Training for Tomorrow's ChallengesBy Charles Buchanan
Harvey the robot may help UAB medical students and residents become better doctors. The high-fidelity mannequin, programmed with different heartbeats to mimic a multitude of heart conditions, is the newest inhabitant of the School of Medicine’s simulation training program. Now Harvey, his mechanical counterparts, and their flesh-and-blood colleagues will play a greater role in clinical skills training—a major focus of the school’s education strategic plan.
“Our goal is to help students learn more effectively,” says H. Hughes Evans, M.D., Ph.D., senior associate dean for medical education. Innovative teaching methods such as simulation training involve “learning by doing, and all students will tell you that they learn better in that kind of environment.” In addition to the interactive mannequins, UAB uses standardized patients—people acting as patients—to simulate real-world clinical experiences. Expanding the training offers a good way to gauge skills, especially those that require more of a thought process, including the interpretation of findings, Evans says. A faculty-student debriefing follows each session with a robot or standardized patient, and that’s where simulation has its greatest impact, she adds. “We make the situation real, and the debriefing helps them learn from the situation.”
Interprofessional education will be another emphasis. Increasingly, the quality of patient care “isn’t just about whether a doctor’s doing a good job,” Evans says. “Medicine is teamwork,” requiring nurses, therapists, and other professionals to work together and communicate effectively. UAB geriatricians have already begun crossing academic boundaries with training exercises that team medical, nursing, and health professions students to create a care plan for a case-study patient. Evans envisions similar training that could emphasize patient safety, quality of care, and clinical skills. “We need to start interprofessional education earlier so that students have a better appreciation of what the team can do for the patient,” she says.
Pipelines and Avenues
Along with promoting innovative teaching, the School of Medicine will provide additional academic support services to encourage and assist students as they progress through the curriculum. Some initiatives, however, will reach back, expanding UAB’s successful “pipeline” and prematriculation programs that expose middle- and high-school students to health careers and educational enrichment. These can help pave the way for academic success for students who get into medical school, Evans says. They also can help remove obstacles for students from underrepresented groups, including minority and rural populations, facing a growing need for physicians. “Students who come from these groups are more likely to return to those groups as doctors,” Evans explains. “We want to help them feel motivated and inspired to keep working toward health-care careers.”
Faculty also will explore new avenues of learning. The new Department of Medical Education will help meet the academic needs of faculty, enabling them to become better teachers and mentors. “We want to do some programmatic development and research in medical education,” says Evans, who has been named chair of the department. “As our expertise grows, we could develop master’s or fellowship programs in areas such as medical simulation. We could teach people here instead of sending them out of state to learn it.”
Costs and Choices
One issue affecting all medical students is the cost of education, which can influence decisions ranging from school choice to career choice. “Our ability to help students has eroded with tuition increases,” Evans says. Now the school is beginning a campaign to increase the number of scholarships for students with financial need—and to lobby the Alabama Legislature to expand its loan repayment program for students who commit to practice primary care in rural areas.
“Supporting these efforts will help us have better doctors in the future,” she adds. “Alabama requires more doctors. We must make sure that our students are prepared to be the kind of doctors we respect and need.”