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Medicine, Health Policy, Education

Medical Education

Inside Medical Innovation: TEDMED2016, Pt 1

The following is a part 1 in a series of guest posts from Evan Yates, TEDMED Front Line Scholarship Winner.

Live from TEDMED2016, Day 1:

Wow. That’s all I can say. I knew being invited to attend something as prestigious and stimulating as TEDMED (@TEDMED) would be special, but I don’t think much could have prepared me for the energy, excitement, or innovation. Day one was dedicated to fighting against those invisible enemies.

Here’s a run down from Day 1 of some select talks:

Dr. Mona Hanna-Attisha. (@MonaHannaA) Never heard of her? She lives, works, and bleeds for Flint, MI. What do you get when you cross legislation that doesn’t care if toxic levels of lead are in drinking water and a whistle-blower pediatrician? You get one pissed off pediatrician who will spend her life fighting for the inalienable, unassailable rights of children.

Emi Mahmoud. Darfur refugee, Yale graduate, slam poetry champion. Everything we take for granted in this country, everything we see as normal, she had to fight for. What stuck with me outside of the chills? She was positive throughout it all- she has faced unthinkable events and someone left with the same radiant smile.

While there were many other chats, I’ll leave with (in my opinion), the most powerful. Sue Klebold is the activist mother of one of the two Columbine shooters. She gave an inspiring, gut wrenching, compassion stirring presentation about her experiences, both intrinsically and extrinsically, in mental health. One of her quotes that I think should be heard loudly was, ‘if love was enough to stop suicide, it would hardly ever happen.’

Follow me on twitter @biroyatesgroup for life updates from talks and other stimulating events going on this week at TEDMED2016.

Education Technology- It’s Here, But Will it Last?

This is a guest post from WesternU medical student Evan Yates

Since the first days of kindergarten, we have become accustomed to a typical style of receiving information- a teacher rattles off facts, we digest it, and regurgitate it on a Scantron. Fast forward 20 years to my second year of medical school, and aside from the Starbucks cups now glued to my hand, the teaching methodologies have remained constant.

While sitting through my 6th hour of lecture one day, I thought to myself- should these orthodox teaching methodologies eventually evolve? Is the way we learned the alphabet the most effective way for us to learn which class of anti-hypertensive medications can also cause ototoxicity? Or is there an untapped market out there for novel tools to better integrate complex information into manageable bites to bed drawn upon later on? Continue Reading

Review: So You Got Into Medical School… Now What?

“My goal was always to do well in school while enduring as little stress as possible.” 

Dr. Daniel Paull, MD, wrote “So You Got Into Medical School… Now What?” as a guidebook for the new medical student looking to make the most of out of their experience with the least amount of stress. An orthopedic surgery resident, Dr. Paull undoubtedly used many of the techniques outlined in his book to match into one of the most competitive specialties. Continue Reading

5 Questions With OnlineMedEd

There aren’t many great resources for medical clerkship education. While programs such as UpToDate offer a wealth of details for practicing physicians, the sheer volume of articles can discourage students from understanding the fundamentals of clinical medicine.

Case-in-point: my education on “real-world” medicine began as a hodgepodge of cases I’d see in the clinic, reading about those cases at night, and practice questions on UWorld. Sure, this method scored me points on multiple-choice tests, but what was missing was a framework for how to think about common medical problems. As much as I’d never want to go back to those months of Step 1/Level 1 preparation, at least there was a gold standard of review material: the much glorified UWorld, First Aid, Pathoma combination. There had to be something better out there for clinical education.

OnlineMedEd, a video series for medical students and interns, aims to change all that by making learning “easier, faster, and more reliable”. And like any education good resource, OnlineMedEd has spread largely through the recommendation of its user base. It wasn’t until I grew tired of hearing my classmate rave about the platform that I gave the videos a try, and my only regret is not starting sooner. Continue Reading

An Evidence Based Method to Acing the COMLEX and USMLE

With the New Year rolling around the corner, many second year medical students are readying themselves for an intense few months of studying in preparation for the USMLE step 1 and COMLEX level 1 exams. For a profession that prides itself on evidence-based practices in real-world clinical scenarios, medical education is certainly lacking when it comes to evidence-based board preparation strategies.

In my first post for the First Aid team, I dive into two studies that analyzed the study habits of high-scorers on the USMLE and COMLEX exams. More specifically, these studies address the correlation between early initiation of board preparation and number of practice questions with test scores. Continue Reading

“Memory Hacks” Part I: The Baker/baker Paradox

What can medical education take away from a USA Memory Champion?!

In 2006, Joshua Foer won the USA Memory Championships by, among other things, memorizing the order of a 52 card deck in a staggering 1 minute and 40 seconds. Other events in the competition included remembering the most names of strangers and reciting the most lines of poetry. Perhaps more astounding is that Foer had been covering the event as a journalist in 2005 and, in just one year, had trained himself to the level of USA champion.  Foer chronicled his incredible journey in a New York Times bestseller, Moonwalking with Einstein, and a famous TED talk watched over 250,000 times.

Medical students are often told during the first-week of school that studying will be “like drinking water from a firehose”. Indeed, the pace and volume are certainly ramped up in comparison to college. While a 4-unit class at UC Santa Barbara would cover 30 hours of material over a 10-week period, exams at my medical school typically engrossed 35 hours of lecture crammed into a mere 2 weeks. Breaking down the lectures, I found between 15-20 testable details in each lecture making for 525-700 items to learn for each exam. Tracking the hours I spent studying for an exam showed I was spending about 75 hours in order to memorize up to 700 testable points. The fact that Foer could memorize the arbitrary order of a 52 card deck in under 2 minutes was thus certainly fascinating to me. Continue Reading

On Board Studying And Clinical Rotations

In late June I took my first set of licensing exams, the USMLE Step 1 and COMLEX Level 1. Scores from these exams play a large role in the residency match process, and as a consequence, most second-year medical students are obsessed (to put it lightly) with exam preparation. A future post will have more details on how I studied for these monster 7+ hour exams, but the short of it is that I used the popular “UFAP” protocol: UWorld, First Aid, Pathoma. I wasn’t alone in finding success with this strategy either, a recent r/medicalschool survey had a respondent average of 243 (~80th percentile) with these three resources being the most widely used.

Following the social isolation that was studying for those exams, my schedule turned to clinical rotations in Family Medicine and Surgery. Jumping from twelve hour study days to twelve hour rotation shifts has been equally exhilarating and terrifying. The exciting part is getting to finally do all the things I’ve been studying for the last two years. Seeing patients, scrubbing into surgeries, hearing heart murmurs, giving shots to crying infants, working on treatment plans, doing procedures, it’s been a blast putting all those hours of studying into use. The terrifying part has been what seems to be a Grand Canyon sized gap between my clinical knowledge and everyone else’s at the hospital. In a way I feel like all the tidbits I learned the first two years formed this giant framework and now all the holes are being exposed and (slowly) filled.

After two years of medical school, I can finally say this is what I signed up for.

From Around The Web

Podcast interview with College Info Geek: “Hardcore Studying Advice”

r/medicalschool Step 1 Survey 

AOA House of Delegates supports single GME accreditation

[Photo via flickr user peterras]

AOA and ACGME Reach Unification Agreement For GME

In a statement released in late February 2014, the AOA and the ACGME announced they have finally agreed to a single accreditation system for graduate medical education. The surprising news comes on the heels of previously failed negotiations in July 2013.

From the official press release:

  • From July 1, 2015 to June 30, 2020, AOA-accredited training programs will transition to ACGME recognition and accreditation.
  • There will continue to be osteopathic-focused training programs under the ACGME accreditation system. Two osteopathic review committees will be developed to evaluate and set standards for the osteopathic aspects of training programs seeking osteopathic recognition.
  • DOs and MDs would have access to all training programs. There will be prerequisite competencies and a recommended program of training for MD graduates who apply for entry into osteopathic-focused programs.
  • AOA and AACOM will become ACGME member organizations, and each will have representation on ACGME’s board of directors.

What does this mean for current medical students, MD and DO alike?

  • The inevitability of a common match: Given all residency programs will fall under a single unification banner by 2020, a single match process is the next logical step. The current system, which forces DO students to choose between the AOA match in February and ACGME match in March, will be streamlined to allow medical students to apply to all US-based residencies at the same time. There is no exact date for the implementation of the common match, but discussions I’ve had with AOA leadership indicate a common match could be implemented in anywhere between two to five years.
  • MD students will be able to apply to DO residency programs: With all residency programs under the ACGME banner, current osteopathic residency programs (which will become residencies with an osteopathic focus) will open their doors to applications from allopathic medical students. Discussions are still underway on how MD students can supplement their current medical education with osteopathic principles to prepare for these residencies.
  • COMLEX and USMLE are to remain separate exams: In talks between the AOA and ACGME, maintenance of the COMLEX as a separate and independent licensing exam remained a non-negotiable item. While a growing number of allopathic-based residency programs are accepting COMLEX (77% according to a 2012 Program Director’s Survey), it’s still in the best interests of most osteopathic medical students to take both COMLEX Level 1 and USMLE Step 1 to keep their options open.

[Featured image via Flickr user uonottingham]

5 Questions With SketchyMicro

SketchyMicro is one of the newest players on the medical-student led quest to shake-up medical education. Led by three UC Irvine medical students, SketchyMicro aims to take the pain out of learning microbiology and improve board scores for COMLEX Level 1 and USMLE Step 1. Somehow finding time in between his surgery rotation and launching SketchyMicro, one of the students leading the project, Andrew Berg, answered some questions for me about the program and how it differs from traditional learning.

What is SketchyMicro? What is the goal of the project?

SketchyMicro is a learning modality that utilizes visual learning as its primary form of teaching. Instead of having to memorize long lists of facts, we try to incorporate all the details of a microbe into it’s own unique, memorable scene.  We then draw these scenes out piece by piece on video starting from a blank canvas, explaining each symbol as we go. By providing intuitive associations of facts with pictures, we hope to present information in a clear and easy way in order to ultimately increase recall and efficiency.

What I mean by all of that, is that we draw cool pictures to teach microbiology.

SketchyMicro2

What separates SketchyMicro from conventional learning methods?

We believe that students who use visual learning techniques will learn the material more quickly and retain it for longer. There are loads of journal articles that support the power of visual learning.  Unfortunately I don’t remember any of them… they didn’t have any pictures.

So rather than making too many unsubstantiated claims, I really encourage people that are interested to just check out the six videos we have available for free on our website.  We’ve made every effort to create a course that eliminates the stress of rote memorization and finally makes microbiology fun!   After all, studies show that having fun increases board scores… but don’t quote me on that.

What has the development process been like? Has there been anything you’ve discovered about the “learning process” along the way?

Honestly, it has been a great learning experience! Going from sketching the mnemonics in our notebooks to a digitally-formatted story that is sketched in real-time along with the narrator was a huge transition. But, we were able to adapt and continue to do so. We have gotten a lot better since our first couple of videos, not just in content and story-telling, but visually as well. The whole process has taught us just how far teamwork can take you.

SketchyMicro1

Can you share any details on the final product (launch date, pricing, differing levels of access, etc.)?

Since our first two videos, we have actually been very hard at work and are finishing up all of the bacteria category! In the meantime, we’ve also already started working on viruses, fungi and parasites.

As far as launch date, we’ve already done a “soft-launch” to allow viewers to see the already-made videos.  Mostly we did this so that people who had tests coming up in the near future could have access to the videos we finished right away. Our program will be divided into two parts. The first part is solely bacteria. The second part will be viruses, fungi and parasites. Right now, people can pre-order the first portion and watch the bacteria videos as they are uploaded. We expect to finish the first part by the end of 2013 and hope to finish the second part by February or March, just in time for Step 1 studying!

What is your vision for SketchyMicro in the future?

We hope to have all of Microbiology done in the very near future (hang in there!) and are also hoping to create a more robust platform for self-testing and review features.  However, we’re also always trying to rethink ways to best get all of the information across.  We’re also getting some great feedback and ideas from our beta testers.  I’m really excited to see where we take things.  Our primary goal is to become the best resource for medical students wanting to learn microbiology.  However, there has definitely been talk of expanding into other subjects! SketchyPharm anyone?

SketchyMicro is now open to product pre-orders that include instant access to 21 bacteria videos and extended 6-month access when the program officially launches by late 2013.

Is IBM’s Watson the Future of Medical Decision Making?

Ever since soundly winning Jeopardy! in 2011, IBM’s Watson has been quite busy.

Besides soundly beating out members of Congress in an untelevised Jeopardy! match, Watson also became possibly the smartest second-year medical student of all time. But like any bright medical student, Watson didn’t just stop there.

IBM recently announced the development of two paradigm-shifting projects, WatsonPath, a diagnosis and education program, and Watson EMR Assistant, a tool for analyzing information stored in medical records. Building upon Watson’s question-answering abilities, WatsonPath draws from clinical guidelines, evidence-based studies, and reference materials to either support or refute a set of hypothesis. WatsonPath is essentially the algorithm machine every medical student wishes they had in their head during board exams. And with a “learning regimen” that includes breaking down board-style questions, why wouldn’t WatsonPath score the highest USMLE score ever?

How can WatsonPath be used as an educational tool?

The video above explains how the project not only offers answer suggestions, but also displays a schematic flow diagram showing the reasoning behind answers and confidence levels. WatsonPath breaks down clinical scenarios the same way any medical student would, looking at signs and symptoms, interpreting lab values, and searching for key associations. The project is currently being assimilated into the Problem-Based Learning (PBL) curriculum at the Cleveland Clinic Lerner College of Medicine.

Beyond the classroom walls, the possibilities of Watson for actual clinical settings are also already being explored. Through a partnership between IBM and the University of Texas MD Anderson Cancer Center, Watson is being used as “MD Anderson’s Oncology Expert Advisor.” This was after Watson was trained to “understand” over 600,000 pieces of medical evidence, more than two million pages of medical journals, and 1.5 million patient records. With a depth of medical information that no single human could ever match, Watson has already been touted as being “better at diagnosing cancer than human doctors.”

This post originally appeared on the Almost Doctors Channel.