BINF G4011 - Acculturation to Medicine and Clinical Informatics

Course Description: This course offers an introduction to the practice and culture of medicine for informaticians using a mix of lectures, case-based discussions, and critical review of scientific journal articles. The goal is to “acculturate” students without clinical backgrounds to the practice of medicine to inform the study and design of clinical information systems. Each class session will be structured to touch upon items from one or more of 3 key competency areas: biomedical science, clinical workflow and culture, and clinical informatics. Students will learn about medical language and terminology; basic anatomy and physiology; introductory pathology and pathophysiology; the process of medical decision-making; patient safety, medication safety, and health IT; telemedicine; and the flow of information in the practice of medicine.


Sivan Kinberg, MD, MS, MA

Teaching Assistant

Harry Reyes, MAS

Class Schedule

Classes meet Mondays from 10 am - 12 pm. In-person classes are held at VEC 1402 & 1403; remote classes are held via Zoom.

Prerequisites: None required. The course is open to graduate students as well as undergraduates. The course does not involve computer programming.

Course Requirements and Grading: Attendance to all class sessions is required unless otherwise pre-approved. Grading is based on class participation (20%), book report and presentation (20%), telehealth-based physician shadowing report and presentation (20%), and final presentation (40%).

Academic Integrity: Columbia’s intellectual community relies on academic integrity and responsibility as the cornerstone of its work. Graduate students are expected to exhibit the highest level of personal and academic honesty as they engage in scholarly discourse and research. In practical terms, you must be responsible for the full and accurate attribution of the ideas of others in all of your research papers and projects; you must be honest when taking your examinations; you must always submit your own work and not that of another student, scholar, or internet source.

Graduate students are responsible for knowing and correctly utilizing referencing and bibliographical guidelines. When in doubt, consult your professor. Citation and plagiarism prevention resources can be found at the GSAS page on Academic Integrity and Responsible Conduct of Research (

Failure to observe these rules of conduct will have serious academic consequences, up to and including dismissal from the university. If a faculty member suspects a breach of academic honesty, appropriate investigative and disciplinary action will be taken following Dean’s Discipline procedures (

Your grade should reflect your own work. If you believe you are going to have trouble completing an assignment, please talk to the instructor or TA in advance of the due date.


Journal Article Readings (weekly)
Students will be assigned journal articles to read and discuss during class. Students are not required to provide a formal write-up but are expected to consider the following questions when preparing for class discussion:
1. Significance: What is the significance of this study? Does it address a significant challenge to biomedical informatics (even though it is not written specifically to that audience)? How did the authors justify the significance? What is the important question the authors are attempting to answer?
2. Innovation: What is different about this study relative to other studies that were mentioned? How is this study innovative? What knowledge does the paper add to what is already known?
3. Approach: How did the authors answer the question? What specific question is being answered? What other ways were suggested that could be used to answer the question? What research design was used? What statistical tests were used?
4. Quality: What were the challenges faced by the research? What weaknesses were identified? How were those weaknesses addressed?
5. Future work: What questions remain unanswered by this study? What other studies are suggested that would assist in answering the broader questions presented?

Medical Abbreviations Exercise (Due: Oct 26, 2020)
Students will be asked to complete a spreadsheet of abbreviations by providing both the full unabbreviated term and the essential meaning of each abbreviation. Each student should complete and submit the assignment individually. The medical abbreviations exercise will be graded on a pass/fail basis.

Book Report and Presentation (Due: Nov 9, 2020)
Students will provide a short report and presentation on one of the books listed below. Each student will select a different book from the list. Students should email their top 3 choices to the TA by 10/05/20. If a student would like to choose a book not listed, it must first be approved by the course instructor.

Book List
1. The Checklist Manifesto by Atul Gawande
2. Complications by Atul Gawande
3. Being Mortal: Medicine and What Matters in the End by Atul Gawande
4. Better: A Surgeon’s Notes on Performance by Atul Gawande
5. The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age by
Robert Wachter
6. How Doctors Think by Jerome Groopman
7. Five Days at Memorial by Sheri Fink
8. The House of God by Samuel Shem
9. When Breath Becomes Air by Paul Kalanithi

1) Report (1-2 pages, single-spaced)

a) Brief summary of the book
b) One finding that confirmed student’s expectations
c) One finding that surprised student
d) One clinical informatics solution you would like to develop to address a problem you observed (comment specifically on study design, implementation, and evaluation)

2) Presentation:

a) 10-minute presentation on the same components described above followed by 5 minutes of questions & answers
b) Upload slides by 9:00 AM before class
* For grading purposes, we recommend students clearly label the 4 criteria noted above in both their presentations and their papers

Shadowing Report and Presentation (Tentatively Due: Nov 30, 2020)*

Students will have 2 separate shadowing experiences. Due to the COVID-19 pandemic, we are not able to do in person shadowing at this time. If this changes as the semester progresses, we will notify the students and have in person shadowing be an optional experience. Students will shadow NYP/CUMC clinicians remotely while they conduct telehealth visits. Afterwards, students will provide a short report and presentation on their experience. Clinician assignments will be arranged by the course instructor and TA.

1) Report (1-2 pages, single-spaced)
a) Brief summary of experience including the specialty of the person shadowed and details about that specialty
b) Finding(s) during shadowing experience that confirmed student’s expectations.
c) Finding(s) from shadowing experience that surprised student.
d) One clinical informatics solution to solve a problem observed during the shadowing experience. Comment specifically on study design, implementation and evaluation.

2) Presentation
a) 10-minute presentation on the same components described above followed by 5 minutes of questions & answers
b) Upload slides by 9:00 AM before class
* For grading purposes, we recommend students clearly label the 4 criteria noted above in both their presentations and their papers

Final Presentation (Date: Monday 12/21/20 9:00AM-12:00 PM)
Students will select and research a disease or acute medical problem of their choosing that would result in the hospitalization of a patient (the topic chosen must be different than one presented in class during the semester). Students will then create a History and Physical for a fictitious patient with this disease or acute medical problem. As part of the final presentation, students are required to teach one Area I (Biomedical Science) point and one Area II (Clinical Workflow and Culture) point related to the chosen topic. Students are also required to either choose an existing paper that covers the topic (preferably a randomized controlled trial) OR propose an intervention/study design to address an issue relevant to the topic (using at least 2 references to support the need/importance of the research proposed).

Each student will provide a 15-minute presentation followed by 5 minutes of questions & answers (20 minutes total per student). Slides should be prepared according to the skeleton below (please follow exactly) and uploaded by 9:00 AM prior to the start of class.

Final Presentation Slide Skeleton (Total max slides: 17)
Title Slide (1 slide max)
   o Title of presentation
   o Student name
Case (4 slides max; 30 points)
   o History (including CC, HPI, PMHx, PSHx, All, Meds, Family Hx, Social Hx, ROS)
   o Physical Exam
   o Assessment & Plan
   o Clinical course, as appropriate
Area I lesson (3 slides max; 20 points)
Area II lesson (3 slides max; 20 points)
Study Proposal or Description of Paper
Background with references (2 slides max; 10 points)
Specific Aims/Hypotheses (2 slides max; 10 points)
Methods & Evaluation (2 slides max; 10 points)

Schedule and Readings

19/14Course Introduction
29/21Hospital Admission – An Acute MI• Bailey TC, Noirot LA, Blickensderfer A, Rachmiel E, Schaiff R, Kessels A, et al. An Intervention to
Improve Secondary Prevention of Coronary Heart Disease. Arch Intern Med. 2007 Mar 26;167(6):586.
• (Optional) Karunathilake SP, Ganegoda GU. Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. BioMed Research International. 2018;2018:1–9.
39/28Yom Kippur (no class)• No readings
410/5Management of Hypertensive Patient• Montgomery AA. Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial. BMJ. 2000 Mar 11;320(7236):686–90.
• Brady TM, Neu AM, Miller ER, Appel LJ, Siberry GK, Solomon BS. Real-Time Electronic Medical
Record Alerts Increase High Blood Pressure Recognition in Children. Clin Pediatr (Phila). 2015 Jun;54(7):667–75.
• (Optional) Kharbanda EO, Asche SE, Sinaiko AR, Ekstrom HL, Nordin JD, Sherwood NE, et al. Clinical Decision Support for Recognition and Management of Hypertension: A Randomized Trial. Pediatrics. 2018 Feb;141(2):e20172954.
510/12Specialists and
Coordination of Care
• Bates DW. Getting in Step: Electronic Health Records and their Role in Care Coordination. J Gen Intern Med. 2010 Mar;25(3):174–6.
• Bates DW. Health Information Technology and Care Coordination: The Next Big Opportunity for
Informatics? Yearb Med Inform. 2015 Aug;24(01):11–4.
• O’Malley AS, Grossman JM, Cohen GR, Kemper NM, Pham HH. Are Electronic Medical Records Helpful for Care Coordination? Experiences of Physician Practices. J Gen Intern Med. 2010 Mar;25(3):177–85.
• (Optional) Bates DW, Bitton A. The Future Of Health Information Technology In The Patient-Centered Medical Home. Health Affairs. 2010 Apr;29(4):614–21.
610/19Patient with GI Bleed
and Handoffs
• Starmer AJ, Spector ND, Srivastava R, West DC, Rosenbluth G, Allen AD, et al. Changes in Medical Errors after Implementation of a Handoff Program. N Engl J Med. 2014 Nov 6;371(19):1803–12.
+ (for reference) Appendix
• Vawdrey DK, Stein DM, Fred MR, Bostwick SB, Stetson PD. Implementation of a Computerized
Patient Handoff Application. :6.
• (For Reference) Riesenberg LA, Leitzsch J, Little BW. Systematic Review of Handoff Mnemonics Literature. Am J Med Qual. 2009 May;24(3):196–204.
710/26Telemedicine• Assignment Due: Medical Abbreviations Exercise
• Dorsey ER, Topol EJ. State of Telehealth. Campion EW, editor. N Engl J Med. 2016 Jul
• Alexander GL, Powell KR, Deroche CB. An evaluation of telehealth expansion in U.S. nursing homes. JAMIA. 2021 Feb 15;28(2):342–8.
• Khoong EC, Butler BA, Mesina O, Su G, DeFries TB, Nijagal M, et al. Patient interest in and
barriers to telemedicine video visits in a multilingual urban safety-net system. JAMIA. 2021 Feb 15;28(2):349–53.
• Dixon RF, Rao L. Asynchronous Virtual Visits for the Follow-Up of Chronic Conditions. Telemedicine and e-Health. 2014 Jul;20(7):669– 72.
• (Optional) Mehrotra A, Paone S, Martich GD, Albert SM, Shevchik GJ. Characteristics of Patients Who Seek Care via eVisits Instead of Office Visits. Telemedicine and e-Health. 2013 Jul;19(7):515–9.
811/2University Holiday (no class)• No readings
911/9Book Report Presentations• Assignment due: Book Report Paper
• No readings
1011/16AMIA Symposium (no class)• No readings
1111/23Health IT Safety• Committee on Patient Safety and Health Information Technology, Institute of Medicine.
Health IT and Patient Safety: Building Safer Systems for Better Care [Internet]. Washington
(DC): National Academies Press (US); 2011 [cited 2020 Apr 3]. Available from:
• Adelman JS, Kalkut GE, Schechter CB, Weiss JM, Berger MA, Reissman SH, et al. Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. J Am Med Inform Assoc. 2013 Mar;20(2):305–10.
• To Err Is Human: Building A Safer Health System
1211/30Shadowing Presentations• Assignment Due: Shadowing Paper
• No readings
1312/7Pediatric ICU Guest Lecture: Katherine Schlosser• No readings
1412/14Health Equity Guest Lecture: Harry Reyes Nieva• Brewer L, Fortuna K, Jones C, Walker R, Hayes S, Patten C, Cooper L. Back to the Future:
Achieving Health Equity Through Health Informatics and Digital Health. JMIR Mhealth Uhealth 2020;8(1):e14512
• Veinot TC, Ancker JS, Bakken S. Health informatics and health equity: improving our reach and impact. Journal of the American Medical Informatics Association. 2019 Aug 1;26(8–9):689–95.
• Chaplin B, Meloni S, Eisen G, Jolayemi T, Banigbe B, Adeola J, Wen C, Reyes Nieva H, Chang C, Okonkwo P, Kanki P. Scale-up of networked HIV treatment in Nigeria: creation of an integrated electronic medical records system. Int J Med Inform. 2015 Jan; 84(1):58-68.
• Ali NB, Reyes Nieva H, Percac-Lima S, Shields HM, Linder JA, Yusuf Osman N. Health Care Use by Muslim Patients During Ramadan. J Health Care Poor Underserved. 2019;30(4):1360-1372.
1512/21Final Presentations• No readings