Biomedical Engineering Education and Technology Transfer

Narender P. Reddy Biomedical Engineering Department University of Akron

ONTINUED INNOVATIONS in a number of technical C disciplines have created a need for rapid technology transfer in health care delivery. The biomedical engineer can play a vital role in this technology transfer.

Biomedical engineering is a vast, challenging, and inter- disciplinary field. It represents the application of engineering principles, wi th judgment, t o problems in biology and medi- cine for the benefit of mankind. Practically, every branch of engineering can have fruitful interactions wi th a number of medical disciplines (Fig. 1) . These interactions, t o a certain extent, have already increased fundamental understanding of both physiological and pathological conditions, have yielded in improved diagnostic methods (e.g., mobility aids and communication aids for handicapped individuals), have in- creased health care (e.g., reduction of hospital stay, im- proved patient care, etc.) and have prolonged life expectancy through the use of prosthetics and artificial organs [l I. These biomedical engineering achievements represent only a minute fraction of what could be accomplished through the applica- tion of existing technology t o biomedicine. As w e look in t o the future, emphasis should be placed on the application of engineering t o more clinically oriented disciplines. On the

BIOMEDICAL ENGINEERING

Figure 1 . Biomedical Engineering Domain: Biomedical engineering represents integration of engineering with medicine which results in numerous benefits to the society (e.g., improved quality of life and prologed life expectancy). Biomedical engineering activities can be classified horizontally with one engineering discipline interacting with one or more biomedical disciplines (eg. biomechanics, and biomate- rials), or they can be classified vertically with numerous engineering disciplines interacting with a single biomedical discipline (e.g., rehabilitation engineering).

other hand, engineering and technology continue t o make rapid advances. As summarized in Fig. 1, all fields of engineering can be brought t o bear on problems in health care. With effective technology transfer, biomedical engi- neering can offer even more benefits to health care. This paper examines the role of a biomedical engineering educator in the technology transfer in health care delivery.

PROBLEM IDENTIFICATION Technology transfer, t o a large extent, depends on identifi-

cation and conceptualization of potential applications. Often, problems in medical disciplines are ignored due t o the lack of proper communication between the physician and the engi- neer. In the current practice, it is the physician who identifies the problem and brings it t o the attention of the engineer. In the future, the biomedical engineer should play a role in identifying medical problems that need engineering attention. In this context, the biomedical engineering educator could play a key role in technology transfer by training students t o identify problems. Internships. The traditional view is that a well prepared student should be able t o solve any problem from fundamen- tal principles. Although a thorough understanding in funda- mentals is essential for problem solving, it should be viewed as necessary but not sufficient [21. The student should be provided with an opportunity t o use his understanding of these fundamentals by identifying and solving "real-world" problems.

Hospital internships provide an excellent opportunity for the biomedical engineering student, both at the graduate and undergraduate levels, t o learn t o identify and conceptualize medical matters that could benefit from technology applica- tion. In addition, students are exposed t o a clinical environ- ment. Several universities are currently experimenting wi th this approach. For instance, The Hartford Graduate Center and Rensselaer Polytechnic Institute encourage their students t o undertake hospital internships. Osmania university in India requires all undergraduate students t o complete a semester of clinical rotation in either the junior or senior year. A t Drexel and Case Western Universities and Trinity College, the clinical internship starts in the summer session and continues through the second year of the graduate program [3, 41. In addition t o learning medical problem identification, the stu- dents who complete these internships also learn how t o communicate with medical personnel in a clinical environ- ment. Grand Rounds. Education is significantly enhanced when biomedical engineering faculty and students participate in hospital "grand rounds," along with members of the medical staff. When these students join the "real" world, they will have better appreciation for medical problems, and will be better equipped to contribute t o technology transfer in the health care field. In addition t o establishing the engineer as a member of the health care team, these "grand rounds" help increase the acceptability of the technology by the health care team. For instance, Ohio State University already has a "Grand Rounds" course as part of the B.M.E. curriculum. Adjunct Faculty Appointments. Physicians should be en- couraged t o become involved in biomedical engineering education by serving as adjunct faculty. A survey of aca- demic BME departmental brochures indicates that several universities in the United States are already doing this. These

8 IEEE ENGINEERING IN MEDICINE AND BIOLOGY MAGAZINE MARCH 1989

physicians should serve on graduate student committees. Undergraduate design projects should be guided by engineer- physician faculty teams. Also, these adjunct faculty should occasionally be invited t o present classroom lectures and departmental seminars. These activities would enhance stu- dent's perception for medical problems and technology transfer. Collaboration. Biomedical engineering students should be encouraged to participate in collaborative projects involving engineer and physician faculty. Many universities are cur- rently involved with such collaborative projects, but a major- i ty of these projects are either basic science or do not involve patients. In this context, rehabilitation engineering has emerged as a distinct discipline, which is representative of engineer-physician collaboration. Biomedical engineering stu- dent projects involving human subjects should be encour- aged. Such experience will serve in industry or hospital t o play a major role in technology transfer. ACCEPTABILITY OF TECHNOLOGY

Rapid technological advances in other fields will soon lead t o new health care concepts such as computer aided surgery, expert systems for diagnosis, and robotic surgical manipula- tors. Acceptability is a major factor in technology transfer in health care delivery. Due t o a lack of awareness and background, the health care team may offer resistance t o the introduction of new technology, at least during the initial stages. The biomedical engineering educator can play a role in enhancing the acceptability of technology: Educating the Health Care Team. The health care team has the responsibility of end-application of a technological tool. Biomedical engineering educators should develop appropriate continuing medical education courses and seminars for physicians, nurses and physical therapists, etc. Continuing medical education (CME) credit is awarded through the American Medical Association.

Full-time and part-time postgraduate courses in biomedical engineering should be developed for physicians. For example, courses t o cover topics such as artificial organs, prosthetics, biomechanics, noninvasive diagnosis, instrumentation for the practicing physician, telemetry, computers in medicine, and biomaterials can all be developed with little or no mathemat- ics. Also, specialized courses emphasizing the application of engineering to a particular medical specialty can be devel- oped. Some examples of this type of course are: engineering in cardiology, engineering in anesthesiology, orthopaedic biomechanics, rehabilitation engineering, and engineering neurology. For example, Columbia University and St. Lukes Hospital in New York City have offered short term "Biome- chanics'' courses for health professionals, which have been widely attended by orthopaedic residents and surgeons, Training of Residents. Training of residents in biomedical engineering is an important arm of technology transfer. Collaborative arrangements should be made between hospi- tals and universities for participation of medical residents in biomedical engineering projects and short courses. Also, short courses similar t o those discussed above should be developed for residents. Several universities currently offer short courses on orthopaedic biomechanics. A t the University of Akron, w e have collaboration wi th area hospitals t o involve orthopaedic residents in collaborative research. When these residents go into practice they wil l be much better prepared t o accept new technology. Engineering in M.D. Training. The medical doctor of tomor- row will be working in an increasingly complex technological environment. Engineering and instrumentation principles could be taught t o medical students 151. A course on biomedical engineering (4 t o 8 credit hours) should perhaps be introduced in the medical school curriculum as an elective.

Also, courses in biomedical engineering should be developed for non-engineering students.

SERVICE DELIVERY: BIOMEDICAL ENGINEERING CLINICS

The biomedical engineer should establish him/herself as a part of the health care delivery team; only then will technol- ogy transfer proceed as the normal course of events. Biomedical rngineering Clinics. Many aspects of physical medicine and rehabilitation could benefit from the physi- cian-engineer team. Patients may require specialized custom made devices to gain independence. In addition, an engi- neer's opinion may be necessary in device prescription. These and similar activities can be grouped into biomedical engi- neering clinics. Already, several major rehabilitation centers in the United States are involved in regular weekly, bi-weekly, or daily clinics in rehabilitation engineering. Wi th increasing technology, rehabilitation engineering clinics may become popular in the future.

Biomedical engineering clinics similar t o the rehabilitation engineering clinic are needed t o cover other medical disci- plines. Technology transfer could be significantly enhanced with these types of clinics. Biomedical engineering students of the future should be trained t o do this type of "private practice". Independent Clinics. Independent biomedical engineering clinics/labs can be established for quantitative physiological, biomechanical and bioelectric assessments of patients. Pa- tients would be referred t o these clinics by the practicing physicians. Quantitative assessment (BME) clinics could be as widespread in the next few decades as clinical labs are today. The biomedical engineering faculty should act as catalysts in training students t o establish such clinics.

CONCLUSIONS Biomedical engineering discipline has emerged t o a point

where it can significantly contribute t o increased and more efficient health care delivery. Universities will play a key role in technology transfer by training biomedical engineering students t o identify medical problems that can be addressed with technological solutions.

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Medical Dewces and Instrumentation, J. G . Webster (Ed). New York, John Wiley, pp. 392-403, 1988.

4. Newhouse VL, Mylraa KC, Topham WS. Clinical Engineering a: an Academic Discipline. J CIrnr Engr, 10,203-21 9, 1985

5. Laufman H: Bioengineering in medical schools of United States and Canada, Medical Instrumentation, 7:2. 1973

Narender P. Reddy received his B.E. degree in mechanical engineering from Osmania univer- sity (India) in 1969, M.S. from University of Mississippi in 1971, and Ph.D. in biomedical engineering from Texas A&M in 1974. He served Texas A&M. Baylor College of Medi- cine, University of California San Francisco, and Helen Hayes Hospital (N.Y.) in various positions before joining the University of Ak- ron in 1981 as associate professor of Biomedi- cal engineering. Also, he serves as an adjunct staff at Edwin Shaw Hospital. Dr. Reddy has

published and presented over a hundred technical papers, and has chaired technical sessions at numerous national and international scientific meetings. Dr. Reddy's interests are broad and include the application of biomechanics to various clinical disciplines including orthopaedic, rehabilitation and cardio-pulmonary medicine.

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