Curing The Gomer

The patron has a question: What is a gomer, and how do you cure him/her? The patron suspects, and rightly so that a gomer must be some sort of patient, but beyond that she is stumped.

What do you do?

First think about your patron. She may be faculty, graduate student, or undergraduate. Who your patron is, determines the kind of searching she may do, and some of the problems she may encounter, as well as some of the tools she uses.

Where To Go?
Patrons and Their Needs
The Trouble with Gomer
When One Question Becomes Many
From Question to Strategy
Two Paths to the Subject Headings
Other Ideas
Patrons and Their Needs
Faculty
Graduate Students
Undergraduates

  1. They may be the ones assigning this question. They will need your help in making this a doable assignment.

  2. Reliance on tools and techniques beyond traditional bibliographic indexes/abstracts. Hopefully faculty share some of this knowledge with their students.

  3. Use of the "invisible college."

  4. A need for seminal papers and very current materials.

  1. Many are working professionals or soon to be working professionals. They will have less trouble focusing this paper.

  2. They seldom get caught having to do a paper the night before.

  3. Their papers tend to be longer than undergraduate papers.

  4. They may need seminal articles and very new material.


  1. If this question/assignment is not carefully given, they are VULNERABLE to having an impossible project.

  2. Undergraduates sometimes start papers the night before.

  3. They will need to choose the focus of this project if their professor does not specify one.

  4. Put another way, undergraduates are more likely to have this question as part of an interdisciplinary project.

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The Trouble with Gomer

gomer pyle USMC

This question can be either a wonderful challenge or an impossible assignment. The reason is that "gomer" is a word with many meanings. Gomer is the wife of Hosea in the Bible. It is a last name, and most obviously, the name of a certain famous television character.

The definition of gomer in medical circles is a derogatory slang term that describes an old patient and infirm patient who at a minimum tries medical staff's patience. He or she may come from a nursing home or off the streets.

The fact that gomer is derogatory slang may indicate that it is the medical staff's attitudes that need a "cure." By now it should be clear that a gentle hint from a professor that "gomer" is a less than complimentary piece of medical slang, can keep this assignment challenging and enjoyable. More importantly, another question lies inside the initial inquiry about curing a gomer, but what question is it....

When One Question Becomes Many

Does the patron face a confusion of options or an embarassment of riches....Here are some possible interpretations of the intial question about curing a gomer..... Note: some questions stress the problem while others are more solution oriented. The questions a graduate student or faculty uses are colored by her professional focus, while an undergraduate must rely on her professor to help her focus her search or she must choose a focus for herself. One of the beauties of an ambiguous topic is that it allows many approaches to a single topic.

  • What are medical professionals' attitudes toward the aged and infirm?

  • How can medical professionals commuincate better with the aged and infirm?

  • What are the stresses (burnout) for medical professionals who work with the aged and infirm?

  • How can hospital staff communicate better with those in nursing homes?

  • How can hospital staff better treat the homeless?

Note: the patron also has to decide on which medical professionals interest her. She has choices that range from social workers to nurses to doctors to those who manage health care facilities.Graduate students may want to concentrate on their own current or prospective professions, but an undergraduate may have a choice.

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From Question to Strategy

Whether faculty member, graduate student or undergrad, the patron now confronts the problem of translating her search question into language that database software can understand. Put succinctly, computers are DUMB AS DIRT.

The first step to a search strategy is to circle key concepts in the question.

search statement with concepts circled

Note: medical professionals is circled in green because it is not necessary to use it in a health science database, and in some other databases, it may vanish because many of those who work with the elderly are medical staff, or because health care professionals are part of a search term that includes their attitude and well being.

Since the search involves two (or three) concepts, the results the patron wants are the overlapping area in this circle (Venn) diagram. The AND does not have to be capitalized and underlined, but I usually write it this way to emphasize that it is not a word, but rather, the intersection symbol, the mathematical operator for intersection of sets, in this case, sets of ideas.

Diagram of a Boolean AND statement

Because this is a professional/social issue in medicine topic, terms and language are also imprecise. The patron may need to think of synonyms for her topic as well. The patron may need to try her search with several synonyms before she gets the results she wants.

But wait.... Where will the patron run her search? As with the search questions this topic spawned, the patron can run her search on any database that fits her focus. For medical students or premedical students, Medline, is a good choice. For those in allied health and nursing, there is CINAHL, which focuses especially well on care giving issues. Social Science Index, provides a different perspective as does PsychFirst.

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Two Paths to the Subject Headings

Despite the pretty diagrams, this is still a very sloppy search. The search is sloppy because language is sloppy. Humans have no trouble understanding language but this is clearly not the compter's strong suit. With any of the search questions and their resulting topics, there are several equally good synonyms for each search term. If you do not believe this, try thinking of all the medical and standard English words for "old person" or "medical professional."

Subject headings offer a way out of this mess. When consistently applied, subject headings mean that the index has chosen one word for all the synonyms for that concept. If you find the subject heading, you automatically get all the synonyms. Medline, for example, uses aged (also aged, over 80) for "old people."

How does your patron find subject headings? First, she uses an index that is clean. Subject headings only work their magic when consistently and accurately assigned. This means Ebsco Academic Search Premier is a poor choice for curing gomers.

But how does one find subject headings...... There are two methods and both work reasonably well. Many users like to dive face first into their database and look for the subject headings in references that look promising. In First Search, the patron needs to do an "advanced search" to obtain subject headings. For many students, advanced search, is actually easier since they can spread out a Boolean search by filling in the blanks of the multibox.

Here is what a face first search might look like.

searching face first

Here is a list of subject headings And here is a list of subject headings from a promising article. The patron can copy and paste one of these headings, or she can write them down since there may be several that work. The patron then repeats the search with the headings she has found. This is an advanced search which simply means fill in the blanks. Note that the patron has set the boxes on the right to MeSH Heading.

the second face first search

Here is the browse box for burnout If the patron has a good list of synonyms or some familiarity with the database or if she likes an organized step-by-step approach, using FirstSearch' browse capability or other indexes' thessauri. For this type of search the patron sets up an advanced search, types in a likely subject heading and clicks the box with the spool on it, on the right side of the screen. She does this after setting the pulldown menu to MeSH Heading Phrase or Subject Heading Phrase. This brings up a list of exact subject headings. The patron clicks on the subject heading of her choice and this sends it to the advanced search screen.

She needs to repeat the browse and click for each concept of her search. A search set up by browsing for subject headings might look like....

A search done with browsing

Of course the patron does not have to stick with just one method. She is free to write down or copy subject headings she sees when looking at references, and she is free to browse the thesaurus while face first searching. In an ideal world, the patron should learn and try both search methods.

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Other Ideas

Of course the patron has several other options in addition to traditional bibliographic index/abstract databases that offer references to journal articles.

Books are one possibility. There is one particular book, The House of God, whose author is said to have coined the term, gomer. The patron can find books by searching the FLITE's catalog. She may need to use the catalog's advanced options or search for only part of her topic.

Current Contents is not an index, but a browsing tool. If the patron knows possible journals that cover professional practice topics or geriatrics or medical sociology, she can check recent issues' tables of contents. Current Contents is not just a tool for graduate students and faculty. With helpful suggestions from their professors, undergraduates can use this tool as well.

Snowballing is the practice of looking for references at the ends of articles. The advantage of this method is that references tend to be closely related to the article that cites them. This is a tool that all three patron groups can enjoy.

Citation searching is snowballing in reverse. It involves using SciSearch, Social SciSearch, or Arts and Humanities Search to find out what other articles list an older but excellent article in their references. This is a great tool for any one who has found a really good older article or a seminal article and wants newer material on the same subject. Note: not all libraries have access to citation searching.

Faculty and graduate students may both rely on the invisible college in addition to the library's database. Preprints, conference papers, and other items circulated by those in the field appears only on the librarian's radar as grey literature. Librarians can help faculty access the invisible college by showing them how to find author affiliations if they don't already know, verifying conference paper interloans, and looking to see if preprints are available, usually by visiting a journal's web site.

Concluusion

Remember that even if the patron is stumped or preparing to stump her students, you do not have to be stymied. "Trick questions" such as how to cure a gomer, offer both you and the patron an opportunity to look closely at language, carefully plan an elegant search strategy, and exercise creativity and critical thinking.

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