Howard Silverman - Developing an Informatics Program to ... - AAMC

tastelesscowcreekΒιοτεχνολογία

4 Οκτ 2013 (πριν από 4 χρόνια και 9 μέρες)

74 εμφανίσεις

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


Clinical Professor of Biomedical Informatics

Arizona State University

Topics: Medical
Student Education

in 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
:
Shortliffe

EH 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
objectives
1


Subsequently incorporated core
content for the
sub
-
specialty of clinical
informatics
2


Lessons
learned
were incorporated into revision
implemented in 2009


Sources
:

1
Association of American Medical Colleges Medical
School Objectives Project, ed. Report II Contemporary Issues in
Medicine: Medical Informatics and Population Health. Washington, DC: AAMC. 1998.


2
Gardner 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
integrated

into
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 Assessment

BMI Student Self
-
Assessment Scores (MS3 year end)

Question
*

Phoenix

Tucson

P value


I
am comfortable defining Biomedical Informatics.

1.76

2.50

.0002

I
understand the relevance of Biomedical Informatics to clinical practice,
biomedical science, and medical education.

1.50

2.00

.0089

I
understand barriers to effective implementation and acceptance of clinical
systems.

1.72

2.19

.0174

I
can utilize a variety of mobile (PDA, online) decision support tools and
determine which is best suited to various tasks.

1.44

1.81

.0314

I
am enthusiastic about employing Biomedical Informatics techniques and
tools in patient care.

1.60

2.13

.0341

I
can explain the role of informatics in the cycle through which we learn from
patient care and feed back the results from those lessons for practice in the
future.

1.76

2.13

.0673

I
have a reasonably good understanding of the legal and ethical issues
involved in the use of clinical systems.

1.76

2.06

.0897

I
understand how to develop information habits to maintain currency in
emerging technologies and biomedical device

1.76

2.00

.1176

I
can access evidence
-
based resources through search engines and other
means.

1.36

1.63

.1357

I
am able to use information technologies to support virtual teamwork.

1.76

1.94

.3518

Total no. (%) responding

25 (100)

16 (50)

N/A

*

Responses were given on a four
-
point
Likert
-
type scale: 1 = strongly

agree, 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)


The Dawn of a New Day…