edition largely via institutional subscriptions • Those who receive print, go online for specific reasons: searching, looking up a specific article, reading e-articles, etc.

43. Conclusions—PEDIATRICS Readers • Those members who do use the online edition seem to like it, but it is still not as convenient for most as print due to: • Portability • Paper is easier to read • It shows up in their mailbox • Members indicate they may use electronic journals more in the future, particular for online-only features such as CME, obtaining figures for PowerPoint lectures, publish ahead of print, etc…

44. Thoughts for Libraries Serving Physicians: • Physicians may not be entirely comfortable yet with electronic journals (they are migrating slower than other scientists) • The role of the librarian is critical in educating physicians in using electronic journals • Tutorials • Instructional material • Web sites designed with physicians in mind