Observers at Georgetown’s School of Medicine might be forgiven if they wonder how its students have so much free time to listen to music, and do so much texting, on their “i" devices. The students seem obsessed with their iPods(R), iPhones™, or iPod Touches(R) – they are always at hand, at ear, even during patient rounds.
The students aren’t just using them for recreation. If buds are in their ears, they are probably listening to lectures being digitally streamed from GUMC computer servers. If they look like they’re texting, it is likely because they are accessing the Internet to find information from a cornucopia of databases available through these tools-- everything from the National Library of Medicine to patient practice guidelines and drug reference guides. Handhelds can help physicians pull up clinical information on the spot, at the point of care.
What medical school should do is both teach students the fundamentals – gross anatomy or pharmacology principles, for example – and also focus on how to apply the latest clinical knowledge to support a decision.
This can only help the practice of medicine in the long run. Medical mistakes are made by every physician, and they are made every single day, but most don’t cause harm.
Other databases and tools are also available, such as the Framingham Risk Calculator, which looks at risk of having or developing heart disease. That can be used to, say, decide whether an individual patient needs to go on a statin drug to lower cholesterol, but at the same time, treatment guidelines can be accessed which help define which statin drug is best given the latest research. These treatment, or practice, guidelines are developed by the government as well as by physician professional organizations, to promote best practices based on available evidence.
Patients have significant access to information these days, but need help interpreting and applying this information. Doctors can now call up original studies and other relevant information to answer their patients’ questions. Students need to be prepared for this type of medicine.
The GUMC is planning to use electronic information systems on an even broader scale. Curricula projects underway for next year are student training in “e-prescribing” and use of electronic health records. The bioinformatics group is currently exploring adapting WorldVistA, an open-source, electronic health record and health information system designed for use by the U.S. Department of Veterans Affairs, for educational use at GUMC. It will be used in a patient simulation center with “patient” actors. Their task will be to use these tools to help support the treatment decisions they make, and to also help answer patient’s questions.
The GUMC also using informatics to help track student procedures and performance and to continue to build up GUMC’s web-based presence, such as the archiving of streaming lectures, podcasts, and videocasts that students can download at any time.
By Renee Twombly, GUMC Communications