Fast Tracking Medical School

Bingo Number 3

Bingo Number 3 (2008) by Leo Reynolds on Flickr (CC BY-NC-SA 2.0)

The chance to finish medical school early is attracting increased attention from students burdened with six-figure education loans: The median debt for medical school graduates in 2013 was $175,000, according to the Association of American Medical Colleges. This year, the combined cost of tuition and fees for a first-year medical student ranges from just over $12,000to more than $82,000. (Washington Post Article, January 13, 2014)

The idea to decrease the number of  years in a typical medical school tenure from four years to three years was reported in a 2010 Carnegie Foundation report summarizing possible reforms in medical education and residency.  Only a handful of the nation’s 124 medical schools have a three year option available for their students including NYU and Texas Tech.  However, there are opponents who worry about what might be missed by those who only do three years of school instead of the traditional four year model.

Whatever your opinion, it’s definitely food for thought for those interested in pursuing a career in medicine.

Number 4

Number 4 (2010) Leo Reynolds on Flickr (CC BY-NC-SA 2.0)

Teaching Neurosurgeons & BRAIN(S)

In April 2013, President Obama said he would ask Congress for $100 million in 2014 for the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative to “revolutionize our understanding of the human brain”.  ( THL Blog post about the BRAIN Initiative) We are now 2 days into 2014 and scientists are reporting that some of the tools necessary to support the initiative already exist in early versions.  The new set of techniques, called optogenetics, allows researchers to control the activity of brain cells using light.  While still in early phases of development, the technique will allow researchers to conduct real-time activation of large groups of cells rather than activating individual cells with wire probes.  Challenges with the technique include how to best deliver light to cells deep in the brain and how to avoid light reaching unwanted cells, a case of power versus finesse.  Scientists believe optogenetic techniques will change the way we understand brain disorders like epilepsy and Parkinson’s disease.

Knitted Neuroscience in Progress (2012) by estonia76 on Flickr (CC BY-NC-SA 2.0)

Knitted Neuroscience in Progress (2012) by estonia76 on Flickr (CC BY-NC-SA 2.0)

Innovation is not only happening in brain mapping but also in teaching neurosurgeons and providing opportunities for them to practice their skills.  3-D printers and visual simulators are providing beginner neurosurgeons with the chance to hone their skills on realistic skulls and brains.  The University of Florida combines practice on 3-D printed brain models with a virtual simulator to “help students get accustomed to using imaging technology in the operating room”.   For more information on the use of 3-D printers in medical training, see this article recently published by the Journal of Neurosurgery.

Med Students, Free Clinics, and a Library: A Few of My Favorite Things

The UM Student Run Free Clinic was featured in the Atlantic for the work they’re doing in Pickney, Mi. Every Saturday, three clinical and three pre-clinical med students (along with three UMMS  physicians) head a decommissioned branch of the Pickney Community Public Library to staff the entirely student run free clinic.

The clinic promises to alleviate the negative impact of health disparities in rural south east Michigan. Additionally, it gives students an opportunity to get hands on experience on tasks like physical exams, health histories and schedule appointments. Many medical schools in the U.S. have at least one free clinic associated with their institution.

In article in the  Atlantic did address some of the concerns with the student run clinic model. Some experts believe that the quality of care is compromised since, while others struggle with the morality of students practicing people who happen to be impoverished. However, the anecdotal evidence in favor of student run free clinics is strong. Chelsea Reighard, a student director, was quoted in the Atlantic saying:

“I feel like medical school can be really about yourself- how much I can learn, how much I can do. I really want to serve people and work with them to improve their health”

Video Games For the Win!

Wordle of Systematic Review of Serious Games for Medical Education and Surgical Skills Training (2012) Article

Wordle of Systematic Review of Serious Games for Medical Education and Surgical Skills Training (2012) Article

Video Games and Learning…it’s not an oxymoron, it’s real life.  In fact, I TAed an undergraduate course with this exact title at the University of Wisconsin-Madison.  UW-Madison is also home to the Games, Learning and Society Organization and this fall, offered its first Coursera course on Video Games and Learning which many of my former peers and professors have tirelessly created.

But enough about Madison, what about video games at the University of Michigan?  Where can I find them and what can I learn from them?  The University of Michigan’s Computer and Video Game Archive is located in the lower level of the Duderstadt Center on North Campus.   They are celebrating their 5 Year Anniversary with a Party on November 16th from 1:00-5:00pm.  There will even be a Super Smash Brothers Tournament. (Participation in the tournament requires pre-registration so be sure to click the link!)  If you are curious about the learning outcomes and teaching applications of video games, I’d encourage you to attend the panel discussion, “Game On! Video Game Research & Teaching at the University of Michigan”.  It is this Tuesday, November 12, 4:00-5:00pm in the Hatcher Graduate Library Gallery (Room 100).

Right about now, you might be asking yourself, this is super interesting and all but how are video games related to the health sciences? (I’m hoping you appreciate the library collection connection.)  Well, it just so happens that video games are being utilized in medical education training.  In their 2012 systematic review published in the British Journal of Surgery, Graafland, Schraagen, and Schijven identified the value of serious games for training professionals in the medical, specifically surgical, field.  They also wanted to asses validity of serious games as a teaching method according to criteria regarded as best evidence.  They found ‘serious games’ provide challenging simulated environments with learning outcomes focused at reducing medical errors and subsequent health care costs.  However, validation measures were not available for all games; “until researchers have completed a full validation process for [serious games], they cannot be considered to be of true value in curricula for surgical resident training” (Graafland, 2012, p. 1328).  The possibility of using serious games as complements for traditional teaching practices should not be underscored and game designers, developers, and educators should work together to create games which meet validation requirements and help fulfill competency requirements through practicing simulated clinical procedures.

Video games are also used in patient rehabilitation and care.  Researchers at Michigan State University created a rehabilitation program using the Nintendo Wii-Fit Plus to promote light-intensity, self-paced walking and balance exercises to address cancer-related fatigue and ease the transition from the hospital to home after surgery for lung cancer patients.  At the University of Michigan Geriatrics Center & Institute for Gerontology, participants in the Silver Club Memory Programs play Wii Sports games, along with more traditional board and card games, to flex their brain muscles in an effort to slow the progression of memory loss and cognitive impairment to Alzheimer’s Disease.

So to review, the University of Michigan has a whole archive filled with video games, researchers study and teach with video games, and ‘serious’ video games can be effective for health sciences training and patient rehabilitation and care.  Like the title of this blog says, Video Games for the Win!

Global & Health Equity Education

The Chronicle of Higher Education published a timely article, “Some Health Programs Overseas Let Students Do Too Much, Too Soon”, about the ethics of undergraduate health science field students and their clinical experiences abroad.  The article raises concern about the ethics of treating patients before certification, especially at-risk populations, and the global health spectrum of care providing services.  Students write about their clinical experiences abroad in their medical school applications, causing concern for educators and global health practitioners.

Far too often, experts say, students are providing patient care—conducting examinations, suturing wounds, even delivering babies—for which they have little or no training. Indeed, as competition intensifies for medical-school slots, some students may actually be going overseas for hands-on experience they could not get in the United States, in hopes of giving their applications a competitive edge.

Instead, they could be putting their own health and that of foreign patients at risk, and putting colleges and study-abroad providers at risk of legal liability.

And they may end up hurting, not helping, their graduate applications, because many medical, dental, and nursing schools view such behavior as unethical and irresponsible. (Chronicle of Higher Education, 2013)

Non-profit organizations which support global health community projects, such as Child Family Health International, have seen a rise in applicants hoping to treat patients during their experience.  CFHI Executive Director Dr. Chris Evert says “professional schools need to become better aware of the problem” of unprepared students’ engaging in patient care abroad, and also recommends that “such activities will count against applicants”, stressing that professional schools have to make it clear that this practice is unacceptable (Chronicle of Higher Education) .

The University of Minnesota’s efforts to dissuade unlicensed students practicing on patients overseas is highlighted in the article.  The University of Minnesota’s Academic Health Center created a course to guide their students participating in health sciences focused study abroad programs about medically ethic practices to protect patients and themselves.  The online workshop “Global Ambassadors for Patient Safety” is available  free of charge to students from other campuses.

GlobalREACH Banner

GlobalREACH Banner (2013) from http://globalreach.med.umich.edu/

The University of Michigan Medical School supports a model of bidirectional practice in its global health initiatives and programs.  The GlobalREACH  program supports educational services for UMMS students, M1-M4, who want to participate in an international experience. GlobalREACH activities include students designing international experiences for their M1 summer or choosing to conduct health-related research with U-M faculty and international partners while in Ann Arbor through the Summer Biomedical Research Program (SBRP).

Opportunities facilitated through GlobalREACH include participating in an M4 clinical elective at an international partner institute or overseas research elective or applying to participate in  Global Health and Disparities Path of Excellence.  This co-curricular program was created to “provide students an opportunity to integrate foundational, investigative, and experiential learning to become agents of sustainable change to reduce domestic and global health disparities” (http://globalreach.med.umich.edu/education/students/ghd).    The second Path of Excellence to be made available to UMMS students will be Medical Ethics (website under construction).

If you have specific information resource questions about global health, I’d encourage you to visit the Global Health and Disparities Path of Excellence Information Resource Starter Kit created by Taubman Health Sciences Informationist Gupreet Rana.

DREAM Launched!

DREAM Logo (2013)

DREAM Logo (2013)

MedEdPortal is an open access resource initiative from the Association of American Medical Colleges (AAMC). The vision of MedEdPortal is to

  • Succeed as the most utilized, cited, and influential health education resource publication.
  • Serve as the premier clearinghouse of high-quality, peer-reviewed health education tools.
  • Promote interprofessional collaboration by facilitating the open exchange of educational resources across the health professions.
  • Equip healthcare professionals across the continuum with effective and efficient educational resources to improve patient care. (Vision)

You might have to register to access some content but it’s free.  Items in MedEdPortal are peer-reviewed so they are considered a peer review publication.   DREAM is the newest subset of the MedEdPortal.

The Directory and Repository of Educational Assessment Measures (DREAM), the newest subset of the MedEdPortal, is now open and ready to share its resources with health sciences educatorsdevelopers, and authors. DREAM seeks to

achieve excellence in health sciences education by providing easy-to-locate, publicly accessible information about assessment instruments to health science educators, educational researchers, and program/curriculum evaluators. (Mission Statement)

The repository contains assessments previously published in at least 2 peer-reviewed publications within the past 10 years and have available validity date in at least one publication. Assessments approaches include self-report, observational, quantitative and qualitative method.  You can search for instruments in DREAM by audience, assessment method, keyword, competency and speciality.  The Index of Health Professions Education Assessments have been created for each of the sub-sets of the eight competency domains.    Each index represents assessment data gathered from an ongoing systematic literature review.  Literature searches are an ongoing process to best reflect new developments in the field.

UMMS: Giving Thanks to Anatomical Donors

As I become more knowledgable about the medical education curriculum at UMMS, I truly believe medical student education really embodies the idea of learning by doing.  One of these important experiential learning opportunities is spending their entire first year in a group of six students with a single anatomical donor’s body, “moving together system by system and learning detailed anatomy, and both empathy and professional detachment” (UMMS News).

"Students" by Piotrek Chuchla, from The Noun Project  CC by 3.0

“Students” by Piotrek Chuchla, from The Noun Project CC by 3.0

UMMS has started a new program that provides future anatomical donors a chance to virtually connect with medical students through creating a video to be viewed only by future students.  The program is a result of studies conducted at the medical school which found that U-M medical students and registered donors favored some mechanism for connecting with students.

For more information about Anatomical Donation at U-M, please visit the Anatomical Donation Webpage.

Other recent discussions about the relationship between medical students and anatomical donors can be found in the following articles:

Sheila M. Crow , Dan O’Donoghue , Jerry B. Vannatta & Britta M. Thompson (2012) Meeting the Family:
Promoting Humanism in Gross Anatomy, Teaching and Learning in Medicine: An International Journal, 24:1, 49-54, DOI:
10.1080/10401334.2012.641487

da Rocha, A. O., Tormes, D. A., Lehmann, N., Schwab, R. S. and Canto, R. T. (2013), The body donation program at the Federal University of Health Sciences of Porto Alegre: A successful experience in Brazil. Anatomical Science Education, 6: 199–204. doi: 10.1002/ase.1335

(in press) Green C, et al., Attitudes of the medical profession to whole body and organ donation, The Surgeon (2013), http://dx.doi.org/10.1016/j.surge.2013.06.002

Teamwork Makes the Dream Work

All of those lesson about teamwork you learned in summer camp are making a major reappearance in medical schools all over the country.

The Association of American Medical Colleges (AAMC) released results from the Annual Medical School Graduation Survey that shows that nearly three quarters (73.4 perfect) of graduating medical students report that their education included interprofessional training with other healthcare professionals such as nurses, dentists, pharmacists, public health officials and others. This is a reflection of medical schools enhancing their programs  to address the real issues that physicians will face in their careers.

This shift is most likely attributable to the criticism that medical professionals tend to work in silos and don’t always maximize communication between other clinicians. This tendency can negatively impact patient outcomes and spending, but it looks like that might be getting better in the recent future thanks to the shift toward team-based learning in medical education.

The 2013 results also revealed that graduates are incurring more debt than the 2012 cohort– there was a 2% increase, leaving the average at a whopping  $135,084. Not surprisingly, in 2013 there was approximately 9 percent more students reported planning on entering a loan forgiveness program than in 2012, leaving the total at 38.1 percent.

Welcome New University of Michigan Medical School Faculty!

thl logo and umms logo

As you’re enjoying your orientation sessions today, we’ve compiled some of the resources you may come across if you stop by the Taubman Health Sciences Library booth in Palmer Commons:

Don’t forget, you can always access the Taubman Health Sciences Library home page and library contacts from the Clinical Home page:

clinicalhomepage1

The second tab of the Clinical Home page, Clinical References, also has many resources, including UMHS clinical guidelines, and a variety of the clinical resources we provide, such as medical textbooks, drug databases, and links to medical journals.

clinicalhomepage

As always, if you have any questions, would like to set up a consultation with your liaison librarian, place contact us at (734) 764-1210 or thlibrary@umich.edu.

UM Med School Wins AMA Grant to Revamp Medical Education Curriculum

Just 11 schools were awarded grants from the American Medical Association in response to their challenge, Accelerating Change in Medical Education, and the University of Michigan’s Medical School is one of the winners.

Over the coming five years, the University of Michigan Medical School will design and phase in changes to the current curriculum, while also working with the other AMA winners to establish best practices.

Dr. Rajesh Mangrulkar, the associate dean for medical student education points out:

“We need to bring medical education into the 21st century, where data-driven, team-based health care, grounded in science and quality, and informed by ethical, social and patient-centric factors, is the norm…Our new curriculum will ensure we produce doctors who will be ready to lead changes in different aspects of health care that will have an impact on patients and their communities.”

Read the full announcement from the University of Michigan Health System, and learn more about the AMA initiative and other winning schools here.