Outcomes from a postgraduate biomedical technology innovation training program: the first 12 years of Stanford Biodesign

Assessing the impact of Medical Education's Innovation & Entrepreneurship Program in China

OBJECTIVE

A growing number of clinical undergraduates are chosen to enter institutions for higher education biotechnology and industry workforce, though most need more laboratory experience training and business practice. Innovation and Entrepreneurship Program (I&E Program) can benefit from biological experiment and commercialization training largely absent from standard clinical medical educational curricula. Our study investigates the impact and status of the I&E Program in enhancing medical students' research and entrepreneurial abilities and provides recommendations for improving this program.

METHODS

A cross-sectional study was applied by delivering a questionnaire to survey medical students from Central South University who participated in the I&E Program. The questionnaire consisted of three parts: basic information, the impact of the I&E Program on medical students' research and entrepreneurial abilities, and attitudes and recommendations regarding the I&E Program.

RESULTS

Many students participating in the I&E Program have received competition awards and improved their academic experience, article writing, and application patents. Their research-related abilities have been enhanced, including in-lab techniques, theoretical research skills, data analysis knowledge, clinical research skills, experimental research skills, entrepreneurship, data analysis ability, teamwork, and communication. While 73.93% of students express satisfaction with the I&E Program, there are still several areas of improvement, including more robust practical components, increased support, and enhanced teamwork.

CONCLUSION

The scale of the I&E Program is rapidly expanding to address scientific research or business skills needed by college students in the new era. However, more programs still need to be discontinued during their further study. The I&E Program significantly enhances research abilities and fosters confidence in their study. This analysis emphasizes the importance of research-oriented and interdisciplinary education for students' holistic development in medical schools compared with formal medical education.

Application of the Stanford Biodesign Framework in Healthcare Innovation Training and Commercialization of Market Appropriate Products: A Scoping Review

The Stanford Biodesign needs-centric framework can guide healthcare innovators to successfully adopt the 'Identify, Invent and Implement' framework and develop new healthcare innovations products to address patients' needs. This scoping review explored the application of the Stanford Biodesign framework for healthcare innovation training and the development of novel healthcare innovative products. Seven electronic databases were searched from their respective inception dates till April 2023: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest Dissertations, and Theses Global. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews and was guided by the Arksey and O'Malley's scoping review framework. Findings were analyzed using Braun and Clarke's thematic analysis framework. Three themes and eight subthemes were identified from the 26 included articles. The main themes are: (1) Making a mark on healthcare innovation, (2) Secrets behind success, and (3) The next steps. The Stanford Biodesign framework guided healthcare innovation teams to develop new medical products and achieve better patient health outcomes through the induction of training programs and the development of novel products. Training programs adopting the Stanford Biodesign approach were found to be successful in improving trainees' entrepreneurship, innovation, and leadership skills and should continue to be promoted. To aid innovators in commercializing their newly developed medical products, additional support such as securing funds for early start-up companies, involving clinicians and users in product testing and validation, and establishing new guidelines and protocols for the new healthcare products would be needed.

Design and Implementation of an Electronic Health Record-Integrated Hypertension Management Application

BACKGROUND

High blood pressure affects approximately 116 million adults in the United States. It is the leading risk factor for death and disability across the world. Unfortunately, over the past decade, hypertension control rates have decreased across the United States. Prediction models and clinical studies have shown that reducing clinician inertia alone is sufficient to reach the target of ≥80% blood pressure control. Digital health tools containing evidence-based algorithms that are able to reduce clinician inertia are a good fit for turning the tide in blood pressure control, but careful consideration should be taken in the design process to integrate digital health interventions into the clinical workflow.

METHODS

We describe the development of a provider-facing hypertension management platform. We enumerate key steps of the development process, including needs finding, clinical workflow analysis, treatment algorithm creation, platform design and electronic health record integration. We interviewed and surveyed 5 Stanford clinicians from primary care, cardiology, and their clinical care team members (including nurses, advanced practice providers, medical assistants) to identify needs and break down the steps of clinician workflow analysis. The application design and development stage were aided by a team of approximately 15 specialists in the fields of primary care, hypertension, bioinformatics, and software development.

CONCLUSIONS

Digital monitoring holds immense potential for revolutionizing chronic disease management. Our team developed a hypertension management platform at an academic medical center to address some of the top barriers to adoption and achieving clinical outcomes. The frameworks and processes described in this article may be used for the development of a diverse range of digital health tools in the cardiovascular space.

Bluegrass Biodesign: Why an Integrated Biomedical Engineering Curriculum is Crucial for Medical Education

Background Medical education often overlooks the significance of design and innovation literacy, resulting in a knowledge gap in undergraduate medical education (UME) regarding formal training in these areas. Incorporating innovation into UME's core curriculum is crucial as future physicians will encounter evolving technologies, and fostering a transdisciplinary approach can enable collaborative problem-solving and improve patient health outcomes. Methodology We developed a comprehensive medical biodesign curriculum focused on innovation, including problem identification, prototype testing, and product commercialization. Participants were selected based on applications, interviews, and diverse criteria. A survey was conducted before and after the program to assess students' biodesign experiences and knowledge, with data analyzed using descriptive statistics and paired t-tests. Results Of the 41 participants, 24 (58.5%) completed both pre- and post-program surveys. These five-point Likert surveys showed a significant shift from pre-program to responses demonstrating increased "comfort levels in explaining and applying biodesign principles" (p < 0.0001). Specifically, the "comfort level in taking a product to market" increased from 33% to 67% (p = 0.01), while the "comfort level in applying the biodesign process" increased from 29% to 92% (p < 0.0001). Moreover, 58.3% of participants expressed interest in continuing their current projects, and 70.8% of students stated feeling confident in generating ideas and solutions with their team members. Conclusions The medical biodesign curriculum demonstrated success in exposing undergraduate medical and engineering students to the concepts of medical innovation and biodesign. The program has led to a significant improvement in students' knowledge and comfort levels in applying the biodesign process and taking a product to market. The high level of interest and participation in the program highlight the need for incorporating innovative training in UME to foster creativity and prepare future physicians to contribute to the advancements in healthcare.

The Application of Design Thinking in Developing a Deep Learning Algorithm for Hip Fracture Detection

(1) Background: Design thinking is a problem-solving approach that has been applied in various sectors, including healthcare and medical education. While deep learning (DL) algorithms can assist in clinical practice, integrating them into clinical scenarios can be challenging. This study aimed to use design thinking steps to develop a DL algorithm that accelerates deployment in clinical practice and improves its performance to meet clinical requirements. (2) Methods: We applied the design thinking process to interview clinical doctors and gain insights to develop and modify the DL algorithm to meet clinical scenarios. We also compared the DL performance of the algorithm before and after the integration of design thinking. (3) Results: After empathizing with clinical doctors and defining their needs, we identified the unmet need of five trauma surgeons as "how to reduce the misdiagnosis of femoral fracture by pelvic plain film (PXR) at initial emergency visiting". We collected 4235 PXRs from our hospital, of which 2146 had a hip fracture (51%) from 2008 to 2016. We developed hip fracture DL detection models based on the Xception convolutional neural network by using these images. By incorporating design thinking, we improved the diagnostic accuracy from 0.91 (0.84-0.96) to 0.95 (0.93-0.97), the sensitivity from 0.97 (0.89-1.00) to 0.97 (0.94-0.99), and the specificity from 0.84 (0.71-0.93) to 0.93(0.990-0.97). (4) Conclusions: In summary, this study demonstrates that design thinking can ensure that DL solutions developed for trauma care are user-centered and meet the needs of patients and healthcare providers.

Engineers in Medicine: Foster Innovation by Traversing Boundaries

Engineers play a critical role in the advancement of biomedical science and the development of diagnostic and therapeutic technologies for human well-being. The complexity of medical problems requires the synthesis of diverse knowledge systems and clinical experiences to develop solutions. Therefore, engineers in the healthcare and biomedical industries are interdisciplinary by nature to innovate technical tools in sophisticated clinical settings. In academia, engineering is usually divided into disciplines with dominant characteristics. Since biomedical engineering has been established as an independent curriculum, the term "biomedical engineers" often refers to the population from a specific discipline. In fact, engineers who contribute to medical and healthcare innovations cover a broad range of engineering majors, including electrical engineering, mechanical engineering, chemical engineering, industrial engineering, and computer sciences. This paper provides a comprehensive review of the contributions of different engineering professions to the development of innovative biomedical solutions. We use the term "engineers in medicine" to refer to all talents who integrate the body of engineering knowledge and biological sciences to advance healthcare systems.

Training the next generation of translational scientists: The Case Western Reserve University Translational Fellows Program

Background

An important part of biomedical research is the translation of discoveries into clinical or community applications that impact patient health. For a vast majority of clinical applications and sustainable community interventions, a time-tested way to get innovations to patients is through licensing of the technology and commercial development, often through startups. While biomedical scientists and trainees are schooled in discovery research, the processes of commercialization are foreign or intimidating. Further, many trainees will not aspire to a faculty position, and other avenues of advancement are desirable.

Methods

At Case Western Reserve University, we developed and launched a Translational Fellows Program to provide such training for the community, focusing specifically on graduate students and postdoctoral fellows. The goals of this program include familiarizing our trainees with the principles of entrepreneurship, product development, and startups. This is accomplished through study of their laboratory's technology to identify points of translational focus and to increase awareness to potentially move ideas and products toward societal impact. This program leverages much of our existing infrastructure and provides a mechanism for the prioritization of the translation of the technology as well as "release-time" to promote effort.

Results

Launched in summer 2020, our first cohort had 3 of the 12 fellows launching startups based on their technology and submitting an National Institutes of Health Small Business Innovation Research (SBIR) proposal. At least 80% reported increased knowledge and confidence in five of six key translational competencies.

Conclusion

We are now continuing and improving the program and searching for sustainable support to stabilize the program for a long-term productive future.

Biodesign program introduction in Japan: promotion of entrepreneurship and viewpoints of education on medical technology innovation

The Stanford Biodesign program was first introduced in Japan in 2015 at three national universities to develop medical technology innovation and its talent. This study aimed to (1) show the outcomes of leadership talent development, (2) indicate the educational results of the program, and (3) objectively analyze the ways in which the program executed in Japan, effectively promoted entrepreneurship orientation and the origination of new businesses. The latter is especially relevant as Japan has low entrepreneurial awareness and new business entry rates compared to the United States and Europe. Herein, fellows were subjected to questionnaires, interviews, and a survey based on academic papers, extant literature, and treatises issued by the Nihon Biodesign Gakkai (Academic Society of Japan Biodesign). Overall program performance showed notable results, despite indicating a need to improve business-related programs and team learning which is greatly influenced by Japanese culture. An externship program, planned and developed in Japan, was most inspiring and served to expose participants to role models. Comparing Japan Biodesign education elements to factors of general entrepreneurship promotion in Japan, sampled and organized from relevant White Papers, proved its educational effectiveness in entrepreneurship promotion from an objective viewpoint. Within the 4-year timeframe, the results indicated that leadership talent was indeed developed. Medical device innovation should progress through the stages of establishing new ventures, followed by contriving medical devices with novel, impactful value. This study revealed that Japan Biodesign education provides a platform for achieving these goals, despite the challenging Japanese new business environment.

The Surgical Program in Innovation (SPIN): A Design and Prototyping Curriculum for Surgical Trainees

PROBLEM

Health professions education does not routinely incorporate training in innovation or creative problem solving. Although some models of innovation education within graduate medical education exist, they often require participants' full-time commitment and removal from clinical training or rely upon participants' existing expertise. There is a need for curricula that teach innovation skills that will enable trainees to identify and solve unmet clinical challenges in everyday practice. To address this gap in surgical graduate education, the authors developed the Surgical Program in Innovation (SPIN).

APPROACH

SPIN, a 6-month workshop-based curriculum, was established in 2016 in the Beth Israel Deaconess Medical Center Department of Surgery to teach surgical trainees the basics of the innovation process, focusing on surgeon-driven problem identification, product design, prototype fabrication, and initial steps in the commercialization process. Participating surgical residents and graduate students attend monthly workshops taught by medical, engineering, and medical technology (MedTech) industry faculty. Participants collaborate in teams to develop a novel device, fabricate a protype, and pitch their product to a panel of judges.

OUTCOMES

From academic years 2015-2016 to 2017-2018, 49 trainees, including 41 surgical residents, participated in SPIN. Across this period, 13 teams identified an unmet need, ideated a solution, and designed and pitched a novel device. Ten teams fabricated prototypes. The 22 SPIN participants who responded to both pre- and postcourse surveys reported significant increases in confidence in generating problem statements, computer-aided design, fabrication of a prototype, and initial commercialization steps (product pitching and business planning).

NEXT STEPS

Incorporating innovation education and design thinking into clinical training will prove essential in preparing future physicians to be lifelong problem finders and solvers. The authors plan to expand SPIN to additional clinical specialties, as well as to assess its impact in fostering future innovation and collaboration among program participants.

A Novel Clinically Immersive Pre-doctoral Training Program for Engineering in Surgery and Intervention: Initial Realization and Preliminary Results

A novel pre-doctoral program is presented that combines (1) immersive observation in the surgical/interventional theatre and (2) thought-provoking exposition activities focused on answering clinically provocative questions. While the long-term goal is to train engineers to conduct clinical translational research in human systems, in this paper, perceived trainee improvements are assessed in: (1) their ability to pose important questions in surgery and intervention, (2) their knowledge of surgical technologies, and (3) their understanding of procedural medicine. The program combines constructivist and constructionist learning approaches through a dual-course suite consisting of: (1) a scaffold lecture design with ten physicians presenting their procedural specialties interleaved with lectures relating engineering principles, and (2) a second course with clinically mentored immersion experiences in the operating room/interventional suite, clinical conferences, and patient rounds. Details of the complementing technical core and learning environment are also provided. Preliminary data reports on the quantitative experiential clinical involvement and on a self-reported survey over 5 cohorts of trainees (n = 18). With respect to immersion, the average surgeries/interventions observed, number of different types, and clinical contact time per student was on average 15.6 ± 7.9 surgeries/interventions, 8.2 ± 3.6 types, and 48.2 ± 14.7 contact hours, respectively. With respect to trainee understanding of procedural medicine, surgical technologies, and value of clinical observation, an average perceived improvement of 41%, 38%, and 41% over the course series was detected, respectively (p < 0.001). Equally impressive, when rating ability to pose important questions affecting human health, an average perceived improvement of 34% was detected (p < 0.001). The preliminary realization of a novel pre-doctoral clinically immersive training program for engineering trainees is described and demonstrates extensive levels of clinical contact and strong evidence that the provided immersion experiences result in significant improvements in understanding of procedural medicine.

Biomedical Engineering Professional Skills Development: The RADxSM Tech Impact on Graduates and Faculty

There are many benefits of the RADx^SM Tech initiative worth exploring beyond that of the current acceleration of diagnostic tests being developed and deployed to the nation. One of those benefits has been the impact on work readiness for recent biomedical engineering (BME) graduates who have been hired by RADx Tech as Assistant Project Facilitators (APFs) and to the students and faculty members on applicant teams. This paper includes a literature review of the current status of BME professional skills development in traditional academic and clinical settings. The organizational structure of RADx Tech teams is described, including how recent BME graduates are integral to the process. Opportunities are discussed on how the RADx Tech structural model can be leveraged to improve professional skills education. It is concluded that the RADx Tech organizational structure and process including APFs may be replicable. Further research is planned to explore its impact.

Entrepreneurship and Innovation in Health Sciences Education: a Scoping Review

BACKGROUND AND PURPOSE

This scoping review aimed to explore the connection between health education and entrepreneurship and to identify gaps in the current literature, educational models, and best practices regarding teaching medical professionals about entrepreneurship and innovation.

METHODS

The methodology for this review was based on the principles of Arksey and O'Malley's (2005) model for scoping review design. Results from Embase, MEDLINE, PsycINFO, Emcare, AMED, PubMed, and Google Scholar were scanned, filtered, and mapped.

RESULTS

Fifty-nine unique papers were found and mapped. The papers discussed common themes, including the entrepreneurial environment (n = 29), career planning and skill development (n = 3), and various skills crucial for the health entrepreneur. The satisfaction was high for most programs, but few reported more fulsome outcomes. The teaching techniques used to engage trainees or physicians in entrepreneurship were also fairly limited.

CONCLUSION

Though some programs are described, few have demonstrated efficacy. More attention should be paid towards faculty-level recruitment, development and reward, so that they may in turn teach these approaches. Those involved with educational planning can help close this gap.

Perspectives on Bioengineering Clinical Immersion: History, Innovation, and Impact

Opportunities to provide clinical immersion experiences to bioengineering undergraduate students have expanded over the last several years. These programs allow students to observe the clinical environment in order to better understand workflow processes, the context in which medical equipment is used, and identify unmet needs firsthand. While each program focuses on identifying unmet needs, these experiences vary in content and implementation. Here we discuss features of clinical immersion programs, share details of our program after six years, and present data regarding post-graduation employment of our participants. Students who participated in the University of Illinois at Chicago Clinical Immersion Program are not more likely to pursue careers in industry as compared to non-participants, nor do they demonstrate an ability to find a job more quickly than non-participants. However, participants who did enter into industry self-reported that the program was impactful to both their career interests and ability to find their first employment position.

Initial experiences with virtual reality as a tool for observation in needs-driven health technology innovation

The Stanford University Biodesign Innovation Fellowship teaches a needs-based methodology for the innovation of health technologies. This involves the direct observation of patient care in a variety of settings, ranging from the hospital to the home, to identify unmet needs that can be addressed via innovative new technology-based solutions. Expanding this model to educate a larger population of undergraduate and graduate students is limited by access to real clinical observations, partly due to hospital policies and patient privacy concerns. We hypothesise that the use of virtual reality (VR) can be an effective tool to provide students access to a variety of clinical scenarios for identifying needs for innovation. In this preliminary study, two undergraduate students observed clinical care live in the operating room (OR) and using VR headsets. The students identified needs in both settings and compared the two experiences with a short survey. While VR did not offer a complete replication of the OR experience, it served as a viable tool for learning how to make observations. VR merits further investigation as an educational tool for needs finding and as a proxy for live clinical observations.

A Forward Move: Interfacing Biotechnology and Physical Therapy In and Out of the Classroom

Ongoing advances and discoveries in biotechnology will require physical therapists to stay informed and contribute to their development and implementation. The extent of our profession's involvement in how physical therapists engage biotechnology is determined by us. In this Perspective article, we advocate the need for our profession to educate clinicians alongside scientists, technologists, and engineers and empower them to collectively think more as codevelopers and less as "siloed" builders and consumers of biotechnology. In particular, we highlight the value of augmenting the physical therapy curricula to provide students with new levels of knowledge about the converging fields of engineering and physical therapy. We present successful examples of how such a concept can occur within physical therapist professional education programs and propose strategies to overcome perceived challenges that may stymie this possibility.

The Yale Center for Biomedical Innovation and Technology (CBIT): One Model to Accelerate Impact From Academic Health Care Innovation

The process of translating academic biomedical advances into clinical care improvements is difficult, risky, expensive, and poorly understood. Notably, many clinicians who identify health care problems do not have the time or expertise to solve the problems, and many academic researchers are unaware of important gaps in clinical care to which their expertise may apply.Recognizing an opportunity to connect people who can identify health care problems with those who can solve them, the Yale Center for Biomedical Innovation and Technology (CBIT) was established in 2014 to educate and enhance the impact of health care innovators. The authors review other health care innovation centers and describe best practices borrowed by Yale CBIT, which tailored its activities and approach to its unique ecosystem.In four years, Yale CBIT has affected over 3,000 people and established a health care innovation cycle as an efficient strategy to guide translational research. Yale CBIT has created or supported graduate and undergraduate courses, clinical immersion programs for industry partners, and large health care hackathon events. Over 200 projects have been submitted to CBIT for mentorship, and some of those projects have been commercialized and raised millions of dollars of follow-on funding.The authors present Yale CBIT as one model of accelerating the impact of academic medicine on clinical practice and outcomes. The project advising strategy is intended to be a template to maximize the efficiency of biomedical innovation and ultimately improve the outcomes and experiences of future patients.

Systems Delivery Innovation for Alzheimer Disease

OBJECTIVE

The authors describe a comprehensive care model for Alzheimer disease (AD) that improves value within 1-3 years after implementation by leveraging targeted outpatient chronic care management, cognitively protective acute care, and timely caregiver support.

METHODS

Using current best evidence, expert opinion, and macroeconomic modeling, the authors designed a comprehensive care model for AD that improves the quality of care while reducing total per capita healthcare spending by more than 15%. Cost savings were measured as reduced spending by payers. Cost estimates were derived from medical literature and national databases, including both public and private U.S. payers. All estimates reflect the value in 2015 dollars using a consumer price index inflation calculator. Outcome estimates were determined at year 2, accounting for implementation and steady-state intervention costs.

RESULTS

After accounting for implementation and recurring operating costs of approximately $9.5 billion, estimated net cost savings of between $13 and $41 billion can be accomplished concurrently with improvements in quality and experience of coordinated chronic care ($0.01-$6.8 billion), cognitively protective acute care ($8.7-$26.6 billion), timely caregiver support ($4.3-$7.5 billion), and caregiver efficiency ($4.1-$7.2 billion).

CONCLUSION

A high-value care model for AD may improve the experience of patients with AD while significantly lowering costs.

Challenges in developing collaborative interdisciplinary research between gastroenterologists and engineers

The role of technology in healthcare is rapidly evolving. However, it can be argued that gastroenterology has not kept pace with other medical fields due to the multifaceted needs of this speciality and other issues. Innovation in healthcare technology increasingly requires interdisciplinary collaboration between engineers and clinicians. Nevertheless, working in such an interdisciplinary environment can be challenging due to factors such as working culture, communication and difference in priorities. We surveyed the views of clinicians specialising in gastroenterology and engineers on interdisciplinary health research. The 21 respondents expressed a range of opinions on the perceived benefits and challenges of interdisciplinary collaboration. Though engineers and clinicians recognised its advantages, they expressed a need for further improvement. However, engineers and clinicians differed in how best this could be achieved. The results of this survey are discussed with reference to the literature on interdisciplinary collaboration.

Institutionalizing healthcare hackathons to promote diversity in collaboration in medicine

BACKGROUND

Medical students and healthcare professionals can benefit from exposure to cross-disciplinary teamwork and core concepts of medical innovation. Indeed, to address complex challenges in patient care, diversity in collaboration across medicine, engineering, business, and design is critical. However, a limited number of academic institutions have established cross-disciplinary opportunities for students and young professionals within these domains to work collaboratively towards diverse healthcare needs.

METHODS

Drawing upon best practices from computer science and engineering, healthcare hackathons bring together interdisciplinary teams of students and professionals to collaborate, brainstorm, and build solutions to unmet clinical needs. Over the course of six months, a committee of 20 undergraduates, medical students, and physician advisors organized Stanford University's first healthcare hackathon (November 2016). Demographic data from initial applications were supplemented with responses from a post-hackathon survey gauging themes of diversity in collaboration, professional development, interest in medical innovation, and educational value. In designing and evaluating the event, the committee focused on measurable outcomes of diversity across participants (skillset, age, gender, academic degree), ideas (clinical needs), and innovations (projects).

RESULTS

Demographic data (n = 587 applicants, n = 257 participants) reveal participants across diverse academic backgrounds, age groups, and domains of expertise were in attendance. From 50 clinical needs presented representing 19 academic fields, 40 teams ultimately formed and submitted projects spanning web (n = 13) and mobile applications (n = 13), artificial intelligence-based tools (n = 6), and medical devices (n = 3), among others. In post-hackathon survey responses (n = 111), medical students and healthcare professionals alike noted a positive impact on their ability to work in multidisciplinary teams, learn from individuals of different backgrounds, and address complex healthcare challenges.

CONCLUSIONS

Healthcare hackathons can encourage diversity across individuals, ideas, and projects to address clinical challenges. By providing an outline of Stanford's inaugural event, we hope more universities can adopt the healthcare hackathon model to promote diversity in collaboration in medicine.

An Extended Hackathon Model for Collaborative Education in Medical Innovation

To support the next generation of healthcare innovators - whether they be engineers, designers, clinicians, or business experts by training - education in the emerging field of medical innovation should be made easily and widely accessible to undergraduate students, graduate students, and young professionals, early in their careers. Currently, medical innovation curricula are taught through semester-long courses or year-long fellowships at a handful of universities, reaching only a limited demographic of participants. This study describes the structure and preliminary outcomes of a 1-2 week "extended hackathon" course that seeks to make medical innovation education and training more accessible and easily adoptable for academic medical centers. Eight extended hackathons were hosted in five international locations reaching 245 participants: Beijing (June 2015 and August 2016), Hong Kong (June 2016, 2017, and 2018), Curitiba (July 2016), Stanford (October 2017), and São Paulo (May 2018). Pre- and post-hackathon surveys asking respondents to self-assess their knowledge in ten categories of medical innovation were administered to quantify the perceived degree of learning. Participants hailed from a diverse range of educational backgrounds, domains of expertise, and academic institutions. On average, respondents (n = 161) saw a greater than twofold increase (114.1%, P < 0.001) from their pre- to post-hackathon scores. In this study, the extended hackathon is presented as a novel educational model to teach undergraduate and graduate students a foundational skillset for medical innovation. Participants reported gaining significant knowledge across all ten categories assessed. To more robustly assess the educational value of extended hackathons, a standardized assessment for medical innovation knowledge needs to be developed, and a larger sample size of participants surveyed.

The Nurse-Engineer: A New Role to Improve Nurse Technology Interface and Patient Care Device Innovations

PURPOSE

The purpose of this article is to describe two innovative biomedical engineering and nursing collaborations designed to educate a new cadre of professionals and develop new knowledge and innovations (robots, patient care devices, and computer simulation).

ORGANIZING CONSTRUCT

Complex health problems demand a highly skilled response that uses teams of professionals from various disciplines. When the biomedical engineering lens is expanded to include the practical perspective of nursing, opportunities emerge for greater technology-nurse interface and subsequent innovation. A joint nursing-engineering degree program provides the ideal preparation for a well-informed nurse-engineer who can explore new and innovative solutions that will improve care and patient outcomes.

APPROACH

A review of the literature provides the background on innovation and engineering in nursing and a rationale for the development of two innovative joint degrees, as well as a description of those programs.

FINDINGS

These innovative programs will advance healthcare-related technology and maximize the potential contribution of the nursing profession in the design and implementation of creative solutions. They also have the potential to increase the skills and knowledge for students enrolled in biomedical engineering or Bachelor of Science in nursing programs individually, providing them with interdisciplinary training and exposure.

CLINICAL RELEVANCE

Important patient care improvement opportunities are missed when nurses are not actively engaged in patient care device innovation and creation. Innovative nurse and engineer collaborations are needed in various forms to leverage nurse ingenuity and create patient care innovations.

Innovation for the future of Irish MedTech industry: retrospective qualitative review of impact of BioInnovate Ireland's clinical fellows

Clinicians have historically been integral in innovating and developing technology in medicine and surgery. In recent years, however, in an increasingly complex healthcare system, a doctor with innovative ideas is often left behind. Transition from idea to bedside now entails significant hurdles, which often go unrecognised at the outset, particularly for first-time innovators. The BioInnnovate Ireland process, based on the Stanford Biodesign Programme (Identify, Invent and Implement), aims to streamline the process of innovation within the MedTech sector. These programmes focus on needs-based innovation and enable multidisciplinary teams to innovate and collaborate more succinctly. In this preliminary study, the authors aimed to examine the impact of BioInnovate Ireland has had on the clinicians involved and validate the collaborative process. To date, 13 fellows with backgrounds in clinical medicine have participated in the BioInnovate programme. Ten of these clinicians remain involved in clinical innovation projects with four of these working on Enterprise Ireland funded commercialisation grants and one working as chief executive officer of a service-led start-up, Strive. Of these, five also remain engaged in clinical practice on a full or part-time basis. The clinicians who have returned to full-time clinical practice have used the process and learning of the programme to influence their individual clinical areas and actively seek innovative solutions to meet clinical challenges. Clinicians, in particular, describe gaining value from the BioInnovate programme in areas of ‘Understanding Entrepreneurship’ and ‘Business Strategy’. Further study is needed into the quantitative impact on the ecosystem and impact to other stakeholders.

The Effectiveness of Hands-on Health Informatics Skills Exercises in the Multidisciplinary Smart Home Healthcare and Health Informatics Training Laboratories

OBJECTIVE

This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course.

MATERIALS AND METHODS

Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories.

RESULTS

All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum.

CONCLUSION

This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices.

Biomedical device innovation methodology: applications in biophotonics

The process of medical device innovation involves an iterative method that focuses on designing innovative, device-oriented solutions that address unmet clinical needs. This process has been applied to the field of biophotonics with many notable successes. Device innovation begins with identifying an unmet clinical need and evaluating this need through a variety of lenses, including currently existing solutions for the need, stakeholders who are interested in the need, and the market that will support an innovative solution. Only once the clinical need is understood in detail can the invention process begin. The ideation phase often involves multiple levels of brainstorming and prototyping with the aim of addressing technical and clinical questions early and in a cost-efficient manner. Once potential solutions are found, they are tested against a number of known translational factors, including intellectual property, regulatory, and reimbursement landscapes. Only when the solution matches the clinical need, the next phase of building a "to market" strategy should begin. Most aspects of the innovation process can be conducted relatively quickly and without significant capital expense. This white paper focuses on key points of the medical device innovation method and how the field of biophotonics has been applied within this framework to generate clinical and commercial success.

Needs-Based Innovation in Interventional Radiology: The Biodesign Process

There are many possible mechanisms for innovation and bringing new technology into the marketplace. The Stanford Biodesign innovation process is based in a deep understanding of clinical unmet needs as the basis for focused ideation and development. By identifying and vetting a compelling unmet need, the aspiring innovator can "derisk" a project and maximize chances for successful development in an increasingly challenging regulatory and economic environment. As a specialty founded by tinkerers, with a history of disruptive innovation that has yielded countless new ways of delivering care with minimal invasiveness, lower morbidity, and lower cost, interventional radiologists are uniquely well positioned to identify unmet needs and develop novel solutions free of dogmatic convention.

Improving health-care delivery in low-resource settings with nanotechnology: Challenges in multiple dimensions

In the two decades after 1990, the rates of child and maternal mortality dropped by over 40% and 47%, respectively. Despite these improvements, which are in part due to increased access to medical technologies, profound health disparities exist. In 2015, a child born in a developing region is nearly eight times as likely to die before the age of 5 than one born in a developed region and developing regions accounted for nearly 99% of the maternal deaths. Recent developments in nanotechnology, however, have great potential to ameliorate these and other health disparities by providing new cost-effective solutions for diagnosis or treatment of a variety of medical conditions. Affordability is only one of the several challenges that will need to be met to translate new ideas into a medical product that addresses a global health need. This article aims to describe some of the other challenges that will be faced by nanotechnologists who seek to make an impact in low-resource settings across the globe.

The Impact of Postgraduate Health Technology Innovation Training: Outcomes of the Stanford Biodesign Fellowship

Stanford Biodesign launched its Innovation Fellowship in 2001 as a first-of-its kind postgraduate training experience for teaching biomedical technology innovators a need-driven process for developing medical technologies and delivering them to patients. Since then, many design-oriented educational programs have been initiated, yet the impact of this type of training remains poorly understood. This study measures the career focus, leadership trajectory, and productivity of 114 Biodesign Innovation Fellowship alumni based on survey data and public career information. It also compares alumni on certain publicly available metrics to finalists interviewed but not selected. Overall, 60% of alumni are employed in health technology in contrast to 35% of finalists interviewed but not selected. On leadership, 72% of alumni hold managerial or higher positions compared to 48% of the finalist group. A total of 67% of alumni reported that the fellowship had been “extremely beneficial” on their careers. As a measure of technology translation, more than 440,000 patients have been reached with technologies developed directly out of the Biodesign Innovation Fellowship, with another 1,000,000+ aided by solutions initiated by alumni after their training. This study suggests a positive impact of the fellowship program on the career focus, leadership, and productivity of its alumni.

Innovation within a university setting

Elisabeth K. Wynne, MD, completed her undergraduate degree in bioengineering and is currently a surgical resident in training at the University of Washington. From 2014-2016, she served as a Biodesign Fellow at Stanford University. She plans to pursue a career of innovation as an academic surgeon. Thomas M. Krummel, MD, is the Emile Holman Professor and Chair Emeritus of the Department of Surgery at Stanford University School of Medicine. Throughout his career, Dr Krummel has been a pioneer and an innovator. For >12 years, he has partnered with Dr Paul Yock to co-direct the Stanford Biodesign program, which is designed to teach innovation at the emerging frontiers of engineering and biomedical sciences. Dr Krummel is Chairman of the Fogarty Institute for Innovation Board of Directors, and President of the International Scientific Committee at Institut de Recherche contre les Cancers de l'Appareil Digestif - IRCAD at the University of Strasbourg and is a frequent consultant to the medical device industry.

Needs-Based Innovation in Cardiovascular Medicine: The Stanford Biodesign Process

More than a decade ago, a formalized fellowship training program in medical device innovation, the first of its kind, was created at Stanford University. Now in its 15th year, the Stanford Biodesign Fellowship Program is a 10-month program whereby postgraduate students with a prior background in medicine, engineering, and/or business form interdisciplinary teams for an experiential process of identifying unmet clinical needs, inventing new solutions, and implementing these ideas (the 3 “I’s”). A key component of this structured process is focused attention on needs finding and characterization, which differs from the traditional “tech-push” model (i.e., technologies looking for problems to solve). Although the Stanford Biodesign process can be applied to a wide variety of clinical areas, cardiovascular medicine is particularly well suited, given the breadth of clinical presentations it touches and its history of innovation to solve important clinical problems. Physicians play a vital role in the process, especially for needs identification and characterization. This paper outlines the Stanford Biodesign process and presents an argument for its repeat applicability, discusses its relevance to physicians and to cardiologists in particular, and provides a case study of the process that resulted in a currently available cardiovascular medical technology that came directly from the Fellowship Program.

Nanotechnology Education for the Global World: Training the Leaders of Tomorrow

Nanoscience is one of the fastest growing and most impactful fields in global scientific research. In order to support the continued development of nanoscience and nanotechnology, it is important that nanoscience education be a top priority to accelerate research excellence. In this Nano Focus, we discuss current approaches to nanoscience training and propose a learning design framework to promote the next generation of nanoscientists. Prominent among these are the abilities to communicate and to work across and between conventional disciplines. While the United States has played leading roles in initiating these developments, the global landscape of nanoscience calls for worldwide attention to this educational need. Recent developments in emerging nanoscience nations are also discussed. Photo credit: Jae Hyeon Park.

Biodesign process and culture to enable pediatric medical technology innovation

Innovation is the process through which new scientific discoveries are developed and promoted from bench to bedside. In an effort to encourage young entrepreneurs in this area, Stanford Biodesign developed a medical device innovation training program focused on need-based innovation. The program focuses on teaching systematic evaluation of healthcare needs, invention, and concept development. This process can be applied to any field of medicine, including Pediatric Surgery. Similar training programs have gained traction throughout the United States and beyond. Equally important to process in the success of these programs is an institutional culture that supports transformative thinking. Key components of this culture include risk tolerance, patience, encouragement of creativity, management of conflict, and networking effects.

Addressing challenges of training a new generation of clinician-innovators through an interdisciplinary medical technology design program: Bench-to-Bedside

Graduate medical education has traditionally focused on training future physicians to be outstanding clinicians with basic and clinical science research skills. This focus has resulted in substantial knowledge gains, but a modest return on investment based on direct improvements in clinical care. In today's shifting healthcare landscape, a number of important challenges must be overcome to not only improve the delivery of healthcare, but to prepare future physicians to think outside the box, focus on and create healthcare innovations, and navigate the complex legal, business and regulatory hurdles of bringing innovation to the bedside. We created an interdisciplinary and experiential medical technology design competition to address these challenges and train medical students interested in moving new and innovative clinical solutions to the forefront of medicine. Medical students were partnered with business, law, design and engineering students to form interdisciplinary teams focused on developing solutions to unmet clinical needs. Over the course of six months teams were provided access to clinical and industry mentors, $500 prototyping funds, development facilities, and non-mandatory didactic lectures in ideation, design, intellectual property, FDA regulatory requirements, prototyping, market analysis, business plan development and capital acquisition. After four years of implementation, the program has supported 396 participants, seen the development of 91 novel medical devices, and launched the formation of 24 new companies. From our perspective, medical education programs that develop innovation training programs and shift incentives from purely traditional basic and clinical science research to also include high-risk innovation will see increased student engagement in improving healthcare delivery and an increase in the quality and quantity of innovative solutions to medical problems being brought to market.

The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation

INTRODUCTION

Technological innovation in surgical science and healthcare is vital and calls for close collaboration between engineering and surgery. To meet this objective, BEST was designed as a free sustainable innovative teaching method for young professionals, combining surgery, engineering, and business in a multidisciplinary, high-quality, low-cost, and learning-by-doing philosophy.

AIMS

This paper reviews the initial outcomes of the program and discusses lessons learned and future directions of this innovative educational method.

METHODS

BEST educational method is delivered in two parts: the first component consisting of live streaming or pre-recorded online lectures, with an interdisciplinary profile focused on surgery, engineering, and business. The second component is an annual 5-day on-site course, organized at IRCAD-IHU, France. The program includes workshops in engineering, entrepreneurship team projects, and in-depth hands-on experience in laparoscopy, robotic surgery, interventional radiology, and flexible endoscopy with special emphasis on the interdisciplinary aspect of the training. A panel of surgeons, engineers, well-established entrepreneurs, and scientists assessed the team projects for potential patent application.

RESULTS

From November 2011 till September 2013, 803 individual and institutional users from 79 different countries attended the online course. In total, 134 young professionals from 32 different countries applied to the onsite course. Sixty participants were selected each year for the onsite course. In addition, five participants were selected for a web-based team. Thirteen provisional patents were filed for the most promising projects.

CONCLUSION

BEST proved to be a global talent incubator connecting students to high-quality education despite institutional and economical boundaries. Viable and innovative ideas arose from this revolutionary approach which is likely to spin-off significant technology transfer and lead the way for future interdisciplinary hybrid surgical education programs and career paths.