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Medical Physics and Biomedical Engineering Teaching

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Highlights of the teaching going on in UCL Medical Physics and Biomedical Engineering

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How do you demonstrate gamma imaging practically to students, without a radiation hazard?

Adam PGibson10 January 2017

By Rebecca Yerworth

This was the challenge set to 3rd year project student Nicola Wolf. The outcome? Gamma Anna, and a paper in Physics Education. The interactive demonstration that Nicola developed is applicable to medical students, secondary school lessons, and younger children when used with an appropriate age specific work sheet.

What is Gamma Imaging? It is a medical diagnostic technique which involves injecting small amount of radioactive material (tracer) in to a patient and looking to see where it goes using a radiation detector, known as a gamma camera.  The tracer is designed to be selectively absorbed into tissues of interest – e.g. radioactive glucose will accumulate in those parts of the body that are using the most energy…. Tumours have a high energy demand, so they will show up bright in the image. This is a useful tool for doctors if they want to see if a cancer has spread.

Why produce a teaching demo? It is common knowledge that well designed interactive activities increase understanding of the subject and retention of knowledge, as well as student engagement and enjoyment. However you can’t safely demonstrate real gamma imaging to students, because of the radiation hazard, quite apart from the logistics: Gamma cameras are large (room sized) and expensive. The Gamma Anna demo uses a series of analogies to explained key concepts of the imaging technique: heat, from an exothermic reaction represents the gamma radiation; tumours are represented by plaster of Paris; saline the radioactive tracer and a thermal imaging camera represents the Gamma camera. ‘Anna’ herself is a ragdoll into which the ‘tumours’ can be placed.gammaanna

Who is the demo for? Nicola tested the demo with GCSE grade students, where it served to explain principles of radiation and showed applications of physics to medicine and engineering – a topic with the potential to motivate students, including girls, to choose STEM subjects at A’ level and beyond. She also tested it with medical students, where the focus was on improving their ability to accurately advise future patients. Gamma Anna could also be used with younger children, either at an outreach event or as play-therapy if they, or a relative, need to undergo gamma imaging.  In each case age/course appropriate work sheets should be used; examples are available for download from the link above.

In conclusion… Gamma Anna is cheap, safe and easy to make and use. The largest expense being a thermal imaging camera, but mobile phone adapters are suitable, can be bought for less than £200, and are a useful resource for other demos too.

Marina Melero reports on Global Entrepreneurship challenge in Malaysia

Adam PGibson15 December 2016

One of our outstanding second year biomedical engineering students, Marina Melero, has returned from a visit to Kualar Lumpur. She had been invited to a meeting of the Global Entrepreneurship Community to lead a workshop on healthcare.

In her blog post, she reports on her visit and gives her thoughts on the future of technology.

marina

 

Thinking clinical at the Learning Hospital

Adam PGibson3 December 2016

By Julian Henty

Clinical Engineering knowledge and skills were put to the test recently during a visit to UCLH’s Learning Hospital. Second year Biomedical Engineering students were given the chance to test various medical devices, such as ventilators, bedside monitors and suction machines, examine the workings of an in-house automated blood pressure machine, and observe vital signs measurement from a real ‘patient’ using a virtual bedside monitor.

Despite making good use of the department’s electronics lab for experimentation with transducers, software driven data acquisition, and aspects of electrical safety, the Clinical Engineering module fulfills its practical aims by providing a hands-on session with real hospital equipment and actual clinical measurements in a realistic clinical environment. The Learning Hospital has a ‘theatre’, complete with operating table and appropriate medical devices, and a ‘ward’ with two beds, nurses’ station and a medical gas supply.

The virtual non-invasive blood pressure (NIBP) device comprised a PC, control board and recycled components from a disassembled standard NIBP device. LabVIEW software measured the photoplethysmogram (PPG) amplitude distal to the cuff during inflation/deflation, which provided feedback to control the air pump and release valve. The software had an illustrative screen showing each step in the process of taking a real measurement. Safety aspects of NIBP measurement could also be demonstrated.

learninghospital

The patient waits anxiously for his results

The virtual bedside monitor displayed real-time graphs of the ECG, PPG, NIBP and chest movement while the ‘patient’ lay on a bed. LabVIEW software demonstrated how heart rate may be extracted from the ECG, PPG, or NIBP measurements, and respiratory rate from the ECG or chest movement. The software could also manipulate the ECG to demonstrate both noise and other lead measurements, and simulation of low amplitude due to pericardial/pleural effusion, pneumothorax, obesity or loss of viable myocardium.

 

With thanks to Dimitros Airantiz, Billy Dennis and Paul Burke

Peer assessment in group work

Adam PGibson13 May 2016

By Pilar Garcia Souto

UCL Engineering trains students to use engineering knowledge within extended group practical activities to better prepare them for their careers after graduation. However, despite the substantial educational benefits of getting students to work in teams, students express and experience concerns that significantly decrease the student satisfaction.

We decided to look deeper into this matter and organized student focus groups across the Engineering Faculty, and spoke with various members of staff that use and assess group work. The message is clear: an element of “individual contribution” is needed, possible set by peers and tutor moderated, which improves the group dynamics and penalize the “passengers”. Otherwise students frequently express dissatisfaction if all members of a team are given the same mark regardless of the individual effort.

The concept is simple. At the end of a group work students rate the contribution of each team member, and this is used by the tutor to generate an individual mark. This encourages self-reflection, increase student satisfaction and reduce student’s complaints. The only major drawback is that the peer assessment of individual contribution is mainly collected using pen and paper, hence very staff consuming, as current e-learning tools are inadequate. From our research, this tool should be online, anonymous, preferable within Moodle and flexible so staff can adapt it and ask or value different aspects (e.g. reliability, punctuality, contribution to ideas, etc.).

This is an ongoing project. We presented some results at the UCL Teaching and Learning conference in April 2016, which attracted a lot of interest. It is clear that individual contribution assessment is something that staff from across UCL want to implement, and yet we lack the appropriate system. We decided to take the lead on establishing a consortium with those interested, and seek for some funding to develop an appropriate system within Moodle that would allow us to efficiently incorporate this practice into our teaching. If you are interested on participating and/or hearing more of our results, please contact p.garciasouto@ucl.ac.uk.

Our thanks to ELDG 2015 who partially funded this project.

Pitching UCL Biomedical Engineering Inventions To A Panel Of Dragons

Adam PGibson11 April 2016

By Jenny Griffiths

We made an unusual homework demand on our second year Biomedical Engineers over the Christmas vacation: they had to watch TV.

The students were asked to use UCL’s subscription to Box of Broadcasts to watch episodes of BBC’s Dragon’s Den in order to prepare for their first week back when they would be asked to spend a few days applying knowledge and understanding of enterprise, ethics, and regulations to medical devices.

On the first day of term, groups of students were each given a UCL Biomedical Engineering invention and told that they were to present a written portfolio and give a pitch to a panel of expert ‘Dragons’ on Friday afternoon.  They then went off, made contact with the UCL inventors of the devices, and with the help of a Teaching Assistant with a background in Medical Device Innovation, researched:

  • the devices’ capabilities
  • the market for the invention
  • routes to that market
  • ethical implications and requirements
  • medical device regulations for the device

All this information – key to bringing an engineering concept from lab to public use –  needed to be at their fingertips for the Friday presentations.

The full assignment marks for the work were split between the presentation, a written group portfolio and individual contributions to the team. We also upped the competitive element by awarding a prize for the best pitch, judged entirely subjectively by the Dragons and unlinked to any summative assessment marks.

dragons den presentation

This year’s devices were an optical ultrasound transcatheter imaging system (Dr Adrien Desjardins), a percutaneous heart valve delivery system (Dr Gaetano Burriesci) and SenseWheel – a force sensing wheelchair wheel to measure biomechanics (Dr Catherine Holloway).

On Friday afternoon, each group had five minutes to present their device to a panel of experts consisting of:

  • an academic medical devices expert
  • a Royal Academy of Engineering Enterprise Fellow
  • an academic who has commercialised a medical device through a spin-out
  • an external marketing and communications expert with no expert medical device knowledge.

The presentations were held in the appropriately intimidating Executive Education Suite, where the panel sat in high backed chairs and asked probing questions after each presentation. The students responded professionally and gave excellent pitches, selling devices that they had not know about just five days before!

Our highly sought after prize of copies of Eric Ries’ ‘The Lean Start up’ and (chocolate) money was won by team SenseWheel.

dragons den prize

In future years we aim to encourage more external Dragons to take part and will link the prize giving to an industrial careers and networking event for the students. If you are an employer who would like to be a part of this fun and valuable event, the department would love to hear from you.

Living Aid – working with Remap

Adam PGibson15 March 2016

By Rebecca Yerworth

remap1During the last week of February the second year biomedical engineers were introduced to ‘Remap’, a national charity working through local groups of skilled volunteers to help disabled people achieve independence and a better quality of life, by designing and tailor making equipment for their individual needs. The week started with a fascinating talk by Remap volunteers, explaining the purpose of the charity, the range of projects they tackle and the life changing effect of these bespoke items.

The students were then tasked with designing an aid that will enable a client to fit and remove spectacles, which she is unable to do without help, due to restricted arm movement. Whilst Remap projects vary in complexity, this is typical of the issues they solve – giving back independence to disabled users, or enabling them to take up a hobby they could previously only dream of.remap2

By the end of the week the students had had two meetings with the ‘client’ (an actor well acquainted with the issues) and we had three prototype devices. Three completely different approaches were taken, all of which the students could operate… though some needed further refinement/customisation to be useable by the client.

remap3The project raised some interesting questions about the relative merits of 3D printing versus traditional DIY techniques and of passive versus active devices. It also highlighted the importance of identifying and taking into account the client’s needs and preferences.

 

Assessment by wiki

Adam PGibson1 March 2016

By Adam Gibson and Rebecca Yerworth

We’re keen to incorporate different methods of assessment into the biomedical engineering programme. This makes the process more interesting and engaging for staff and students, and allows us to teach and assess a wide range of transferrable skills. In a new module on anatomy and physiology for biomedical engineers, we teach the basic anatomy and physiology in workshops and in a dissection room, and provide enhanced context by asking biomedical engineers to give two-hour “case studies” where they describe how their research interacts with the relevant anatomy and physiology.

We’ve built on this concept of a “case study” in the assessment where we ask students, in pairs, to research and present their own case study. The twist is that we have asked them to prepare and produce this using an online wiki interface. This allows us to move away from the standard boring Word document and introduce new skills. We ask students to demonstrate advanced writing skills by writing for a lay audience. They also need to consider how writing a website is different from a typical document, and address topics such as accessibility, web design and ensuring that any images have appropriate copyright. Academic referencing is as important as ever but has a different nuance if hyperlinks can be used. We produced a rubric which shows how we emphasised these areas in the assessment.

Asking students to research their own case studies based on those presented by experts in the field fits in nicely with UCL’s emphasis on research-based education and the connected curriculum, particularly as an example of outward-facing assessment.

A wiki interface includes a “history” log which makes it easier for an assessor to track the contributions of each partner, and also allows permissions to be controlled so that only members of a pair or team have access to edit the document, but tutors can view progress. Once the assignment is complete and assessed, we opened up access completely. This encourages students to take pride in their work, and gives them something they can link to if they choose. We hope that our collection of case studies will lead to a useful resource as different cohorts of students add to it year by year. We will also encourage students in subsequent years to read previous submissions and hopefully learn from them.

The case studies wiki is now available for all to see.

Smartphone app for detecting pulse rate

Terence SLeung17 February 2016

By Terence Leung

Our 1st year Biomedical Engineering students had very little computer programming experience when they began their first scenario week on Monday, 8th February. So to them, developing a smartphone app that can measure pulse rate seemed almost like an impossible task. However, as they struggled through the week, they learned about building the graphical user interface, switching the phone’s flash on and off, accessing pixel values from the phone’s camera, and performing Fast Fourier Transform to get the frequency of a periodic signal. Gradually, their apps were taking shape. Indeed by Friday all 10 teams had successfully developed their apps, some completed with a customised logo, animation, and even sound effect. It was a tough week, typically 9 to 5 (except Wednesday afternoon off). Many students found it tiring but were very proud of their first ever healthcare apps. Hopefully not their last!

Anxiously waiting for the test result…

Anxiously waiting for the test result…

 

Test result looks good!

Test result looks good!

 

Students took turn to demonstrate their apps

Students took turn to demonstrate their apps

 

This app apparently has the approval of fellow students

This app apparently has the approval of fellow students

 

Explaining why this is a great app!

Explaining why this is a great healthcare app!

 

This app has incorporated an animation in the background!

This app has incorporated an animation in the background!

 

This app has a customised logo (top left corner)!

This app has a customised logo (top left corner)!

 

This app plays simulated heart sounds during the measurement!

This app plays simulated heart sounds during the measurement!

Regaining Control

Adam PGibson18 January 2016

By Rebecca Yerworth

Just before Christmas, DSCN2511 the second year Biomedical Engineering students spent a week in the lab designing and building a device to replace a computer mouse for a hypothetical client who had no hand. The devices picked up electrical activity in the muscle of the arm and translated these into cursor movements and clicks – or at least that was the theory.

Regaining controlThe students’ knowledge of electronics, anatomy and problem solving were all put to the test as they built and tested their circuits. They discovered the delights of bread-boarding moderately complex circuits – and the importance of keeping your ‘spaghetti’ colour coded! Of equal importance was realising that some muscle groups are easier to control independently that others – and that what most of us do routinely, without consciously thinking about it, takes a lot more physical and mental effort when being relearnt.

All the groups successfully detected and recorded electrical activity from muscles. Detecting muscle activity from multiple muscle groups with a sufficiently clear signal to control a mouse pointer is much more challenging, but everyone managed this, at least intermittently. In amongst the hard work, it was good to see the moments of fun and hear the cries of delight as the first hand-free mouse clicks appeared.

Writing a research grant in radiotherapy

Adam PGibson6 January 2016

By Adam Gibson, Konstantin Lozhkin and Gary Royle

We have a long-standing module on “treatment with ionising radiation“. Ten years ago, one of us, Konstantin Lozhkin, completed UCL’s teaching course run by CALT. For his dissertation, Konstantin proposed teaching the module using Problem-Based Learning techniques, and, back in the day before research-based teaching became a big thing, we decided to give it a try.

Problem-based learning (PBL) is not new. It was developed by Célestin Freinet who was injured during the First World War. After the war, he became a teacher, but due to his war injury, he found talking in class difficult. This acted as the inspiration for a new style of teaching where he set problems and encouraged students to solve them co-operatively thereby learning from each other. The concept was taken further by McMaster University Medical School, who pioneered teaching by PBL. It is now widely used, especially in medical schools and it is seen to give students responsibility for their learning, reinforce deeper understanding, lead to improved motivation and encourage the development of teamwork and collaboration.

Our implementation of PBL has changed somewhat. The task we used first was to ask the students to imagine they are a medical consultant for a TV drama series in which a character is about to undergo radiotherapy. Students were asked to write a portfolio for the scriptwriters which summarised the radiotherapy issues and propose a plot. This successfully engaged the students but we found that they could avoid the technical aspects of radiotherapy physics which was the whole purpose of the exercise. We therefore changed the task, and now we send the students a spoof email from a “head of department”, asking them to produce a research grant application which compares two forms of radiotherapy.

Problem based learning task

An example task for the problem based learning exercise

We give an introductory lecture which describes PBL, gives some tips on teamwork and how to prioritise tasks, and then provide space for students to meet with tutors once or twice a week. The task lasts for around 4 weeks, at the end of which each team of 5-6 students give a presentation and submit a portfolio. Individual students also fill in an anonymous sheet in which they assess their own contribution and that of their teammates, and they also write a short (<300 word) self-reflection. These let us differentiate individual effort from the team performance. One real advantage of this type of team-learning exercise in this module is that it attracts students from a wide variety of programmes (usually Medical Physics, medical students taking an intercalated BSc in Medical Physics, straight physics students, Natural Sciences students and often others), which encourages students from different disciplines to learn from each other. The presentations are invariable excellent, and often contain dose calculations, original data and a costing for the grant application. Feedback is given instantly after the presentations, and a later team-specific “email” is sent from the “Head of Department” commenting on the grant application.

We provide students with a Moodle forum which allows them to communicate with each other. They tend to find this limited, however, and organise their own electronic communication. Students have used email, Facebook, Google Docs, Dropbox, text messages, MySpace and WhatsApp. This means we are less able to track the group’s activity, but it wouldn’t be in the spirit of PBL to impose a particular method of communication on the students.

Students typically put in a lot of work and enjoy the exercise. Feedback to us from students includes “it’s been amazing working with such a brilliant team”, “I am grateful to have had the opportunity to learn so many valuable lessons”, a good experience to simulate working in the real world”, and “every member of the team worked hard and well so we ended up with a high quality final piece that I thoroughly enjoyed working on”.

We as staff enjoy it too. It’s good to see students develop in confidence as they come to grips with the problem they have been set, and to see the positive way in which they tackle the problem. There are disadvantages: it’s hard to give a genuine individual mark for a team effort such as this (although the peer assessment sheet and the reflective essay help), and we have sacrificed some lectures to make time for this, which reduces the core syllabus on which the exam is based. However, we feel the advantages outweigh the disadvantages and look forward to continuing this into the future, and perhaps extending PBL techniques into other modules.