Maybe you can teach an old dog new tricks after all

It is springtime, the semester is over, and my garden is coming up.

All things considered, the class Transcontinental Design for Uganda was a success because the students on both sides of the Atlantic had positive experiences. In some cases the class may have even been transformative. Fortunately, the 10 students in my class were mostly predisposed to the difficulties that we encountered.  This was a great group of students that seemed to bond pretty tightly and even came over to my house for a class dinner, which was a first for me.

While all of the Duke students have offered to stay in touch with their Makerere teammates, by my count only four of the projects from this semester will continue over the summer and into the fall.

Wireless neonatal oximeters: Siji Oluwadara and Team Biosievers

Urine test strips for pre-esclampia and esclampia: Denali Dahl and Team Aero-Tech

Solar-powered mosquito traps: Jerrod Brown, Happy Ghosh and Team Dynatech

Infrared vein locators: Maitreyee Mittal and Team Sentim-Tech

In the student’s final report I asked for feedback, both positive and negative. Here is my laundry list that I aim to fix the next time around.

Work in teams.  It seems universal that the students would have preferred to work in teams rather than being assigned individually to each Makerere design group.  Many students said that much of their frustration centered on not having someone to bounce ideas and strategies off of. This often led to indecision and thus stagnation. One suggestion that I liked was pairing each BME undergrad with a MS student since the class is intended to be comprised of half of each.

Use the beginning of the semester more strategically. The Duke spring semester begins a good three weeks before Makerere classes start at the beginning of February.  This time was largely spent on reviewing the projects in the state that the Makerere students had left them at the end of the previous semester, with the plan of the Duke students picking up where the Makerere students left off.  There were two things wrong with this arrangement.  First, we were not given (nor did I ask for) the final reports on the Makerere design projects.  We only had brief problem statements from each Makerere group to work with.  Next time I’m asking for the final reports that in most cases were quite detailed.  Second, we need to be more hard-nosed about triaging projects to eliminate those that we do not want to move forward with. At least four of the 10 projects that we examined really had no legitimate basis for a semester long project.  Unfortunately only one of these four was eliminated.  Much of this was my fault because two projects that we should have dropped were electrical in nature and I had really no idea whether or not they were doable.  The other one we should have dropped on medical waste worker protection just never coalesced.

Rethink early lectures on design and circumstances in Uganda.  I spent way too much time on generic discussions of design and life in Uganda, and should have spent more class time on prioritizing the feasibility of the various projects coming out of Makerere.  I also need to learn more on human-centered design and designing for scarcity.  Honestly, I knew virtually nothing about teaching design going into the class and now at least know what I don’t know.  Karrie Stewart from Global Health is also going to  provide a two week module early in the semester on developing cultural competency for Uganda that will help tremendously.  The way that I structured discussions of the assigned reading also was too contrived and I need to promote a more free flowing discussion.  Perhaps I’ll assign broader expectations ahead of reading assignment and let the discussion evolve.

Communication was a persistent irritation for most.  Some of the Makerere groups were quite forthcoming about communicating with their Duke student partners, while other Makerere groups never were able to make the communication piece work.  While we are going to improve the communication infrastructure at Makerere by setting up a video conferencing facility (if we get the Bass Connections money), a lot of this was simply unwillingness to make the effort.  Next spring term Kenneth Rubango and Henry Kiwumulo will be here from Makerere as MS students and I am expecting them to help cut through the communication haze.

Bring in experts earlier and more often.  I asked Bob Malkin and Mark Palmeri, two BME experts in medical instrumentation at Duke, to discuss projects with my students.  In both cases the experience was very positive and well received.  While Bob came in early in the semester to discuss global health design, Mark did not provide input until after the midterm to review the instrumentation-based projects.  Having Mark come in late was a mistake.  I also need to reach out to more experts that I can bring into the class.

Allow more time for brainstorming.  Only after Spring Break did I open the class up to presentations and student feedback on projects.  I’m thinking that once we have decided on the projects that will be going forward, and once the Makerere students are back in session, I will need to designate at least one day a week for brainstorming and class discussion.

Require the spring break trip to Uganda.  Each of the students that went to Uganda felt that that experience was crucial in being able to communicate with their Makerere counterparts and to appreciate the circumstance in Kampala.  I was reluctant to do this the first time around but am now fully prepared to require it.  I’m going to have to be up front that this is going to cost each student $2000 for airfare that either comes out of pocket or from financial aid for those that have it.

Be more intentional about avoiding the student advisor role. One of the hardest aspects of this class was avoiding the tendency of taking on an advisorship role. I think it will be important during the triage process to identify those projects with the potential for the Duke students to directly participate in the hands-on design process. The four projects that will be continuing beyond this semester have each had a clearly defined design role for the Duke students involved.

Picture and Post by Dr. Monty Reichert

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