At a Glance

SUBJECT

Technical Services Partnership at the University of Vermont

LOCATION

Burlington, VT

SIZE

34 hospitals and several hundred clinics

STAFF

Project team of six biomedical equipment technicians, four biomed service supervisors, three clinical engineers, and three global interns

Promoting diversity and inclusion is a central tenet driving excellence at the University of Vermont. The Technical Services Partnership at the University of Vermont (TSP-UVM) in Burlington, VT, has supported healthcare technology management (HTM) in the developing world for nearly 30 years. Based on its history and contributions, TSP-UVM became a World Health Organization (WHO) Collaborating Center for HTM in August 2017—the only WHO Collaborating Center in the United States with a focus on health technology.

Challenge

Although recognized as progressive, Vermont is a rural, aging state with a small population and limited diversity. Staff interaction with diverse populations is limited to the healthcare delivery organizations (HDOs) served by TSP-UVM in Vermont, New Hampshire, Maine, and upstate New York.

“With this in mind, we set forth an initiative to not only provide international outreach but also improve TSP-UVM staff's awareness of other cultures, racial and ethnic backgrounds, and the value of global engagement,” said Michael W. Lane, director of TSP-UVM.

The TSP-UVM team chose the department's internship program as one vehicle to promote engagement with individuals from diverse backgrounds. For nearly 30 years, their internship program has provided critical work experience to biomedical engineering and technology students in the United States. The plan was to expand the internship program's reach to HTM students outside the U.S.

“TSP's international expansion started in the early 2000s when we received a grant from the Pan American Health Organization's (PAHO's) foundation to develop bilingual biomedical equipment technician (BMET) and HTM online courses,” said Tobey Clark, engineering supervisor at TSP-UVM and codirector of the WHO Collaborating Center for HTM. The classes have since been taken by more than 1,200 students from 40 countries.

“From the work funded by the PAHO grant, we were able to develop partnerships with universities in Colombia and Peru. These partnerships gave us the opportunity to expand our internship program in 2006 to include a global exchange that would provide training opportunities for engineering students from Peru and Colombia,” said Clark.

“And in 2017, when we were designated a WHO Collaboration Center for HTM, we were able to bring in more countries to our global internship program,” said Clark.

Paige Hamilton (left), a biomedical engineering student at UVM, and global intern Vadisha Peru, a biomedical engineering technology student from the University of West Indies in Trinidad and Tobago, repair a Dräger ventilator.

Paige Hamilton (left), a biomedical engineering student at UVM, and global intern Vadisha Peru, a biomedical engineering technology student from the University of West Indies in Trinidad and Tobago, repair a Dräger ventilator.

Solution

The global internship program at TSP-UVM begins with a three-week onboarding and training period. During this time, the interns interact with TSP-UVM's clinical engineers, BMETs, and department leads Lane and Clark. After passing a learning assessment, the interns are paid to work with their mentors servicing the UVM Medical Center and supporting the HTM team for HDOs in Vermont that are serviced by TSP-UVM.

The interns participate in a wide variety of tasks through the program, including preventive maintenance and inspections, repairs, and installations of medical devices and equipment alongside their mentors. They also conduct research and database analysis related to TSP-UVM's engineering consultation services and support work for the TSP-UVM WHO Collaborating Center for HTM.

The interns are either in or graduates of biomedical engineering technology or biomedical/clinical engineering programs. “The biomedical engineering technology interns spend more time with the equipment, and the biomedical engineering interns are more focused on research and analysis projects,” said Clark. The TSP-UVM global internship program takes interns on a rolling basis and typically has three to four interns each year.

One of 2020's global interns, Julian Pinzon, a fifth-year biomedical engineering student from the School of Engineering of Antioquia in Medellín, Colombia, said that “with the support of the clinical engineers and the BMETs, it's been quite easy for me to adapt here.”

“The healthcare system here in the U.S. is very different from Colombia,” he added. “Learning about it has been fun and challenging. I've been learning a lot of things that I might put into practice in my country to improve the system there.”

In fact, certain knowledge gained by Pinzon is directly applicable to situations he's encountered in Colombia. For example, his internship involved interfacing with infusion pumps. “We have the same infusion pumps in Colombia, so it was practical to learn how to do the software updates and other maintenance tasks,” he said.

TSP-UVM Clinical Engineer Robert Painter (left) with Global Intern Julian Pinzon, a biomedical engineering student from the School of Engineering of Antioquia in Medellín, Colombia.

TSP-UVM Clinical Engineer Robert Painter (left) with Global Intern Julian Pinzon, a biomedical engineering student from the School of Engineering of Antioquia in Medellín, Colombia.

Pinzon also is working on several data analytics projects, including a re-evaluation of the alternative equipment maintenance program, report development, and data cleansing.

Vadisha Peru and Matthew Tung from the University of the West Indies, St. Augustine, Trinidad and Tobago campus, also participated in the global internship program for 2020. Peru and Tung have biomedical engineering technology degrees, and their training at TSP-UVM has been focused on medical equipment quality assurance and service.

The global internship program has, for the most part, run smoothly for the past 14 years. “One of the challenges with the interns and mentors is language,” said Leah Francoeur, a clinical engineer at TSP-UVM. “The interns speak English very well—certainly, their English is much better than my Spanish—but there are times when it is difficult to explain, for example, a piece of equipment or a regulation because it requires a very specific technical vocabulary.”

Francoeur added that the communication challenges usually are resolved very early in the program. She shared that the language barriers and differences in healthcare systems have given mentors the opportunity to look at U.S. regulations from a different perspective. “Having to explain why we do the things we do gives us a chance to reflect and see our work with different eyes,” she said.

Although the TSP team does not formally keep track of their global internship graduates, members do check in with their Vermont colleagues. “We never truly leave them alone,” joked Francoeur. “They are free to email us any time after their internship ends.”

Results

Since 2006, TSP-UVM has trained 47 HTM interns from Colombia, Peru, Argentina, Trinidad and Tobago, St. Vincent and the Grenadines, Dominican Republic, China, India, and Spain.

“There is a shortage of HTM professionals—not just in the small state of Vermont but across the globe. That's one reason that the global internship program at TSP has had such longevity,” explained Robert S. Painter, clinical engineer at TSP. “Through the program, we are working toward solving the problem.”

TSP-UVM Global Intern Matthew Tung, a biomedical engineering technology student from the University of West Indies in Trinidad and Tobago, repairs an infusion pump.

TSP-UVM Global Intern Matthew Tung, a biomedical engineering technology student from the University of West Indies in Trinidad and Tobago, repairs an infusion pump.

The TSP-UVM team said the positive results of this initiative go well beyond HTM services alone.

“The benefits that the international interns have brought to our staff and our UVM student workers have been immense: a global awareness, differing cultural and contextual perspectives, a strong sharing of knowledge to benefit the world, and lasting friendships. The quality educational experience of hands-on work, projects, and curriculum is at the heart of UVM's global internship program,” said Lane.

Conclusion and Next Steps

When asked about next steps for the global internship program, Clark paused before saying, “Well, the COVID-19 pandemic has certainly presented a challenge to ‘next steps' for the program, but the significance of viewing the world as a global community, accepting cultural differences, and working together is now more important than ever.”

Team members from TSP-UVM (left to right): Leah Francoeur, clinical engineer; Julian A. Pinzon, global intern from Medellín, Colombia; Robert Painter, clinical engineer; Michael W. Lane, TSP-UVM director; and Tobey Clark, engineering supervisor at TSP.

Team members from TSP-UVM (left to right): Leah Francoeur, clinical engineer; Julian A. Pinzon, global intern from Medellín, Colombia; Robert Painter, clinical engineer; Michael W. Lane, TSP-UVM director; and Tobey Clark, engineering supervisor at TSP.

Interns Peru and Tung finished their programs in mid-May but cannot go home because, at the time this article was written, the borders remained closed in response to the public health crisis.

“We've been fortunate,” said Clark, “in that Vadisha, Matthew, and Julian—who also is unable to go home—wanted to continue working with our staff to support the fight against the coronavirus.”

“I very much want to see this program continue,” added Painter. “These interns come hungry to learn new technologies and processes—and are equally eager to share their knowledge with us. I've really enjoyed working with all of them. The global interns are exceptional, and TSP-UVM continues to improve because of them.”

Resources

Author notes

Sarah Michaud is the former news editor at AAMI.