First in a series
By Jennifer J. Salopek
Three weeks ago, at a restaurant in Houston, the solution to a major health care problem may have germinated. Around a table were gathered Michael Fisch, MD, chair of the Department of General Oncology at the University of Texas MD Anderson Cancer Center, and four undergraduates who are enrolled in ENGL 386 at Rice University. The goal? To figure out how to use digital innovation and technology to encourage adult cancer patients to enroll in clinical trials.
Much about this equation may seem unlikely: Department chair + Undergrads + English course = Improved cancer research? But indeed, that is the hope.
The students—Erich Wieshofer, Veronica Kuhn, and Aaron Roe—are enrolled in an innovative new course at Rice known as the Medical Media Arts Lab. The course teaches critical thinking and design skills as it tackles real-world problems in health communication. Conceived by Professor Kirsten Ostherr, PhD, the course matches students with physicians in a collaborative team whose goal is to solve a problem. Along the way, the students must interview patients, blog, create videos, learn app creation, develop prototypes, and present their work for critique.
Fisch is one of the “problem owners.” As medical director and principal investigator of the Community Clinical Oncology Program at MD Anderson, an NCI-funded research program, he had long been frustrated by the low number of adults enrolling in clinical cancer trials. The logistics and infrastructure are barriers to entry, he says:
“[The system] is notoriously low-performing. Too few patients enroll, enrollments take too long, sometimes they never end. This diminishes the value of the studies, and too many trials lost value for those reasons.”
When Ostherr approached Fisch about presenting a problem for the class, he jumped at the chance. “I have many ideas but don’t know how to design solutions or bring them to business,” he says. “Further, I’ve been bereft of interaction with undergraduates. It’s a privilege to engage with these students.”
Although Medical Media Arts Lab is an English and film course, all but three of the enrolled students are pre-med. Ostherr thinks that fresh perspectives, leveraged into a multifaceted design approach, with a strong underpinning of technology and social media, can yield unique solutions.
“The students are working through an engineering-type process of participatory design,” she says. “Although non-experts, these students can generate innovative solutions.”
They certainly have the interest and the curiosity. “I’ve always been interested in cancer. It’s like a puzzle that I wanted to solve,” says Wieshofer.
Kuhn is a Hodgkins lymphoma survivor. “People are not very educated about clinical trials. There are issues of trust and poor public image; it’s a huge problem,” she says.
The semester-long course features three evening project critiques by patients and relevant stakeholders. “We know that visual media can solve problems with health literacy. The patient perspective is very valuable,” Ostherr says.
Social media instruction and critique is provided by Bryan Vartabedian, MD, a pediatric gastroenterologist and well-known “public physician” who teaches at Baylor College of Medicine. In a previous class, Vartabedian observed that students were not entirely comfortable with sharing their thoughts.
“They were in the dark about true digital literacy, but once we provided some instruction, they moved from hesitant to confident,” he says. “We saw a real uptake in capacity, and the students recognized that social networks can be a source of real professional value.”
For Medical Media Arts Lab, student teams are required to blog twice a week; each student must craft six posts over the course of the semester.
Fisch’s team is just one of five in the course. The other four are working on such diverse topics as how to redesign cardiovascular ICU rounds; how to get older adults with diabetes more engaged in their care by setting measurable goals; how to help more patients become e-patients; and how to tell the complete story of patients’ experience of living with an artificial heart. The problem owners—all respected experts in their fields—commit to meet with the project teams at least three times during the semester, hold virtual office hours, and attend three evening critiques.
Fisch already has done some learning of his own. “When we first met at the restaurant, I found that explaining the problem to open-minded people who had not drunk the same Kool-Aid exposed some of my own biases and use of jargon. The students asked me simply, ‘Why would a patient want to participate in a clinical trial?’
“Clinical trials may not necessarily be patient-centered, or a great idea,” he continues. “Maybe we should think harder about what’s really happening. Maybe we haven’t wondered that enough.”
At the first evening critique on February 13, teams presented a “thick description” of their problems and identified key stakeholder concerns, core questions, hypothetical solutions, and project plans.
“Doctors don’t even think about design,” Fisch says. “We’re trapped in our own skill set that’s pretty lame. This kind of approach is necessary if we want to innovate and talk about things that matter.” The team has already discussed navigators, gamification, social connections such as eHarmony, and other constructs whose elements could be instructive in the work.
“It’s a beautiful communication problem to work on in this setting,” says Ostherr.
This is the first in a series of posts about Medical Media Arts Lab. Wing of Zock will be following Dr. Fisch and his team throughout the semester and providing periodic updates on their work. For questions about the course, please contact Kirsten Ostherr at email@example.com.