For medical students in need of a little downtime, the new Li Ka Shing Center for Learning and Knowledge can be the perfect refuge, where a gym with a sweeping fourth-floor view or a nearby study room offers a moment of respite and reflection. But when it's time to get to work, other parts of the $90 million School of Medicine facility deliver an experience of intense engagement, through interactions with people at every crossway of medical education and some of the most sophisticated training tools in the world.
The building's opening is a signature expression of the school's determination to be among the international leaders in adapting to the demands of rapidly advancing technologies and vast increases in scientific knowledge. "Most medical schools are interested in producing doctors. A handful are interested in producing transformers," says Dean Philip Pizzo.
The center, situated along Campus Drive between the Beckman and Fairchild buildings and hailed at its September dedication as a portal to a world of multidisciplinary thinking, was designed to be flexible. For example, a large conference hall with roll-out stadium seating is divisible into smaller rooms that might feature clusters of tables for small discussion groups. Electronic junction boxes in the floor could enable participants to expand the discussion via videoconference with people almost anywhere around the globe.
Some elements are firsts for Stanford, such as that balcony-embellished fourth floor, reserved for recreational and study use by about 1,200 MD and PhD students. Other elements represent intriguing next steps in the evolution of teaching practices such as simulation-based learning. There is even a chunk of empty space reserved for virtual reality technologies yet to be budgeted or fully developed. The center, whose major benefactor is Hong Kong entrepreneur Li Ka-shing, is the med school's first new education building in 50 years.
Simulation-based learning, centralized in a ground-floor mock hospital and clinic setting, features a new generation of mannequins used to teach such techniques as the insertion of probes for ultrasound imaging. Imaging the heart, for example, involves a small probe on the end of a long tube placed into the esophagus. "All of these ultrasound techniques are tricky to learn," notes David Gaba, associate dean for immersive and simulation-based learning, "and now there is a pretty good simulator that allows people to do hands-on learning of manipulating the probe and interpreting the images in real time."
Beyond their practical benefits, simulators reinforce the idea that medical education needs to be reshaped, as Gaba explains, to rely less on "passive learning," such as lectures, and more on "active" methods, wherever applicable. "I would embed simulation fully into the way that we do health care, such that experienced personnel would use it much more as individuals, teams and whole work units," says Gaba. "In bits and pieces in different domains of health care and departments and divisions, some of these things are starting to happen, but there is a long way to go to fully implement these reforms."
Gaba, whose influence on immersive learning includes engineering a pioneering simulator more than two decades ago, points to the consolidation of training at Li Ka Shing as a model for educational architecture. In addition to a mock operating theater and ER, there are exam rooms where students have appointments with actors portraying patients experiencing various symptoms and complaints. This type of active learning can be coordinated with related training on mannequins.
"Some schools are still hardly doing many of these things, or only for a smaller set of learner populations," notes Gaba. "A few others are in the league with us. Very few have all the modalities in one place and serve the entire spectrum of learners from professional school students—medical students and grad students—and interns, residents and fellows, and experienced clinicians, including [those in] continuing medical education."
Everything happening at Li Ka Shing fits within the context of Pizzo's efforts to have the Stanford medical community collectively brainstorm its way into the future. In the final months of 2010, he convened a series of think tanks on medical education, graduate student education, and postdoctoral education and training, all as a prelude to specific measures and implementation schedules. Pizzo emphasizes the "work in progress" nature of the initiative, but in his regular newsletters and conversation with Stanford, some concepts stand out.
Along with other Stanford leaders from highly technical fields, Pizzo stresses the need to attune students to lifelong learning, particularly within the framework of synthesizing information, rather than compartmentalizing it. Elaborating on that in one newsletter, he wrote about an educational model in which a team of students, led by "a teacher-coach," might approach a patient from the aspect of investigating a broad "value chain—molecular, physiological, pharmacological, healthcare system, social, economic, cultural."
Also up for serious consideration: shortening the duration of medical education, which might, Pizzo says, lead to a revamping that makes it less disjointed and more humanistic. "This includes," he notes, "the art of listening, the art of understanding."
