Something Old and Something New: The Time Is Right for Geriatric Engineering Programs

This editorial comments on the article by Lubliner et al. in this issue. The fields of geriatric medicine and gerontology take pride multidisciplinary/interdisciplinary team approach to caring for exploring ways improve lives older adults. These teams often include health care professionals such as physicians, nurses, nurse practitioners, physician assistants, dentists, ophthalmologists, opticians, audiologists, physical occupational therapists, pharmacists, podiatrists, social workers. 1, 2 Often challenges addressed these involve or functional needs that benefit from innovation assistive devices, accessible technology, environmental adaptations. 3 Yet, rarely are engineers even adults themselves formally included members. It is time update concepts multidisciplinary a new model includes engineering programs. Adding creates powerful opportunity contemporary, education curriculum more effectively efficiently address unmet today, well (perhaps importantly) educate next generations leaders adaptable design thinking approaches. 4, 5 (Figure 1) incorporation frameworks into will equip us with who adept at continually evolving our understanding aging, so identify not just today's needs, but also emerging tomorrow. In issue, Lubiner describes inception maturation one program. 6 addition providing important context scope scale sub-discipline, shows rich diversity brings medicine, engineering, persons together, moving beyond familiar combined MD/PhD degree outlining learnings development launch program author's institution, we see an which interested readers may broader learning about objectives, pedagogy interface fields, assessment improvement metrics allow evaluation, evolution, dissemination power integrating that—in manner nearly analogous role scientific method basic research—the process provides systematic disciplined rigorously elucidate gaps (“unmet needs”) confidently create knowledge bridge those gaps. At its simplest level, processes comprise sequence reinforcing stages: (1) finding, (2) benchmarking setting target performance specifications, (3) concept generation ideation, (4) down-selection, (5) prototyping testing top solution concepts, (6) refinement final (7) matured user environment. Drilling each stages, used introduce approaches, suites structured methods, well-defined tools. intersection aging wellness, there tremendous potential advancements big small. 7 Several key elements increase likelihood impactful outcomes use process, novice adopters college students. First iterative (not linear) staged frequent looping between stages integrate dynamically. can be both intimidating frustrating adopters, making well-structured educational environment perfect place then gain experience design. Gaining practical mitigates misconceptions common among novices iteration indicates failure. need is, accurately, acquiring yield high-quality custom designed meet needs. Secondly, human-centered considerations ensures real contrived) identified, articulated, addressed. voice essential meaningful motivating first-time practitioners process. Meaningful impact stem undergraduate courses. Over last decade plus, have been engaged UC Berkeley Bioengineering seniors first course design, integrates clinical patient stakeholders. Educating clear thinkers today tomorrow priority objective. As corollary objective, startup companies do form. One outsized example Eko Devices, launched 1-semester now has multiple FDA-approved biomedical products hundreds hospitals (https://www.ekohealth.com/). Springing first-design seniors, regarding objective analysis heart sounds were identified designers working clinicians. terms pedagogy, “total design” approach, vs experts similar specialty areas “partial approach. Human-centered adaptable, again educating adapt challenges, successfully applying COVID-19 pandemic demonstrated value striking example, Fall 2020 pivoted respiratory personal protective equipment (PPE) across diverse medically relevant Collaborating optometrists Berkeley's School Optometry dental hygienist members American Dental Hygienists Association, devised approaches limit fogging eyeglasses during examinations while donning PPE (and other optical ocular components). resuscitation emergency departments (University Pennsylvania), developed means seamless verbal communication wearing respirators requiring hands-free, sterile functionality. medical volunteers tent encampment asylum-seekers Matamoros, Mexico, integrated desiccants N95 reduce humidity—and discomfort—for personnel extended periods. All activities stakeholders fully remote, utilized remote emphasizing total geographically dispersed. Thirdly, highly adoption version only nature, places beneficial all 8 ethos exemplified “universal “design all,” applies arrive solutions “barrier-free” users, regardless abilities. A set principles adapted M.F. Story guide how foster universal applicability, comprising roughly: equitable use, flexibility simple intuitive perceptible information, tolerance error, low effort, size space use. 9 Entire technical conferences pedagogical research themes exist aging-focused including “Universal Design & Higher Education Transformation Congress” (https://www.udheit2018.com/). Certainly, architecture built pioneered adult-focused bioengineering,10 mechanical computer science electrical engineering11 disciplines engaged, albeit most through full programs (i.e., European Alliance Innovation's GOODTECHS). Clearly, directly engineering. There great hope technology help maintain independence overcome isolation. early examples success simplified tablets modeled phones televisions (GrandPad, 12 Norwegian Komp13), electronic pets (robotic seal pup Paro robot Pepper 14, 15), devices virtual assistants reminders appointments and/or medications,16 robots able lead daily balance exercise tasks become dance partner robotic walkers,17, 18 activity detectors sensors,19 range hearing aids fall detection capability.20, 21 But, life could using lower walking, entering exiting cars, stairclimbing, dinnerware eating utensils patients tremors, others. Input allied needed expertise solutions. Currently, live train little other. must change many face their lives. To better adults, right We learned cannot recruit graduate adequate numbers geriatric-trained provide adult professional training curriculums.22, 23 similarly predict would produce enough graduates described Lubiner6 either current future propose focus interdisciplinary efforts expansion joint efforts. should leverage field introduction students every level collaborative promotes improved functioning closing, it recognize part improving collaborations. authors wish acknowledge colleagues, participated bioengineering courses (https://bioeng.berkeley.edu/undergrad/design-in-bioe) helped shape views open eyes what possible. None. Indicate authors' study acquisition subjects data, interpretation preparation manuscript. Amy E. Herr, conceived, wrote, reviewed, edited manuscript collaboration Janice B. Schwartz Undergraduate team-based here supported National Institute Biomedical Imaging (NIBIB) Institutes Health under award number R25EB013068 (to AEH).