Thursday, December 9, 2010

A Practical Medical Informatics Curriculum for Medical Students

How can best prepare our medical students to practice medicine in world of technology?  A number of efforts have been made to create curricula for medical schools and also for special fellowships in medical informatics.  This is a very rapidly moving target and the products of these efforts need constant updating. 
The American Medical Informatics Association website states that "biomedical and health informatics applies principles of computer and information science to the advancement of life sciences research, health professions education, public health, and patient care"


If we had to develop a list of concepts that we need our graduating medical students to be familiar with; what would it include today?  Maybe, if our students were all self motivated, reflective, life long learners, all we would have to do it ensure that they know how to find answers to their problems and questions, share this list of concepts with them and we would be set; we would not even have to develop a course for this curriculum!

This list of Core topics for all medical students would look something like this: (clearly a work in progress):

  1. Computers (desktops, laptops), mobile devices, smartphones, portable data storage devices
  2. Networking and connectivity – Intranet, Internet, WWW, VPN, Wireless, Bluetooth, 4G etc
  3. Software – Office (word processing, presentation, spreadsheet etc), Statistical software, Bibliography tools, Cloud computing, Browsers and add-ons, mind mapping etc.
  4. EBM concepts – Information resources, information retrieval, Appraisal of literature, Application to clinical practice, guidelines etc, also related to this are the concepts of public health informatics
  5. Communications – e-mail, list serv, text messaging, discussion groups, social media, professional and patient communication, presentations (live and online),  Web 2.0, blogs and Wikis, social networking
  6. Data – data collection, organization, storage and representation, data standards (including HL7), data interchange,
  7. Personal knowledge management, project management, organization tools
  8. EHRs/EMRs, Personal (patient) health records, meaningful use, physician report cards, Quality metrics etc. ePrescribing, RxHub, etc.  (Some topics like PACS might be more relevant to those going to radiology)
  9. Decision science (decision analysis, probability, test characteristics, likelihood ratios etc) , online and point of care decision support tools,  Clinical decision support (Alerts, reminders),
  10. Ethics, professionalism, legal and regulatory issues, privacy, security, authenticity and encryption
  11. Ontology, terminology (Thanks to comment from Anonymous)
There are areas that might be optional for some students and be offered as electives.
  1. Education informatics – Learning management systems, virtual learning environments, personal and social learning environments 
  2. Bioinformatics (genomics etc)
  3. Research informatics 
What do you think?  What are some other concepts that every graduating medical student should have that are not included here or could be better defined/organized?  


For reference, here is a recent JAMIA article with a detailed curriculum for clinical informatics specialists.
J Am Med Inform Assoc. 2009;16:153–157. DOI 10.1197/jamia.M3045.
And
Here is the AAMC Medical School Objectives Project (MSOP) Phase II report that covers medical informatics and Public Health.  https://services.aamc.org/publications/showfile.cfm?file=version88.pdf&prd_id=199&prv_id=240&pdf_id=88