Friday, December 12, 2014

Education in Informatics: Distinct Yet Integrative

One of the challenges we face in informatics education is how to call out its knowledge, skills, and competencies in the larger context of health and biomedicine. In other words, how do teach its important contributions while recognizing informatics does not exist in a solitary vacuum?

I see this at all levels of education in which I am involved, from that of medical and other health professional students to those training for professional careers in informatics.

One example of this is seen in medical student education. The importance of informatics in the training of physicians is finally being seen as important, yet the challenge is how to integrate appropriate informatics education into an environment where the evolution of the curriculum has been away from discrete courses to integration of all topics, typically organized into blocks and sometimes further divided into cases (i.e., case-based learning). Just as medical education no longer has standalone courses in biochemistry, pathology, physical examination and so forth, we should not aspire to have any sort of standalone informatics course either. Not only is informatics best learned in the context of solving real problems in clinical medicine, it also needs to be seen as integrated with the other subjects being learned.

The same applies to other healthcare professions. We must find ways to make informatics knowledge, skills, and competencies important, yet also integrated with their primary role as deliverers of healthcare.

Even for those training to work in informatics professionally, it is still important to understand its context. Some may be informatics professionals in clinical settings, public health settings, research settings, and even consumer-focused settings. The skilled informatician must know how to add value to those settings by best applying informatics.

This issue also plays out in one of the concerns I have for clinical informatics fellowships. As I have written before, I am troubled the idea of a standalone, one-size-fits-all, two-years-on-the-ground fellowship that is required by ACGME rules. Two additional years of fellowship is a lot to ask of physicians who do not start meaningful earning until into their 30s or later. Several of my clinical faculty colleagues at OHSU have asked why fellows cannot train simultaneously in informatics and another discipline. Not only do I not object to such integrated training, I actually believe it would be a great boon for an oncologist, cardiologist, surgeon, etc. to simultaneously train in informatics along with his or her other discipline, especially if they plan to pursue informatics in the context of that discipline.

But all this integration of informatics aside, I still strongly assert the title of this posting, which is that informatics should be distinct with its knowledge, skills, and competencies. However, its training and practice should be appropriately integrated with other health, clinical, and biomedical aspects of where it is being applied.

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