Category Archives: Education

A Champion for Medical Simulation

There’s a model in higher education used to describe different levels of assessment called Miller’s Pyramid. The idea is that educational objectives should go beyond recalling and understanding facts and basic concepts, giving learners the ability to apply knowledge; analyze and evaluate processes, procedures and principles; and eventually create new or original work.

Medical simulation fits in the higher levels of this pyramid because it allows physicians and nurses-in-training to take what they learned in the classroom and apply it in a realistic, but safe wprismay. To me, it’s an essential part of medical education. And even now as an emergency medicine physician at OSF Saint Francis Medical Center, I strive to learn more about simulation to not only demonstrate its benefits but create new ways to utilize simulation to improve health care.

I recently joined Jump Simulation as part of a two-year fellowship where I will learn to be a health educator and how to make simulation a productive tool. It’s my future goal to understand how to make a unique environment such as Jump Sim work and apply that knowledge in rural areas that aren’t typically exposed to centers like these.

Finding My Path

My mother was a nurse, but getting into the health care industry was never a given for me. In fact, I initially resisted the field because I wanted to pave my own career path. A couple of mission service trips overseas opened my eyes to the importance of medicine. I was exposed to so many people who don’t have access to health care and were unable to live normal lives. I knew I had to go to medical school to change that.

voz-podolejWhat I learned in medical school is that the emergency room is a great place to master the art of taking care of very sick people. It’s a place where decisions matter and time is of the essence. Learning life-saving procedures at the bedside isn’t the best option. It was in the ER where I came to discover the benefits of training for medical emergencies in a simulated environment, so we don’t put patients at risk.

I gained much more experiential knowledge through various simulation cases than I ever did reading a textbook, doing homework or taking a test because those cases were so formative for me.  An internship with Dr. John “Voz” Vozenilek during his time with Northwestern University’s Simulation Center peaked my interest even future.

It was Voz who taught me that deliberate practice makes technically competent doctors. Working with him helped me understand how using simulation to repetitively do something until you get it right makes you comfortable and safe dealing with patients, leading to fewer complications and better health care delivery.

Gaining Simulation Expertise

As part of my Fellowship here at Jump, I am working with various departments to identify gaps in knowledge among medical students and residents. The goal is to create well-thought-out educational interventions that could include classroom or simulation work. I’m also learning to create and implement simulations and assess learners.Simulation-3

One case I’m partnering with OSF Saint Francis Medical Center nurses on is to produce simulations around new American Heart Association guidelines for maternal cardiac arrest. Sometimes a C-section is needed if a soon-to-be mother goes into cardiac arrest. We are generating scenarios that will train residents and nurses to work as a team as they deal with that situation. I’m also working to make simulation scenarios for pediatric and behavioral health cases.

As someone who’s gone through medical school and residency, I understand why teaching hospitals and universities around the world are pushing to make simulation a rite of passage for anyone entering the field. There’s certainly a place in education for classroom learning, but there’s nothing like actually performing medical procedures or dealing with critically ill patients in a realistic, safe environment. The ability to practice until you achieve your educational goals instills learner confidence.

That’s why I’m excited that my simulation fellowship is taking place at Jump. It’s a unique space, especially with its connection to OSF HealthCare and the University of Illinois College of Medicine at Peoria.  I believe Jump Sim is poised to make a big difference in health care, and I can’t conceive of a better place to learn the trade than right here. I’m really fortunate to be a part of this experience, learn from leaders in the medical education field, and put my ideas into use.

 

Mobile Technology in Healthcare Education

Fig 1- Screenshot of iMed concept between Steve Jobs and Scott Barrows. (2003)

Steve Jobs never stopped searching for new ideas. He always wondered how technology can seamlessly interface with the “human experience.”

In 2002, I had an opportunity to collaborate and trade thoughts with Steve on this concept as it relates to the human body. We had a working title of “iMed” (Figure 1) and now much of that early vision is captured by mobile devices like the iPad Pro, wearable devices like the Apple Watch and Fitbit, and through portable versions of 3D virtual glasses and goggles (from products like the high-end HTC Vive to the inexpensive Google Cardboard and variations that use a smartphone).

Although the total number of medical apps (iOS) make up only 1.99% of the total number of downloads from the App Store, when lifestyle and health/fitness are added, that number expands to 13.67% to all iOS downloads. Interactivity, personalized health data availability, game-like engagement, and a focus on “edutainment” make the vision of technological integration more dynamic than ever.

New Learning Styles & Apps May Help Change Unhealthy Behaviors

Fig 2- Variety of mobile technology used in learning and interactivity

Mobile, interactive, and wearable technologies have altered how we learn, and the impact in healthcare is enormous. Social media, game-play platforms, collaborative e-community based learning, immersive programs, simulation apps, built-in biosensors, virtual reality, augmented reality, artificial intelligence, and peer-to-peer learning all have promise to help better educate patients and health professionals. (Figure 2)

Some of the most difficult challenges in healthcare are unhealthy behaviors from foods we eat, overeating, smoking, lack of exercise, and a lack of motivation to change. Centers for Disease Control and Prevention statistics in 2014 indicate that up to 40% of annual deaths from each of the five leading causes of death in the U.S. are from “modifiable risk factors”. Habit formation develops in the basal ganglia of the brain and once established, may take weeks or months to change. Most programs and apps fail to make much of an impact so far in changing bad habits.

The good news is that more effective proven methods such as Prochaska’s stages of behavior change (pre-contemplative, contemplative, preparation, action, and maintenance) are now being integrated into personal mobile apps that merge personal lab results and up-to-the-minute recording of lifestyle data in a dynamic network. Additionally, some apps include live contact with health counselors who assist in answering

Fig 3- Wellness app (screenshot) we created for behavior change, includes patients biomarkers that can predict future disease.

questions and providing personalized support. (Figure 3)

The challenges are steep and while 10% of Americans report they own an activity tracker, 50% report they do not know how to use them and 33% say they stop using them after six months. Better technology is warranted. As biosensors improve, wearable technology will provide not only valuable data but real-time feedback to help patients better manage their health.

New Mobile Technology & Platforms in Healthcare Education

Jump Simulation is at the forefront with many of the new integrated technologies in medical education and innovation. Next year, the campuses of the University of Illinois College of Medicine will launch a new curriculum in human anatomy and construct a state-of-the-art anatomy lab in Peoria at UICOMP. The vision is to blend the best in traditional dissection with new technological resources.

One excellent resource may be Complete Anatomy, which recently won the coveted 2016 Apple Design Award in healthcare. This highly interactive mobile app combines much of the information and visualization contained in books like Gray’s Anatomy along with the interactivity and endless editable views of an iPad. Complete Anatomy is designed for the advanced iPad Pro technology and features numerous editable functions using the Apple Pencil that provide endless cross-section views, selective anatomical structures and systems, collaborative interaction, and recording functions. Complete Anatomy is one of the finest healthcare mobile apps on the market. (Figure 4)

Fig 4- Screenshot from Complete Anatomy iPad AppAnother outstanding interactive medical app is Touch Surgery. Touch Surgery provides a guided, interactive experience that simulates specific surgical procedures in a step-by-step process. The ever expanding library of surgical procedures in many specialty areas is an excellent approach that utilizes visual learning and experiential activity. (Figure 5)

Fig 5- Screenshot from Touch Surgery app (mobile device surgical simulator)

With the explosion of virtual reality (VR) and augmented reality (AR) capabilities, 3D interaction in healthcare provides immersive explorations inside of the human body. When combined with patient 3D scans from CT and high res MRI, clinicians can look deeper and in endless dimensions at specific structures. High-end goggles like the Oculus Rift and HTC Vive offer exquisite high definition interaction and even low-end devices like Google Cardboard and others utilize mobile smart phone technology to give a “3D” experience.

Other interactive mobile programs and technologies are used in health professions education, like Health Scholars. A Peoria-based educational series developed by the nurses at OSF HealthCare in conjunction with SIMnext and CSE Software Inc. The interactive, self-contained learning encounter for nurses is built on a mobile, tablet-based platform created to help standardize nurse education. It is a series of self-directed learning modules that take education from the classroom to mobile sites, including the hospital floor.

Mobile and app-based learning will continue to evolve, and researchers, faculty, and staff at Jump are actively involved in the exploration. These new technologies will impact education and improve patient care, safety, and reduce costs. Steve Jobs would approve but reminds us that much more needs to be done. Fortunately, much of that work is in development at Jump.

Incorporating the Creative Disney Mindset in Healthcare

“It’s kind of fun to do the impossible.” –Walt Disney

Creative thinker and former Disney Imagineer Marty SklarA group of Jump employees recently got the chance to watch a Walt Disney Company legend speak about the innovative thinking that goes into creating the “Happiest Place on Earth” and other attractions. Former Disney Imagineering vice chairman and principal creative executive, Marty Sklar, recently spoke at the Chicago Museum of Science and Industry. Sklar is Disney’s only “cast member” to have been involved in all 11 Disney Parks.

He was joined on stage by two current Disney Imagineers, who contributed to Sklar’s book, One Little Spark: Mickey’s Ten Commandments and the Road to Imagineering. The trio discussed many of the projects they’ve been part of, what it takes to succeed as a creative visionary, and how to land the coveted position of Imagineer.

While most people think of Disney as an entertainment company, the presentation also described other insights and skills that culminate into what we see as the magic of Disney theme parks: physics, electrical engineering, human behavior, chemistry, sensory perception, creative innovation, experiential design, and an overarching creative vision. These, and the insights below, can be employed into the work we do every day at Jump to improve healthcare outcomes and reduce costs.

  1. To be a true creative, lose your fear of being wrong. It is ok to fail and if you don’t, you are not doing anything new. (Marty Sklar)
  2. Success before work only appears first in the dictionary.
  3. Create work that brings the good out in people.
  4. Transcend cultures.
  5. Make every day of your life the best day of your life. (Walt Disney)
  6. Take a chance. (Walt Disney)
  7. Educate people, but don’t tell them you are doing it.
  8. A blank piece of paper is either intimidating or the greatest opportunity in the world.
  9. Re-invent yourself every few years and you will have great stories to tell. 

Creative Minds in Healthcare

Disney Imagineers have a history of contributing to the healthcare industry. The simulated ride inside of the human body in a miniaturized submarine at the Epcot Center in Orlando, Florida was inspired by the motion picture, The Fantastic Voyage. Former Disney Imagineer Frank Armitage (who created the Academy Award-winning set design for the movie) also created the early concepts for the Epcot experience.

This rare image was a concept drawing for the Fantastic Voyage done by Frank Armitage. It is a scene within the lung.

This rare image was a concept drawing for the Fantastic Voyage done by Frank Armitage. It is a scene within the lung.

I am blessed to have known Mr. Armitage as a mentor, friend, and a major influence in my life, as he was regarded as one of the finest medical illustrators in history. Frank was also awarded the prestigious title of Disney Legend in 2009. He passed away earlier this year, but his beautiful work is immortal and reflects true genius, a genius of the “artist-scientist” visionary in the tradition of Leonardo daVinci, Dr. Frank Netter, and Steve Jobs.

In 2006, the Biomedical Visualization graduate program at the University of Illinois at Chicago initiated an endowed annual lecture series honoring Frank Armitage. The lecture honors “visual genius in healthcare”. The first Frank Armitage Lecturer was Marty Sklar. Many of the original paintings and drawings that Frank Armitage created were on display at the first event. This included paintings, designs, and concepts for Epcot, Life Magazine, classic Disney animated movies (Sleeping Beauty, the Jungle Book, Mary Poppins), Disney theme park murals, and Fantastic Voyage set designs.

This year, I have been asked to present at the 2016 Frank Armitage Lecture, and it will be an honor to share his legacy with new generations of visionaries, future leaders, and fellow lifelong learners, and share how Mission Partners at Jump are applying the same thinking to challenges in healthcare.

Cultivating the Next Generation of Creative Thinkers

Experiential learning, edutainment, interactive design, engaging media, mobile access, and simulation in education are not new, but as technology and information delivery continues to evolve and integrate into our lives, many tremendous opportunities are ahead. The impact will influence both what people learn, and how they learn. The stakes may be the highest in healthcare, wellness, distance education, sharing innovation, telemedicine, and changing unhealthy behaviors with wearable devices (and personal health data feedback).

George Lucas recognized the importance in developing future creative minds and new ways of thinking when he launched Edutopia for K-12 educators. Lucas and others like the Imagineers at Disney understand the importance of fostering creative thinking in children as a critical component for the future of the world.

For the innovators and visionaries at Jump, the idea of incorporating the Disney style of thinking into the work we do is not a bad thing. Borrowing the tagline from Apple in “thinking different”, creative problem-solving at Jump is a fun ride into the present and future of healthcare. It is a creative ride that will improve healthy outcomes and practices, as well as educate and inspire new generations of providers, students, and patients.