Dale C. Alverson

Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease.

Medical students learn over distance using virtual reality simulation.

Introduction: This article presents the results of a demonstration project that was designed with the goal to determine the feasibility and acceptability of medical students in using distance technology and virtual reality (VR) simulation within a problem-based learning (PBL). Methods: This pilot project involved students from the Universities of New Mexico and Hawaii and compared (1) control groups consisting of medical students in a tutor-guided PBL session using a text-based case, (2) distance groups using the same text-based case but interacting over distance from multiple sites, (3) groups using a VR simulation scenario integrated into the case without interaction over distance, and (4) combination groups interacting over distance from multiple sites with integration of a VR simulation scenario. Results: The study results suggest that it is possible to successfully conduct a PBL tutorial with medical students from two institutions with the integration VR and distributed distance interaction in combination or independently. The addition of these modalities did not interfere with learning dynamics when compared with traditional tutorial sessions. Conclusions: These findings suggest the feasibility and acceptability by students in the use of VR simulation integrated into a PBL learning session, as well as multipoint distance technologies that allowed interaction between students and tutors in different locations. The authors believe that these modalities can be applied where students and tutors from different institutions are in separate locations and can be used to support interactive experiential learning in a distributed network or on site and suggest areas for additional research.

Center for Telehealth and Cybermedicine Research, University of New Mexico Health Sciences Center: A Model of a Telehealth Program Within an Academic Medical Center

An overview of the Center for Telehealth and Cybermedicine Research at the University of New Mexico Health Sciences Center was presented along with several other national and international programs as part of the of a symposium-workshop on telehealth, Sustaining and Realizing the Promise of Telemedicine, held at the University of Michigan Health System in Ann Arbor, MI, May 18-19, 2012 and hosted by the University of Michigan Telemedicine Resource Center and its Director, Rashid Bashshur. This article describes our Center, its business plan, and a view to the future.

Sustaining and Expanding Telehealth: A Survey of Business Models from Selected Prominent U.S. Telehealth Centers

INTRODUCTIONnTelehealth centers across the country, including our own center, are addressing sustainability and best practice business models. We undertook this survey to explore the business models being used at other established telehealth centers. In the literature on telehealth and sustainability, there is a paucity of comparative studies as to how successful telehealth centers function.nnnMETHODSnIn this study, we compared the business models of 10 successful telehealth centers. We conducted the study by interviewing key individuals at the centers, either through teleconference or telephone.nnnRESULTSnWe found that there are five general approaches to sustaining a telehealth center: grants, telehealth network membership fees, income from providing clinical services, per encounter charges, and operating as a cost center. We also found that most centers use more than one approach.nnnCONCLUSIONnWe concluded that, although the first four approaches can contribute to the success of a center, telehealth centers are and should remain cost centers for their respective institutions.

The complementary roles of the advanced initiative in medical simulation and the society for simulation in healthcare.

In 2003, almost simultaneously and independent of each other, two organizations dedicated to the advancement of medical simulation were organized. One was the Society for Medical Simulation (SMS). In 2006, in recognition of the broader scope of medical simulation, SMS changed its name to the Society for Simulation in Healthcare (SSH). The other organization was the Advanced Initiative for Medical Simulation (AIMS), which came about as a result of interactions between various individuals interested in furthering the use of simulation for the public good. AIMS held its first public meeting in May 2004. The birth of these two groups so temporally close to one another and their shared focus has led to confusion in the medical simulation community regarding the role of each organization and their complementary value for the physicians, scientists, educators, and industry who comprise the medical simulation community. This commentary seeks to clarify the purpose of AIMS and explain the separate roles that AIMS and the SSH each can play in the growth and acceptance of medical simulation.

Learning and Usability within a Virtual Reality Trainer for Medical Students

Virtual reality (VR) offers the potential to train medical students on high-risk situations. The current study investigated VR training of medical students to diagnose and treat a patient avatar experiencing a serious head injury. The user interface was investigated, including use of tools, comfort and VR locomotion, and found to be sufficiently high to warrant training within a medical curriculum. In addition, actual learning as a function of VR training was assessed by comparing medical students knowledge structures to an expert knowledge structure before and after training. Students knowledge structures became more similar to an experts knowledge structure indicating that their conceptual understanding of core head-injury concepts increased as a result of VR training. The study was carried out under the auspices of Project TOUCH (Telehealth Outreach for Unified Community Health), a multi-year collaboration between The University of Hawaii (UH) and The University of New Mexico (UNM).