Using technology to transform medical education

Building a new home for the USF Health Morsani College of Medicine offered an amazing opportunity to leverage the best of technology to change how medical education is delivered.

The USF Health Morsani College of Medicine is transforming how medical education is delivered, and technology is helping to drive that change.

In January 2020, USF Health medical students will enter a new building just completed in downtown Tampa, and will experience a shift in the way they learn medicine, from both the literal hardware and software perspective and a construction and physical space perspective.

“From the moment plans were announced for the new building about five years ago, we knew we had the opportunity of a lifetime to build from scratch a physical environment and a virtual world that would completely transform how we teach medicine,” said Bryan Bognar, MD, vice dean for Educational Affairs for MCOM.

“We aimed for innovative ways to teach today’s medical students but to also stay adaptable and relevant for learners for decades to come.”

Central to the new MCOM building is collaborative learning, and here are some of the ways technology and space design make that happen:

  • Easier ways for students to collaborate and connect with each other and with faculty. Technology will allow for more real-time interactivity with coursework and with group learning with increased flexibility in the location of the learner and educator.
  • Wireless everything, which allows connectivity throughout the building without missing any detail in a lesson. Construction included a fraction of networking cables of typical new buildings, allowing a totally untethered experience.
  • Seamless remote access to real-time courses and group learning, which gives students and faculty greater flexibility for maintaining active participation in coursework, regardless of location.
  • A ‘black box theater’ (Experiential Learning Lab) that can quickly transform from one type of learning space to another – from team learning to hands-on extensions of lessons to simulation reinforcing the foundational sciences. The flexibility allows today’s students to take their coursework in lectures to small group study and then to experiential learning. The space is intentionally designed to be easily adaptable to how future students might be taught. Driving many of the learning spaces are the opportunities to teach using mixed modalities. Now a student can practice taking a blood pressure on a standardized patient and be within feet of the Microsoft Surface Hub with slides that simulate how arteries are affected by hypertension.
  • Extensive curriculum mapping that delves into coursework by the lesson, by the subject matter, by the hour, and allows education administrators, course directors and faculty to track coursework and make adjustments on when and how subjects are taught. This analysis means tweaks can be made to better meet national benchmarks, enabling student success on course exams and national licensing exams.
  • A visualization wall within a modern medical library. This multitaction screen offers an interactive experience for a single user or dozens of users who can delve deeper into a range of scientific topics. Anatomy, for example, moves seamlessly from full body to organ systems to regions to cellular levels.

 

Technology in central to learning.

“Our number one priority is to deliver physician graduates who are ready to meet patient and health system needs,” said Deborah DeWaay, MD, associate dean for Undergraduate Medical Education at the USF Health Morsani College of Medicine (MCOM).

“In the past, medical schools strived to create physicians the way they wanted them to be and then figured the residency programs would make them ready for the workforce. At the Morsani College of Medicine, we’re thinking about what the residency programs require and then working back from that.”

This fits in, Dr. DeWaay said, with the Core Entrustable Professional Activities (EPAs) created by the Association for American Medical Colleges, an effort that sets expectations for both learners and teachers for what every medical student should know and be able to perform upon entering residency.

“Where we are taking it a step further by working closely with our departmental graduate medical education community to deliver exactly the skillset they need from our students,” she said.

To help faculty accomplish this, MCOM is using several programs, including Appian and Microsoft’s PowerBI.

Appian is an intelligent business process management software and MCOM is using it to map every aspect of the four-year medical school curriculum. Microsoft’s PowerBI uses the data from Appian to help faculty create the reports and dashboards that show the nuances of the data.

In tandem, both Appian and PowerBI give MCOM an effective way to create a curriculum that better mirrors national competency standards and for offering students fast feedback for areas they need to bolster in order to succeed on later content and on exams that are part of national licensing.

“Appian has completely changed the curriculum mapping process here at USF Health,” Dr. DeWaay said. “We are able to drill down hour by hour into the content students are getting, which makes continuous quality improvement much simpler.”

Curriculum mapping involves tagging every topic taught, the duration of lessons, their correlation with other related or subsequent topics across the four years of medical school, and measuring those against national benchmarks.

“The traditional curriculum map will compare program objectives with your content and determine if you are meeting program objectives, course objectives, and session objectives. But you may be only meeting the spirit of the accreditation standards, the bare minimum.” Dr. DeWaay said.

“With Appian, we are able to tag all of our sessions to national content competencies. So, I can look at our map, search any topic and, within about 30 seconds, see exactly where in the curriculum it’s being taught, which sessions are teaching it, which program objectives are being met, and which correlated courses are being tied in. In an instant, I can see any gaps or redundancies. This level of detail makes continuous quality improvement much, much simpler.”

The challenge with any medical school curriculum, Dr. DeWaay said, is the sheer volume of information being taught.

“We have over 1,400 sessions in our Year 1 and Year 2 alone, so if you’re going to make decisions on where a topic is taught and how it is taught, you have to be able to go in granularly with those 1,400 sessions,” she said. “A big-data, analytics type approach, like with Appian, is the only way to effectively handle the volume of information.”

In addition to Appian and PowerBI, MCOM is making use of Microsoft’s Teams collaboration software.

“I’m very excited about how we are using Teams,” Dr. DeWaay said. “We’re one of the first medical schools in the country to incorporate Teams into a medical curriculum.”

Think of Teams as a cloud-based workspace. Users – in this case students and faculty – can access the content at any time from anywhere. People can work simultaneously while being next to each other in class or miles apart. Project work – the heart of collaboration – can be done in real-time no matter where team members are. Need to update a project with your contribution? Your addition shows up in real time while others are actively working at that same time. No tracking revisions across updated versions attached to emails.

At MCOM, Teams is giving students a completely untethered way to access coursework, team-based projects, and general communications with faculty and with each other.

“With Teams, students can work synchronously and asynchronously, on-site or off-site, and at any time,” Dr. DeWaay said.

“Previous remote access was watch only, with maybe an audio interactivity,” said Jason Hair, senior director of infrastructure and operations for USF Information Technology. “With Teams, anyone in the lesson can activity participate, throwing information onto the screen, literally opening and sharing visual data, reports and cases, and adding to the discussion.”

Teams also includes a platform called Whiteboards, something medical students everywhere can relate to.

“If you go to medical school across the country there are physical whiteboards all over the place and students don’t go anywhere without their dry erase markers,” Dr. DeWaay said. “You know what test they’re about to take based on the different drawings on those whiteboards.

“With Teams, students and faculty can be in different places drawing on the same virtual whiteboard. And if the students have been drawing on a real whiteboard, they can take a picture of it and upload it to the Teams whiteboard and the image will pixelate and be saved onto their digital whiteboard.”

Teams also has a component called Forms, which is what faculty use for quizzes and worksheets.

“With Forms, faculty can see where and when students have worked together, who typed in what, who did what part, they can even tell if only one person did all of the work,” Dr. DeWaay said. “This makes assessing them and knowing which members of the group are participating and contributing to the work a lot easier.”

To facilitate access to Teams, MCOM is using several types of hardware throughout the new building. Almost every classroom will have Surface Hub 2, a large tablet set on an easel that can be easily rolled untethered within the class and to another classroom or other learning spaces without disconnecting and reconnecting anything.

 

Built for Tomorrow’s Tech

From the moment plans were announced for the new building about five years ago, MCOM education teams, USF facilities staff and USF information technology experts have been devising how to best use this new space to transform medical education.

“It is critical to pay attention to how technology, physical space, and user behavior are related; and not view the three in silos,” Hair said.

“In looking at the design of the building, we looked for opportunities to incorporate technology based on the behaviors we wanted to support in the spaces. And we focused on technology that drove the desired learning experience based on how today’s medical students learn. We wanted to make sure technology supported our pedagogy, but did not drive it.”

For example, to enable a collaborative and mobile workflow for faculty and students, Microsoft Teams and user devices are relied on over Wi-Fi wherever possible, versus a more traditional approach of fixed/wired AV systems or hardware video conferencing.

“The building has full high-speed wireless coverage,” Hair said. “Faculty and students from anywhere in the entire building can wirelessly join meetings or classes through Teams.”

In other buildings, a group learning room might have a computer tethered to a podium that connects to a projector showing information on a roll-down screen. Using this classroom would require booting up the podium computer or your own laptop, logging into the network, launching software, waiting for a projector to turn on, and opening the pertinent content to show on the screen. This AV hardware all takes up space in the classroom or a nearby AV rack, and the workflow consumes valuable time at the start of the class, hindering collaboration by having a single computer at a podium.

In the new MCOM building, Microsoft Teams Rooms allows all classrooms to act as Teams meetings and presenters use the “one-touch join” to begin their presentation instead of logging into a computer. This reduces the startup time of the AV in the room to seconds. Content can be shared to the screen in the room by joining the Teams meeting with a laptop, or even a phone. AV in these learning spaces allow for more than “just work” and encourage collaboration and sharing with people in the room or who are joining remotely.

“Sending live AV from cameras and microphones in a large classroom or auditorium typically requires a lot of specialized cabling,” Hair said. “But in the new facility, we send the AV signal our IP network. This allows us to send the AV signal to anywhere in the building where we have network and at a fraction of the cost of traditional cabling. We can send a camera feed from the auditorium to any other room in the building, even on another floor. This is great for classes or presentations with an overflow audience.”

Also in the new building is a 19-foot-tall Sony Crystal LED video wall. Mounted in the building’s lobby, the over 4k capable display offers opportunities for high-impact video and graphics to all who enter the new facility.

A 7-foot-tall by 20-foot-wide Multitaction visualization wall in the Florida Blue Health Knowledge Exchange supports dynamic, interactive digital content creation, and collaboration for multiple people simultaneously.

 

Technology alone won’t make students become great physicians.

Using technology to enhance medical education is only a piece of what makes someone become a great doctor, Dr. DeWaay said.

“Technology is a tool for medical students to use to better handle the sheer volume of information required to safely practice medicine,” she said. “Our role is to offer the best tools for taking in that information, but also to serve students as a whole so they can learn how to maintain their humanity and remember why they went into medicine and wanted to become physicians in the first place.”

Photos by Torie Doll and Allison Long, video by Allison Long, USF Health Office of Communications

Related stories:

MCOM and Microsoft create first-ever Medical School of Innovation: https://hscweb3.hsc.usf.edu/blog/2019/10/30/university-of-south-florida-medical-school-and-microsoft-create-first-ever-medical-school-of-innovation/

Where business analytics meet student success: https://hscweb3.hsc.usf.edu/blog/2019/10/24/where-business-analytics-meets-student-success/

A completely digital library experience in Florida Blue Health Knowledge Exchange: https://hscweb3.hsc.usf.edu/blog/2019/10/18/florida-blue-health-knowledge-exchange/