UMEC Spotlight on Faculty Development: Brian MacArthur, MD

Meet Brian MacArthur, MD
Ob-Gyn Medical Student Site Director
Banner – University Medical Center Phoenix, University of Arizona

At the 2018 Martin L. Stone, MD, Faculty Development Seminar, Doctor MacArthur (with Laura T. Mercer, MD, and Christopher Morosky, MD, MS) presented Hacking Health Education: An Open-Source Makeover for the Health Care Curriculum.

APGO: What is your role in medical student education?
Doctor MacArthur: 
I am fairly new to medical student education and will be attending APGO’s Clerkship Directors’ School this year. I am transitioning into the role of Ob-Gyn Medical Student Site Director at Banner – University Medical Center Phoenix, University of Arizona. I see in medical students the heroes of the health care system. They have given up more of their youth and vitality than they realize to take on responsibilities that they do not yet comprehend in a future that is increasingly uncertain. I see it as my responsibility to provide them with optimal experiences as they navigate the culture of medicine. That involves giving them a humane mix of duties that are just beyond and well within their grasp, and fostering a sense of continual accomplishment so that eventually they will be able to achieve more than their current vision of themselves. I also believe we must have the emotional intelligence to recognize and acknowledge when a student is at risk of depression or burnout and normalize the experience of offering and asking for help in such circumstances.

APGO: What was the inspiration for your presentation topic?
Doctor MacArthur: I am basically a software engineer trapped in a physician’s body and have experienced life as a student, resident and attending through that lens. It was not until I saw a presentation about standardization of care by Steven Clark, MD, in 2014, though, that I became occupied with the idea of applying open source principles–free and open creation, modification, and redistribution of content–to problems in health care. That ultimately led to my first foray into open source medical education. I created a biomedical article bookmarking service I called Litsignal because I wanted an efficient and open system for creating, sharing, and organizing scholarly articles, consensus statements and protocols. I had been through several iterations of that project when Doctor Mercer, one of my co-presenters, approached me after an APGO Academic Scholars and Leaders session with an idea for a new direction. She had read the commentary “Medical Education Reimagined: A Call to Action” by Charles Prober, MD, of Stanford and Salman Khan of Khan Academy, and wanted to create a platform for sharing curricular resources. Although it was beyond the scope of what I had previously imagined for Litsignal, it was achievable. With her input and feedback from other users in our department, I turned Litsignal into a platform for authoring, sharing, and organizing educational modules. We felt it was only appropriate to share it first with other educators at the APGO conference in January 2018.

APGO: What were some of the challenges you faced while developing your program? What was the solution?
Doctor MacArthur: The primary challenge facing the independent software developer is no different than the one facing the physician educator–finding the time and energy to create. Whether crafting a curriculum or coding a software platform, time is hard to come by for the full-time physician. Fortunately, there is a vibrant community of open source software contributors, some employed by large corporations and others completely independent, who have created an unspeakably rich ecosystem of reusable software components that someone like me can leverage in the creation of new products. Automation is another essential source of efficiency and has become an indispensable component of testing, deployment, and monitoring. A few days spent here and there automating processes have resulted in weeks of reclaimed productivity.

Marketing is another challenge. We are here to sell a big idea: that the educational community can save time and increase quality by embracing the concept of open creation, modification, and redistribution of curricular content, and that the community deserves tools that make those tasks as effortless as possible. In a value-based environment, every decision we make and every partner we choose needs to be a reflection of the limited resources available to provide care to our patients. A marketplace crowded with vendors that do not share those values does not make our work any easier. We hope that our audience will be convinced of the value of our message and the fitness of our solution.

APGO: What resources did you find the most useful in developing your program (including APGO resources)?
Doctor MacArthur: This entire project is about organizing and sharing resources. Without the high quality resources produced by our professional organizations and colleagues there would be no need to organize and nothing to share. APGO’s Medical Student Objectives and YouTube videos provide a foundation for building engaging and worthwhile educational content. ACOG’s collections of practice bulletins, committee opinions, patient safety checklists, and consensus statements give us a variety of entry points to the relevant medical literature. Conferences like this one give us opportunities to learn from one another and bring each other’s messages back to our home institutions. Our colleagues, both locally in Arizona and across the country through APGO contacts, have provided critical feedback and reaffirmed the need for better tools for openly organizing and sharing our educational content.

Additionally, the open source software community has been both a source of inspiration and an invaluable resource. It still takes time and effort, but what once would have only been possible with a team of developers can now be accomplished by one motivated programmer with a laptop and an Internet connection. I have relied on open source projects from the Linux Foundation, Facebook, IBM, Microsoft, and many other companies and individuals to make Litsignal. I have also had to do a lot of technical problem-based learning and relied on resources like Stack Overflow, Mozilla Development Network, and GitHub to find solutions.

APGO: What are one to three things that you hope people who attended your presentation at the Faculty Development Seminar take home with them?
Doctor MacArthur: Attendees will leave with an open source educational module of their own creation, but I hope they will also walk away convinced of the message that open source content has an important role to play in medical education and value-based health care. Further, I hope they will gain a greater awareness of the unseen obstacles to cooperation and collaboration in medical education and an appreciation of the need for proper tooling to eliminate those obstacles. I also hope that our project will demonstrate to others that we do not have to wait for outside forces to bring us innovation. Some problems we can solve ourselves.

The 2019 Martin L. Stone, MD, Faculty Development Seminar is January 6-9 at the Hyatt Regency Maui in Lahaina, Hawaii. Click here to learn more about the meeting.