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TO ERR IS HUMAN

TO ERR IS HUMAN. HEALTHCARE IN AMERICA. • 1.2 Trillion dollars • 12-14% of GDP • Affects every American. MEDICAL EDUCATION. • Largely unchanged in last 100 years • Apprenticeship model • “See one, Do one, Teach one” Education by Random Opportunity.

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TO ERR IS HUMAN

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  1. TO ERR IS HUMAN

  2. HEALTHCARE IN AMERICA • 1.2 Trillion dollars • 12-14% of GDP • Affects every American

  3. MEDICAL EDUCATION • Largely unchanged in last 100 years • Apprenticeship model • “See one, Do one, Teach one” Education by Random Opportunity

  4. WHAT’S WRONG WITH MEDICAL EDUCATION? Imagine: As your plane (a packed 747) approaches SFO Airport, the pilot announces: “Folks, our co-pilot hasn’t had the opportunity to do a solo instrument landing, so she will be practicing one shortly. I’ll join you in the cabin while she lands the plane.”

  5. WHAT’S WRONG WITH MEDICAL EDUCATION? Imagine: A squadron commander, in the United States Army during Operation Desert Storm, tells his troops on the eve of battle: “While none of you have actually fought under these conditions, I hope you will figure it out”.

  6. WHAT’S WRONG WITH MEDICAL EDUCATION? These two scenarios are Unthinkable Why? For quality, safety and cost reasons, neither the airlines nor the military would demand performance without extensive prior practice.

  7. WHO ARE STUDENTS OF MEDICINE? Medical Students Residents Practicing Surgeons Nursing Students Practicing Nurses

  8. EDUCATION: KEY CONCEPT I Hear, I Forget I See, I Remember I Do, I Understand Lao-Tsu 604-531BC

  9. In the last 50 years, mankind’s most profound advancements have been in Biomedicine and Computer Science. They are converging!

  10. MEDICAL EDUCATION Cognitive Sensory Five senses + common sense Motor*

  11. INFORMATION TECHNOLOGY IN MEDICINE We will use VR to select, train, credential and retrain physicians and surgeons. Surgeons will rehearse an operation on a patient-specific palpable hologram and deliver the data set of that operation with robotic assistance. Ubiquitous computing will revolutionize medical education and patient care.

  12. ? SCIENCE FICTION ? Not Science Fiction But Scientific Eventuality S. Spielberg

  13. Radio has no future. LORD KELVIN Scottish mathematician and physicist, former president of the Royal Society, 1897

  14. Everything that can be invented has been invented. CHARLES H. DUELL U.S. commissioner of patents, 1899

  15. There is no reason for any individual to have a computer in their home. KENNETH OLSEN president and founder of Digital Equipment Corp., 1977

  16. ©2000 David Williamson Shaffer learning to be a doctor • what makes a skilled practitioner?

  17. ©2000 David Williamson Shaffer learning curve • from chaudhry et al., “learning rate for laparoscopic surgical skills on mist vr…,” annals of the royal college of surgeons of england, 1999

  18. 1-33 34-66 67-99 ©2000 David Williamson Shaffer complication rate • from pratt, laparoscopic gastric bypass, 2000

  19. ©2000 David Williamson Shaffer the part-task problem It is not true that a complex reaction consists of a chain of separate processes which may be arbitrarily added and subtracted. --- l.s. vygotsky, mind in society

  20. IMPEDIMENTS • Tradition • Service Roles • Finances • Efficacy?

  21. WHO WILL DEVELOP? • Academics • Military • Industry

  22. INDUSTRY • Start-Up • Simulation Company • Consumer Electronics

  23. HOW WILL IT BE FUNDED? • Federal Government Grant SBIR • Industry • Insurance Industry

  24. mentorship breadth thoughtabout action thoughtin action judgement analysis knowledge motor skills perception build on what medical education does right use the power of simulation to make it better a learning system ©2000 David Williamson Shaffer

  25. The best way to predict the future is to invent it. Alan Kay

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