Biomedical Technology Online Courses for the Americas Tobey Clark, University of Vermont USA Alexandre Lemgruber and Francisco Caccavo, Pan American Health Organization USA Tatiana Molina Velasquez, Universidad CES, Colombia Federico Graciá, Universidad Technologica National – Facultad Regional Mendoza, Argentina Rossana Rivas and Luis Vilcahuaman, Pontificia Universidad Católica del Perú

Why Online Learning? Asynchronous – 24x7 access Online educational resources always available Does not interfere with work or other activities Cyberspace – no limitation on location Just need a computer and connection No travel time No set scheduling No travel costs – gas, parking, tolls, tickets

Key attribute of online courses: Full Use of the World Wide Web Resources! Documents E.g. WHO Medical Device site Tutorials Case studies Scenarios Videos Academic, YouTube, Industry Computer-based simulations From the EMS Professional website

Need for Training in Developing Countries Limited medical device regulations, A high percentage of devices that are out of service, Weak after sale device support with nearly all service from manufacturers or their representatives, A shortage of technical staff in hospitals with few trained in medical technology support Very limited maintenance budget, and Limited technology management

Project Funding Grant submitted to PAHO Foundation* in December 2005 to develop a bilingual on-line course in Medical Equipment Technology and Clinical Engineering Original Funding June 2006-July 2008 Course in English completed and taught in year one Course in Spanish completed and taught in year two More recent funding WHO & PAHO 2009 (Eastern Caribbean students) PAHO Foundation 2011-2012 (UTN Mendoza) PAHO 2015 (HT Planning & Management course) * PAHO Foundation (formerly called the Pan American Health & Education Foundation), Washington, DC, USA www.pahofoundation.org

Collaboration: Bilingual, Adapted for the Americas A collaborative effort University of Vermont - UVM (USA) Universidad – CES (Colombia) Universidad Católica – PUCP (Peru)

Course Audience Designed for Primary: Technical staff in hospitals – BMET, electricians, maintenance and other technical personnel Engineers without training in medical equipment, life sciences, healthcare, and other areas – career changers Nursing and other clinicians Administrators and managers

On-line training courses Areas covered for each device/topic area: Principles of operation Proper clinical application Device safety Common problems and solutions Inspection, testing and preventative maintenance Technology management

Biomedical Equipment Technology Sequence* Three online courses plus one laboratory course Patient Care Equipment ** Anatomy/physiology, engineering principles, common bedside equipment Advanced Medical Equipment Systems ** Imaging, surgical systems, therapy, laboratory, clinical information systems Medical Equipment Application One week hands-on laboratory course/internship in hospital Healthcare Technology Planning & Management Convergence of technology, health technology life cycle, clinical engineering, global HTM * 2015 University of Vermont course sequence ** Original PAHO Foundation funded courses

Initial Course Evaluations Vermont 2007-2008 Students: 80% engineering 10% nursing, 10% miscellaneous Approval rating: 100% Colombia 2008 Students: 56% engineering; 44% miscellaneous Approval Rating: 85% Peru 2008 Students: 100% professionals - engineering, nursing, and technicians

PAHO Virtual Campus for Public Health The PAHO Virtual Campus for Public Health offers over 100 courses with adult learners from 140+ institutions enrolled from the Americas “The Virtual Campus of Public Health is a network of people, institutions and organizations that share courses, resources, services and activities of education, information and knowledge management in training, with the common purpose of improving the skills of the workforce and practices of public health through the development and innovative use of information and communication technologies for continuous improvement in the performance of continuing education programs in health” September 2014, the original PAHO foundation funded biomedical technology online courses were placed on the PAHO Virtual Campus for Public Health Reaches adult learners in the healthcare system in the Americas who do not have funding for university courses

PAHO Virtual Campus for Public Health Introduction to Biomedical Technology 100% online course Patient Care and Advanced Technology courses combined into one seven (7) month course Healthcare environment; review of the human body and technical principles; intensive care equipment, imaging, surgical, laboratory, therapy, and clinical information systems 52 participants chosen through a very careful selection process Course in Spanish: 252 applications MAIN TOPICS: - Device principles Common device/technique problems and resolution  Care, maintenance, and quality assurance - Proper clinical application Technology management - Patient safety Spanish version: -252 applications -34 selected -Participants from 20 countries: Argentina, Bolivia , Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Dominican Republic, Uruguay and Venezuela. English version: -47 applications -19 selected -Participants from 9 countries: Anguilla, Antigua y Barbuda, Barbados, Bahamas, Belize, Dominica, Guyana, Saint Vincent & the Grenadines and Trinidad &  Tobago.

PAHO Virtual Campus for Public Health Interactive discussion PAHO Virtual Campus for Public Health Example assignments: Quizzes

PAHO Virtual Campus for Public Health Course completion English: Twelve passed; six with excellence and five with distinction Spanish: Fifteen passed; two with excellence and six with distinction Course Evaluation Positives (strongly agree) The instructor is knowledgeable about the subject: 100% The course content is valuable: 82% The course assignments contributed to my learning: 82% Areas for improvement (strongly agree) Understanding the grading criteria for assignments: 37% Instructors contribution to online discussions: 46% No negative ratings for any evaluation question Example student comment “Thank you, it was a wonderful introduction for a first time to biomedical engineering and hospitals; well laid out; Good assignments and relevant discussions”

Results 2007 - 2015 Over 1000 students from 40 countries have taken course Colombia, Peru, Mexico, Venezuela, Uruguay, Costa Rica, Bolivia, Brazil, Uruguay, Paraguay, Chile, Argentina, Puerto Rico, Dominican Republic, Barbados, Jamaica, Grenada, Antigua, St. Lucia, Belize, British Virgin Islands, St. Vincent, St. Kitts, Turks & Caicos, France, Spain, China, Trinidad and Tobago, Dominica, Barbuda, Guyana, Bahamas, Anguilla, Honduras, Cuba, El Salvador, Panamá, Ecuador, Nicaragua, and the USA English & Spanish versions taught at: PAHO Virtual Campus for Public Health Universidad CES in Medellin, Colombia Pontificia Universidad Catolica de Peru in Lima, Peru Universidad Technological Nacional/Mendoza, Argentina University of Vermont in Vermont, USA

Course Challenges Technology infrastructure Availability of high speed lines Computer availability Showing the value of the course Awareness Value to healthcare improvement in the country Value to administration, authorities and supervisors Allowing staff time to take the course Resource commitment Continual updates As technology changes Dead link replacement

Future Directions Additional courses on PAHO Virtual Campus for Public Health English & Spanish Healthcare Technology Planning and Management course to be offered in July Convergence of technology, health technology life cycle, clinical engineering, global HTM Portuguese translation Adaptation for Brazil Combine online with hands-on workshops at regional sites

International Clinical Engineering Internships Program Six month paid internships One month formal training Five months of clinical engineering assistance to our CE’s and project work Database analysis Device development Simulations Online course development Students from Peru, Colombia and Argentina

Clinical Engineering Internship Purpose: To provide orientation, training and mentoring of engineering students in the area of clinical engineering to allow them to begin a career in clinical engineering with an ethical, cross-disciplinary and global perspective. Expectations: 1. Attendance: 8am - 4:30pm unless traveling; you will not be paid for hours not worked including holidays 2. Attire: Business Casual 3. Follow the guidelines of TSP and UVM in completing your orientation. Complete all compliance requirements. 4. As part of the training period, successful completion of readings, an online course, oral and written tests is expected along with appropriate behavior, values and ethics. Reading includes chapters in the book: A Practicum for Biomedical Engineering & Technology Management by Les Atles and other articles. 5. You are being paid for the internship and will need to accomplish tasks as assigned by the Director, clinical engineer, or other TSP supervisor. 6. Weekly review meetings will be held to assess progress. 7. After the internship is complete, the goal is for you to work independently performing clinical engineering tasks.

Clinical Engineering Internship Orientation & Training Classroom Laboratory Online Reading

Clinical Engineering Internship Schedule: Week 1: Orientation to organization and the clinical engineering field Weeks 2-3: Training by Certified Clinical Engineers; readings; online course Week 4: Oral and written assessment of student learning Weeks 5-25: Clinical engineering internship 8-12 weeks at University of Vermont Medical Center performing safety & performance testing, preventative maintenance and repair of medical equipment Assist staff clinical engineers in completion of hospital work, e.g. product evaluation, safety studies, hospital meetings, facilities surveys 3-5 database orientated projects, e.g. research end–of-support, purchase price, optimum PM schedule, other as required Other projects as needed, e.g. educational product development, website programming, instrument development Week 26: Final report, evaluation, and celebration of achievement (certificate of completion, party, etc.

Clinical Engineering Internship Weekly reporting Weekly Topics and Activities: Summary of insights and new knowledge Important Concepts Conceived Using Mind Maps and Other Tools Conclusions Activities scheduled for next week (objectives, topics and activities)

University of Vermont (UVM): Clinical Engineering Internship Program

Peru: Lima 2012 ACEW Synopsis Background 3rd ACEW in November 12-16, 2012 Theme: Leadership and Innovation Structure 4 ACCE faculty, CENETEC Mexico, IFMBE, country leaders 5 days, 35 participants on-site, +20 from 4 other regions of Peru, Paraguay & Guatemala via Internet streaming Ministry of Health, ESSALUD, and private hospital administrators, physicians, and engineers, PUCP faculty and biomedical engineering students Sponsors/Partners Organized by CENGETS PUCP & ACCE Sponsored by Pontificia Universidad Católica del Peru (PUCP) & IFMBE Supporting organizations - Ministry of Health, PAHO, DIGEMID, Maternity Hospital of Lima, APBIO, CENETEC, CORAL, EMB Peru

Peru: Lima 2012 ACEW Synopsis Participant Engagement Two Discussion Sessions/Day Key points from discussions; Key questions; Input from group – answers to question; Review list and identify top priorities (model AAMI Summits) Case Studies Policy & Planning, Safety & Maintenance

Key Initiatives Following ACEW University partnerships Pontifica Universidad Catolica del Peru and University of Vermont/Boston University Faculty and student exchange Collaborative activities: Peru-US Other universities Government Associations Emerging technology Requires leadership