130 likes | 297 Views
Medical Student Education in Biomedical Informatics. Howard Silverman, MD MS howards@u.arizona.edu Associate Dean for Information Resources and Educational Technology & Professor, Family and Community Medicine The University of Arizona College of Medicine – Phoenix
E N D
Medical Student Educationin Biomedical Informatics Howard Silverman, MD MS howards@u.arizona.edu Associate Dean for Information Resources and Educational Technology & Professor, Family and Community Medicine The University of Arizona College of Medicine – Phoenix Clinical Professor of Biomedical Informatics Arizona State University
Topics: Medical Student Educationin Biomedical Informatics • Biomedical Informatics Defined • Phoenix BMI Educational Program • Course Evaluation & Student Assessment • Lessons Learned • Future Directions
The Goals • Enable informed automation (clinical decision support) to decrease the cognitive load on clinicians so they can better attend to communication, relationship and information management • Respond to national movement toward individual and collective responsibility and interoperability (“send data to others as you would have them send data to you”) • Increase quality, safety and efficiency
Biomedical Informatics (BMI) Defined • Biomedical informatics is the scientific field that deals with the storage, retrieval, sharing, and optimal use of biomedical information, data, and knowledge for problem solving and decision making. • Biomedical informatics touches on all basic and applied fields in biomedical science and is closely tied to modern information technologies, notably in the areas of computing and communication. Source: ShortliffeEH and Cimino JJ (eds). Biomedical Informatics Computer Applications in Health Care and Biomedicine, 3rd edition. 2006, page 24.
Biomedical Informatics Defined • Biomedical informatics sub disciplines • Bioinformatics • Imaging Informatics • Clinical Informatics • Public Health Informatics • BMI is much more than • Information Literacy • Using EHRs
Phoenix BMI Educational Program • Curriculum designed in 2005, implemented in 2007 • Initially based on MSOP BMI educational objectives1 • Subsequently incorporated core content for the sub-specialty of clinical informatics2 • Lessons learned were incorporated into revision implemented in 2009 Sources: 1Association of American Medical Colleges Medical School Objectives Project, ed. Report II Contemporary Issues in Medicine: Medical Informatics and Population Health. Washington, DC: AAMC. 1998. 2Gardner RM, Overhage JM, Steen EB, et al. Core content for the sub-specialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):page 154.
Phoenix BMI Educational Program • 45+ hours of required instruction in BMI topics integratedinto all curricular components across all four years • Basic science lectures in system-based blocks • Single week BMI blocks • Case based instruction, Doctoring, Capstones, Intersessions, Scholarly Projects, Elective • Carefully sequenced • MS1 Year – focus on data (acquisition, storage, manipulation, extraction) • MS2 Year - builds on this foundation to focus on decision making and decision support • MS3 Year - data and decisions are combined to discuss key issues related to safety and quality • MS4 Year - elective
Course Evaluation & Student Assessment • Course evaluations: • Bimodal responses from students • I don't think I learned anything in this block that I'll be able to apply in my career • exposure to important, yet rarely addressed, aspects of clinical medicine • Overall positive responses regarding BMI labs • data acquisition, storage, manipulation, extraction • decision analysis
Course Evaluation & Student Assessment • Student Assessment: • NBME-style questions on standard block exams • Group projects (decision tree construction and analysis during BMI block) • Structured observations of EHR use during Doctoring course (to be implemented this spring) • Student self-assessments
Course Evaluation & Student AssessmentBMI Student Self-Assessment Scores (MS3 year end) * Responses were given on a four-point Likert-type scale: 1 = stronglyagree, 2 = agree, 3 = disagree, 4= strongly disagree. † Calculated using an unpaired t test utilizing the number of responses, standard deviation, and mean.
Lessons Learned • Finding curricular hours • Student and faculty perceptions of BMI training • Computer use versus informatics competency • Longitudinal student assessment of BMI instruction • Clinically trained BMI faculty are crucial for content creation and teaching (Clinical Subspecialty will help) • NBME
Future Directions • Comprehensive longitudinal evaluation • Impact of the pending subspecialty of clinical informatics • Access to “Educational EHR” • For more info, see: The Evolution of a Novel Biomedical Informatics Curriculum for Medical Students Howard Silverman, MD, MS, Trevor Cohen, MBChB, PhD, and Douglas Fridsma, MD, PhD Academic Medicine (epub end of November, in print January 2012)