From Missouri to Haiti
Radiology is often crucial in identifying and diagnosing injuries or diseases efficiently and accurately. Medical imaging techniques, such as x-ray, ultrasound and computed tomography (CT), have advanced alongside technology. Dr. Jennifer Nicholas has a long history of working to improve diagnostic imaging capacity and radiology training around the world, having traveled to Nicaragua, Kenya and Haiti to improve training for radiology residents and, ultimately, the outcomes for patients.
In September of 2016, she joined Washington University School of Medicine as an assistant professor and pediatric radiologist who practices at Saint Louis Children’s Hospital. As part of Washington University’s Mallinckrodt Institute of Radiology, Jennifer is helping to develop a global outreach program, part of which involves providing radiology training in Haiti to residents at Hôpital de l’Universite d’Etat d’Haiti (HUEH), the state hospital in Port-au-Prince. One of the first stops on that journey, however, was at a mall in Missouri to explore device and technology solutions that would enable her to deploy a tablet-based curriculum, which utilized tools like PowerPoint for presentations and OneNote to serve as a dynamic professional toolbox.
A Particular Request
Upon meeting her in the Saint Louis Galleria, Jo Otey, business sales specialist at Microsoft Store, showed Jennifer how Surface Pro 4 and Office 365 would provide her with a way to seamlessly facilitate the tablet-based radiology curriculum in Haiti.
Jennifer’s goal was to create a flipped classroom environment in Haiti. Educators use a flipped classroom to break free from the traditional paradigm of educational lectures in a classroom. In this case, Jennifer’s flipped classroom needed to extend across geographic, cultural, and linguistic boundaries so the residents could complete their assigned reading, interpret cases, and create preliminary reports in advance of their virtual conference with Jennifer where the cases were reviewed, and the lectures given.
In September, Jo traveled to Haiti with Jennifer at her request to lay the groundwork for the flipped classroom at HUEH and help train the radiology residents on the technology. While the idea of flipped learning is not new, Jennifer’s program would take the concept to a new level. Radiology residents would be required to read course materials pre-loaded on the Surface Pro 4, interpret cases, and create preliminary reports in advance of a virtual conference and lecture where the case studies are reviewed.
The Flipped Classroom
Once Jennifer and Jo opened the possibilities of Business essentials to implement the curriculum, she discovered how transitioning to Microsoft 365 Business gave her the ability to manage devices remotely and securely and deploy new apps to the residents. Jennifer also had the ability to restrict usage of the devices until the residents completed the curriculum for the course. In addition to Microsoft 365 Business, Jo and Jennifer discovered solutions major challenges such as file sharing for the curriculum, facilitation, and communication limitations (language barriers and productivity tools). SharePoint allows her a means of monitoring the curriculum, usage, and progress of the radiology residents.
Since September, the residents have been preparing for the formal launch of the curriculum and Jennifer has noticed a major shift in the computer literacy of the radiology residents, due in part to the decision to use Surface Pro 4 with Windows and Office. The residents have been quick to take advantage of features like Skype for Business to interact with their colleagues within and outside of the Haiti. Microsoft Translator has helped bridge the language gap. Program participants can translate English coursework and reading into their native French to better understand the information, then translate to English to communicate curriculum-based questions to faculty. With OneNote, the residents create a virtual residency toolbox, and Jennifer will be able to use Forms to facilitate quizzes and surveys. Jennifer can then easily deploy apps and curriculum either in Haiti or the United States via a simple Microsoft 365 Business dashboard.
“The current infrastructure of the radiology department at HUEH is traditional x-ray film and paper printouts of relevant ultrasound images with hand-written reports,” says Jennifer. “During their careers, this group of radiologists will lead the transition to digital imaging in Haiti. In addition to the radiology content the residents are learning through this curriculum, the computer skills they are strengthening with the use of the Surface Pro 4 and Windows will be invaluable as they negotiate new technology in the future.”
Currently, the radiology residency in Haiti includes 13 residents across the three-year program, but the curriculum also includes eight recent graduates of the program who are newly-minted practicing radiologists in Haiti. More than 20 Surface Pro4 were distributed to the radiologists-in-training. The resident doctors are responding positively to the program and are excited about the technology.
Unfortunately, the unexpected arrival of Hurricane Irma as the new devices were being implemented forced Jennifer and team to have to evacuate two days early. Still, the program is under way and Jennifer looks forward to the expansion of future global health programs in other parts of the world where there are radiology residents who are eager to learn, but their access to the latest educational resources is limited.
“I look forward to evaluating the curriculum in 2018,” says Jennifer. “I will be tracking how the residents are using the devices and the educational resources loaded on them. I will also evaluate how the residents’ levels of confidence in interpreting radiology studies have improved. During my last trip to Haiti, I was approached by doctors from other specialties who have heard about the curriculum and are interested in how they might be able to implement similar programs with their residents.”
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