Manual Making Sense of Disaster Medicine: A Hands-on Guide for Medics

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Part of making in-person time more valuable includes rethinking who teaches what courses. Previously, many of the foundation courses at UCI have been taught by professors with Ph. The medical school is finding that M. Another way to give doctors hands-on patient experience faster is by accelerating the time it takes to get through med school. This program covers the same material as the four-year curriculum, said Marc Triola, associate dean for educational informatics, associate professor of medicine and director at the Institute for Innovations in Medical Education, "and it gives students the opportunity to be mentored by the clinical department that they're going into.

Triola pointed out that reducing the time students are in school not only cuts the substantial costs of their education, but also helps students get through all the various stages of medical training and become credentialed healthcare professionals faster. At Western University of Health Sciences, a switch to competency-based learning is speeding the process for medical students.

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Robert Hasel, associate dean of simulation, immersion and digital learning for the College of Dental Medicine, noted that many students who come to med school already have advanced degrees in subjects like cellular biology. Helf and Hasel, colleagues in different departments, have a vision for competency-based learning that relies on adaptive learning technology. As each individual student interacts with the adaptive software, the technology gets to know the student's strengths, weaknesses and primary learning style.

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It then adapts lessons to provide the information the student needs in the format in which the student learns best. With this approach, students can proceed through learning segments at their own pace. Some content areas can be quite accelerated, while remedial or reinforcing content is provided to help fill in knowledge gaps. The result is more thoroughly, consistently educated graduates.

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First, they identified the competencies that a dental school graduate needs to have and the different disciplines required to fulfill those competencies. From the competencies, they have generated a list of granular, stand-alone topics that support each competency.

In the dental school, there are about 20, Legos that students need to learn. Hasel's team plugged course material into Realize IT's adaptive learning engine, essentially building a wall of 20, learning Legos. Thanks to the modular format, if content becomes outdated, it can easily be replaced or revised. Two people taking the same class with the same expected outcome might go through the material in completely different ways, depending on their individual learning styles, but you can't move on until you master that Lego or that learning node.

Hasel's department has developed a couple of courses on a low-tech gaming mechanism that enables students to interact with the learning material through games of drag and drop, mix and match, hang man and picture IDs, among others. Each chapter consists of four or five games, and students work through the games repeatedly until they get percent on each game. Each chapter culminates in a one-time log on test. According to Hasel, the adaptive platform has enabled his department to free up seven weeks in the 2,hour "classroom" curriculum by eliminating the redundant and irrelevant topics and by integrating the different groups that cover the same content, such as suturing.

Now those topics are available as one-time, interdisciplinary learning segments — helping students across the board get through their course requirements faster. NYU Medical School's new Institute for Innovations in Medical Education considers big data and learning analytics as a vital part of the institution's educational mission. That's because in practice, doctors spend almost half their time doing information management, pointed out Marc Triola, associate dean for educational informatics, associate professor of medicine and director at the institute.

And then trying to take a step back, and look at their whole panel of patients and decide what they should or shouldn't do about their practice," he explained. By , not using one did.


Evidence that temperature signaled disease made patient expectations change too. Thermometry was part of a seismic shift in the nineteenth century, along with blood tests, microscopy, and eventually the x-ray, to what we now know as modern medicine. From impressionistic illnesses that went unnamed and thus had no systematized treatment or cure, modern medicine identified culprit bacteria, trialed antibiotics and other drugs, and targeted diseased organs or even specific parts of organs.

Imagine being a doctor at this watershed moment, trained in an old model and staring a new one in the face. Your patients ask for blood tests and measurements, not for you to feel their skin.

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Would you continue feeling skin, or let the old ways fall to the wayside? That if those results dictated future tests and prescriptions, doctors may as well be replaced completely? The original thermometers were a foot long, available only in academic hospitals, and took twenty minutes to get a reading. How wonderful that now they are cheap and ubiquitous, and that pretty much anyone can use one.

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It's hard to imagine a medical technology whose diffusion has been more successful. Even so, the thermometer's takeover has hardly done away with our use for doctors. If we have a fever we want a doctor to tell us what to do about it, and if we don't have a fever but feel lousy we want a doctor anyway, to figure out what's wrong.

Still, the same debate about technology replacing doctors rages on. The other camp thinks Grimaud was on to something. They resent all these tests because they miss things that listening to and touching the patient would catch. They insist there is more to health and disease than what quantitative testing shows, and try to limit the tests that are ordered.

As CT scans become cheaper, faster, and dose less radiation, they will become even more accurate. The same will happen with genome sequences and other up-and-coming tests that detect what overwhelms our human senses.

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There is no hope trying to rein in their ascent, nor is it right to. Medicine is better off with them around. What's keeping some doctors from celebrating this miraculous era of medicine is the nagging concern that we have nothing to do with its triumphs. Children often have fevers, as anyone who has had children around them well knows. But about once in a thousand cases, feverish kids have deadly infections and need antibiotics, ICU care, all that modern medicine can muster. To try to capture the remainder of these children being missed, hospitals started using quantitative algorithms from their electronic health records to choose which fevers were dangerous based on hard facts alone.

And indeed, the computers did better catching the serious infections nine times out of ten, albeit also with ten times the false alarms. Too many doctors have resigned that they have nothing to add in a world of advanced technology. They thoughtlessly order tests and thoughtlessly obey the results.

When, inevitably, the tests give unsatisfying answers they shrug their shoulders.