Small Groups, Big Impact

In most areas of the United States, many of us take access to medicinal resources, or even something as simple as internet access for a telehealth visit, for granted.

Without access to common resources for medical product design, engineers must think outside the box to create effective solutions for health problems around the world, which is why University of Pittsburgh Swanson School of Engineering Assistant Professor of Bioengineering Kevin Bell and University of Pittsburgh School of Public Health Behavioral and Community Health Sciences Assistant Professor Cynthia Salter teamed up to teach *BIOENG 2173: Medical Design for Low Resource Environments.

Offered to both bioengineering and public health graduate students, this project-based course combines engineering concepts like human-centered design and frugal innovation with social, economic, and cultural public health perspectives to pair student groups with global partners who’ve already identified the need for these medical devices or health interventions.

Incorporating public health into this course was a necessity not only for understanding communities' cultural and economic differences when it comes to medicine, but also for instilling a diverse set of problem-solving skills into the students. 

“When you're on a problem-solving team, you might be the only engineer along with an economist, a politician, a global health expert and two clinicians,” Salter said. “It can be really challenging, and people really do work with some different fundamental problem-solving paradigms, so learning to work with the people who have a different background than you is a hugely critical skill. 

This kind of multidisciplinary problem solving is especially important for working with partners with minimal resources. Both the students and co-instructors must tackle obstacles firsthand to make things work across time zones, internet connection, and language barriers. 

“There's a lot of learning about how long everything takes, how hard it can be to communicate, or even figuring out if we’re all talking about the same problem,” Salter said. “I can tell my students, ‘Oh, you have to be flexible and ready to adapt,’ but if their partner can’t meet because they have no internet, how can we productively use our time when we can't get through to them?”

Finding the Fruit of Frugal Innovation 

This course is part of the Professional Master of Science in Medical Product Engineering program (MS-MPE) offered by Pitt’s Department of Bioengineering, which teaches students to develop new products for the clinical marketplace. Bell’s initial idea for this course stemmed from his personal passion for innovation in low-resource areas and also because of its different approach to engineering than other MS-MPE courses.

“Most of the courses are taught from a market driven perspective, and as a result, there's just not a lot of attention to problems that don't have a huge market,” Bell said. “But there is still opportunity for sustainable business models by incorporating frugal innovation.” 

Frugal innovation refers to low-cost products or services born out of necessity and lack of resources, built with locally sourced or easily available materials. Bell and Salter’s students have worked on projects in Jordan, Guatemala, Kenya, and Mexico, and also look to partner with other nations and low-resource areas in the United States in the future. 

One project a group of students worked on was a “mountain access chair,” built for individuals in Guatemala with physical disabilities. Because of mountainous terrain, parents struggle transporting their children to doctor’s appointments. The students worked to connect PVC pipes together to create a lightweight, low-cost chair to help parents or caretakers carry these individuals across the terrain to their appointments. 

Katrina Morgan, a student who worked on the chair, is currently a general surgery resident and took this course for a global health certificate. As an MD, this course has not only informed her on how to engage more creatively in finding solutions for her patients but also provided a crucial multidisciplinary background for patient care.

“There's a lot of medical voluntourism going on, and I don’t want to be one of those ignorant people that comes in and does a week of operating but ends up leaving the community in a worse-off position than when they started,” Morgan said. “It's really important to have as much background education and awareness as possible on how to approach global surgery or global health in the communities that you're working in.”

Looking ahead, Bell and Salter hope to improve the efficacy of these projects by incorporating independent studies or study-abroad programs. This semester,  one engineering student is doing an independent study with Bell  to further the Mountain Access Chair design with the goal of ultimately  implementing the device in Guatemala. 

BIOENG 2173 is a recent addition to the MS-MPE curriculum- this spring will be the third year the course is offered. Bell noted many of the ethical considerations students addressed about working on a project for just a few months. 

“The challenge in such a short class is that it's really not easy to deliver as much as you want to, so the students felt that they weren’t returning enough value to their partners.” Bell said. “Interestingly, when we met with all of the partners at the end, they were overjoyed with how much work was done, but we still struggle with the fact that we can’t solve everything.” 

Even with these challenges, Salter and Bell are enthusiastic about the future of the course and are proud to work with their students to foster medical product innovation sustainably and equitably. 

“We are deeply committed to the idea of authentic, not exploitive, collaboration, and that’s something we’ve been intentional about modeling for our students,” Salter said. “ I think this course has been wonderfully synergistic.”

*PUBHLT 2173:  Transforming Global Health Education into Action is offered concurrently for Public Health Students. This course is a part of the Global Health Certificate program in the School of Public Health.