Department of Surgery TO ERR IS HUMAN
Department of Surgery 1.2 Trillion dollars 12-14% of GDP Affects every American HEALTHCARE IN AMERICA
Department of Surgery MEDICAL EDUCATION Largely unchanged in last 100 years Apprenticeship model “See one, Do one, Teach one” Education by Random Opportunity
Department of Surgery WHAT’S WRONG WITH MEDICAL EDUCATION? Imagine: As your plane (a packed 747) approaches SFO Airport, the pilot announces: “Folks, our co-pilot hasn’t had the opportunity to do a solo instrument landing, so she will be practicing one shortly. I’ll join you in the cabin while she lands the plane.”
Department of Surgery WHAT’S WRONG WITH MEDICAL EDUCATION? Imagine: A squadron commander, in the United States Army during Operation Desert Storm, tells his troops on the eve of battle: “While none of you have actually fought under these conditions, I hope you will figure it out”.
Department of Surgery WHAT’S WRONG WITH MEDICAL EDUCATION? These two scenarios are Unthinkable Why? For quality, safety and cost reasons, neither the airlines nor the military would demand performance without extensive prior practice.
Department of Surgery
WHO ARE STUDENTS OF MEDICINE? Medical Students Residents Practicing Surgeons Nursing Students Practicing Nurses
Department of Surgery EDUCATION: KEY CONCEPT I Hear, I Forget I See, I Remember I Do, I Understand Lao-Tsu BC
Department of Surgery In the last 50 years, mankind’s most profound advancements have been in Biomedicine and Computer Science. They are converging!
Department of Surgery
MEDICAL EDUCATION Cognitive Sensory Five senses + common sense Motor*
Department of Surgery We will use VR to select, train, credential and retrain physicians and surgeons. Surgeons will rehearse an operation on a patient-specific palpable hologram and deliver the data set of that operation with robotic assistance. Ubiquitous computing will revolutionize medical education and patient care. INFORMATION TECHNOLOGY IN MEDICINE
Department of Surgery Not Science Fiction But Scientific Eventuality S. Spielberg ? SCIENCE FICTION ?
Department of Surgery Radio has no future. LORD KELVIN Scottish mathematician and physicist, former president of the Royal Society, 1897
Department of Surgery Everything that can be invented has been invented. CHARLES H. DUELL U.S. commissioner of patents, 1899
Department of Surgery There is no reason for any individual to have a computer in their home. KENNETH OLSEN president and founder of Digital Equipment Corp., 1977
Department of Surgery learning to be a doctor what makes a skilled practitioner? what makes a skilled practitioner? ©2000 David Williamson Shaffer
Department of Surgery learning curve from chaudhry et al., “learning rate for laparoscopic surgical skills on mist vr…,” annals of the royal college of surgeons of england, 1999 from chaudhry et al., “learning rate for laparoscopic surgical skills on mist vr…,” annals of the royal college of surgeons of england, 1999 ©2000 David Williamson Shaffer
Department of Surgery complication rate complication rate from pratt, laparoscopic gastric bypass, 2000 from pratt, laparoscopic gastric bypass, ©2000 David Williamson Shaffer
Department of Surgery the part-task problem It is not true that a complex reaction consists of a chain of separate processes which may be arbitrarily added and subtracted. --- l.s. vygotsky, mind in society ©2000 David Williamson Shaffer
Department of Surgery IMPEDIMENTS Tradition Service Roles Finances Efficacy?
Department of Surgery WHO WILL DEVELOP? Academics Military Industry
Department of Surgery INDUSTRY Start-Up Simulation Company Consumer Electronics
Department of Surgery HOW WILL IT BE FUNDED? Federal Government Grant SBIR Industry Insurance Industry
Department of Surgery motor skills perception thought in action knowledge analysis judgement mentorship breadth thought about action build on what medical education does right use the power of simulation to make it better a learning system ©2000 David Williamson Shaffer
Department of Surgery The best way to predict the future is to invent it. Alan Kay
Department of Surgery