The Future of Medical Education: Death-Defying Robots

by Claire Watry, Terra Linda HS

This week the Marin Science Seminar introduces a unique presentation on medical education with Rich Fidler PhD MBA and Abi FitzGerald MSN RN of the VA Medical Center and their special guests - robots! These humanlike robots are utilized by medical practitioners at the Simulation Center at the VMCA in San Francisco to learn how to perform a variety of procedures and respond appropriately to different emergency scenarios. 

Rich Fidler is the Director of the Healthcare Simulation which places him in charge of all of the simulation research, education, training, and process evaluations that take place in the entire hospital, including emergency, critical care, surgery, and disaster preparedness. Fidler is also the Co-Director of the Fellowship Program in Advanced Clinical Simulation. Fidler explains this role in the following quote; "I am responsible for ensuring that our advanced fellows are receiving challenging experiences, quality didactic education in statistics, research design, thoughtful data analysis. I also ensure that they will be able to go out to conduct clinical simulations independently." In order to obtain these job titles, Fidler has collected numerous degrees and gone through extensive medical training. 

Read the interview with Rich Fidler below and be sure to attend this weeks's Marin Science Seminar. 

What degrees and training do you have, and how do they relate to each other?

PhD in Physiological Nursing from UCSF--allows me to apply knowledge and principles of physiology to understanding biomedical engineering solutions to clinical problems.

MS in Human Factors Engineering--allows me to understand human-technology interfacing, and allows me to more completely understand the reasons that people have problems operating medical equipment. 

Anesthesia Training--allows me the skill set for airway and physiologic patient monitoring and surgical perspective for a well-rounded clinical practice

Critical Care Training--allows me the experience to provide care for the sickest of hospitalized patients, applying physiology, chemistry, and pharmacology to improving patient conditions.

Primary Care Training--allows me the perspective to understand how diseases evolve over long periods of time, and also allows me to see how patients choose to participate in their healthcare

MBA--having a master's of business administration allows me the knowledge to understand people operating in a system, particularly with skills related to managing people. Frequently, it is important for me to elicit a particular behavior from our staff, but this needs to be done respectfully so that the employees WANT to do a good job.

How did you become interested in the medical field? 

I developed a special interest in healthcare when my grandfather became ill with heart problems while I was young. As early as 8 years old, I would go to spend every evening with my grandfather to try to make him feel better by pushing the fluid out of his legs. From there, I got more interested in why his heart was failing and how I could make it better. I got more interested in cardiac resuscitation after my grandfather had a sudden cardiac death event and we saved him. Then my own father had a series of 3 cardiac arrests which he survived from high quality CPR and early defibrillation, but he eventually died with the fourth cardiac arrest. 

How did you become involved in the Simulation Center?

I have always liked teaching, and I think that learning with your hands is better than someone talking you to death. When I told my father about what I did with simulation, he said, " You can't make a living playing with dolls." I guess I showed that you should do what you like to do, even if your parents don't think it's worthwhile. You have to make yourself, not your parents, happy with your career. The harder stunt is to figure out how to make lots of money doing what you love!

Example of a Simulation Center

What projects have you worked or are you currently working on in the Simulation Center?

Defibrillators.

Resuscitation.

Heart monitors.

Disaster evacuation from the hospital in the middle of surgery.

Should we unwire a jaw wired closed or do a cricothyrotomy to get oxygen to the patient?

What is the best way to open a chest for bleeding in the immediate post-open heart period?

What is the most rewarding part of your job?

Seeing people that did not know how to do something not only learn how to do it, but also gain a certain amount of confidence and mastery doing the new task. 

What advice do you have for young people aspiring to have a career in the medical field? 

Do it! My grandfather said that I should either be an obstetrician or an undertaker, that way you can get people either coming or going! If you aspire to go into the healthcare field, explore your options. Becoming a physician or nurse is not your only option to make a meaningful contribution to healthcare. Medical research, especially with the human genome, is really exciting. If I were growing up now, I would probably be fascinated with that. Also, the roles of pharmacists and therapists are frequently overlooked as vital members of the healthcare team. The money should NOT be a factor in your decision. No job is worth getting up every day if you hate going. I love going to my job every single day.

Check out this very exciting presentation "Death-Defying Robots in Medical Education" with Rich Fidler PhD MBA and Abi FitzGerald MSN RN of the VA Medical Center on Wednesday, May 14 7:30 – 8:30 pm, Terra Linda High School, San Rafael, Room 207. 

Read an excellent article about Rich Fidler here 

~Claire Watry

Links:
http://scienceofcaring.ucsf.edu/acute-and-transitional-care/improving-cardiac-care-science-human-use
http://www.ucsf.edu/news/2011/01/8397/new-teaching-and-learning-center-transform-health-education-ucsf
https://www.youtube.com/watch?v=cZNa0vmdgSI

Public Health Challenges in Kenya

by Claire Watry, Terra Linda HS

As inhabitants of a developing nation, the people of Kenya face many obstacles in receiving basic healthcare. According to the Global Health Department at the Massachusetts Institute of Technology, there are five main issues in delivering adequate healthcare in Kenya: infrastructure, lack of funding, access to care in rural areas, price and affordability of medicines, and politics. Statistics from the World Health Organization in 2006 showed that the top five causes of death in Kenya were HIV/AIDS followed by respiratory infections, diarrheal disease, tuberculosis, and malaria. While healthcare in Kenya has been steadily improving, there are still many challenges to overcome especially concerning healthcare access in rural areas. The video below shows the hardships people in rural areas of Kenya face in obtaining healthcare.

Affordable Health Care Still a Dream for Rural Kenya

Access to clean water is one of the biggest health issues in Kenya, especially in rural areas. In rural areas only 54% of people used improved water sources compared to the 83% of people in urban areas who used improved water sources in the year 2011 (UNICEF). In rural areas, the water sources are often shared by livestock and contaminated by feces from the livestock, making the water unsafe to drink. 

A short-term solution to unsafe drinking water is the LifeStraw water filter. The LifeStraw water filter allows an individual to drink directly from a water source or bottle just as a person would normally drink through a straw. The waterborne bacteria and other contaminants found in the water can cause severe diarrhea, which is the third leading cause of death in Kenya. LifeStraw prevents these deaths by effectively removing 99.99999% of bacteria and 99.9% of protozoa from the water. 

Kenya is reliant on outside donors and organizations in order to receive adequate and affordable health services. The LifeStraw Carbon for Water campaign put on by ClimateCare is one of these many organizations. This project distributed 877,505 LifeStraw Family filters to households in Kenya’s Western Province which supply safe drinking water directly to 4.5 million people. The video here explains the project and its success in depth. 

Another organization called BedNets for Children distributes bed nets to prevent children and their families from contracting malaria from mosquitos. A statistic from the organization's website states that a child in Africa dies every 60 seconds from malaria. Bed nets have been shown to be very effective in preventing malaria especially for young children under two years of age. The World Health Organization has reported a 33% reduction in malaria deaths in sub-Saharan Africa since 2000. 

The First Lady of Kenya Margaret Kenyatta recently announced a "Beyond Zero Campaign" to improve maternal and child health outcomes by combating HIV/AIDS. According to the website, "fifteen women die every day due to pregnancy related complications in Kenya and 20% of all deaths among mothers in the country are AIDS-related." The campaign has five key elements: "(i) Accelerating HIV programs, (ii) Influencing investment in high impact activities to promote maternal and child health and HIV control, (iii) Mobilizing men as clients, partners and agents of change, (iv) Involving communities to address barriers to accessing HIV, maternal and child health services and (v) Providing leadership, accountability and recognition to accelerate the attainment of HIV, maternal and child health targets." The goal of the project is to eliminate preventable deaths in children and mothers. 

This week's MSS speaker Maureen Valley DMD MPH participates in two organizations that teach the importance of oral hygiene in Kenya, Kenya Smiles and the Loitikotok Oral Health and Nutrition Project. Through these organizations, Valley distributes toothbrushes and toothpaste, collects research about dental hygiene, and educates children and other community members about oral health. 

The objectives of Kenya Smiles

Loitikotok Oral Health and Nutrition Project

To learn about oral healthcare outreach in Kenya, attend the Marin Science Seminar presentation "Spreading Smiles Worldwide: Oral Healthcare Outreach and Research among the Maasai in Kenya" with Maureen Valley DMD MPH and Samson Saigilu on Wednesday April 23, 2014, 7:30 – 8:30 pm, Terra Linda High School, San Rafael, Room 207. 

Information Sources:

World Health Organization http://www.who.int/countries/ken/en/

UNICEF http://www.unicef.org/infobycountry/kenya_statistics.html#115

Center for Disease Control http://www.cdc.gov/globalhealth/countries/kenya/why/

Global Health at MIT http://globalhealth.mit.edu/country-briefing-kenya/

ClimateCare http://climatecare.org/our-projects/lifestraw-carbon-for-water/
UnAIDS http://www.unaids.org/en/resources/presscentre/featurestories/2014/january/20140130beyondzerocampaign/
Kenya Smiles http://www.kenyasmiles.org/
Valley Orthodontics http://www.valleyorthodontics.net/#!about4/csaq

Image Sources:

http://episcopaldigitalnetwork.com/ens/2011/12/16/gifts-that-give-back-year-round/

http://alvpfchristiancharity.org/kenya-water-project-christian-charity/

http://www.blackmountainsurvival.com/catalog/lifestraw/

Video Source:
https://www.youtube.com/watch?v=_ansnQOfz2Y

~ Claire Watry