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\begin{document}

\title{Joint Engineering-Medical School Programs Prepare Physicians for
Clinical Challenges: An Innovation Curriculum}



\author[1]{Tyler Gathman}%
\affil[1]{Affiliation not available}%


\vspace{-1em}



  
  \date{May 26, 2024}


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Tyler J. Gathman MS\textsuperscript{1,2}, Ranveer M.S. Vasdev
MS\textsuperscript{1,2}, Miriam R. Smetak MD MS\textsuperscript{3},
Anthony Williams MD MS\textsuperscript{1,4}, Anna Budde
MD\textsuperscript{1,5}, Paul A. Iaizzo PhD\textsuperscript{1}

\emph{\textsuperscript{1}University of Minnesota School of Medicine,
Minneapolis, MN, USA.}

\emph{\textsuperscript{2}Department of Biomedical Engineering,
University of Minnesota, Minneapolis, MN, USA.}

\emph{\textsuperscript{3}Department of Otolaryngology, Vanderbilt
University, Nashville, TN, USA.}

\emph{\textsuperscript{4}Department of Internal Medicine - Pediatrics,
University of Minnesota, Minneapolis, MN, USA.}

\emph{\textsuperscript{5}Department of Anesthesiology, University of
Minnesota, Minneapolis, MN, USA.}\selectlanguage{english}
\begin{longtable}[]{@{}ll@{}}
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Address correspondence, reprint requests, and proofs to:\strut
\end{minipage} & \begin{minipage}[t]{0.48\columnwidth}\raggedright\strut
Tyler J. Gathman, MS Address: 420 Delaware Street S.E. Minneapolis, MN
55455 Telephone: (507) 993-5486 Fax: (612) 624-2002 Email:
gathm003@umn.edu\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Funding: None

Declaration of Conflicting Interests and Disclosures: None

Ethical Approval: Not Applicable

Word count: 1900 (inclusive of manuscript body)

Figures and Tables: 3

Author Contributions: All authors contributed to the study conception
and design. Material preparation, data collection, and analysis was
performed by Tyler J. Gathman and Ranveer M.S. Vasdev. The first draft
was written by Tyler J. Gathman and Ranveer M.S. Vasdev. All authors
approved the final manuscript.

Journal: Health Science Reports -- Observation

Keywords: Medical Education, Engineering, Innovation, Transdisciplinary
Education

\textbf{Joint Engineering-Medical School Programs Prepare Physicians for
Clinical Challenges: An Innovation Curriculum}

\textbf{Abstract}

\textbf{Purpose}

Modern healthcare faces a plethora of challenges including the delivery
of quality and cost-efficient care. Physicians are first-hand observers
of clinical problems but may lack the requisite training and education
to develop innovations that improve patient care. Few medical education
programs address innovation, leadership, and transdisciplinary
collaboration despite being highlighted by national medical and
education organizations including the American Medical Association. The
University of Minnesota has implemented the Augustine program over the
last ten-years to produce physicians that are leaders in medical
innovation.

\textbf{Methods}

As a novel joint engineering-medical school curriculum to educate
medical students, residents, and fellows, the Augustine program
incorporates engineering coursework, biomedical research, and a
multidisciplinary design and business development experience to produce
physicians capable of designing and marketing ``disruptive
technologies.'' The Augustine program takes one-year to complete in
addition to the four-year medical education and provides a Master of
Biomedical Engineering upon completion.

\textbf{Results}

Augustine program graduates (n = 6) have reported significant
contributions related to the joint engineering-medical education
including peer-reviewed publications (Median: 13), deployable assets
(Median: 2), and intellectual property (Median: 1). Most surveyed
graduates (n = 5, 83\%) continue to be active contributors to medical
innovation and all (n = 6, 100\%) utilize their transdisciplinary
education to improve patient care.

\textbf{Conclusion}

Augustine program graduates impact the entire spectrum of innovation and
continue to improve patient care. The program will seek to emphasize the
inclusion of residents and fellows with position expansion. The addition
of a multi-week medical innovation clerkship will provide a more focused
experience for students unable to dedicate an entire year to a
transdisciplinary experience.

\textbf{Introduction}

Addressing Clinical Challenges Through Innovation

Delivering high-quality, equitable, and cost-efficient healthcare are
major challenges. The obesity epidemic, an aging population, and rising
costs continually test the modern healthcare system. As an answer to
these mounting demands, innovative technologies seek to alleviate
clinical problems and advance patient care. For example, healthcare
informatics and machine learning have harnessed routinely captured
patient data to optimize care delivery and improve treatment outcomes
(Sharma et al. 2018). Robotic surgery has been increasingly utilized for
minimally invasive surgeries to reduce morbidity compared to open
procedures (George et al. 2018).

Medical innovations that redefine clinical practice often benefit from
insight on human factors and patient-centered design (Thimbleby 2013).
Physicians are first-hand observers of the obstacles faced in healthcare
and well-positioned to be the catalysts for ``disruptive technologies''.
However, most physicians do not receive the necessary training and
skills to develop and market such technologies that could remedy
clinical problems (Niccum et al. 2017). Unlike basic science coursework
and clinical skills, technical design concepts and innovation strategies
are not commonly taught within the medical school curriculum, a
formative time for physician development (Niccum et al. 2017). While
medical students recognize the need for formal training in innovation,
leadership, and transdisciplinary collaboration, less than 10\% of
medical education programs in the United States directly address these
core values (Niccum et al. 2017; Brazile et al. 2018; Sendak et al.
2021). Nevertheless, the National Academies of Medicine, American
Medical Association, and Association of Medical Colleges have all
stipulated that technological innovation should be a key component of
medical education, especially in the context of machine learning
(Wartman and Combs 2018; Matheny et al. 2020; Sendak et al. 2021).

Fortunately, select medical schools have initiated programs specifically
aimed at enhancing medical innovation and transdisciplinary
collaboration (Niccum et al. 2017; Coiado and Ahmad 2020; Sendak et al.
2021). Herein we discuss the University of Minnesota's 10-year
experience with the Scott and Sue Augustine Biomedical Engineering
Fellowship (referred to as the ``Augustine'' program), a joint
engineering and medical training program designed to educate and guide
aspiring physician-innovators to become effective leaders in developing
cutting-edge biomedical technologies. In this review, we detail the
novel program design, perspectives from practicing physician graduates,
and considerations for medical schools that may implement an engineering
and innovation curriculum.

\textbf{Methods}

Educational Model for Medical Innovation

The Augustine program was established in 2012 through a private grant
made to the Institute for Engineering in Medicine (IEM). The purpose was
to enable Doctor of Medicine (MD) students to build bridges between
engineering, innovation, and medicine to serve the dynamic healthcare
setting. Participants are expected to be thought-leaders that understand
the entire medical device development process including regulation,
reimbursement, and funding.

The Augustine program seeks to educate medical students how to
effectively define, approach, and implement solutions to clinical
problems. The program allows up to three medical students, residents, or
fellows each year to complete a dedicated Master of Science (MS) in
Biomedical Engineering (BME) degree program with a required research
thesis over the course of ten to twelve months. Research is conducted
under the mentorship of established faculty in areas such as healthcare
informatics, medical device development, neural engineering, and other
emerging fields. In addition to engineering and elective coursework,
Augustine program participants collaborate with a multidisciplinary team
to navigate and solve a clinical problem while learning about market
research techniques, prototyping, and business development. Students
take part in the New Product Design and Business Development (NPDBD)
course with a collaborative multidisciplinary team to complete an
industry-sponsored medical technology project. The experience teaches
conceptual design, business development, intellectual property
assessment, and regulatory aspects.

One participant was tasked with designing a trans-catheter pulmonary
valve. The team mastered the required cardiac anatomy and reviewed the
unique challenges in replacing a pulmonary valve. After formulating
potential ideas, multiple prototypes were designed with common
materials. The best-performing design went through an extensive business
development evaluation including patentability, budgeting, regulation,
and manufacturing. The experience concluded with a detailed presentation
to the industry-sponsor who ultimately assumed responsibility for the
remainder of the project. The NPDBD experience becomes the core process
for methodologically approaching and solving clinical problems as
physicians. Graduates are taught to think critically about the usage and
design of technology utilized in medical practice. The program becomes a
nidus for future physicians to explore dual-careers as a
physician-scientist or engineer, providing a clinical context for the
development of medical devices. These individuals ultimately bridge the
gap between technology and medicine for the benefit of their patients.

For medical students, the joint MD/MS with the Augustine program takes
five years to complete compared to four years for the sole MD pathway.
Because a standalone MS in BME can take 1.5 to 2 years, the MS component
of the Augustine program takes advantage of the basic science medical
school courses from years one and two to satisfy biology and elective
requirements of the MS-BME degree program. Students are then responsible
for taking primarily engineering and technical courses to complete the
MS portion of the dual degree (Table 1). The program does not require
students to have an engineering degree although prerequisite coursework
in physics and mathematics must be completed. With provided funding, all
students in the program receive full tuition coverage and a one-year
stipend comparable with doctoral program candidates in engineering.

The Augustine program typically takes place between the second and third
year of medical school, often after the student has passed their first
medical licensure exam. While the timeline takes advantage of the
natural demarcation between pre-clinical and clinical education,
students can participate in the Augustine program at any point of their
medical education from medical school to residency and fellowship.
Recently, a Pediatric Cardiology fellow participated in the program.

\textbf{Results}

Augustine Graduate Outcomes

Over the last decade, thirteen medical students have participated in the
Augustine program and have moved onto residency, fellowship, and
attending physician roles. Participating medical students have diverse
backgrounds ranging from Music to Engineering. Approximately one-third
(n = 4) of medical students selected for the Augustine program do not
have degrees in technical fields, although Engineering backgrounds are
common (n = 9, 70\%) (Table 2). A variety of clinical fields have been
selected by graduates. About one-half (n = 6) of participants have
clinical interests in surgical fields with surgical sub-specialties,
such as Urology and Otolaryngology-Head and Neck Surgery,
well-represented (23\% and 15\%) (Table 2).

Participants (n = 6) were surveyed on their scholarly contributions
related to the Augustine program education as well as their continued
involvement in medical innovation. Respondents were on average 4.3 years
(Standard Deviation: 3.2 years) post-completion of the Augustine
program. Participants have made a multitude of scholarly contributions
attributed to their joint medical-engineering education including
peer-reviewed publications (Median: 13), conference presentations
(Median: 23), intellectual property (Median: 1), and quality improvement
and leadership initiatives (Median: 1) (Table 3). The contributions
impact the entire pipeline of medical innovation including basic science
research, clinical translation, and deployment and optimization. Most
surveyed graduates (n = 5, 83\%) were active contributors to medical
innovation or biomedical engineering developments within the past year
and all (n = 6, 100\%) continue to utilize the skills and knowledge
gained during the Augustine program to enhance patient care.

\textbf{Discussion}

Practical Considerations

Translation and implementation of a combined engineering-medical school
model to other institutions has challenges. At our institution, tuition
and stipends were grant-funded for participating students, and similar
resources may not be available at other programs. Institutions may opt
for fundraising initiatives specifically aimed at previous graduates
with contributions to medical innovation. However, lack of funding does
not preclude the ability to implement a joint engineering-medical school
track. Other dual-degree curriculums, including Master of Public Health
(MPH) or Business Administration (MBA) programs, may not have built-in
tuition waivers or stipends but are still pursued by medical students
looking for a transdisciplinary education. Alternatively, institutions
without similar resources may develop a shorter and less intensive
experience such as an elective, clerkship, or seminar experience.

Essential to a joint program is a partnership with an established
engineering department. Our experience has underlined the importance of
a combined organization or committee, such as the IEM, to formalize the
relationship that are composed of both medical school and engineering
faculty. The joint committee enables effective instantiation and
oversight of a medical-engineering program. This, in fact, may encourage
further collaboration between medical and engineering units across
institutions. Medical schools without an existing collaboration should
consider agreements that would allow medical students to complete their
engineering degree at neighboring universities or consider
online-learning.

The prerequisites of advanced mathematics and physics coursework are
necessary for students to successfully complete upper-division technical
coursework. However, there is a growing focus at our institution on
enrolling medical students with non-technical backgrounds who may not
satisfy this requirement. Structured opportunities to complete
mathematics and/or physics prerequisites during the first or second year
of medical school can successfully address limitations and allow
students early exposure to core engineering concepts.

The most substantial challenge has been filling the program position
allotment which relates to student interest and program visibility. Two
of the ten previous years did not enroll any students into the program
while four additional years had only one participant. These observations
underscore that many physician trainees may not be interested in a joint
engineering-medical education, likely due to an additional year
commitment or goals that do not align with engineering or innovation.
This supports our program implementation as a separate, elective pathway
from traditional medical education. Nonetheless, our program has
continued to enhance visibility by highlighting former participants,
holding information sessions, and ensuring the program design and
implementation has been communicated with all perspective students. A
physician faculty position was added specifically for IEM outreach
responsible for representation of innovation opportunities to the
medical school. These adjustments were made within the past two years
leading to five of six positions being filled potentially indicating an
increase in interest.

Opportunities Across Medical Education

Enrollment of residents and fellows with specialized tracks has been
emphasized recently. Expansion of the Augustine program to include up to
seven students annually would provide the resources to include
additional physician trainees. Our institution has also explored the
development of a multi-week elective medical clerkship to take place
during the third or fourth year of medical school. The clerkship would
focus on the medical device innovation process with the goal of
educating medical students that may not be able to participate in the
Augustine program. Studies on the outcomes of joint engineering-medical
school and innovation programs will need to be conducted to assess the
relative strengths and weaknesses of various education models.

Write large, medical education must continue to prioritize innovation
and transdisciplinary experiences in line with positions from national
organizations. Our experience has demonstrated that there may not be a
one-size-fits-all approach. Medical programs should consider the
implementation of a spectrum of innovation opportunities from
longitudinal seminars and clerkships to year-long immersive experiences
consistent with the Augustine program. Maximizing benefit from
innovation programs would likely correspond with empowering physician
trainees to pursue opportunities that align with career goals.
Otherwise, medical education risks overlooking individuals that may have
interests in innovation.

\textbf{Conclusion}

There is a growing need for physicians with technical expertise to lead
the development of innovative solutions to challenges facing the modern
healthcare system, and to participate collaboratively in the advancement
of novel medical devices and technologies. A joint engineering and
medical school curriculum such as the Augustine program exemplify a
unique opportunity for medical students, residents, and fellows to gain
the necessary expertise to become future thought-leaders. Nonetheless,
innovation, leadership, and transdisciplinary collaboration should be
incorporated longitudinally with diverse opportunities throughout
medical education.

REFERENCES

\begin{enumerate}
\tightlist
\item
  Brazile T, Hostetter Shoop G, McDonough CM, Van Citters DW. 2018.
  Promoting innovation: Enhancing transdisciplinary opportunities for
  medical and engineering students. Medical Teacher. 40(12):1264--1274.
  https://doi.org/10.1080/0142159X.2018.1426841
\item
  Coiado OC, Ahmad K. 2020. Introducing First-Year Medical Students to
  Product Innovation and Entrepreneurship. MedSciEduc. 30(1):19--20.
  https://doi.org/10.1007/s40670-019-00879-y
\item
  George EI, Brand TC, LaPorta A, Marescaux J, Satava RM. 2018. Origins
  of Robotic Surgery: From Skepticism to Standard of Care. JSLS.
  22(4):e2018.00039. https://doi.org/10.4293/JSLS.2018.00039
\item
  Matheny ME, Whicher D, Thadaney Israni S. 2020. Artificial
  Intelligence in Health Care: A Report From the National Academy of
  Medicine. JAMA. 323(6):509. https://doi.org/10.1001/jama.2019.21579
\item
  Niccum BA, Sarker A, Wolf SJ, Trowbridge MJ. 2017. Innovation and
  entrepreneurship programs in US medical education: a landscape review
  and thematic analysis. Medical Education Online. 22(1):1360722.
  https://doi.org/10.1080/10872981.2017.1360722
\item
  Sendak MP, Gao M, Ratliff W, Whalen K, Nichols M, Futoma J, Balu S.
  2021. Preliminary results of a clinical research and innovation
  scholarship to prepare medical students to lead innovations in health
  care. Healthcare. 9(3):100555.
  https://doi.org/10.1016/j.hjdsi.2021.100555
\item
  Sharma A, Harrington RA, McClellan MB, Turakhia MP, Eapen ZJ,
  Steinhubl S, Mault JR, Majmudar MD, Roessig L, Chandross KJ, et al.
  2018. Using Digital Health Technology to Better Generate Evidence and
  Deliver Evidence-Based Care. Journal of the American College of
  Cardiology. 71(23):2680--2690.
  https://doi.org/10.1016/j.jacc.2018.03.523
\item
  Thimbleby H. 2013. Technology and the future of healthcare. J Public
  Health Res. 2(3):e28. https://doi.org/10.4081/jphr.2013.e28
\item
  Wartman SA, Combs CD. 2018. Medical Education Must Move From the
  Information Age to the Age of Artificial Intelligence: Academic
  Medicine. 93(8):1107--1109.
  https://doi.org/10.1097/ACM.0000000000002044
\end{enumerate}

\textbf{Table 1:} Coursework and research requirements for students
completing the Augustine program.\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
\begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Requirement}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Credits}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Description}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Representative Topics}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
BME Core\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
BME courses designated as core knowledge\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Functional Biomedical Imaging Biomedical Digital Signal Processing\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
BME Seminars\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Seminars on BME research and career development topics\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Industry Grand Rounds Research Ethics\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Biology Electives\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Courses with primarily biological content\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Molecular Cell Biology Genetics and Genomics\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Technical Electives\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
6-9\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Courses in engineering, physical sciences, and mathematics\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
New Product Design and Business Development Computer Aided
Engineering\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Free Science / Technical Electives\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
5-6\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Courses in any field of science or engineering; may include coursework
in areas such public policy, ethics, etc.\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Introduction to Clinical Ethics Introduction to Clinical Trials\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Research Project or Thesis\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
2-10\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Research completed with BME faculty advisor\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Neural Engineering Bioinstrumentation and Medical Devices\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Medical School Coursework\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
(12)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Up to 12 credits from the MD curriculum may be counted toward the BME MS
requirements as Biology and/or Free Electives\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Gross Anatomy and Embryology Medical Genetics, Biochemistry, and
Cellular Biology\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 2:} Summary of Augustine program participant
characteristics including educational background and clinical interests.

\textbf{Educational Background N (\%) (n = 13)}\selectlanguage{english}
\begin{longtable}[]{@{}ll@{}}
\toprule
Biomedical Engineering & 5 (38.5)\tabularnewline
Aerospace Engineering & 2 (15.4)\tabularnewline
Chemical Engineering & 2 (15.4)\tabularnewline
Biological Sciences & 1 (7.7)\tabularnewline
Biochemistry & 1 (7.7)\tabularnewline
Music & 1 (7.7)\tabularnewline
Spanish & 1 (7.7)\tabularnewline
\textbf{Clinical Interest} & \textbf{Clinical Interest}\tabularnewline
Urology & 3 (23.1)\tabularnewline
Otolaryngology & 2 (15.4)\tabularnewline
Internal Medicine & 2 (15.4)\tabularnewline
Cardiology & 1 (7.7)\tabularnewline
General Surgery & 1 (7.7)\tabularnewline
Neurology & 1 (7.7)\tabularnewline
Internal Medicine-Pediatrics & 1 (7.7)\tabularnewline
Radiation Oncology & 1 (7.7)\tabularnewline
Anesthesiology & 1 (7.7)\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 3} : Scholarly contributions with relevant examples from
participants attributable to the Augustine program education.\selectlanguage{english}
\begin{longtable}[]{@{}lll@{}}
\toprule
\begin{minipage}[b]{0.32\columnwidth}\raggedright\strut
\textbf{Student Outcome} \textbf{(n = 6)}\strut
\end{minipage} & \begin{minipage}[b]{0.32\columnwidth}\raggedright\strut
\textbf{Median} \textbf{{[}25-75\%{]}}\strut
\end{minipage} & \begin{minipage}[b]{0.32\columnwidth}\raggedright\strut
\textbf{Select Examples}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Peer-Reviewed Publications\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
13 {[}3,23{]}\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Ory J, et al. (2022). Artificial Intelligence Based Machine Learning
Models Predict Sperm Parameter Upgrading after Varicocele Repair: A
Multi-Institutional Analysis. \emph{World J Mens Health.} Tabdanov E, et
al. (2021). Engineering T Cells to Enhance 3D Migration Through
Structurally and Mechanically Complex Tumor Microenvironments. \emph{Nat
Commun.}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Conference Presentations\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
23 {[}9,35{]}\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Vasdev R, et al. (2021). Objective Identification of Detrusor
Overactivity in Urodynamics Using Spectral Analysis. \emph{International
Continence Society Meeting.} Gathman T, et al. (2022). Prediction of
Objective Hearing Loss from Demographics and Subjective Hearing Status
with Machine Learning. \emph{American Academy of Otolaryngology.}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Intellectual Property (Disclosures, Applications, and Patents)\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
1 {[}1,2{]}\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Nedrelow D., et al. (2021). Device to Expand Soft Tissue (U.S. Patent
Application No. 63/049,437). U.S. Patent and Trademark Office Nelson D,
et al. (2021). Bladder or Bowel Dysfunction Assessment Systems and
Methods (U.S. Patent Application No. 17/689,298). U.S. Patent and
Trademark Office Scorzelli C, et al. (2016). Composition Delivery Device
and Methods of Use (U.S. Patent No. 9,283,363). U.S. Patent and
Trademark Office\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.30\columnwidth}\raggedright\strut
Leadership and Quality Improvement\strut
\end{minipage} & \begin{minipage}[t]{0.30\columnwidth}\raggedright\strut
1 {[}0,2{]}\strut
\end{minipage} & \begin{minipage}[t]{0.30\columnwidth}\raggedright\strut
Malik S, et al. (2022). A Standardized Gastrografin Challenge Order Set
Improves Accuracy of Orders While Increasing Provider Efficiency and
Satisfaction. \emph{American College of Surgery Quality and Safety
Conference.}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Assets Built\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
2 {[}1,4{]}\strut
\end{minipage} & \begin{minipage}[t]{0.32\columnwidth}\raggedright\strut
Cannon P, et al. (2022). A Novel Tool for Auricle Retraction During
Closure of Post-Auricular Incisions. \emph{Frontiers in Biomedical
Devices (Design of Medical Devices Conference).} Tradewell M, et al.
(2018). Design and Validation of an Organizational Device for
Endourological Surgery. \emph{Frontiers in Biomedical Devices (Design of
Medical Devices Conference).}\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

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