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Medical Student Education in Biomedical Informatics

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

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Medical Student Education in Biomedical Informatics

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  1. Medical Student Educationin 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

  2. Topics: Medical Student Educationin Biomedical Informatics • Biomedical Informatics Defined • Phoenix BMI Educational Program • Course Evaluation & Student Assessment • Lessons Learned • Future Directions

  3. 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

  4. 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: ShortliffeEH and Cimino JJ (eds). Biomedical Informatics Computer Applications in Health Care and Biomedicine, 3rd edition. 2006, page 24.

  5. Biomedical Informatics Defined • Biomedical informatics sub disciplines • Bioinformatics • Imaging Informatics • Clinical Informatics • Public Health Informatics • BMI is much more than • Information Literacy • Using EHRs

  6. Phoenix BMI Educational Program • Curriculum designed in 2005, implemented in 2007 • Initially based on MSOP BMI educational objectives1 • Subsequently incorporated core content for the sub-specialty of clinical informatics2 • Lessons learned were incorporated into revision implemented in 2009 Sources: 1Association of American Medical Colleges Medical School Objectives Project, ed. Report II Contemporary Issues in Medicine: Medical Informatics and Population Health. Washington, DC: AAMC. 1998. 2Gardner 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.

  7. Phoenix BMI Educational Program • 45+ hours of required instruction in BMI topics integratedinto 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

  8. 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

  9. 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

  10. Course Evaluation & Student AssessmentBMI Student Self-Assessment Scores (MS3 year end) * Responses were given on a four-point Likert-type scale: 1 = stronglyagree, 2 = agree, 3 = disagree, 4= strongly disagree. † Calculated using an unpaired t test utilizing the number of responses, standard deviation, and mean.

  11. 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

  12. 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)

  13. The Dawn of a New Day…

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