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Teaching in medical school

Since the winter semester of 2016/17, the Image Guidance Lab works in cooperation with the Humboldt University of Berlin and the Rice University in Houston on a compulsory elective course offered by the Charité called “ICONIC TURN – The impact of images on our actions”. By including this programme into their curriculum, medical students can learn about the increasingly complex and highly specialized visualization strategies in diagnostics and therapy. In cooperation with the Berlin Simulation and Training Centre (BeST), the Image Guidance Lab develops course concepts for standardized pre-, intra- and postoperative applications of medical technology.

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ICONIC TURN – The impact of images on our actions

Aim and content of this compulsory elective course

Medical imaging is an important, constantly improving tool for diagnosing medical conditions. The visualization of a possible anomaly and its surroundings is highly relevant for physicians who aim to surgically correct it. Therefore, medical imaging also plays an essential role in surgical planning. It enables an accurate evaluation of the situation and an in-depth consultation regarding potential risks and benefits of the planned intervention with the patient prior to surgery. If the patient agrees to undergo surgical treatment, the medical imaging-based surgical planning process begins. Planning softwares can be used for determining the optimal approach towards the anomaly by visually presenting it to the surgeons and highlighting diverse risky structures that surround it. During surgery, the information from the created pictures helps surgeons to perform target-oriented actions. In an extreme scenario, the entire surgical intervention could be planned based on medical imaging and could then be robotically conducted. The postoperative assessment of the surgery’s success also takes place image-based.

The main aim of this course is to raise the students’ awareness for the importance of the “image” in modern medicine, especially in surgical fields: Images have an imperative, instructing function in clinical settings and future physicians should learn to use them in the most advantageous way possible for their patients.

In order to achieve this competency, medical students need to acquire knowledge on how to critically question medical images. This kind of knowledge will be transmitted to the course’s participants on the basis of the following three subject areas: Firstly, the relevant media for medical imaging, its technical use and different modalities of visualization will be analysed and compared. Secondly, students will learn about the historical placement of medical imaging methods and thirdly, an overview of when and where images are of advantage will be given. This course concept aims to shed light on the various processes that are influenced by images and educate medical students about them.

In addition to this general knowledge on critically questioning images, this course includes aspects of technical developments in medical imaging primarily focusing on the increasing synchronisation of the image and the body in 3D, Augmented-Reality- and Virtual-Reality-applications and the progressing distancing between the staff and the patients (preplanning, remote control and robotics).

The students learn how to professionally use images in a clinical context which – now and in their future careers – will enable them to make optimal use of medical imaging. The theoretical input provided during seminars with a larger group of participants will be further discussed in extra lessons in which students are divided into small groups. In their small groups, they will work with clinical case studies corresponding to the respective theoretical topic previously discussed in the larger group. Furthermore, conversations with thematically suitable simulation patients and OR-visits will be offered.

Structure and content of the compulsory elective course

The theoretical knowledge transmitted during the seminars correlates with the respective concrete hands-on- or OR-visit-example of each day. Due to the interconnection between theory and clinical implementation, the importance of a multidisciplinary perspective – which the students learn about in the seminars – is emphasized. The common thread of each seminar will be a real oncological neurosurgical case that guides the students through the lesson, starting with discussing medical imaging for finding the diagnosis of the case and ending with talking about an appropriate, image-based planned surgery.

The module “ICONIC TURN – The impact of images on our actions” is provided by the department of neurosurgery, primarily because it is a field in which novel methods of imaging are frequently used. The reason for that lies within the fact that explorative interventions cannot be conducted intracranially and that the brain’s (functional) anatomy is characterized by its particularly complex structure. Traditionally, it is the surgeon’s task to mentally create a 3D-plan with 2D-sectional images. Their visual thinking ability plays an essential role in surgical planning and intraoperative orientation and is crucial for a successful outcome of the surgery. Even though 3D-technologies are widely used in the gaming industry, up until now, they haven’t been properly integrated into clinical routine. A possible explanation for those cirumstances is that potential users like the medical staff holds onto traditional visual habits and lacks in experience concerning stereoscopic visualization. Therefore, the introduction to modern visualization strategies and stereoscopic projection technologies thematized in the course “ICONIC TURN – The impact of images on our actions” is an important requirement for the necessary development of the implementation of 3D-technologies in clinical routine. Knowledge from the modules “Health and Society“, “The Nervous System” and “Neoplasia as a Disease Model” will be deepened in this course.

Progressive learning concept

The module “ICONIC TURN – The impact of images on our actions” offers a unique way of acquiring interdisciplinary competencies in the field of medical imaging and combining them with their clinical applications in a neurosurgical context. Regardless of their choice of medical speciality, students will greatly benefit from those skills in their future careers.

Required skills and knowledge

With the help of the course “ICONIC TURN – The impact of images on our actions” students learn how to professionally work with present and future visualization strategies. The teaching content will be communicated using an innovative, interdisciplinary format that combines theory and practical experience. There are no requirements in terms of qualifications or knowledge to attend the course. However, an open-minded attitude towards the idea of group discussions, critical self-reflexion, thinking out of the box and experimenting with thoughts and visualization strategies would be of advantage if you are aiming for a successful completion of the course.

Educational objectives

Due to the rapid development in the field of information technologies, drastic changes in clinical routine have emerged. A physician’s typical algorithm of taking a patient’s history, doing a physical examination and making a diagnosis is now progressively replaced by visualizing methods in diagnostics and therapy planning. The visualization strategies used are becoming more and more complex and specialized. The compulsory elective course “ICONIC TURN – The impact of images on our actions” sheds light on their multiple facets by introducing students to their use in different medical disciplines. This helps the participants to acquire the contemporary image competencies required for a useful application of currently relevant media for medical imaging. The ICONIC TURN module is a unique chance for receiving this precious kind of knowledge. Its team of lecturers consists not only of physicians but also of social scientists, interaction designers, visualization specialists, gaming experts and cultural historians. The content of this compulsory elective course is the creation of a cooperation with the Medical Future Lab of Rice University, Houston, USA ( which is one of the few institutions worldwide that has experience in integrating modern communication strategies into academic teaching.

Therefore, the course “ICONIC TURN – The impact of images on our actions” provides knowledge way beyond the spectrum of neuroradiological diagnostics. It helps participants to develop competencies in the clinical use of images which are skills that are inevitably required in a future physician’s daily work routine.

The following topics will be taught:

  • You will learn about the importance of images for diagnostics not only from a technical perspective but also when looking at the history of medicine and cultural history.
  • You will learn how to use image data in order to guide surgeons through a surgical procedure.
  • You will have the opportunity to get to know modern visualization strategies like 3D, Augmented Reality or Virtual Reality in a medical context.
  • You will be able to reflect on the influence progressive mechanization has on physician-patient relations and will be able to name possible consequences it could have on the healthcare system and hospital infrastructure.