Transforming the educational experience
There are two great articles currently on GOOD: the first is about a new kind of classroom-less college for adult learners; and the second is about transformational schools that are working to create new notions of learning and teaching.
College Unbound is a new learning system that allows students to focus their education around a particular passion, interest or goal. Individualized plans are created for each learner, incorporating online seminars, technology and team learning, and an internship or job where the student gets to master and incorporate real-world skills into their educational objectives.
Some scary information from the article:
"How broken is the system? Over the past 20 years, the United States has fallen from first to 12th in the percentage of young people with postsecondary degrees. Tuition’s doubled in the past decade, rising faster than any other item in the Consumer Price Index since 1978. Student loan default rates are increasing. Only 56 percent of students complete a four-year degree in six years. And a nationwide study last year, using a test called the Collegiate Learning Assessment, found that 36 percent of students demonstrate no gain in learning between freshman and senior year."
I think we all know that the higher-education system is broken, and there are a lot of opinions out there right now about how to fix it. But sometimes it feels like people are just throwing ideas against a wall to see what sticks, and so many are being tested right now that it will likely be decades before any one design comes out on top. But it seems more and more as though "integrated, experience-based and outcome-based" strategies like College Unbound are coming into vogue, and I hope that (with increased funding) they can start to pull together the data they need to prove that it's a worthwhile system for many adult learners.
In a similar vein, educational activist Sam Chaltain is asking his readers (and the general public) to submit the names of schools they feel are "transformational", based on the Q.E.D. Foundation's Transformational Change model. The Q.E.D. Foundation states that truly transformational education is where students find the "skills and know-how to co-create their public world, to participate in their community and help shape the local and global decisions that will impact their lives". I enjoyed reading over the 22 traits of a transformational school (and learned a lot!), and am discouraged to hear that only two schools have so far met his requirements. I truly hope that more educators, parents, and administrators read the Transformational Change Model and start brainstorming ways to incorporate the ideas there into a more progressive system for students of all ages.
Surgeon assessment
The da Vinci robort is a devise that scales down a surgeons hand movement in order to allow him to perform operations using tiny incisions. This innovation allows for less tissue damage and a much quicker recovery period for patients. There are over 200,000 being used for surgical procedures today.
The newest innovation to the da Vinci Robot is the MScore which assesses the robot to more reliably predict whether new surgeons are ready to operate on patients. MScore compares the skills of novice surgeon to that of an experiences surgeon. This is a great tool for surgeon’s own assessment and continuing growth and skill.
Patient-centered care and cultural conflict
I just finished this fascinating article on cultural conflicts that can exist between patients and physicians. The case presented is simple and realistic, and the commentary provided very thought-provoking. The author touches on a wide array of cultural topics such as autonomy, privacy, and differing cultural standards, along with a thorough dissection of a variety of pre-conceived notions that both patients and physicians may bring to the clinical setting. The article ends with a rational suggestion on how cultural conflicts can still result in quality, patient-centered care, and includes a good justification for when and how to yield to a patient's wishes when they are in conflict with the physician's beliefs.
"Patient-centered medical care is not only a rejection of “my way or the highway” thinking; it is also a commitment to meeting patients on their own terms and respecting their values. We need to enhance our focus on commonality, rather than on difference, especially as the United States becomes more diverse. Providers must avoid thinking in “us versus them” terms—not only because “us versus them” is a false dichotomy but also because such thinking decreases the resolve to meet patients where they are."
3-D virtual anatomy
NYU School of Medicine designed a new and a more innovative approach for studying organs in cadavers. This approach involves a virtual cadaver projected on a screen in 3-D. With a simple click, all organs and veins are projected, allowing the capability to instantaneously navigate through the human body. The reviews of the virtual cadavers were mixed. Some students stated that dealing with a real human cadaver was difficult and often time neglects to cover all organs. The example given is dealing with a cadaver who has undergone multiple surgeries during its lifetime and is now missing its appendix and spleen. In this case the student is left without the knowledge of vital organ parts, while a virtual cadaver will always cover all organs and systems. Other students state that they believe that no computer will ever replace real cadavers. NYU administrators state that as of right now there are no plans to eliminate real cadavers as part of the curriculum but to simply use virtual cadavers to assist in the learning process.
Friday round-up
Federal investigators have released a new report stating that only about 1 in every 7 hospital errors are reported. Adverse events ranging from infections to excessive bleeding to even death are supposed to be reported through systems present at almost every hospital in the US. The systems often allow for anonymous reporting, in order to encourage hospital staff to cooperate. However, as it states in the article: "organizations that inspect and accredit hospitals generally "do not scrutinize" how hospitals keep track of medical errors and other adverse events". And if the accrediting bodies do not scrutinize the process (and results thereof), there isn't much incentive for staff to report. It also states in the article that no new federal regulations regarding this are expected.
The National Science Foundation has released the 14 winners of the "Digging into Data" challenge. The 14 winning projects all involve innovative ways to use data analysis and natural language processing (NLP) to enhance research in the humanities and social sciences. Those interested in large-scale data mining and investigation should read through the winning projects, as they all sound extremely interesting. I think my favorite might be the analysis of newspaper reporting on the 1918 flu pandemic (and not just because most of the PIs are from my alma mater!), in order to see how such reports affected public opinion and the idea of "authority" during the outbreak. I will be eagerly anticipating their results. The 14 winning research projects are sharing nearly $5 million in funds.
Dr. Matheson Harris has written a brief and clear tutorial for patients (with some help from the Chicago Tribune) on how to spot a good doctor (and a bad one!) and how to be a good, educated patient. I really like a lot of what is said here, and agree with the vast majority of it; though it might be a little harsh to tell patients not to go see a doctor who can't see them within a few days. I think it greatly depends on the type of doctor you're seeing, and what the appointment for. I make my dermatology appointments a year in advance because it is so hard to get an appointment at the practice (widely considered one of the best in the nation). And many women in the state of Pennsylvania can tell you about the difficulties in getting an OB-Gyn appointment due to the shortage of those specialists. But the gist of the advice and guidance here is very strong, and all patients should read and take it to heart.
Eight technologies for a healthier 2012
With the fast approach of the New Year, most of us have a New Year resolution. One of the biggest New Year’s resolutions is losing weight and with all the new technological advances, some say that this year may be much easier than the others to do so. The article states that the technology that may improve your health are tracking devises, exercise applications, and devices such as FitBit which counts the steps you take and calculates the calories you burn. While such devised may be extremely helpful in losing weight, the biggest contributor is motivation. Having the desire and will power are first on the list, and then technology which is used as an aide.
The stories we tell ourselves
I have been thinking a lot about this article from Wired by Jonah Lehrer (the author of the wonderful book How We Decide) since I read it two weeks ago, and even had a couple of discussions about it over the holidays. It is extremely interesting and thought-provoking, and raises a number of important questions: from how pharmaceutical companies work, to the use of the scientific method, and the general state of medical decision-making and care in the modern world.
To me, one of the more intriguing concepts brought up is the idea of cause and effect, and what Lehrer refers to as "the story we tell ourselves" about what happens between point A (cause) and point B (effect). As science and medicine work on ever-smaller bits (past cells, down to molecules and atoms) we think that what we know to be true about the larger whole will continue to hold up. But that seems to not be the case all the time, and yet we don't want to admit it. I was reminded of the book In Defense of Food by Michael Pollan while reading this article, as the main portion of the beginning of that book also revolves around reductionism and the errors it has created. An example from In Defense of Food is baby formula, and how major, vital components were missing from manufactured formulas when they were first introduced, resulting in many sick babies. We often think that knowing the component parts is the same as understanding the whole, and as Lehrer's examples of cholesterol and back pain show, that is not always true.
I dislike the title of this piece and I think it's a little too incendiary (more than likely an editor's choice and not the author's), because I don't think science is "failing" us. And I hope that the title doesn't turn too many people off from the points being made in the article. Because at some point we do need to face that breaking down the nutrients in our food, or the human brain or body, or whatever, into incrementally tinier pieces isn't going to teach us much that is new. (Obviously if you're a particle physicist that isn't the case, but the idea that human health and well-being is akin to particle physics seems rather problematic and maybe that's where we're going wrong.)
I read passages like this:
Although the scientific process tries to makes sense of problems by isolating every variable—imagining a blood vessel, say, if HDL alone were raised—reality doesn’t work like that. Instead, we live in a world in which everything is knotted together, an impregnable tangle of causes and effects. Even when a system is dissected into its basic parts, those parts are still influenced by a whirligig of forces we can’t understand or haven’t considered or don’t think matter. Hamlet was right: There really are more things in heaven and Earth than are dreamt of in our philosophy... And yet, we must never forget that our causal beliefs are defined by their limitations. For too long, we’ve pretended that the old problem of causality can be cured by our shiny new knowledge. If only we devote more resources to research or dissect the system at a more fundamental level or search for ever more subtle correlations, we can discover how it all works. But a cause is not a fact, and it never will be; the things we can see will always be bracketed by what we cannot. And this is why, even when we know everything about everything, we’ll still be telling stories about why it happened. It’s mystery all the way down."
And I, like countless others, wonder what we can do about it. He gives the example of the field of public health, which continues to make strides in a wide variety of areas: vaccines and immunizations, infectious diseases, nutrition, women's health, sex ed, STIs, and so on. Public health advances in water and sanitation, for instance, have helped increase the lifespan by close to 25 years, so what are they doing right? Is it that they look at the big picture, the biopsychosocial landscape, and track human behavior thusly? Is the focus of public health growing ever broader, while that of pharma is shrinking ever smaller?
I don't know the answer to that, or to any of the issues raised by Lehrer, but I can promise that I will continue to mull over the points he raises for a long time.
The future of medicine: 2012 edition
Livescience.com has a list of five expected medical advances for the year 2012, and they are:
- the use of vaccines in cancer treatment (not just for prevention)
- better vaccines for malaria
- better air quality regulations
- cheaper life-saving drugs
- clearer consumer information regarding health insurance plans and the nutritional content of food
What I like about this list is that it is partially focused on prevention/pro-action and not just reactive health care (which is frequently more expensive and less efficient). All good things: giving consumers more (and more comprehensible!) information regarding the food they purchase and eat, cheaper medication (such as drugs for diabetes, rheumatoid arthritis and heart disease), clear summaries and comparisons of health care plans, a wider variety of cancer treatments (which may end up being less invasive and with fewer side effects), and better vaccines for life-threatening illnesses like malaria.
2012 may have a lot to look forward to!
3D printer used to make bone-like material
An amazing new medical inkjet was created by Washington State University; a 3D printer that creates bone-like structures. The bone like material can be used for a number of procedures such as dental and orthopedic work. Testing is still being done however; results have been promising, showing success in rats and rabbits. Amazing innovation!
Avoiding medical errors
Medical errors are unfortunately a big part of our health care. Medical errors do occur and sometimes are unavoidable, however there are things that patients can do to prevent or decrease errors. Taking steps and being persistent can help avoid being a statistic. Communication, monitoring, and being involved can help patients avoid errors from happening to them. Being engaged in one’s own treatment and having access to medical records is a great start to living a healthier life.