Dipping a Toe into Emerging Technologies
Librarian shares his experience introducing innovations like 3D printing and virtual reality to medical school.
May 4, 2018
Gabriel Rios’s love of medical-related technology goes back decades. Fresh out of graduate school in the 1990s, he worked as a circuit rider librarian, traveling across Virginia teaching physicians how to access MEDLINE through the playfully named software Grateful Med. By necessity, he became his own technical support guy: when the computers broke, he took them apart, replaced faulty parts, and put them back together. In subsequent librarian jobs, he found himself acting as a system administrator or teaching classes on accessing information through early mobile devices. During one of those classes, a medical student offered a glimpse into the revolution that was to come. “He wanted to read an article on his PalmPilot and my reaction was, Why would you want to do that?”
Twenty years later, Rios is the director of the Indiana University School of Medicine’s Ruth Lilly Medical Library. It comes as no surprise that he has made technology one of his top priorities. With nine campuses, it’s the largest medical school in the country, so Rios and his team of librarians, who are based at the main campus in Indianapolis, do a lot of traveling.
NEJM LibraryHub recently spoke with Rios about how his library has upped its technology game in the past several years and some of the tools his staff is introducing to students and faculty.
Q: Once you decided that upgrading the library’s technology would be an area of focus, what did you do next?
A: When I started this job in January 2014, I asked for an emerging technologies librarian position because my first step in beefing up technology would be to create a technology team. I assigned one of our librarians to oversee and coordinate the team and then I hired the emerging technologies librarian. Her role is to research new technologies, assess and test them. If we move forward with a purchase, she provides training to other librarians and to students and faculty. The team also includes a programmer/web designer. I’m also hoping to add one more technology-focused librarian to the team.
Q: Why is it important for medical students to be exposed to these technology tools?
A: One of our roles as medical librarians is to democratize access to technology — technology that will impact careers. Our students don’t need to become experts, but I would like them to be familiar enough with these tools that when they are exposed to them in the workplace, they feel comfortable. None of the technologies we’ve purchased have involved huge investments, so my approach has been to listen to what students are asking for and then throw things against the wall to see if they stick.
Q: Your 3D printer was your first venture into an emerging technology. What prompted you to purchase one?
A: It began when some of our medical students were going to the main university library to print bones and skull cross-sections and we thought we should have more knowledge and resources in this area. Our library ended up buying two printers — an entry level one that cost about $1,500 at the time (it would be cheaper today) and a mid-range one for about $5,000. At first, we encouraged students to use the technology by allowing them to use the printer for something fun — like printing an iPhone holder or a trinket— before moving on to more educational uses. We do the printing ourselves now and fulfill orders from students — at no charge — on all of our campuses. Requests have included parts of the heart, nerve structures, knee joints, and diseased bones. We have had a few requests from first-year students for the skull of Phineas Gage, the 19th century railroad construction foreman who survived an accident in which an iron rod was driven completely through his head.
The National Institute of Health has a 3D Print Exchange that has been a good resource. We’ve depended on undergraduate and graduate engineering students to do some of the cleanup work because the Exchange models are of variable quality. Engineering students can be a great resource for libraries looking to beef up their technology.
Our less expensive printer, which is portable, has traveled to our other campuses to expose as many students as possible to the technology.
Q: Tell us about your next purchase, the visualization wall.
A: I wanted a tool that would help visualize big data. The wall is made up of eight 55-inch LED screens. They can be used as eight separate screens or one large one. They’re great for looking at things like a molecule or gene sequence because they’re ultra-high-resolution and you can zoom in and out.
Our students have used the wall for concept mapping — studying anatomy, disease states, and different body systems and seeing how they all relate to each other. We had a fourth-year student teaching first and second years how to do this. Peer-to-peer teaching is great because students sometimes prefer to learn from each other. We have a Technology in Medicine group at the medical school and I’d like to do some collaborative projects with them, using the wall.
I anticipate we’ll also use the wall for purposes not related to teaching. For example, our medical education research office could use it to look at the geographic trajectories of our graduates, which is especially relevant in light of physician shortages in rural areas. They could plot out which medical campus the student studied at, where they did their rotations and their residencies, and where they ended up practicing. Visualizing data in this way speaks to you more than just looking at numbers or a chart.
We also purchased a 92-inch monitor. Anatomy professors are using it with a software product called BodyViz and 3D glasses, enabling students to manipulate anatomical structures in 3D. It allows you to take an existing MRI or CT scan, import the DICOM data, and then view it in three dimensions.
Q: Tell us about your venture into virtual reality.
A: We bought a couple of virtual reality systems called HTC VIVE. Frankly, we didn’t have any requests for the technology, but we were curious about the capabilities and knew about a couple of intriguing VR programs out there. And it was a small investment. We purchased an anatomy app called Organon, which lets users interact with anatomical structures. You can peel back layers of skin or remove and examine organs. We’re very early in our exploration of virtual reality. We haven’t received buy-in from the anatomy faculty, so VR hasn’t yet been integrated into the curriculum. I understand their reluctance because it takes a lot of time to customize a technology like VR so it can be used as part of a lesson.
There is another VR tool that’s very intriguing called We are Alfred. It helps users experience what it’s like to be an older adult with visual or hearing impairments. By 2030, it’s projected that one in five American adults will be over 65, so it’s likely that most of our students will be caring for many older patients and this could help teach empathy and communication skills. We haven’t purchased it yet, but I would like to.
Q: How have you been exposing students and faculty to these technologies, besides traveling to other campuses with the 3D printer?
A: Much of it is word of mouth. Additionally, every week we hold a Virtual Reality Friday. We open the library’s VR room to anyone who wants to play with Organon or a non-educational app to become familiar with the environment. Also, for the past two years we’ve held a maker fair. We’ve had groups from the entire university and outside groups as well talk about or demonstrate ways they’re using technology. We had occupational therapy folks demonstrating adaptive equipment they printed with 3D printers and a dental surgeon showing jaw implants he made. A local school for the deaf and blind spoke about 3D transportation maps they’ve printed for their students.
It’s been great to introduce our medical students to this cutting-edge technology and to become known as a library that brings tech innovators together.