Opportunities and Challenges in Biomedical Engineering Education

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4thMediterranean Conference on Embedded ComputingMECO - 2015Budva, Montenegro

Opportunities and Challenges in Biomedical Engineering Education Focus on Bosnia and Herzegovina

Dušanka Bošković

Almir Badnjević

Faculty of Electrical Engineering University of Sarajevo Sarajevo, Bosnia and Herzegovina [email protected]

Verlab Ltd Sarajevo Faculty of Electrical Engineering University of Sarajevo Sarajevo, Bosnia and Herzegovina [email protected]

Abstract— Biomedical engineering employs engineering expertise in solving biological and medical problems to improve the quality of life. The paper describes the significance of combining life sciences with technology and engineering, and discusses objectives and characteristics of biomedical engineering education. The huge interest in this area and also a rapid development of relevant engineering fields provides opportunities both for educators and graduates. Some of the challenges are: building competences in two demanding fields: biology and engineering, importance of medical ethics relation to study programs in other engineering disciplines and health professions, relation with relevant stakeholders as industry and healthcare institutions. The role and the need of biomedical engineering education in the region are discussed, and didactic paradigms suitable to address opportunities and challenges are explored.

educated to integrate engineering competences in solving biological and medical problems. It is apparent that foundation of their education has to be rooted in traditional engineering disciplines such electrical or mechanical engineering. Application of their engineering competences in biomedical domain requires training in biology, physiology and biochemistry. The challenge of combining engineering with biomedical domain lies in the complexity of the biological systems. Opportunities are in rapid development of the technology, and it is expected that demand for the profession increase. In the United States it is anticipated that the number of biomedical engineers rise more than 50 percent until 2020 [2].

The rest of this paper is organized as follows. The Section II provides basic definitions and main objectives of the BME, identifying most common challenges. The Section III presents the BME education and professional context in Bosnia and Herzegovina. Section IV discusses the competences related to the BME education, and Section V presents the didactic approaches suitable for addressing these competences. Finally, conclusions are presented in the Section VI.

When discussing the challenges we can start with the common disagreements and misunderstandings about the biomedical engineering (BME) definition. The notion of biomedical engineer as instrumentalist developing or maintaining medical devices, once common in 60s and 70s, is narrowing the large span of the BME nowadays. The BME incorporates diverse fields as: electronics, telecommunications, computer and software engineering, computer science, mechanical engineering, chemical engineering. The diversity of the BME field became apparent more than a decade ago, and here we provide an excerpt from a list of clinical engineer competences identified: adopt a systems and process approach; monitor technological, regulatory, economic, and other developments; plan for the integration of existing and new medical technologies; become conversant in the “business” of technology, incorporate continuing education [3]. In Bosnia and Herzegovina we need to guide our efforts when introducing BME courses to avoid repeating the same mistakes, and overcoming the wrong presumptions that the BME is related exclusively to electronics or bio-materials.

II. BME DEFINITION AND OBJECTIVES Biomedical engineers are defined as professionals that apply electrical, chemical, optical, mechanical, and other engineering principles to understand, modify, or control biological systems [1]. The biomedical engineers should be

The diversity of the field and its attractiveness brings another challenge: what is the framework for teaching the BME. Although the demand in the BME related job-market is increasing, the BME represents only a few percents of the engineering jobs generally [2]. The same source provides the opinion of the experts in the field, that the eminent and specific

Keywords- Biomedical Engineering; education; cognitive competences

I. INTRODUCTION (HEADING 1) This paper presents aims and objectives of biomedical engineering (BME) education, reflecting on opportunities and challenges presented before this discipline. The authors describe their experience in teaching a BME course and didactic paradigms appropriate to the core subject and also beneficial for address higher level of competences.

4thMediterranean Conference on Embedded ComputingMECO - 2015Budva, Montenegro BME education is an advantage for research oriented careers, but to compete for jobs in industry, the good quality traditional engineering degree is considered as educational foundation. III.


A. BME Education in Bosnia and Herzegovina Analysis of the BME related study programs and courses offered in Western Balkan countries was performed through activities in the Tempus project “Studies in Bioengineering and Medical Informatics - BioEMIS”. Their report for Bosnia and Herzegovina mentions only a few BME courses as: biomedical systems, biomechatronics, telemedicine and medical informatics, without a specific reference to institution or study programme [4]. The BioEMIS report focused only on public universities, and also did not include in the analysis Faculty of Electrical Engineering University of Sarajevo, that offers two courses at master level: Biomedical Signals and Systems [5] and Computer Algorithms in Bioinformatics [6], since the introduction of the Bologna education model. Knowing the popularity and expansion off the BME field, we can identify opportunity in developing new courses or study programs, but respecting European good practice [7]. B. BME Job Market in Bosnia and Herzegovina Authors' experience through contacts in the public health sector in Bosnia and Herzegovina: 3 clinical centers, 25 hospitals and 65 general practice clinics and with 350 private practice clinics. Clinical centers employ 2-3 clinical engineers responsible for clinic equipment maintenance. The clinical centers have engineers employed for maintenance tasks in information and communication technology (ICT) sector. It is usual that hospitals have one clinical engineer employed, and majority of these engineers are also responsible for the ICT tasks. This is the reason they have prevailing electrical/electronic engineering background, but there are also mechanical engineers performing all above mentioned tasks. The professional experience varies from 3 to 20 years. To our knowledge in Bosnia and Herzegovina there are more than 20 companies suppliers of medical equipment. The companies are also responsible for the equipment maintenance. These companies employ engineers and technicians, with the professional focus on the specialized equipment they supply and maintain. These engineers were additionally educated for their job. C. Overview of the Results in Traditional Engineering In developing new courses and programs it is important to build upon already achieved results, because many of the BME topics were already addressed in teaching and research. These topics were included either in teaching as attractive case studies, or in the research performed at different study levels. Here are some of the published results linked to the engineering topics: signal processing [8], image processing [9], telecommunications [10], software engineering [11], artificial intelligence [12] and mechanical engineering [13]. The examples presented are not a result of a systematic or

comprehensive analysis. We present them as illustration that BME topics are explored in the framework of the traditional engineering degrees, proving that these study programs provide foundation for their alumni to deal successfully with the biomedical problems. IV. COMPETENCES AND BME EDUCATION It is recognized that development, understanding and practical use of learning outcomes is crucial to the success of the higher education, and especially the attainment of learning outcomes in assessment procedures [14]. National Report for Bosnia and Herzegovina 2012 states that credits award linked to the learning outcomes acquirement is present in 5 to 50 percent of the study programs, and that use of learning outcomes is regulated only on advisory level [15]. The range of cognitive competences comprises basic levels as knowledge and understanding, followed by application of the acquired knowledge and higher levels of competences as: analysis, synthesis and evaluation, as classified in the Bloom taxonomy [16]. Study programs in engineering in BH are the most developed in sense of the Bologna model, but our experience is that their learning outcomes are mainly focused to the basic competences. There are examples of application of that knowledge, but mainly in the laboratory context. Important opportunity in teaching BME is possibility to address higher levels of competences as: analysis, synthesis and evaluation, giving importance to creativity of students. Teaching BME is also beneficial in broadening competences from cognitive domain to affective. Therefore, we should consider teaching importance of medical ethics as an opportunity, not only as challenge. Here, we would like to bring into attention the following competences identified in [16], but not usual for engineering education: accept the need for professional ethical standards, appreciate the need for confidentiality in the professional relationship, and resolve conflicting issues between personal beliefs and ethical considerations. V. DIDACTIC APPROACH The biggest challenge lies in the core of the BME discipline: the necessity to bring together two demanding fields: biology and engineering, not only during the education, but also during the professional work. Didactic approach for teaching biomedical engineering courses described in this paper is derived from authors’ experience in teaching the course Biomedical Signals and Systems [5], offered as elective course within the Master Study Programme at the Automatic Control and Electronics Department at the Faculty of Electrical Engineering, University of Sarajevo. For the first time it was offered in Spring semester 2008/2009 and has been offered every Spring semester since then. The important difference in teaching the more traditional engineering disciplines and the broader disciplines is recognized by authors teaching system engineering. The conclusion that students need to become aware of the inherent

4thMediterranean Conference on Embedded ComputingMECO - 2015Budva, Montenegro ambiguities in contrast to the focused world of monodisciplinary engineering [17] is also appropriate for teaching biomedical systems. The same source recommends active learning style, what is in compliance with our experience. Syllabus of the course includes the following topics: biopotentials, heart and ECG, blood pressure measurement, EEG and Dialyses. Traditional lectures covering theoretical principles are followed with lab exercises, homework assignments and a final project. In addition to a paper exam, overall knowledge and ability to discuss BME issues are assessed based on the final project. Students have to learn to apply classical engineering knowledge as signal processing in a new context of biological systems and physiological signals. In order to achieve better results traditional lectures are blended with inventive didactic techniques. The lectures are highly interactive building upon students’ previous knowledge acquired either during engineering study programme or in the biology/chemistry/physics classes in the high school. The lack of cutting edge technology laboratories can be compensated with different tools available to support teaching in class, and improving laboratory experience for students. Lectures are facilitated with numerous video clips as suggested in the same source, but also lab exercises are using open software tools for modeling, physiological signal processing and visualization as: 

HHsim: an open source, real-time, graphical HodgkinHuxley simulator [18];

PhysioNet, PhysioBank signals, and PhysioToolkit [19];

EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics [20].

There are examples of a low budget and high performance laboratories for BME education [21] developing countries. The proposed solutions are non expensive and designed suitable for lab assignments related to physiological signals measurement, vital signs monitoring and biomedical signal processing. The final project demonstrates whether students have learned to apply classical engineering knowledge, as signal processing, in a new context of biological systems and physiological signals. It has been suggested that Problem Based Learning (PBL) is well-suited for students within the interdisciplinary field of BME [22]. We also share the experience that a critical aspect of PBL is that a problem represents a real-world, complex challenge. VI. CONCLUSIONS The opportunities and challenges for biomedical engineering education, both in general and in the local context are discussed. The opportunities in teaching multidisciplinary topics are linked with advanced didactic approaches, and increasing the level and scope of students’ competences. Important part in teaching the BME is interdisciplinary interactions between experts in engineering and medicine.

The BME experts, regardless of their educational background, can produce noteworthy research results when cooperating with the medical professionals. Without the cooperation, their results are reduced to exercises demonstrating engineering skills and competences. If we want our students to achieve higher level of cognitive competences: analysis, synthesis, and evaluation, their efforts need to be employed in solving real life problems. This is the reason why we need to establish informal and formal links between the biomedical and engineering communities in BH, and through this co-operation foster the research in the BME. Only such endeavors will generate positive feedback towards education and specific courses within engineering degrees. We are witnessing the process of developing the multidisciplinary links evolving into formal initiatives as establishing joint professional association: the Society for Biological and Medical Engineering in Bosnia and Herzegovina [23]. Such initiatives has high importance, not only in Bosnia and Herzegovina, but through globally recognized need to facilitate dialogue between engineering and biomedical/life sciences communities and to encourage symbiotic multi-disciplinary research between the two diverse communities [24]. REFERENCES [1]

John Enderle, Joseph Bronzino, Introduction to Biomedical Engineering, Academic Press; 3 edition, 2011. [2] A. Monaco, What it takes to be a bioengineer, The Institute, IEEE, Issue: December, 2012. [3] S.L. Grimes, Clinical notes [opportunities and challenges in clinical engineering], Engineering in Medicine and Biology Magazine, IEEE Volume: 23 , Issue: 2 DOI: 10.1109/MEMB.2004.1310991, 2004 , pp: 94 - 95 [4] TEMPUS Project BioEMIS (2013) [online] Bioengineering and Medical Informatics degree programmes in the West Balkans, Available at: http://www.birmingham.ac.uk/Documents/collegeeps/bioemis/12AnalysisandreportonexistingBEMIinWB.pdf [5] Biomedical Signals and Systems, Master Study Programme in EE, Automatic Control and Electronics [online] Faculty of Electrical Engineering, University of Sarajevo, Available at: http://www.etf.unsa.ba/courses/index.en.php?id=461 [6] Computer Algorithms in Bioinformatics, Master Study Programme in EE, Computing and Informatics [online] Faculty of Electrical Engineering, University of Sarajevo, Available at: http://www.etf.unsa.ba/courses/index.en.php?id=449 [7] G. Devedžić et al, “Developing curriculum in bioengineering and medical informatics at Western Balkan Universities,” Embedded Computing (MECO), 2013 2nd Mediterranean Conference on, 15-20 June 2013, Budva, Montenegro, pp. 274 - 279 [8] S. Avdaković, I.Omerhodžić, A.Badnjević, D.Bošković, “Diagnosis of epilepsy from EEG signals using global wavelet power spectrum,” 6th European Conference of the International Federation for Medical and Biological Engineering, IFMBE Proceedings Volume 45, Springer, 2015, pp. 481-484 [9] J. Smailović, Z. Babić, V. Risojević, “Iris segmentation”, The X Symposium INFOTEH-Jahorina 2010, Vol. 9, Ref. E-II-4, pp. 510-514 [10] A. Šećerbegović, A. Mujčić, N. Suljanović, M. Nurkić, J. Tasič: "The research mHealth platform for ECG monitoring", 11th International Conference on Telecommunications CONTEL 2011, June 15–17, 2011, Graz, Austria, pp. 103-108 [11] D. Bosković, Z. Avdagić, I. Bešić, “Object-oriented integrated approach for the design of scalable ECG systems,” Medical Informatics in a

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