Apps and Their Applications

In a society dominated by the use of technology as a primary method of communication and education, it should come as no surprise that medical professionals rely heavily on its use as well. The new dominance of smartphones over cell phones and pagers in medicine is largely influenced by convenience and efficiency, and over 70% of healthcare professionals have reported using a mobile device in their workplaces. This chapter aims to highlight the transition to mobile devices in the medical realm and the benefits for both clinicians and patients. For clinicians, mobile devices and apps may serve as diagnostic aids, med calculators, and clinical references. They can also be used for medical education purposes and access of electronic medical records. For patients, mobile devices and apps are often utilized to find resources and information about diseases, to help with disease management, and to promote lifestyle modification and fitness. Nevertheless, despite the numerous benefits of mobile devices in practice, potential risks and drawbacks must also be considered.

Modern Technology in Dermatopathology Education

Technological advancement is steadily reshaping the field of medical education. In histopathology and especially dermatopathology training, the transition from glass slide microscopy (GSM) to virtual microscopy (VM) is serving as an instructional tool for medical students, residents, fellows, and experienced physicians. Online slide atlases and digitalized content are being utilized by educators and trainees to enhance and assess both individual and collaborative learning. With the expansion of mobile technology, new avenues are emerging for image attainment, in addition to remote instruction and consultation in resource-limited areas. Various computer-based applications (“apps”) and social media sites also serve as digital assets in education and training and allow for rapid dissemination and sharing of information around the world.

Technologic Advances in Neurologic Practice and Education

Although the visualization of the ocular fundus yields important clinical information regarding the optic nerve and retinal vasculature, proficiency in using the traditional handheld direct ophthalmoscope by both practicing physicians and medical students continues to deteriorate. A replacement for the direct ophthalmoscope is long overdue. The authors suggest a role for non-mydriatic fundus photography as having potential to resurrect the dying art of visualizing the fundus in both clinical practice and medical education. This chapter reviews the substantial barriers in both patient care as well as graduate and undergraduate medical education created by technical difficulties encountered using the direct ophthalmoscope to visualize the ocular fundus. The authors propose that a smartphone-compatible adaptor to view the ocular fundus will replace the direct ophthalmoscope.

Simulation Technology in Anesthesia Education

This chapter provides an overview of increasing role of simulation technology in anesthesia education. A brief history of the role of simulation is discussed, spanning across the introduction of the first medical simulators of the 18th century to the role of modern simulation technology in education today. The capacity in which anesthesia education is conducted has dramatically improved with the advancement in simulation technology and use of part-task and full-body simulation trainers. In this chapter, focus is placed on the indications and utility of simulation for airway management, bronchoscopy, and central line placement education, as well as whole-body simulation models and their role in practicing complex scenarios. Key elements that ensure a successful simulation scenario are outlined, and the advantages and barriers to the use of simulation technology in anesthesia education are discussed.

Collaborative Learning for Histopathology Education

The authors have developed a pedagogical approach to the teaching of histology and histopathology using a team-based, collaborative learning model. To accomplish this, students are assigned to small groups of “microdissection” teams, mirroring the approach used in gross anatomy dissection. These collaborative groups present the case, including history, relative labs, imaging, gross pathology, and microanatomy, to their classmates. Each clinical case contains normal and abnormal virtual microscopy slides with links to key areas of interest, as well as hyperlinked references to the medical literature (the electronic pathology text or an article from a general medical journal, e.g., The New England Journal of Medicine®). In order to facilitate this collaborative process, they use Microsoft Office 365® and the included OneNote® program. The approach has facilitated integration of histopathology into the curriculum with more interactive laboratories stimulating active learning to build improved diagnostic skills for the learners.

Are Electronic Medical Education and the EHR Helping or Hurting the Quality of Medical Education and Patient Care?

This chapter addresses some of the negative aspects of both electronic medical education and the electronic health record. This includes the dilution of the doctor/patient interface, the emphasis on documentation rather than on learning the healing arts, and the intellectual dishonesty that arises from the use of templates and automated fillers. The authors address concerns about the dehumanization of medicine, starting with the style of medical education carrying through to the style of function within the clinical environment.

Using Competency-Based Learning to Improve Clinical Skills

This chapter serves to provide medical educators with an overview of competency-based education (CBME) and the clinical skills necessary for medical school graduate. Technology that supports the teaching, learning, and assessment of CBME and clinical skills is defined and examples are provided for each of the Accreditation Council for Graduate Medical Education (ACGME) core competencies. The competencies are defined, and clinical skills embedded in each are highlighted. This chapter provides a summary of the useful technological tools and provides examples of medical schools that use technology to teach and assess CBME with these tools. Online teaching or eLearning, simulation, online assessment, virtual humans, the electronic health record, gaming, procedural software, discussion boards, reflective writing, portfolios, and telemedicine programs are covered in detail.

The Use of Mobile ECG Monitoring Devices in Embolic Stroke Associated With Atrial Fibrillation

Stroke prevention is a primary aim in clinical neurology. Atrial fibrillation (AF), the most common cardiac arrhythmia affecting 35 million people worldwide, carries a 5x risk of devastating stroke largely preventable with anticoagulation. The AliveCor Kardia™ mobile application for iPhones and Kardia Band™, a wristband for the Apple Watch, are approved by the Food and Drug Administration (FDA). These clinically validated mobile electrocardiograms (ECGs) utilize an artificial intelligence algorithm to provide instant analysis for detecting AF. The preliminary experience using this novel technology at a safety net, teaching hospital was very positive. AliveCor's™ was easy to use by neurologists, residents, medical students and nursing personnel and, in combination with pulse palpation, consistently detected AF that was confirmed by a cardiologist with standard ECG. With this new technology, the identification of AF that previously went unrecognized and often asymptomatic has prompted significant changes in patient therapy (additional cardiology evaluation and administration of anticonvulsants). AliveCor™ improved the ability to identify AF in elderly patients with and without a prior history of stroke. Although detection of paroxysmal, persistent and chronic AF was achieved, stratification of the risk versus benefit of anticoagulation therapy in individual patients became more difficult. The anticipated epidemic of AF will be easier to detect with technological advances like AliveCor™, which provides accurate analysis compared to current anticoagulation risk population-based assessment tools. One assessment tool, the CHA2DS2-VASc, depicts a predictive value for stroke in patients with AF with a P value equal to 0.58, making it merely significant. More precise physiologic biomarkers of thrombus formation using blood or cardiac imaging are needed to segregate subgroups of this expanding population of patients found to be in AF.

Asynchronous Education for Graduate Medical Trainees to Reduce Health Disparities and Address Social Determinants of Health

Health disparities and social determinants of health are directly linked to access, quality of healthcare, and increase in morbidity and mortality in minority and diverse communities. It is accepted that physicians lead healthcare teams; therefore, academic medical centers must assume the responsibility to provide training to reduce health disparities. The nation's academic medical centers and teaching hospitals have a responsibility to provide education on how healthcare disparities impacts diverse patient populations. This chapter provides a detailed overview of the curriculum development process and design of two asynchronous learning modules on health disparities and social determinants of health for graduate medical learners enrolled in multiple clinical specialty areas throughout one academic medical center's three geographic regional campuses. Formative and summative evaluation processes allowed the curriculum design team to revise the module design process, in situ and throughout the creation of the modules as well as evaluate learner growth and satisfaction.

Technological and Ethical Challenges of Online Education

The impact of technology can be felt throughout the medical education continuum. From online learning environments in blended learning approaches to exclusively providing the preclinical curriculum online, there is a growing need to optimize the way that technology supports self-directed learning in the next generation of medical professionals. In this chapter, the authors address issues of best practice surrounding the development of virtual content for medical education. The information presented will be integral for medical education professionals, basic science/clinical faculty, and educational assessment specialists with an interest in the use of technology for contemporary medical education. The goal is to offer an overview of the theory and ethics behind adopting an online strategy for medical education. An emphasis is placed on developing best practices for presenting content, a comparison of blended and online-only approaches, and the ethical considerations necessary for the successful training of medical professionals online.