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The purpose of this paper is to present longitudinal data on the accessibility of 56 North American academic library web sites, as well as insights into the connection between accessibility and certain design methods and technologies.

Bobby 3.1.1 was used to evaluate compliance with the Web Content Accessibility Guidelines 1.0. Also studied were the main method of page layout (CSS versus HTML tables), whether a content management system was used, and whether skip‐navigation links were employed.

The percentage of Bobby‐approved pages has remained consistent around 60 per cent in 2010 and 2012. However, the percentage of errors per page, a metric more sensitive to the pervasiveness of accessibility barriers, has steadily and significantly decreased. Sites whose layouts are built with cascading style sheets have fewer errors per page than those that use tables for layout. Sites that use a CMS have considerably higher percentages of approved pages and fewer errors per page than sites that are not built with a CMS.

The principal tool used, Bobby 3.1.1, is capable of detecting only a subset of accessible design principles. Future studies should examine compliance with the newer WCAG 2.0 guidelines.

The use of a content management system may have a positive impact on accessibility. While this study reveals some promising trends, more education and continued advocacy is needed to increase web accessibility at libraries.

This is the only study that provides up‐to‐date trend information about the accessibility of a broader set of academic library web sites (a set not limited to one state) over an extended time period. It is also the only accessibility study comparing academic library web sites that use a content management system to those that do not.

The purpose of this paper is to take a critical view at leadership of the American Library Association (ALA) and discuss the extent to which its policies promote, or fail to promote, a barrier‐free online library environment.

Analyses selected ALA policies, and examines the degree to which accessibility advocating groups within ALA participate in the process of policy making.

Several ALA policies and guidelines dealing with digital resources neglect to address the needs of users with disabilities. The organizations within ALA that are advocates for people with disabilities, particularly the Libraries Serving Special Populations Section (LSSPS) and the Accessibility Assembly, fail to pay attention to policy development in other ALA branches.

Suitable ALA organizations should establish a clearinghouse providing easy access to vendor‐supplied information as well as pointers to data collected by independent researchers. Advocates for people with disabilities within ALA need to band together and put in place an organizational structure (a kind of watchdog group) that enables them to systematically monitor, and, if deemed necessary, to respond to the policies and guidelines drafted by other ALA groups.

This is the only article that takes a critical view at ALA's leadership and discusses the extent to which ALA's policies promote, or fail to promote, a barrier‐free online library environment.

Only properly designed web sites are accessible to people with print disabilities. The purpose of this paper is to follow up on earlier investigations of this kind by looking at the web sites of all 56 ALA‐accredited library schools, and of the libraries on these campuses.

Bobby 3.1.1 was used to evaluate compliance with major accessible web design guidelines. In addition, key web pages were checked manually for the presence of skip‐navigation components, and the sites' re‐design status was ascertained. The results were presented in the form of basic descriptive statistics, including percentages of Bobby‐approved pages and the average number of barriers per page. Correlations of the current accessibility data with older data sets and with library school ratings were also calculated.

The results indicate that despite an increase in accessibility, only 50 to 60 per cent of the web sites were free of Bobby‐detectable errors. Canadian sites were more accessible than US sites. Contrary to previous findings, recently redesigned sites tended to be more accessible. Highly ranked sites also tended to have higher accessibility scores. US sites showed a random‐like up‐and‐down movement in accessibility status between 2002 and 2006.

The collected data reflect compliance with only a subset of accessible design principles.

More education and continued advocacy is needed to increase web accessibility at libraries and library schools and to help establish library schools as models of program accessibility.

This is the only study that provides trend information about the accessibility of a broader set of library and library school web sites.

Research shows that family is influential to African Americans in college choice (Chapman et al., 2018; Chapman et al., 2020; Freeman, 2005; Hines et al., 2019; Lowry, 2017; Williams, 2018). However, it often overlooks unique, African-rooted characteristics of African American families and culture. This study aimed to explore whether and how these characteristics shape college choice for these students.

Data were collected through semi-structured interviews with six, first-year African American students at an urban university. The data were analyzed using theoretical thematic analysis.

The major themes showed the influence of family, community and spirituality in shaping participants’ college choice decisions and perception of higher education.

In addition to identifying specific family members who were influential to African Americans in college choice, this work highlighted the role of communities as a whole in shaping these students’ decisions and creating supportive environments. It also showed the importance of these students’ relationship with God through the college choice process. The work can guide researchers and educators in considering African American families and culture as strengths in helping these students through college choice.

The purpose of this paper is to report on the dynamics of “identity leadership” with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi et al., 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients.

A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments’ perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months.

The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas.

More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech et al., 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity.

This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS.