UCLA librarians are advancing teaching, research and patient care

By Caroline Champlin, UCLA Newsroom

As an emergency room doctor at the Harbor-UCLA Medical Center, Jake Toy sees the aftermath of the most serious incidents happening on a daily basis in Los Angeles.

“It’s the spectrum of traumatic injuries: falls, car crashes, gunshot wounds, stabbings,” Toy says.

Tough as his job is, he’s sympathetic to paramedics who arrive on the scene first.

“There’s a lot of environmental factors going on. They’re on the highway; it’s often chaotic,” he says. “They have to make a lot of critical decisions quickly.”

Toy is passionate about ensuring that teams treating patients en route to the hospital have the best tools available to make those split-second decisions. In addition to his day job in the ER, Toy conducts academic research on this topic.

Recently, he became interested in the power of new technology. More specifically, he wondered: What if paramedics could get accurate medical advice from artificial intelligence?

Toy’s curiosity led him to the Louise M. Darling Biomedical Library, located on the southeast side of the university’s campus. The library supports the UCLA health and life science communities’ teaching, research and patient care needs.

He wanted to learn about the state of artificial intelligence in medical contexts and write a paper on his findings. But first, he needed to search the “endless sea” of medical literature for relevant information.

“It felt like a very daunting task to put that search together,” Toy says.

As a clinical and research support librarian, that daunting task is the heart of Bob Johnson’s job. He regularly offers consultations for doctors, residents, medical students and faculty who want to publish research on novel topics.

Earlier this year, Johnson and Toy met over Zoom and prepared to search the literature. Toy planned to publish a scoping review, a type of academic paper that provides a broad overview of a topic.

“After I was done with my first meeting with Bob, he sent me a huge Word document with hundreds of search terms,” Toy says.

Johnson typically spends three hours meeting with each medical researcher, but in the case of more in-depth studies, this collaborative process can take years. When conducting a systematic review, for example, librarians and researchers seek to answer a single clinical question by compiling every relevant study on the topic, sometimes reading thousands of papers.

That kind of investment is what it means to be a medical librarian in the digital age.

“There has been a huge shift in what librarians do,” Johnson said. “We’ve become a research partner.”

Medical libraries still provide the infrastructure to access literature: The Biomedical Library houses thousands of hard-copy medical journals and teaching materials. Many more resources are digital. PubMed, an online collection of medical literature, is the university’s most visited online database.

With an unlimited amount of information on these web platforms, it takes a specialized skill set to find what you’re looking for. Modern librarians are experts at sifting through search results, earning them authorship on research publications.

Johnson is currently working on a long-term project with researchers on healthy aging in people with intellectual disabilities. 

“It is a grind, but I’m really dedicated to getting a result from this,” Johnson said.

The Biomedical Library team receives requests from the university network nearly every day. Johnson specializes in serving doctors and faculty. His colleague, Molly Hemphill, helps medical students, while Antonia Osuna-Garcia supports projects with nurses.

In the past, when a medical researcher needed a librarian’s help, they would call or send an email. To streamline this process, UCLA Library launched an online portal to triage systematic review consultations. This past year alone, they’ve fielded 105 requests from departments including psychology, surgery, pediatrics, dentistry, urology, public health and emergency medicine.

For Toy, collaboration with the library has been rewarding. This summer, he published his article on trauma and artificial intelligence. He found studies on the subject are growing, and AI may soon analyze data to predict whether a patient will need a blood transfusion, or if they’re likely to survive. Determining if these tools are ready for prime time will require more research — something Toy is already considering.

Toy is among the thousands of UCLA researchers, students and faculty whose work was advanced through the resources and services offered through the library this past academic year.

Some patrons are patients

Bob Johnson will be the first to admit he’s not a doctor. He majored in English literature before earning his master’s degree in library and information science. But, serving as a medical librarian does require a good bedside manner.

Researchers aren’t the only Biomedical Library users. The facility also receives visits from patients. This includes people who walk over from the Westwood UCLA Medical Plaza. Sometimes, they’ve recently been diagnosed with an illness and are looking for more information.

“People usually come in after an appointment. … It’s intense,” Johnson says. “Some people have a gallows humor about it. But sometimes they’re trying not to cry, and then I’m trying not to cry.”

This used to be a common experience, but since the advent of online medical resources, it has happened less — around a handful of cases in the last year. Still, Johnson is glad to provide help when he can. He empathizes with people who are overwhelmed by what their doctor told them and want to understand better what’s happening to their bodies.

“When you get a diagnosis, all this information just washes over you, and you don’t always retain it,” Johnson says. “You walk away knowing something is wrong, and maybe this treatment can make it better.”

So he listens and, with the library patron, searches for the information they need, including potential treatment options and outcomes. Over the years of doing this job, Johnson knows to give a preamble before diving into the medical literature.

“I’ve learned to tell people, ‘What we read together is not a prophecy.’ This might be what happens in the majority of cases, but it doesn’t determine what happens to you,’” he says.

Before the patient goes, Johnson pulls out his stash of blank notecards. Using the medical literature as a guide, he helps them draft a list of questions they want to ask their doctor. They leave with the power of the library behind them.

Helping people help people

Statistics from the library are clear: Nurses and nursing students make up the largest percentage of all Biomedical Library users. As the health science librarian serving this community, that’s something Osuna-Garcia takes pride in.

When it comes to supporting nursing students, no time is busier than the fall. That’s when Osuna-Garcia makes in-person visits to most of the classes offered that quarter, giving workshops on how to use the library’s resources.

“Sometimes I look back at my calendar, and I’m like, how did I even do that?” Osuna-Garcia said.

Because students can access librarians in-person and online, over her seven years on the job, Osuna-Garcia has met nearly every student who’s gone through UCLA’s bachelor’s, master’s and Ph.D. nursing programs.

The nursing program integrates the library into its curriculum — research projects require students to search medical databases to answer clinical questions. So even after workshop season is over, Osuna-Garcia gets regular requests from students looking for one-on-one help.

“I make myself available 20 hours a week, and during busy times, I’m doing 20 hours a week of consultations. Like, I’m booked,” Osuna-Garcia says. “They’re not shy about reaching out.”

Sometimes, students know exactly what they want from the archives. Recently, Osuna-Garcia assisted students studying ADHD in adolescents, food allergies in infants and hospitalized neurology patients, to name a few topics.

Sometimes, though, students get overwhelmed by all the studies and papers available and have a hard time narrowing their focus.

“Many come to me in distress, and I have to say, ‘It’s OK, we’ll take it one step at a time and figure it out,’” Osuna-Garcia says.

And they do. Over the last seven years in this role, Osuna-Garcia has watched nursing students finish school, some with doctorates, and go on to permanent positions in the field.

She doesn’t know why nurses, in particular, use the library at such high rates, but she has some theories.

“It’s generally well known that the nursing community uses the help that’s available to them,” Osuna-Garcia says. Because nurses are used to helping others every day, they might be more inclined to seek support themselves.

Plus, what nurses learn from the library can be immediately implemented. Research projects ultimately help nurses provide better care to patients in hospitals and clinics. That impact keeps Osuna-Garcia invested in her role, even when her schedule is nearly overbooked.

“We are helping these people that go on to help many people,” Osuna-Garcia says.

Democratizing tools for knowledge

A librarian’s impact can seem invisible. After helping a nursing student find an online article or answering a patron’s question about a disease, they likely won’t know what happens next in that user’s life.

But as a librarian in the UCLA Library Data Science Center and head of the Lux Lab, Doug Daniels has physical proof of his contribution to the university community.

Daniels has visited all corners of the UCLA campus, making 3D models for researchers. He’s scanned ant nests and replicated Viking building tools. He even mapped an entire wooden boat used by Vietnamese refugees.

The Lux Lab specializes in emerging technologies, like 3D scanning, and offers consultations to help researchers across campus generate, process, analyze, publish and archive 3D data.

With his background, Daniels didn’t think twice when UCLA ophthalmology researchers asked him to make 3D scans of eyelid tissue.

“I walked in with my scanner, and there were six medical cadavers lined up on different tables,” Daniels says. “I just had a ‘whoa’ kind of moment. To them, it’s just a normal day.”

He didn’t realize he’d be present for the dissection. As he watched, the ophthalmologists removed the eyelids and created copies of the tissue in a mold. After an initial shock, Daniels got down to business. Using a 3D scanner, which he says looks like a “Star Trek” iron, he carefully rotated it around the samples, capturing them from all angles.

The result was a 3D digital replica of the inner membrane of the eyelid, which helped the research team compile useful examples of healthy and unhealthy tissue.

“For me, it just comes down to democratizing access to tools that are needed for research,” Daniels says.

Most of the people he and his team of student employees work with already have a doctorate or medical degree. Saving them the effort of learning a new skill set, like 3D modeling, is hugely rewarding for members of the Lux Lab, like Connor Lim. He’s a UCLA undergraduate.

Last year, Lim fielded a request from UCLA medical staff: They needed a cost-effective mount to hold their surgical probes, but options on the market were limited.

“So the idea is, can we manufacture them in-house,” recalls Lim.

As it turned out, yes. Lim met with the medical team, and using the library’s 3D modeling software, they drafted a digital prototype. After a few revisions, the medical team was able to use a campus 3D printer to create the probe holder.

“It was super simple, like not difficult at all,” Lim says.

Jacob Niles Creer is a clinical equipment specialist and a member of the UCLA medical staff. He says those 3D-printed mounts are currently used by doctors on a daily basis at the Ronald Reagan UCLA Medical Center.

“These expensive surgical probes were consistently misplaced, dropped or lost, and the simple holder has dramatically reduced this occurrence by at least 90% in these critical instruments,” he says.

For Lim, the success of using library resources to solve real-world problems also better prepared him for internships in the private sector this summer.

“It was eye-opening,” Lim says. “I think that’s a mutual benefit.”