What needs to change in medical education to prepare clinicians of the future

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The rate of medical knowledge creation has continued to increase and accelerate  over the years to a dizzying speed.

In 1950, the estimated amount of time it would take to double medical knowledge was 50 years. By 1960 it was 10 years. Now the projected time it will take to double medical knowledge in 2020 will be under three months.

“One way to think about this is a medical student who starts medical school this year will have as many of 20 doublings of medical knowledge before they graduate,” said Michael Pitt a professor of pediatrics at the University of Minnesota School of Medicine during a speech at the Manova Summit in Minneapolis.

This overwhelming spigot of medical knowledge is coupled with the fact that there is a projected shortage of physicians and care providers that will only worsen as the U.S. population ages.

In response, Pitt posits that medical education needs to fundamentally change to meet the growing healthcare needs of the country.

“We have to accept that we cannot possibly teach everything and we have to move from a focus on traditional medical education which taught us what to know and shift to teaching providers how to know and how to behave,” Pitt said.

This means the reexamination of the frameworks on which clinical decisions are being made to combat innate biases and using real-time feedback to shape and correct diagnostic mistakes.

Another type of necessary behavior change, according to Pitt, is the integration of empathy as a core part of clinical practice, instead of a distraction to effective and objective data gathering.

He cited a study from University of Wisconsin researchers that demonstrated providers using at least one empathy phrase during patient visits for the common cold saw symptoms less than one day longer than others.

“Unfortunately most medical providers are good at empathy in the real world, but we train it out of them,” Pitt said. “It would be malpractice if I was not prescribing a medicine to shorten things or using technology to shorten things.”

Luckily the influx of medical knowledge has also been paired with new technological avenues to access and utilize that knowledge.

Pitt said board certifications and continuing medical education also needs to keep up with these new types of information retrieval.

He pointed to the American Board of Pediatrics shifting their board certification and re-certification tests has moved to a periodic testing system through smartphones that allows physicians to look for answers via readily available real-world resources.

Another major point highlighted by Pitt was the need to diversify the pool of providers, which has been shown to improve outcomes for patients.

The healthcare industry is still struggling to increase the number of underrepresented minorities in medicine. While black and Latino people make up 30 percent of the U.S. population, they only make up around 9 percent of the country’s physicians.

“Unless we are doing things to train more providers and different types of providers we will fall short of being able to provide the care our families need,” Pitt said.

One way to bolster these numbers is by leveraging the existing knowledge base and talent of immigrants and international medical graduates, a traditional cultural strength of the United States. One in three board-certified internal medicine physicians trained outside of the country.

These doctors often have to repeat their training, reapply for medical school or residency and end up taking less desirable jobs.

One way to expedite this process is through programs like the University of Minnesota’s International Graduate Medical Assistance program which provides earmarked residency spots who commit to working in the undeserved parts of the state.

Pitt added that the medical education model itself needs to evolve from having a fixed amount of time with variable competency to being able to adapt to a student’s pace of learning and proficiency.

“We need to specialize our training and allow people to have personalized training, not just personalized healthcare as patients,” Pitt said.

“It’s quite possible that pretty soon we may get an alert on our watches that will say we have cancer, but I want to train the person, the human resource, that will be there to help make the diagnosis make sense, answer questions with empathy, readily retrieve information and help me collaboratively create a treatment plan.”

Picture: tonefotographia, Getty Images



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