{"id":10827,"date":"2018-11-07T13:46:31","date_gmt":"2018-11-07T18:46:31","guid":{"rendered":"https:\/\/geiselmed.dartmouth.edu\/news\/?p=10827"},"modified":"2018-11-07T13:46:31","modified_gmt":"2018-11-07T18:46:31","slug":"key-elements-valuing-medical-students-in-research","status":"publish","type":"post","link":"https:\/\/geiselmed.dartmouth.edu\/news\/2018\/key-elements-valuing-medical-students-in-research\/","title":{"rendered":"Key Elements: Valuing Medical Students in Research"},"content":{"rendered":"<figure id=\"attachment_10831\" aria-describedby=\"caption-attachment-10831\" style=\"width: 1170px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10831 size-full\" src=\"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2.jpg\" alt=\"\" width=\"1170\" height=\"550\" srcset=\"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2.jpg 1170w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2-230x108.jpg 230w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2-640x301.jpg 640w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2-117x55.jpg 117w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2-800x376.jpg 800w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-gph2-580x273.jpg 580w\" sizes=\"auto, (max-width: 1170px) 100vw, 1170px\" \/><figcaption id=\"caption-attachment-10831\" class=\"wp-caption-text\">Researcher Paul Barr, PhD, MSc (left), with Kanak Verma MED '18 (center), and Michelle Dannenberg, MPH (right). Photo by Mark Washburn<\/figcaption><\/figure>\n<p>Conversations between doctors and patients can be wide-ranging and complex\u2014unfortunately, a large percentage of the information discussed is immediately forgotten by patients.<\/p>\n<p>Geisel School of Medicine researcher <a href=\"https:\/\/tdi.dartmouth.edu\/about\/our-people\/directory\/paul-barr\" target=\"_blank\" rel=\"noopener\">Paul Barr, PhD, MSc<\/a>, believes these conversations should be recorded and shared to increase patient and family engagement in decision making and care management. For the past three years, he and the <a href=\"http:\/\/www.openrecordings.org\" target=\"_blank\" rel=\"noopener\">Open Recordings<\/a> team have been working with Geisel medical students on a range of projects centered on developing and implementing scalable solutions for the use of recordings in clinical practice.<\/p>\n<p>Because he lacks medical expertise, Barr, an assistant professor at <a href=\"https:\/\/tdi.dartmouth.edu\" target=\"_blank\" rel=\"noopener\">The Dartmouth Institute for Health Policy and Clinical Practice<\/a>, turns to medical students for guidance in the language of medicine\u2014clinicians, of course, can and do provide guidance, but medical students, he says, are the perfect conduit between the medical and research communities. His easy collaboration with students stems from his commitment to mentoring students interested in research.<\/p>\n<p>\u201cStudents have been central to the development, conduct, analysis, and write-up of a national survey of recording prevalence among physicians,\u201d Barr says. \u201cAnd they have also been hard at work on the development of the ORALS (Open Recording Automated Logging System) recording system platform that allows patients to record clinic visits with their doctors and uses machine-learning methods to automatically identify key elements of the clinic visit for patients to rehear at home.\u201d<\/p>\n<p>Machine learning uses complex statistical techniques enabling computers to learn and act like humans by learning from data that hasn\u2019t been explicitly programmed.<\/p>\n<p>To assess how well the system platform uses machine learning to identify key elements of each recorded visit\u2014such as test results or medication discussions\u2014James Finora \u201921 and Kyra Bonasia \u201920 review transcripts of clinic visits and tag segments for relevance.<\/p>\n<p>\u201cIt can be unclear what doctors mean when discussing a treatment option, and as medical students we have an understanding of what\u2019s important in that conversation,\u201d Finora explains. \u201cWe tag relevant portions of the transcript about treatment options, for example, and also tag segments that are unimportant. Eventually, the computer learns what these things are.\u201d<\/p>\n<p>But trying to connect how people talk with how computers operate is tricky for a machine learning program\u2014distinguishing between a disease and a vaccine isn\u2019t simple. Finora says a doctor may suggest to a patient to get a tetanus shot\u2014this is confusing for the computer because tetanus is both a vaccine and a disease.<\/p>\n<p>The program needs to learn these distinctions in order to retrieve relevant conversations. When a patient wants to review what their doctor said about medications, the program will also retrieve a discussion about supplements, and how they may interact with prescription medication.<\/p>\n<p>\u201cIn deciding what is important to teach the computer and how we are teaching it, Kyra and I created a guide\u2014which is exciting for me because it is the foundation of the project. If the computer isn\u2019t well trained it won\u2019t function,\u201d Finora says. \u201cWe want to teach the computer to adapt rather than change how doctors and patients interact.\u201d<\/p>\n<p>The medical students make such a difference\u2014their work is critical to the system\u2019s operation, Barr notes. \u201cBy working closely with myself, my colleague <a href=\"https:\/\/bmds.dartmouth.edu\/faculty\/saeed-hassanpour-phd\" target=\"_blank\" rel=\"noopener\">Dr. Saeed Hassanpour<\/a>, who leads the development of the machine learning methods for the system, and the rest of our team, the medical students have refined an annotation guide that we are happy with.\u201d<\/p>\n<p>Finora says he has learned a lot about building machine learning programs in general\u2014and \u201cit has been really cool being involved in a project on such a foundational level.\u201d<\/p>\n<p>\u201cOne of the goals of the ORALS project is that family members can also access the conversation in order to help the patient. I think it will be impactful because there is a huge need for patients to remember what their doctor has said in order to adhere with plans, to be medication compliant, and to keep them from being readmitted to the hospital, which is happening with greater frequency,\u201d Finora adds. \u201cThis can help patients\u2014and that feels good.\u201d<\/p>\n<p>Barr says he often reminds researchers to be flexible and willing to change. \u201cI always have to be that way because of the perspective medical students bring to the work\u2014I\u2019ve changed my strategy based on their feedback. They are doing very good research and I\u2019m fortunate to be able to work with such a talented group of medical students.\u201d<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dedicated to mentoring Geisel students interested in research, Paul Barr, PhD, values their perspective and views them as a natural conduit between the medical and research communities.<\/p>\n","protected":false},"author":12,"featured_media":10829,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[9,679,1,8],"tags":[847,536,741,320,45],"class_list":["post-10827","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-education","category-insider","category-news","category-research","tag-home-feature","tag-medical-students","tag-paul-barr","tag-research-2","tag-tdi","author-12"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2018\/11\/paul_barr_students-nc2.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4r3h1-2OD","_links":{"self":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/10827","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/comments?post=10827"}],"version-history":[{"count":5,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/10827\/revisions"}],"predecessor-version":[{"id":10830,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/10827\/revisions\/10830"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media\/10829"}],"wp:attachment":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media?parent=10827"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/categories?post=10827"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/tags?post=10827"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}