As someone who has been teaching undergraduates and supervising research students for the last 50 years, first in Mechanical Engineering and latterly in Biomedical Engineering, I think I am pretty well placed to write a few things on what I feel is still the gap that can be bridged, or the potential that can be realised, by university policymakers.
World’s most integrated interfaces between human and machine
For the first time, people with arm amputations can experience sensations of touch in a mind-controlled arm prosthesis that they use in everyday life. This is a new concept for artificial limbs called neuromusculoskeletal prostheses – as they are connected to the user's nerves, muscles and skeleton. Photo: iStock
FROM MECHANICAL TO BIOMEDICAL ENGINEERING
For most of us, our outlook of the world is shaped by our personal experiences of life. I spent just over seven years (from 1963 to 1971) at Imperial College, a research university in London, where I obtained my Bachelor, Masters and Ph.D. degrees in Mechanical Engineering. On my return, I joined the Mechanical Engineering department of the University of Malaya.
During my early years at the University of Malaya, I was fortunate enough to be sponsored by the International Development & Research of Canada (IDRC) to lead a team to design and develop a novel PVC handpump for the less-developed world. It was adopted for implementation in more than ten developing countries. Those were my ‘formative’ years in inventions and innovations and that was when I learned not only to work with researchers from other disciplines in problem solving, but also about the impact of engineering on basic human health – the importance of clean water, especially to the vulnerable poor.
Medicine and Engineering are usually the two schools that most big universities will have all over the world. They, understandably, are run quite independently of each other in most universities. There are few collaborations in terms of teaching or research. Yet in life, they are so dependent on each other for advancements – the engineering in the practice of medical imaging, audiology, orthopedics, and so on. To me, much more can actually be achieved if the collaboration were to start at the undergraduate level, than during the breakthroughs at commercial level.
When some colleagues from the Medical faculty approached me to collaborate on some projects, I began to realise how distant we were in terms of the knowledge sharing and expansion domains.
3D printing for Biomedical Engineering
3D printing makes it possible to create anatomical structures that are compatible with the body. 3D-printed cranial, jaw or facial implants offer a more precise fit and higher sucess rate for patients at lower cost. Bioprinting human organs is now also a reality. It is estimated that 900,000 deaths each year could be prevented using engineered organs. Source: www.imaginarium.io
Much more can actually be achieved if the collaboration [of Medicine and Engineering] were to start at the undergraduate level, than during the breakthroughs at commercial level.
Through this collaboration, we developed external fixators for bone transport for treatment of tibial fractures and for the correction of fixed flexion deformity of fingers. Both the faculties were happy to “brag” about the outcome of this collaboration. In a region where vehicular accidents are outrageously common, there are so many devices that engineers can help to design to ease discomforts experienced by orthopedic patients, if they only had a chance to discuss them with doctors and patients. But if there are no processes to advance this, status quo will always be the order of the day. You can always see patients agonising over their conditions each time you step into an orthopedic ward. The sad thing is, few universities have made an effort to bridge this engineering and medicine gap.
Another case in point: one day a Medical colleague showed us a rudimentary artificial hand. I told her that we could help develop a more intelligent hand that can be activated by nerves or brain signals. That led us to the study of the brain-computer interface to control prosthesis and other devices. (The brain-computer interface is the study of different types of brain signals and the use of artificial intelligence to correlate the brain signals with the intent of the subject.) This work prompted us to ask how the brain signals were being generated by the brain cells. As a result, we conducted a parallel study in the field of neuroscience where some of our research students cultivated brain cells and observed the electrical bursts by brain cells as they formed networks. Later, we suggested a model to explain the role of neuron-glia interactions in the emergence of ultra-slow oscillations.
The above shows how interactions between Engineering and Medical colleagues could encourage multidisciplinary research.
THE ESSENTIALS OF A BIOMEDICAL ENGINEERING COURSE
A department of Biomedical Engineering was subsequently formed within the Engineering Faculty to teach an undergraduate course. The four-year course consists essentially of components of Mechanical and Electrical Engineering, and biological subjects like Biochemistry, Anatomy and Physiology. It also covers many other topics that are of interest to the medical profession, including bioinstrumentation, biomaterials, biomechanics, orthotics and prosthetics, and implants, with the view that graduates of Biomedical Engineering can work as colleagues with medical clinicians in hospitals. To encourage interaction between students and Medical colleagues, Biomedical students are required to spend at least one afternoon every week during a full semester in the third year with a Medical lecturer in a clinical environment. There is also the opportunity for academic staff of the Biomedical Engineering department and the Faculty of Medicine to collaborate in research on a whole range of multidisciplinary subjects of mutual interests.
One of the fruits of the collaborative research is that a couple of staff of the Biomedical Engineering department founded a company that is based at the university’s teaching hospital, to design, construct and install orthotics and prosthetics for patients who need them.
TEACHING VERSUS MAKING STUDENTS LEARN THROUGH THINKING
Most universities in the developed world are now classified into research and teaching universities, where the better students usually end up in the former and the less academically accomplished students in the latter. Be that as it may, for some countries there are also other socio-economic factors to consider, such as racial quotas, political needs, and so on, and the circumstances may not allow this ‘course of nature’ to happen. In any case, some universities will always be more competitive than others. So, the research-teaching university-type differentiation will also exist.
In the research universities, staff-student contact hours are fewer. This encourages the better students to figure things out for themselves rather than being coached to solve problems. This approach was also advocated by a group of the UK’s Council of Engineering professors who visited us some years ago. Their first observation was that we had too many staff-student contact hours, and we were advised to reduce them to allow time for students to think.
Healthcare’s hidden heroes
With the hugely increased demand for intensive care ventilators and patient monitoring equipment during COVID-19, biomedical engineers have become a vital link in coordinating supply chains of life-saving medical technology in hospitals, making sure every piece of equipment is working at its best. Photo: Shutterstock
Having taught in the region for more than 50 years, I cannot help feeling a little uneasy about the general quality of the graduates we are now churning out. There is simply too much teaching in our institutions. Students also come in hoping to be ‘taught’ in their learning journey. Many enrol not because they love the course but, rather, see it (or have been prompted by parents to see it) as a means of preparing oneself for a career in a certain profession. Our systems are also too rigid and examination-oriented. Education systems should cultivate innovative thinking, hence the rarity of seeing the likes of Bill Gates or Steve Jobs in our part of the world.
Nonetheless and generally speaking, though, the better students are usually more adaptive. Some will fulfil just the minimum class requirements and devote much of their time and effort to pursuing things that interest them instead. (There are always exceptions to the rule, though.) With this caveat, the majority of the better students are able to adapt to overcome deficiencies in teaching. In private universities, the range of capabilities of the students in the same class is even wider. Teaching such a class is challenging. But, again, the better students are very adaptive. It is still up to the lecturer to bring the best out of the better students. The proof is that I have had excellent graduates who are comparable with the best from research universities overseas, their apparent lack of status in this university-ranking world notwithstanding. University teachers must not generalise too much; instead, they should help bring out students’ potentials.
In postgraduate research, it is a one-to-one situation. It is up to the lecturer to challenge the student to stretch his or her own limits. Because of the culture in the region, research students here tend to complain if they are left very much to their own devices. Many successful ones would later agree that this was actually a good way to bring the best out of them.
An excellent combination in such a system would be an undergraduate degree in Biomedical Engineering followed by the Medical degree programme.
THE NEED TO GO ‘BEYOND CONVENTION’
Engineering is one discipline of learning that requires a great deal of critical thinking, essentially how to mathematically and physically make things work. A friend who lectured in Biomedical Engineering in a constituent college at the University of London related a story about having a class of third-year Medical students, who were for the first time, required as part of their course to attend one of his modules in Biomedical Engineering. The Medical students told him that it was the first time that they had been asked to think! It now appears, to him, at least, the Medical course at the undergraduate level is basically and overwhelmingly designed to impart knowledge; his short stint in Biomedical Engineering prompted him to exercise thinking skills in other dimensions.
Maybe it is time for the medical schools in the region to recognise the strengths of the medical training that is being practised in America (and increasingly adopted by more outward-looking universities elsewhere). The American system requires enrolling students to have completed an undergraduate degree programme, whereas in Malaysia and most Commonwealth countries, we basically follow a British-type five-year Medical degree programme with entry straight from pre-university or A-level classes. Such a path allows Medical students to understand education and learning in a more holistic context. In my opinion, an excellent combination in such a system would be an undergraduate degree in Biomedical Engineering followed by the Medical degree programme. Law is already being taught as a graduate degree in the US and universities in many other countries.
SOME FOOD FOR THOUGHT FOR UNIVERSITY POLICYMAKERS IN THE REGION
I left the University of Malaya – after 34 years – to join Universiti Tunku Abdul Rahman (UTAR), a not-for-profit private university founded through donations from the community. I am still teaching there, albeit on a ‘flexy scheme’ (part-time basis) for the last few years. Just as I have benefitted greatly from the excellent teachers that I have had the fortune to meet, I hope, in a small way, that I, too, have contributed to the development of my former students to become better engineers, researchers and good human beings.
Many universities have tall visions, usually hatched when they open. But, in reality, few of these visions are being pursued as a matter of great conviction. University presidents and vice chancellors are increasingly pressured to ‘manage’ their universities to stay high or to start climbing in the scores put up yearly by the various ranking bodies, even though most know that their bases are not entirely objective. Key performance indicators are therefore structured – usually by administrators who hardly know the nitty-gritty of the discipline – to make lecturers and professors deliver in the manner corresponding to how these ranking bodies evaluate. Ministries of Education must first and foremost realise that universities are institutions that help a nation build and expand its knowledge and skills pool. Learning must be the ultimate goal.
PROF DATO’ DR GOH SING YAU
Prof Dato' Dr Goh Sing Yau studied Mechanical Engineering at Imperial College of Science and Technology, London University, where he obtained his Bachelor’s, Master’s and Ph.D. degrees. He taught at the University of Malaya as a Professor of Mechanical Engineering and a Professor of Biomedical Engineering. After his retirement in 2005, he joined Universiti Tunku Abdul Rahman where he is still supervising Ph.D. students. His current interest is in Direct Brain-Computer Communication for neuro-prostheses.
Prof Goh is a Fellow of the Academy of Sciences Malaysia. He was also a Fellow of the Institution of Mechanical Engineers UK and a recipient of the Tun Abdul Razak National Award. Prof Goh was the Chairman of the Malaysian Industries Standards Committee for Mechanical Engineering and a consultant to the International Development Research Centre, Canada.
MARCH 2022 | COMMEMORATIVE ISSUE
Healthcare and Education for Asian Development