The Revolution of Medical Learning - Exploring Novel Teaching Tools…

Textbooks and formal lectures were previously considered the main sources to build a solid medical knowledge. However, the advancements of technology have transformed our learning process. Nowadays, students, residents and fellows learn from a combination of resources including Internet, Uptodate, webcasts, podcasts, blogs and apps in addition to formal teaching. 

One of the limitations of this is that learning became fragmented… I have personally experienced this fact as an Attending since fellows would learn very well certain topics in transplantation such as treatment of antibody-mediated rejection though would lack basic concepts about histocompatibility at the end of their fellowship. They were interested in learning more about anti-HLA testing though did not have the time to visit the lab or to read about it, in particular since most books go into to excessive details for their learning needs. 

Ultrasound is another area where fellows really ought to learn more during their fellowship, since I am confident that performing a bedside ultrasound can significantly improve patient care by identifying earlier abnormalities such as an obstruction or a lack of blood flow in kidney grafts. Ultrasound books made by radiologists are also over detailed for the fellow and are rarely used in practice. 

Finally, learning to assess kidney transplant biopsies and nuances of the diagnoses of various conditions is critical for the appropriate management of patients. Most centers lack a formal teaching of how to consistently approach a kidney biopsy. Helmut Rennke and Vanesa Bijol, two fabulous renal pathologist at the BWH, were critical for my learning on this topic but there is no fellow-oriented resource to quickly overview this subject other than renal pathology books. 

 To overcome the above limitations, I have been working for the past 6 years in an interactive transplant learning tool that contains more than 300 original figures/illustrations, questions, key-points and videos to consolidate all aspects of transplantation in one place. Helmut and Vanesa have provided me with slides from all kidney transplant patients that I have attended on, allowing me to share individual cases with beautiful biopsy findings. 

It was a lot of work since I decided to do all by myself, including illustrations, collection of radiology images, videos, graphs, questions,… The goal was really to have a book with a consistent approach to topics and similar style through out. This would be impossible if I had invited multiple contributors… Videos were elaborated to explain difficult topics such as anti-HLA assays, and problem-based cases describe the thought processes, differential diagnosis and management of common conditions affecting kidney transplant recipients. Lastly, questions and review key-points on every chapter will test the reader’s knowledge and hyperklinks will allow direct access with one-click to key references on Pubmed. The end-product was just made available online two weeks ago. 

I hope students, residents and fellows would enjoy the format and really get the most learning possible while seeing transplant patients. Our beta testing last year with BWH fellows was excellent! 

Hopefully you will also enjoy it...

 Have fun! 

Leo Riella

PS1. Read more about it the iBook here

PS2. To download the iBook,  an iPad, iPhone 6 or Mac computer is required.