education for health technology innovation · 2018-10-09 · myocardial infarction (42%) or stroke...

Education for Health Technology Innovation

Serena Zacchigna, MD PhD

Department of Medical Sciences, University of Trieste

Cardiovascular Biology Group, ICGEB, Trieste

szacchigna@units.it, zacchign@icgeb.org

Density of medical schools by region

• Maldistribution, between and within countries

• 36 countries have no medical schools (26 in sub-Saharan Africa)

• Total global expenditure for health professional education: $100 billion per year

(with great disparities between countries), less than 2% of health expenditures

worldwide

The Flexner, Welch-Rose and Goldmark reports

• Integration of modern science into curricula at university-based schools

• Result: doubling of life span during the 20th century

• New infectious risks

• New environmental risks

• New behavioural risks

• New technological risks

Static curricula that produce ill-

equipped graduates do not keep

pace with these new challenges

Informative learning: acquiring knowledge and skills to produce

experts

Formative learning: socialising students around values to produce professionals

Transformative learning: developing leadership attributes to produce

enlighten change agents

- from fact memorisation to searching analysis

and synthesis of information for decision

making

- from non critical adoption of educational

models to creative adaptation of global

resources to address local priorities

- from seeking professional credentials to

achieving core competences for effective

teamwork in health systems

From specialisation to global interdependence in education

Promote interprofessional and

transprofessional education that

breaks down professional silos

while enhancing collaborative

relationships in effective teams

Superspecialization

Department of Medical, Surgical and Health Sciences,

University of Trieste

“From simulation to precision medicine”

(i) simulation and modelling

(ii) big-data analysis

(iii) biomaterials

(iv) international vision

(v) precision medicine

Simulation medicine @ UNITS

Why Do Simulation-Based Training?Simulation-based training gives healthcare providers a new, enlightening perspective on how to handle real-life clinical situations. With

high-realism patient care scenarios that closely simulate genuine crises, participants develop preparedness to both prevent and

respond to critical events. Simulation is poised to help fundamentally change healthcare to meet the challenges of our times.

State-of-the-art manikins

Surgery room

Intensive care room

Heart auscultation

Lung auscultation

Male and female catheterization

Mammary gland examination

Big data analysis: need to introduce

bioinformatic skills in health education

Megabytes (MB)

Gigabytes (GB)

Terabytes (TB)

Petabytes (TB)

EMBL, 2016

Developing innovative therapies for

cardiovascular disorders

Cardiovascular disorders are the most

common, serious, chronic, life-

threatening disease causing more

deaths, disability and economic costs

than all other diseases, including cancer.

More than 1 person out of 3 dies because of cardiovascular disorders, including myocardial infarction (42%) or stroke (36%). The total deaths due to these diseases per year is >17 million peopleworldwide.

More than 50% of patients with ischemic cardiomyopathy develop towards heart failure; there are 15 million new cases of heart failure each year worldwide, a number that is rapidly increasing because of the aging population.

Causes of deathWorld Health Organization, 2011

Global Atlas on cardiovascular disease

prevention and control, WHO 2011

Developing innovative therapies for cardiovascular

disorders

Time line showing the development of drugs against heart failure

Digitalis

Diuretics

Aldosterone antagonists

ACE inhibitors, beta-blockers

1910

1920

1930

1940

1950

1960

1970

1980

1990

2000

2010

Angiotensin II receptor blockers (ARBs)

2020LCZ696?

Novel biotherapeutics for myocardial

ischemia and heart failure

Synthetic peptides or

recombinant proteinsGene Therapy

Protein-coding cDNA?

siRNA? miRNA? Which

vector?Syringe containing factor,

vector or stem cells

Cell TherapyStem cell? Source?

Neoangiogenesis

Myocardial protection

Myocardial regeneration

border zoneinfarct

Global Monoclonal Antibody Therapeutics Market

ShareBy Application (2016)

Biotherapeutics

Screening for cardiomyocyte proliferation

using a library of microRNA mimics

40 human miRNAs increase both rat

and mouse cardiomyocyte

proliferation

hsa-miR-590-3p

48.5%

cel-miR-67cel-miR-67

12.5%

Eulalio et al. 2012. Nature 492, 376

MIControl

MImiR-199a

4 weeksafter MI

Biotherapeutics: need to introduce

business and market skills in health

education

Research

Challenges for bringing biotherapeutics

to the market (in the developing countries)

Zacchigna, 2018, Journal of Biotechnology

• Resistance to accept innovation (poor knowledge on biotechnology)

• Lack of skilled human resources and infrastructure

• Limited financial availability

• Poor governmental support (policies, funding, encouraging investment by the

private sector, international collaborations with advanced centres)

• Lack of appropriate business models (different from small molecule drugs, usually

developed and marketed by big pharmas)

Spin-off universities

Small biotech companies

High level scientific know-how

Intellectual property

Limited financial support

Venture

capitalists

Proof of

efficacy in

early clinical

trials

Large pharmaceutical

companies

2016 2017

Thanks!

szacchigna@units.it, zacchign@icgeb.org