Novel Teaching Tools for Tomorrow's Physicians

How Technology is Enhancing Medical Education
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Tomorrow’s physicians are increasingly educated in an environment that is starting to harness the latest in educational technology. New health technology-inspired projects and initiatives are also making medical students’ learning experience more engaging. This type of innovation is also helping to bridge the divide that exists between theory and practice in health science.

It is expected that not only will the next generation of health-care professionals adopt more technology to enhance their practice, but they will also be able to enhance their ability to learn and become skilled practitioners.

Furthermore, with the emergence of technology in education, less practice needs to take place in real-world environments. This helps create safer learning environments where patients are not put at risk. 

In many cases, medical education is being designed to advance patient-centered care. This evolution has been supported by the American Medical Association and the Institute of Medicine. Dr. Robert M. Wah, the previous president of the American Medical Association, emphasized that contemporary medical education needs to be bold and innovative, and there needs to be commitment to design cutting-edge, technology-driven programs that augment the student experience.

Teaching Version of EHRs for Improved Decision-Making Skills

Electronic health records (EHRs) have been a big challenge for the U.S. health-care system. To provide students with a more hands-on experience of EHR technology, some universities have now introduced a teaching version of EHRs. For instance, at the Indiana University School of Medicine, they call this tEHR, and at Oregon Health & Science University, they are referred to as Sim-EHR.

The idea is that students learn how to use and interact with EHRs while practicing their clinical skills. To emulate the real world as much as possible, existing EHR systems are often cloned—with all personal patient information removed—so students work with real medical scenarios.

The teaching software can, for instance, give the option to compare students’ decisions with that of a patient’s real-life physician. Teaching EHR systems can also issue warnings if a student is about to order an inappropriate test. This approach focuses on the patient’s safety and educates future physicians in line with current best practices. Since technology has such a prominent place in today’s medicine landscape, it is even more important that future health-care workers are impressed with humanitarian values.

Wi-Fi-Enabled Mannequins That Can Bleed and Respond to Drugs

Different simulators can help medical students develop skills and competencies. Professor Roger Kneebone of the Imperial College London classifies simulators into three groups. Model-based simulators are basic models that help teach basic clinical skills such as resuscitation, urinary catheterization, wound closure and removal of cysts. Computer-based simulators make clinical situations very realistic by employing virtual reality technology. Lastly, integrated procedure simulators can recreate whole procedures. They perform multiple tasks and usually combine a manikin and a computerized system to create a high-fidelity setting.

Resuscitation techniques used to be taught on inanimate dummies. These are now giving way to a new type of Wi-Fi-enabled mannequin. These learning tools are helping medical students study how to respond in emergency situations. They can be used in operating rooms and critical care units.

SimMan 3G by Laerdal is an example of a lifelike dummy that acts as an integrated procedure simulator. It can exhibit neurological symptoms (e.g. convulsions and seizures can be created) and has light sensitive pupils. The simulator also comes with automatic drug recognition and exhibits appropriate physiological reactions following drug administration. In addition, the device can be connected to an internal blood reservoir, which makes it bleed from artificial arteries and veins.

At the Centre for Interprofessional Clinical Simulation Learning in British Columbia, Canada, they are trying out another model of Wi-Fi-enabled mannequin. Controlled by staff in a nearby control room, their model can display common human actions — it can breath, cough, talk, bleed and even moan in pain. Medical students are directed to take care of the mannequins as if they were their patients. This gives the learning experience situational context and has been compared to pilots learning how to fly on flight simulators.

Birthing simulators are also becoming more common. The School of Nursing at Baylor University in Dallas uses Victoria, Gaumard's newest NOELLE simulator, which is considered one of the most advanced in the field. It can produce clinically challenging scenarios, such as shoulder dystocia (a case of obstructed labor that requires significant manipulation) and postpartum hemorrhage.

The mannequin also recognizes drugs and allows for epidural procedures, as well as contraction recognition. The fetus, which is included as part of the package, can be monitored using commonly used fetal monitors. For instance, the heart and lung sounds can be checked and it is even possible to program a cyanotic look. There is an amniotic fluid reservoir and full-term delivery can be simulated. Almost all birthing scenarios are possible, from breached delivery and assisted delivery to surgical procedures like performing a C-section.

Although modern simulators offer remarkable visual, physical, physiological and tactile realism, more studies are required to establish their reliability and validity. Dr. Ahmed Kamran and his colleagues at the King’s College in London also warn that simulators might not be able to produce challenging situations that are required to learn advanced clinical skills. 

High-Tech Anatomy Apps for Medical Schools

The days when medical students have to spend endless nights slouched over voluminous anatomical books are coming to an end. There are now numerous applications available that are transforming the learning experience, making it fun and interactive to learn anatomy. Many iPad apps cover different medical topics in-depth and can provide students with both 3D graphics as well as interactive lectures.

There are so many of these apps out there, free and purchasable versions, that it can be hard to decide which one is right for you. Once you do your due diligence to find the application that fits your needs, up-to-date anatomical knowledge is in your pocket, always accessible and readily available at a place and time of your choosing.

One example of this type of app is Complete Anatomy by 3D4Medical. This app brings anatomy to life. It features accurate 3D models and over 6,500 high-resolution medical structures. You can view real-time animations of muscles, cut through bones and muscles to create custom views, view body structures at different angles, and use recordings and quizzes to solidify your knowledge. The skeleton and connective tissue system modules are free to download, while an upgrade is required for full access of the app.

There are no Windows or Android versions available at the moment, and we are also still waiting for the female model of the body (currently, only a male model is featured). The company also designed Essential Anatomy, which provides the user just with a general anatomical overview.

Augmented Reality Anatomy Apps Bring a Touch of Science Fiction

4D anatomy applications are also already being designed. DAQRI launched Anatomy 4D, a free app that gives you a novel interactive experience of the human body. The app provides spatial relationships between different organs and body systems and offers a deeper look in some systems.

To enhance the way we study anatomy even further, 3D4Medical Labs are now working on Project Esper. The project is about immersive anatomical learning through the use of an augmented reality app. Imagine having a 3D image of a skull in front of you as a holographic diagram and being able to control it with your hand gestures. Body structures can be pulled apart, so different bones and body organs, as well as their anatomical descriptions, appear in midair right before your eyes. Medical students assume virtual superpowers as they learn anatomy without the need of cadavers. The app, planned to be released in 2017, might also be helpful to physicians and other health professionals when trying to explain medical details to their patients.

Technology as Enabler of Interdisciplinary Practice

Many experts warn about the fragmentation of contemporary health-care systems and the tendency for narrow specializations. Students therefore benefit from learning how to work alongside different professionals and coordinate patient care together. With this goal in mind, some universities introduced programs that partner medical students with nursing students and other health-care professionals, and let them care together for a virtual patient. Students learn how to work together through coordinated simulations. This new way of learning is expected to bring a more team-orientated approach and might help contribute to better health outcomes in the future.

However, there is a lack of evidence to suggest that skills learned in simulated environments can be transferred to real-life scenarios. Also, some specialties are still lagging behind as systems that would support their practice have not been developed yet. One such example is surgery.  

Some Universities are Full of Ideas for Novel Teaching Tools

The Division of Educational Informatics at the New York University School of Medicine manages a plethora of innovative teaching tools. These include a virtual microscope that is powered by Google and is a substitute for certain uses of the traditional microscope.

Another advanced technological tool they use with their medical students is The BioDigital Human. This is an interactive virtual 3D map of the human body. Students use 3D glasses to view life-sized images that are displayed on a projector screen. The selection of anatomical models includes more than 5,000 images of human structures and conditions. This digital learning experience emphasizes an interactive approach and also uses gamification techniques to motivate deep learning.

The NYU School of Medicine also designed an application for their third-year medical student surgical clerkship. Named the WISE-MD or the Web Initiative for Surgical Educational Modules, it provides a computerized narrative and tells a story about the patient’s illness and his or her interactions with the doctor. The patient is followed from his or her first visit all the way to the surgical procedure and postoperative care, which increases familiarity of the whole treatment process.

One of the many challenges health education is facing is the pace with which new discoveries are being made. By the time medical knowledge makes it to traditional print, the information might already be outdated. In fact, some knowledge may become outdated by the time students finish their residencies. That is why problem-based learning facilitated through technology is so important.

One, this approach helps students understand what they do not know and how they can learn it. Two, it is easy to scale as well as to update. Technology will continue to play an important role in the medical learning process. It is expected that in the future, even more transformative technologies will be included in medical education to keep up with advancements in the field.

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