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Transforming Medical Education

USF鈥檚 new facility in downtown Tampa ushers in a new era for tomorrow鈥檚 health care professionals.

The Morsani College of Medicine is making use of Microsoft鈥檚 cloud-based collaboration software called Teams, giving students a completely untethered way to access coursework, team-based projects and general communications with faculty and with each other. [video: USF Health Communications]

By Fredrick Coleman, Torie Doll 鈥�13, Allison Long, and Sarah Worth 鈥�86

Across The Last Weeks of December 2019, the entire MD program of the USF Health Morsani College of Medicine (MCOM) moved into its new home just completed in downtown Tampa.

Many have watched the building become a reality since its inception about five years ago, thanks to the ongoing support of state legislators, who have helped steer millions of dollars to the building鈥檚 construction, and businessman Jeff Vinik, who donated to USF an acre of land in the heart of his $3 billion redevelopment of the Water Street district in downtown Tampa.

Now, with the building opening and medical students beginning classes Jan. 13, the medical school is finally ready to make use of the innovative facility. As students enter the facility, they will experience a shift in the way they learn medicine, from both the literal hardware and software perspective and a construction and physical space perspective.

鈥淭his new building affords us a blank canvas on which we can create an innovative and technologically advanced learning environment while we also seek to nurture the 鈥榮ouls鈥� of our students to prevent burnout,鈥� says Dr. Charles J. Lockwood, senior vice president of USF Health and dean of the Morsani College of Medicine. 鈥淎nything we can do to help our students engage and curate information better and faster in an era where medical knowledge is increasing logarithmically will help our graduates succeed as physicians. With these first-rate medical facilities in the heart of a rapidly growing downtown setting, our students will be the envy of the nation.鈥�

About the facility

• The MD program is the first to make the move downtown, with classes beginning Jan. 13. The Heart Institute will begin its phased move in February 2020, the Physician Assistant Program will move in May 2021, and the Taneja College of Pharmacy is tentatively scheduled to begin classes in the new building in August 2021. USF Health will also share this facility with Tampa General Hospital for collaborative efforts focused on cardiology, urgent care, imaging and executive wellness.
• Skanska/HOK is the design/build team
• 13 stories
• 395,000 total square feet
• Occupancy for up to 1,800 students, faculty, researchers and staff
• The total project is composed of 47,437 tons of concrete, comparable to the weight of 155 Boeing 747-8 jets.
• The project contains 500,000 pounds of duct, 2.53 million linear feet of rebar (478.6 miles) and 254 miles of IT wiring.

Technology

Using technology to transform medical education

Building a new home for the Morsani College of Medicine offered an amazing opportunity to leverage the best of technology to change how medical education is delivered.

鈥淔rom the moment plans were announced for the new building about five years ago, we knew we had the opportunity of a lifetime to build from scratch a physical environment and a virtual world that would completely transform how we teach medicine,鈥� says Dr. Bryan Bognar, MPH 鈥�08, vice dean for educational affairs.
鈥淲e aimed for innovative ways to teach today鈥檚 medical students but to also stay adaptable and relevant for learners for decades to come.鈥�

Central to the new building is collaborative learning, and here are some of the ways technology and space design make that happen:

• Easier ways for students to collaborate and connect with each other and with faculty. Technology will allow for more real-time interactivity on coursework and for group learning with increased flexibility in the location of the learner and educator.
  
  
• Wireless everything, which allows connectivity throughout the building without missing any detail in a lesson. Construction included a fraction of networking cables of typical new buildings, allowing a totally untethered experience.
  
  
• Seamless remote access to real-time courses and group learning, which gives students and faculty greater flexibility for maintaining active participation in coursework, regardless of location.
  
  
• A 鈥渂lack box theater鈥� (Experiential Learning Lab) that can quickly transform from one type of learning space to another 鈥� from team learning to hands-on extensions of lessons to simulation reinforcing the foundational sciences. The flexibility allows today鈥檚 students to take their coursework in lectures to small group study and then to experiential learning. The space is intentionally designed to be easily adaptable to how future students may be taught. Driving many of the learning spaces are the opportunities to teach using mixed modalities. Now a student can practice taking a blood pressure on a standardized patient and be within feet of the Microsoft Surface Hub with slides that simulate how arteries are affected by hypertension.
  
  
• Extensive curriculum mapping that delves into coursework by the lesson, by the subject matter, by the hour, and allows education administrators, course directors and faculty to track coursework and make adjustments on when and how subjects are taught. This analysis means tweaks can be made to better meet national benchmarks, enabling student success on course exams and national licensing exams.
  
  
• A visualization wall within a modern medical library. This MultiTaction screen offers an interactive experience for a single user or dozens of users who can delve deeper into a range of scientific topics. Anatomy, for example, moves seamlessly from full body to organ systems to regions to cellular levels.

Technology is central to learning

鈥淥ur number one priority is to deliver physician graduates who are ready to meet patient and health system needs,鈥� says Dr. Deborah DeWaay, associate dean for undergraduate medical education.

鈥淚n the past, medical schools strived to create physicians the way they wanted them to be and then figured the residency programs would make them ready for the workforce. At the Morsani College of Medicine, we鈥檙e thinking about what the residency programs require and then working back from that.鈥�

This fits in, DeWaay says, with the Core Entrustable Professional Activities (EPAs) created by the Association for American Medical Colleges, an effort that sets expectations for both learners and teachers for what every medical student should know and be able to perform upon entering residency.

To help faculty accomplish this, the college is using several programs, including Appian and Microsoft鈥檚 PowerBI.

Appian is an intelligent business process management software and MCOM is using it to map every aspect of the four-year medical school curriculum. Microsoft鈥檚 PowerBI uses information collected by Appian to help faculty see the nuances of the data.

In tandem, both Appian and PowerBI give MCOM an effective way to create a curriculum that better mirrors national competency standards and for offering students fast feedback for areas they need to bolster in order to succeed on later content and on exams that are part of national licensing.

鈥淎ppian has completely changed the curriculum mapping process here at USF Health and lets us drill down hour by hour into the content students are getting,鈥� DeWaay says. 鈥淲ith Appian, we are able to tag all of our sessions to national content competencies. So, I can look at our map, search any topic and, within about 30 seconds, see exactly where in the curriculum it鈥檚 being taught, which sessions are teaching it, which program objectives are being met, and which correlated courses are being tied in. In an instant, I can see any gaps or redundancies. This level of detail makes continuous quality improvement much, much simpler.鈥�

The challenge with any medical school curriculum, DeWaay says, is the sheer volume of information being taught.

鈥淚f you鈥檙e going to make decisions on where a topic is taught and how it is taught, you have to be able to go in granularly,鈥� she says. 鈥淎 big-data, analytics type approach, like with Appian, is the only way to effectively handle the volume of information.鈥�

MCOM is also making use of Microsoft鈥檚 Teams collaboration software.

鈥淚鈥檓 very excited about how we are using Teams,鈥� DeWaay says. 鈥淲e鈥檙e one of the first medical schools in the country to incorporate Teams into a medical curriculum.鈥�

Think of Teams as a cloud-based workspace. Users 鈥� in this case students and faculty 鈥� can access the content at any time from anywhere. People can work simultaneously while being next to each other in class or miles apart. Project work 鈥� the heart of collaboration 鈥� can be done in real time no matter where team members are. Need to update a project with your contribution? Your addition shows up in real time while others are actively working at that same time. No tracking revisions across updated versions attached to emails.

Teams is giving students a completely untethered way to access coursework, team-based projects, and general communications with faculty and with each other.

鈥淧revious remote access was watch only, with maybe an audio interactivity,鈥� says Jason Hair, 鈥�97 and 鈥�00, senior director of infrastructure and operations for USF Information Technology. 鈥淲ith Teams, anyone in the lesson can activity participate, throwing information onto the screen, literally opening and sharing visual data, reports and cases, and adding to the discussion.鈥�

Teams also includes a platform called Whiteboards, something medical students everywhere can relate to.

鈥淚f you go to medical schools across the country there are physical whiteboards all over the place and students don鈥檛 go anywhere without their dry erase markers,鈥� DeWaay says.

鈥淲ith Teams, students and faculty can be in different places drawing on the same virtual whiteboard. And if the students draw on a real whiteboard, they can take a picture of it and upload it to Teams and the image will pixelate and be saved onto their digital whiteboard.鈥�

To facilitate access to Teams, MCOM is using several types of hardware throughout the new building. Almost every classroom will have Surface Hub 2, a large tablet set on an easel that can be easily rolled untethered within the class and to another classroom or other learning spaces without disconnecting and reconnecting anything.

Built for tomorrow鈥檚 tech

From the moment plans were announced for the new building about five years ago, MCOM education teams, USF facilities staff and information technology experts worked to determine how to best use this new space to transform medical education.

鈥淚t is critical to pay attention to how technology, physical space, and user behavior are related; and not view the three as silos,鈥� Hair says.

鈥淚n looking at the design of the building, we looked for opportunities to incorporate technology based on the behaviors we wanted to support in the spaces. And we focused on technology that drove the desired learning experience based on how today鈥檚 medical students learn. We wanted to make sure technology supported our pedagogy, but did not drive it.鈥�

For example, to enable a collaborative and mobile workflow for faculty and students, Microsoft Teams and user devices rely on Wi-Fi wherever possible, versus a more traditional approach of fixed/wired AV systems or hardware video conferencing.

鈥淭he building has full high-speed wireless coverage,鈥� Hair says. 鈥淔aculty and students from anywhere in the entire building can wirelessly join meetings or classes through Teams.

鈥淪ending live AV from cameras and microphones in a large classroom or auditorium typically requires a lot of specialized cabling. But in the new facility, we send the AV signal to our IP network. This allows us to send the AV signal to anywhere in the building and at a fraction of the cost of traditional cabling. We can send a camera feed from the auditorium to any other room in the building, even on another floor. This is great for classes or presentations with an overflow audience.鈥�

Also in the new building is a 19-foot-tall Sony Crystal LED video wall, one of the first in the country. Mounted in the building鈥檚 lobby, the over-4k-capable display offers opportunities for high-impact video and graphics to all who enter the new facility.

And a 7-foot-tall by 20-foot-wide MultiTaction visualization wall in the Florida Blue Health Knowledge Exchange supports dynamic, interactive digital content creation, and collaboration for multiple people simultaneously.

Digital library

Digital library experience: Florida Blue Health Knowledge Exchange

A library is traditionally thought of as a place kept under strict orders of silence and filled with wall-to-wall books that have a nostalgic, musty smell.

The Florida Blue Health Knowledge Exchange is the future of medical libraries: an epicenter of collaboration and technology. Located on the second-floor mezzanine of the new building, the Knowledge Exchange is an almost completely digital database of medical information. At this time, there are only 18 physical books reserved for MCOM鈥檚 use.

鈥淩esources are available wherever our students and faculty are and 24/7,鈥� says Rose Bland 鈥�89, MA 鈥�91, and MPA 鈥�13, director of the Shimberg Health Sciences Library at USF Health. 鈥淟ibraries are changing for the needs of the people. We do need quiet spaces, but the Knowledge Exchange is meant to be a place where people can meet and collaborate.鈥�

Some of the other exciting features of the Knowledge Exchange are a large-scale video visualization wall for multimedia presentations, an executive-style reading room, public-use computers, an IT help desk, and a space for technology demonstrations and recording lectures for online learning. A medical database accessible from wherever you are is also an important asset for distance-learning students and staff spread across multiple campuses.

Beyond the access to the digital database, 鈥渢here will be digital-learning tutorials created by the librarians on topics, such as how to do a quick search in PubMed or how to use EndNote, which students can access when they are studying at 1 in the morning and they need a quick refresher,鈥� says Larry L. Cramer, Jr., 鈥�93, assistant director of library operations.

Students and staff can also use the video conferencing capabilities outfitted in the Knowledge Exchange for a Microsoft Teams session or watch a live, face-to-face screen capture tutorial by a librarian.

鈥淜eeping pace with the rapidly evolving world of health data and technology is critical in today鈥檚 health care environment. The Florida Blue Health Knowledge Exchange is aptly named, as it will serve that goal by facilitating information sharing and collaboration among students, health professionals and entrepreneurs,鈥� said Florida Blue CEO Pat Geraghty in a 2017 interview with USF Health Development after giving a $1 million gift to support the Health Knowledge Exchange. 鈥淯SF and the Tampa Bay community are well positioned to be a center of health knowledge and learning. We are very proud to be a part of this public facility, which aligns so closely with our own mission of helping people and communities achieve better health.鈥�

The 5,000-square-foot space is not only a resource for students, but also Heart Institute researchers, USF Health and Tampa General Hospital patients, residents and the downtown community.

Adaptation

Amazing space: Flexible and adaptable for decades to come

From its inception, the new building was meant to transform how medical education is delivered to today鈥檚 students. But it was also meant to be flexible and adaptable for the needs of medical students for decades to come.

鈥淲e don鈥檛 know the demands medical education will have 30 years from now,鈥� says Steve Lafferty, director of design and construction for USF Facilities and Management. 鈥淚t was critical for this building to be designed beyond today鈥檚 learners and to be easily adapted to tomorrow鈥檚 learners. This building was designed for teaching medicine for the next 20 to 50 years.鈥�

While classrooms were easy to make adjustable 鈥� large rooms can be partitioned down to be small rooms, classroom configurations vary from a capacity of 400 down to 12 鈥� two other main areas showcase this flexibility best: a learning lab and the auditorium. The building can be configured and re-configured to accommodate the full population of the first two years of medical students in spaces that accommodate groups of 400, 200, 100, 50, 24, or 12 simultaneously.

Experiential Learning Lab

A 鈥渂lack box theater鈥� is a single space designed to be easily transformed to meet a wide variety of needs for a stage performance.

This general concept was used to create the Experiential Learning Lab, an open space in the heart of the student learning area that can be quickly transformed from one type of learning space to another. Students can go from team learning to hands-on extensions of lessons to clinical skills practice with standardized patients to simulation 鈥� all within the same space.

This type of learning environment is where faculty can both teach and evaluate the students. The quick transformation of the space means set-ups for another group of students can happen much faster, giving more students access to learning and evaluations. The space will also be available at all hours for students to avail themselves of various methods of learning.

Auditorium: The heart of the building

The demand was clear: Flexible space with no columns and easy access by the general public for special events.

The 400-seat auditorium is the largest single space in the building. It holds more than double the capacity in current space on the USF Health campus.

To create a space as large as the auditorium, there had to be incredible engineering in the design and strength in the materials because rising above the auditorium are 12 other levels. Whatever support traversed the open space had to be strong enough to support the floors above it and stiff enough to support the vibration-sensitive research above.

Four transfer beams were constructed to do just that, each measuring 6 feet wide by 12 feet tall by 88 feet long, and each weighing more than 1 million pounds. In total, the four transfer beams included 237 cubic yards of concrete and 56 tons of rebar.

The result is a large space that offers a sense of openness, a collaborative space with no visual barriers. And to continue with the theme of flexibility, the auditorium was designed to serve students and researchers, but also be available as a gathering space for both public and private groups.

Data analytics

Where business analytics meets student success

Big data and real-time analytics are helping the college track the coursework and efforts of medical students to better identify areas of struggle. The result is not only an enhanced education experience but also a direct impact on student success.

Tracking the curriculum as a whole and how students perform within it provides a large data set that can help identify which courses correlate to good and bad outcomes later, such as the link with struggles in a course to low scores on medical licensing exams.

As a result, the curriculum team is able to connect with students early to identify ways to support them and help them improve their work, and may even adjust the timing of certain courses to improve exam performance.

The MCOM Department of Medical Education (DME) works closely with the Information Technology experts to build and work with the analytics programs.

Central to the effort is the use of an intelligent business process management system called Archivum (Appian). This large data set is useful to the DME and was originally built in an accreditation capacity. However, the data the system produces has a much deeper and strategic purpose, says Swapna Chackravarhy, associate vice president of integrated data management in Information Technology.

鈥淭he wealth of the data that鈥檚 in there can be used for more test preparation and having the ability to pinpoint where certain test topics are being taught,鈥� Chackravarhy says. 鈥淥ur end goal in working with the DME is to provide them as much information as we can to help better serve the students.鈥�

The effort can also identify potential risk for outcomes later on, such as a student鈥檚 performance on the USMLE Step 1 exam, part of medical licensing. If students get a certain score in certain courses, the data shows they are likely to score in a certain range in the Step 1 exam. Tracking students鈥� early performance can help instructors and advisors identify those who may potentially be at risk.

The next phase of using these data sets is to identify more targeted student strengths and areas that need improvement. For example, DeWaay says, a student can pass every course with good scores, but levels of competency within the courses give a much more in-depth look at what specific areas and competencies students should bolster.

The end goal is to deliver the most comprehensive medical school experience possible, DeWaay says.

鈥淧roducing the best medical school graduates who are ready to work in an ever-changing healthcare field is our primary mission here.鈥�

Collegia

Collegia: A space for medical students

In 2013, MD freshmen launched a mentor-building program used in many boarding schools, colleges and medical schools 鈥� a la Harry Potter 鈥� that sorts new students into various 鈥渉ouses鈥� with students from all years. The practice helps the newcomers immediately feel welcomed into the fold of an institution, regardless of its size, and offers students mentorship and social interaction opportunities.

The medical students formed nine collegia, smaller groups that contain members from all four classes, with an aim to also integrate more faculty and alumni in the future. Creating smaller communities allows students across all years to connect and create positive, supportive environments that result in a better college experience and a better likelihood for academic success.

The collegia are called Bourne, Debakey, Farmer, Galen, Hippocrates, Koch, Lower, Osler, and Paracelsus.

In the new facility, a student鈥檚 collegium becomes a home base while in the building, a landing spot available 24/7 for continued studying, social interaction and much-needed downtime. Spanning a periphery on the third floor, the nine collegia provide ample space for students to go between classes, late into the night and over the weekends. Seating for both studying and relaxing fill each collegium, as well as a refrigerator and microwave oven. All include full windows with views across downtown Tampa.

Fundraising continues as USF Health works to realize the full vision of the new building. to make a gift online, or contact USF Health Development at 813-974-1470 to learn about naming opportunities or other ways to give.