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Limann B, Kankam SB. Promoting innovation and startups in neurosurgery in low- to middle-income countries: insights from the barrow innovation center. Neurosurg Rev 2024; 47:231. [PMID: 38787467 DOI: 10.1007/s10143-024-02473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Bernice Limann
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | - Samuel Berchi Kankam
- Harvard T.H Chan School of Public Health, Harvard University, Cambridge, USA.
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
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Cutler CB, King P, Khan M, Olowofela B, Lucke-Wold B. Innovation in Neurosurgery: Lessons Learned, Obstacles, and Potential Funding Sources. NEURONS AND NEUROLOGICAL DISORDERS 2022; 1:003. [PMID: 36848305 PMCID: PMC9956204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Innovation is central to neurosurgery and has dramatically increased over the last twenty years. Although the specialty innovates as a whole, only 3-4.7% of practicing neurosurgeons hold patents. Various roadblocks to innovation impede this process such as lack of understanding, increasing regulatory complexity, and lack of funding. Newly emerging technologies allow us to understand how to innovate and how to learn from other medical specialties. By further understanding the process of innovation, and the funding that supports it, Neurosurgery can continue to hold innovation as one of its's central tenets.
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Affiliation(s)
| | - Patrick King
- Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Majid Khan
- University of Nevada, Reno School of Medicine, Reno, NV, USA
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Maloney LM, Hakimi M, Hays T, Adachi J, Chau A, Esper BS, Koulouris V, Kung P, Meier KR, Schum RS, Sha S, Wong A, Wu A, Yin W, Page CR. Learning the Language of Medical Device Innovation: A Longitudinal Interdisciplinary Elective for Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1341-1345. [PMID: 35507458 PMCID: PMC9474701 DOI: 10.1097/acm.0000000000004723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PROBLEM Physicians are playing a growing role as clinician-innovators. Academic physicians are well positioned to contribute to the medical device innovation process, yet few medical school curricula provide students opportunities to learn the conceptual framework for clinical needs finding, needs screening, concept generation and iterative prototyping, and intellectual property management. This framework supports innovation and encourages the development of valuable interdisciplinary communication skills and collaborative learning strategies. APPROACH Our university offers a novel 3-year-long medical student Longitudinal Interdisciplinary Elective in Biodesign (MSLIEB) that teaches medical device innovation in 4 stages: (1) seminars and small-group work, (2) shared clinical experiences for needs finding, (3) concept generation and product development by serving as consultants for biomedical engineering capstone projects, and (4) reflection and mentorship. The MSLIEB objectives are to: create a longitudinal interdisciplinary peer mentorship relationship between undergraduate biomedical engineering students and medical students, and encourage codevelopment of professional identities in relation to medical device innovation. OUTCOMES The MSLIEB enrolled 5 entering cohorts from 2017 to 2021 with a total of 37 medical student participants. The first full entering cohort of 12 medical students produced 8 mentored biomedical engineering capstone projects, 7 of which were based on clinical needs statements derived from earlier in the elective. Medical student participants have coauthored poster and oral presentations; contributed to projects that won WolfieTank, a university-wide competition modeled after the television show Shark Tank; and participated in the filing of provisional patents. Students reflecting on the course reported a change in their attitude towards existing medical problems, felt better-equipped to collaboratively design solutions for clinical needs, and considered a potential career path in device design. NEXT STEPS The MSLIEB will be scaled up by recruiting additional faculty, broadening clinical opportunities to include the outpatient setting, and increasing medical student access to rapid prototyping equipment.
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Affiliation(s)
- Lauren M Maloney
- L.M. Maloney is clinical assistant professor, Department of Emergency Medicine, and adjunct assistant professor, Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York; ORCID: https://orcid.org/0000-0001-7073-055X
| | - Mathew Hakimi
- M. Hakimi was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now a pediatric resident at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-0836-9182
| | - Thomas Hays
- T. Hays was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an orthopedic surgery resident at Orlando Health, Orlando, Florida
| | - Joseph Adachi
- J. Adachi was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now a psychiatry resident at Oregon Health and Science University, Portland, Oregon
| | - Annie Chau
- A. Chau was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now a pediatric resident at Cohen Children's Medical Center, Northwell Health, New Hyde Park, New York
| | - Brecken S Esper
- B.S. Esper was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an anesthesia resident at University of Rochester Strong Memorial Hospital, Rochester, New York; ORCID: https://orcid.org/0000-0002-2201-2999
| | - Vasilios Koulouris
- V. Koulouris was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an internal medicine resident at Montefiore Medical Center-Einstein Campus, Bronx, New York
| | - Preston Kung
- P. Kung was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now completing a preliminary year in internal medicine at NYU Langone Hospital-Long Island, Mineola, New York, before entering an ophthalmology residency at Temple University, Philadelphia, Pennsylvania
| | - Karl R Meier
- K.R. Meier was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an emergency medicine resident at the Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | - Ryan S Schum
- R.S. Schum was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an emergency medicine resident at University of Massachusetts Memorial Medical Center, Worcester, Massachusetts
| | - Sha Sha
- S. Sha was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an obstetrics and gynecology resident at the Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Ada Wong
- A. Wong was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an anesthesia resident at Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Ariel Wu
- A. Wu was a medical student at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, at the time of writing and is now an emergency medicine resident at Ronald Reagan UCLA Medical Center, Los Angeles, California; ORCID: https://orcid.org/0000-0003-3993-6087
| | - Wei Yin
- W. Yin is associate professor, Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York; ORCID: https://orcid.org/0000-0002-2853-0375
| | - Christopher R Page
- C.R. Page is clinical associate professor, Department of Anesthesiology, and an adjunct assistant professor, Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
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Arias J, Scott KW, Zaldivar JR, Trumbull DA, Sharma B, Allen K, Gravenstein N. Innovation-Oriented Medical School Curricula: Review of the Literature. Cureus 2021; 13:e18498. [PMID: 34754659 PMCID: PMC8567699 DOI: 10.7759/cureus.18498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/05/2022] Open
Abstract
Innovation and entrepreneurship (I&E) programs in medical education have become available as medical schools recognize the need to train forward-thinking physicians. There is considerable diversity in the design and implementation of these curricula, which represents a challenge and possibly serves as a deterrent for the development of additional I&E programs. A comprehensive search of medical school I&E programs and review of all Association of American Medical Colleges member websites (n = 171) were conducted. This review sought to (1) identify all American and Canadian allopathic medical schools with I&E curricula, (2) evaluate their structure/integration in the context of medical education, (3) outline core learning themes, and (4) describe the evaluative metrics. Information was collected through published or publicly available websites and through a questionnaire sent to identified I&E program leaders. Twenty-eight I&E-oriented medical education programs were identified from 26 schools; all of the programs integrated faculty leadership with backgrounds in medicine, engineering, and/or business/entrepreneurship. Of the programs, 57% (16/28) had been launched within the past four years and 75% (21/28) based program enrollment on a selective application process. Nearly all (27/28) incorporated lecture series and/or hands-on modules as a teaching technique. The most prevalent metric was completion of a capstone project (22/28; 79%). At least 15.2% (26/171) of American and Canadian allopathic medical schools include the option for students to participate in an I&E curriculum-based program. This review can be used to help medical school faculty with developing I&E curricula.
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Affiliation(s)
- Jonathan Arias
- Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Kyle W Scott
- Neurosurgery, University of Florida College of Medicine, Gainesville, USA
| | - J R Zaldivar
- Anesthesiology, University of Florida College of Medicine, Gainesville, USA
| | | | - Blanka Sharma
- Biomedical Engineering, University of Florida, Gainesville, USA
| | - Kyle Allen
- Biomedical Engineering, University of Florida, Gainesville, USA
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Bohl MA, McBryan S, Newcomb AGUS, Lehrman JN, Kelly BP, Nakaji P, Chang SW, Uribe JS, Turner JD, Kakarla UK. Range of Motion Testing of a Novel 3D-Printed Synthetic Spine Model. Global Spine J 2020; 10:419-424. [PMID: 32435561 PMCID: PMC7222693 DOI: 10.1177/2192568219858981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
STUDY DESIGN Biomechanical model study. OBJECTIVE The Barrow Biomimetic Spine (BBS) project is a resident-driven effort to manufacture a synthetic spine model with high biomechanical fidelity to human tissue. The purpose of this study was to investigate the performance of the current generation of BBS models on biomechanical testing of range of motion (ROM) and axial compression and to compare the performance of these models to historical cadaveric data acquired using the same testing protocol. METHODS Six synthetic spine models comprising L3-5 segments were manufactured with variable soft-tissue densities and print orientations. Models underwent torque loading to a maximum of 7.5 N m. Torques were applied to the models in flexion-extension, lateral bending, axial rotation, and axial compression. Results were compared with historic cadaveric control data. RESULTS Each model demonstrated steadily decreasing ROM on flexion-extension testing with increasing density of the intervertebral discs and surrounding ligamentous structures. Vertically printed models demonstrated markedly less ROM than equivalent models printed horizontally at both L3-4 (5.0° vs 14.0°) and L4-5 (3.9° vs 15.2°). Models D and E demonstrated ROM values that bracketed the cadaveric controls at equivalent torque loads (7.5 N m). CONCLUSIONS This study identified relevant variables that affect synthetic spine model ROM and compressibility, confirmed that the models perform predictably with changes in these print variables, and identified a set of model parameters that result in a synthetic model with overall ROM that approximates that of a cadaveric model. Future studies can be undertaken to refine model performance and determine intermodel variability.
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Affiliation(s)
- Michael A. Bohl
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Sarah McBryan
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Anna G. U. S. Newcomb
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Jennifer N. Lehrman
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Brian P. Kelly
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Peter Nakaji
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Steve W. Chang
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Juan S. Uribe
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Jay D. Turner
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - U. Kumar Kakarla
- Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA,U. Kumar Kakarla, c/o Neuroscience Publications, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Road, Phoenix, AZ 85013, USA.
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Bohl MA, McBryan S, Nakaji P, Chang SW, Turner JD, Kakarla UK. Development and first clinical use of a novel anatomical and biomechanical testing platform for scoliosis. JOURNAL OF SPINE SURGERY (HONG KONG) 2019; 5:329-336. [PMID: 31663044 PMCID: PMC6787359 DOI: 10.21037/jss.2019.09.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/19/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Previous studies have demonstrated that, by using various three-dimensional (3D) printing technologies, synthetic spine models can be manufactured to mimic a human spine in its gross and radiographic anatomy and the biomechanical performance of bony and ligamentous tissue. These manufacturing processes have not, however, been used in combination to create a long-segment, biomimetic model of a patient with scoliosis. The purpose of this study was to describe the development of a biomimetic scoliosis model and early clinical experience using this model as a surgical planning and education platform. METHODS Synthetic spine models were printed to mimic the anatomy and biomechanical performance of 2 adult patients with scoliosis. Preoperatively, the models were surgically corrected by the attending surgeon of each patient. Patients then underwent surgical correction of their spinal deformities. Correction of the models was compared to the surgical correction in the patients. RESULTS Patient 1 had a preoperative coronal Cobb angle of 40° from L1 to S1, as did the patient's synthetic spine model. The patient's spine model was corrected to 17.6°, and the patient achieved a correction of 17.3°. Patient 2 had a preoperative mid-thoracic Cobb angle of 88° and an upper thoracic Cobb angle of 43°. Preoperatively, the patient's spine model was corrected to 19.5° and 9.2° for the mid-thoracic and upper thoracic curves, respectively. Immediately after surgery, the patient's mid-thoracic and upper thoracic Cobb angles measured 18.7° and 9.5°, respectively. In both cases, the use of the spine models preoperatively changed the attending surgeon's operative plan. CONCLUSIONS A novel synthetic spine model for corrective scoliosis procedures is presented, along with early clinical experience using this model as a surgical planning platform. This model has tremendous potential not only as a surgical planning platform but also as an adjunct to patient consent, surgical education, and biomechanical research.
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Affiliation(s)
- Michael A Bohl
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Sarah McBryan
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Steve W Chang
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Jay D Turner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - U Kumar Kakarla
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Bohl MA, Baranoski JF, Sexton D, Nakaji P, Snyder LA, Kakarla UK, Porter RW. Barrow Innovation Center Case Series: Early Clinical Experience with Novel Surgical Instrument Used To Prevent Intraoperative Spinal Cord Injuries. World Neurosurg 2018; 120:e573-e579. [PMID: 30165209 DOI: 10.1016/j.wneu.2018.08.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The Barrow Innovation Center comprises an educational program in medical innovation that enables residents to identify problems in patient care and rapidly develop and implement solutions to these problems. Residents involved in this program noted an elevated risk of iatrogenic spinal cord injury during posterior cervical and thoracic procedures. The objective of this study was to describe this complication, and a novel solution was developed through a new innovation training program. METHODS A case report demonstrates the risk of iatrogenic spinal cord injury during posterior cervical decompression and fusion. Solutions to this problem were developed at the innovation center via an iterative process of prototype creation, cadaveric testing, and redesign. Patent law students who partnered with the center wrote and filed a provisional patent protecting the novel prototype designs. RESULTS The concept of a protective shield for the spinal cord was developed, and within only 6 weeks the devices were provisionally patented and used in the operating room. This device was named the Myeloshield. Initial clinical experience indicates that the Myeloshield can be used without impeding the flow of surgery and has the potential to prevent iatrogenic spinal cord injury; this experience is presented through 2 case reports demonstrating the use of Myeloshields in the operating room. CONCLUSIONS This report demonstrates how programs like the Barrow Innovation Center can provide neurosurgery residents with a unique educational experience in medical device innovation and intellectual property development and can serve as an avenue of surgical quality improvement and problem solving.
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Affiliation(s)
- Michael A Bohl
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Jacob F Baranoski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Daniel Sexton
- Cleveland Clinic Lerner College of Medicine Cleveland, Ohio, USA
| | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Laura A Snyder
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - U Kumar Kakarla
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Randall W Porter
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
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