In this episode of the Global Medical Device Podcast, Etienne Nichols sits down with Dr. Matthew Wettergreen, Director of the Global Medical Innovation Master of Bioengineering program at Rice University. Dr. Wettergreen shares his extensive experience in developing client-based engineering design courses and discusses the importance of global and contextual perspectives in medical device innovation. They delve into the unique approaches of the Global Medical Innovation program, highlighting the critical role of diverse healthcare settings in shaping future medtech innovators.

Key Timestamps:

• [00:01:00] Introduction of Dr. Matthew Wettergreen and his background.
• [00:03:30] Overview of the Global Medical Innovation program at Rice University.
• [00:07:45] Importance of contextual and global perspectives in medical device innovation.
• [00:14:00] Experiences and lessons learned from Costa Rica’s healthcare system.
• [00:22:15] Discussing out-of-context healthcare settings in Brownsville, Texas.
• [00:30:00] Navigating healthcare hierarchies and observer bias in medical device innovation.
• [00:45:00] Differences between student learning processes and typical industry practices.
• [00:55:20] Practical tips for companies to broaden their medtech innovation perspectives.
• [01:05:30] Final thoughts on the importance of diverse lenses in medtech innovation.

Quotes:

1. "Understanding healthcare from a 360-degree view is important because it helps you to understand why those specific practices are done." - Dr. Matthew Wettergreen
2. "Our goal is to prepare students to enter the medtech industry in a range of jobs by simulating professional practice in diverse contexts." - Dr. Matthew Wettergreen
3. "Recognize that you're wearing a lens and train yourself to try and take off that lens and put on a new one." - Dr. Matthew Wettergreen

Key Takeaways:

Latest MedTech Trends:

1. The significance of global and contextual perspectives in medical device innovation.
2. The rising role of telemedicine in reaching low-income and underserved populations.
3. The importance of functional, cost-effective solutions in global healthcare settings.

Practical Tips for MedTech Enthusiasts:

1. Engage in clinical needs-finding activities to better understand the healthcare environment.
2. Encourage facilitated discussions and case studies within your organization.
3. Explore and appreciate diverse healthcare systems to innovate effectively.

Questions Predicting Future Developments:

1. How will telemedicine evolve to cater to the needs of the lowest SES populations?
2. What are the potential impacts of integrating global healthcare perspectives in local innovations?
3. How can medtech companies better prepare their employees to understand upstream and downstream processes?

References:

• Rice University's Global Medical Innovation Program
• Pumani CPAP Device
• Dr. Matthew Wettergreen on LinkedIn
• Etienne Nichols LinkedIn

MedTech 101:

• Telemedicine: Remote diagnosis and treatment of patients through telecommunications technology.
• Clinical Needs Finding: The process of observing and identifying unmet clinical needs in healthcare settings.
• Global Healthcare: Understanding and incorporating diverse healthcare systems and practices from around the world.

Questions for the Audience:

1. Audience Poll: What is the most significant challenge you face in medical device innovation? Email us your thoughts at podcast@greenlight.guru
2. Discussion Question: How do you think advancements in MedTech will transform healthcare in the next decade? Share your insights with us!

Feedback:

We value your feedback! Please leave a review on iTunes to help others find us. Reach out to us at podcast@greenlight.guru with suggestions for future topics.

Sponsors:

This episode is sponsored by Greenlight Guru. Greenlight Guru offers the only quality management system (QMS) and electronic data capture (EDC) software designed specifically for the medical device industry. Streamline your processes and ensure compliance with ease. Visit their website for a special offer for our listeners.

Dr. Matthew Wettergreen: I'm doing great. I'm here in Costa Rica with my graduate program, and it is a beautiful day.

Etienne Nichols: You were mentioned just a little bit about the. Was it vw bus on one of the levels of the buildings you're in. That sounds like a really cool spot that you're at.

Dr. Matthew Wettergreen: We've really enjoyed traveling to Costa Rica, both with my graduate program and with family and friends. One of the things that I like about Costa Rica is how is its natural beauty, which seems to be a key feature that is preserved. Another thing I like is the quality of the medicine down here, which we'll talk a little bit about today. But we're staying in one of the tallest buildings in the country, which has a beautiful co working space that I'm currently working in now.

Etienne Nichols: That's awesome. Well, I'm glad it's working out that we're able to record it while you're there. It's very cool. I wish that I could have flown down and we did this in person. Now I'm thinking about this a little bit late, but the way I was introduced to you was through one of your students, Ellie Reynolds. And she was just kind of a raving fan of the global medical device innovation curriculum. And I wonder if you could talk to us a little bit about that program. What inspired you to create that program and the curriculum that is contained within.

Dr. Matthew Wettergreen: Yeah, I'm excited to talk about this. So, I run a graduate program at Rice University called global medical innovation, and it's a one year professional masters non thesis. It's a one year experience where students work on a number of project based courses to explore a medical innovation process. And we do this at a number of contexts, local, global, and out of context. But the goal is to prepare students to enter the med tech industry in a range of jobs.

Etienne Nichols: How would you reflect on the goal being met? Maybe before we get into a few more nuances.

Dr. Matthew Wettergreen: Yeah. So the GMI program is a full year. Students start in May, and we go to Costa Rica, and then in the fall and the spring, they work in Houston, Texas, simulating professional practice. And so much of the professional practice that we simulate will show up when the students get a full time job. And so our outcomes are very pragmatically measured as job placement. And in our program, 85% of students have full time positions in medtech within six months post graduation. That's very high for a professional master's program, but we attribute it to a number of things, which, again, are very practical. So we work them in teams. They do projects that teach them the steps of medical device innovation. They have reports, presentations, design reviews. We use Greenlight guru for our ecosystem qMs. Students essentially work as if they're in a medical device company for a whole year while seeking a role in a medical device company.

Etienne Nichols: Yeah, I love that. And part of me. So I'm a little torn because I know the audience, not everybody listening to this will be able to take this, this course, for example. So I wonder if you could teach us a few things. One of the things I'm curious about is you mentioned Costa Rica, you mentioned Texas, a few of these different places. And I'm curious, why Costa Rica? And what have you learned from going there specifically?

Dr. Matthew Wettergreen: Yeah, that's a great question. I want to go a little back and explain more about these innovation programs in the United States. So there are just a handful of them right now. Georgia Tech has an excellent one. Johns Hopkins is the best one in the nation. Carnegie Mellon, Berkeley. These are all really good programs that teach a process of medical innovation for unmet clinical needs. And they all have their own flavor at rice, we believe that it's important to show students not just the process of medical innovation, but how to do it in different contexts and settings. And so our global medical innovation program is not about teaching individuals in high income countries how to go into low and middle income countries and develop solutions for unmet clinical needs. And it's also not about taking individuals from low and middle income countries and teaching them how to get jobs in the us medical technology, it is very much about teaching an innovation process and then showing different settings where the steps of that process have to be changed. Okay, we think about this like developing functional muscle response. So when you work out, you don't just deadlift for power, you might change up both the intensity and the variety of your exercises so that you actually have functional power rather than just raw power. And Costa Rica is the hub for our program's focus, and that's for a number of reasons. Costa Rica is the medical technology hub for Central America. It has almost 100 medical technology companies here that are either doing manufacturing or service and repair. It is a company which is a country which is welcoming to visitors, it is easy to navigate, and it has excellent education and excellent healthcare. So we bring our students here to see their universal public health care and understand that it is possible to achieve very high patient outcomes with a public healthcare setting mixed with a private setting. So the students see this global setting, and global is not euphemistic for low resource. Global is a middle income country that has excellent health outcomes and that changes their assumptions a little bit about what global healthcare is. Now, for me, if Im an American going to a different country to learn healthcare, I can go to the UK and I can learn about healthcare where outcomes are very good or if not better. I don't have to go somewhere where there's a delta to work on. Similarly, if somebody who's british wants to learn about global healthcare, they can go to the United States or Canada or Mexico. So we think about global healthcare as in context to your own local healthcare. And so for our students, global is Costa Rica.

Etienne Nichols: Awesome. So I've heard you use that phrase out of context versus out of country, which I think maybe some of us maybe immediately start to mention. And you've already kind of described what the difference is there. When I think about developing that medical device, it's a lot easier for me to think, okay, this surgeon in this country is going to do the same arthrosc arthroscopy procedure that they would do in the United States. But what is it about this out of country, if anything, that could potentially be different in how I innovate this medical device product. Is there any difference?

Dr. Matthew Wettergreen: Sure. Just because the arthro, just because the arthroscopic procedure is the same doesn't mean that anything that happens before or after is the same. And if you take a 360 view, you could talk about when knee problems emerge, who the primary caregiver is that is met with first, how long that takes, who pays, how long it takes to set that up, and then afterwards, what does physical therapy look like? What does long term care look like? So, best practices in treatment aren't just what we're looking at when we're seeing these experiences outside of the United States. And, in fact, when our students do needs finding in the United States, they do a variety of settings. And the first setting they do is a waiting room. They just go to a waiting room and they observe what's happening. Are people pensive? Are they pacing? Are they comfortable? Do they look like they understand what is going on? Is there a cue? Is there a physical cue that they're standing in? Are there numbers? Understanding healthcare from a 360 view is important because it helps you to understand why those specific practices are done. So, going back to one thing you mentioned, I really want your listeners to understand what we call lenses. And these lenses are what we use to see how to solve problems. And we use three different lenses. Our first lens is local. And for us, that is the Houston, Texas Medical Center. Texas Medical center is the largest medical center in the world. Hundreds of clinics and research institutions and hospitals, some of the best in the nation, if not the world. And our students see a healthcare setting that is driven by technology and best practices. They are able to see management of lifestyle diseases, as well as critical care. Theyre able to see world class cancer treatment. And its all in a setting of the United States. When they go to Costa Rica, the public healthcare system, Laca, theyre able to actually see what its like to basically go in and receive public health and also see these critical care conditions. And that helps our students to understand what it is like from the patient perspective, but also the doctor perspective, being paid by the government versus being paid by private insurance. And we have a third lens. And that third lens is what were calling in country, out of context. In country and out of context to us is in the same country where you are from. So for us, the United States, but it is a radically different situation than you are used to. So our students take this mentality of the high resource, high technology Texas Medical center, and we take them to Brownsville, Texas, which is south Texas, on the border of Matamoros, one of the poorest counties in the nation. And they are fundamentally shown a different system. In this setting, we have patients with many comorbidities, obesity, diabetes. Many of them don't have a smartphone and do not receive a regular doctor care. This is not a setting where more technology will improve patient outcomes. This is a setting where more public health and more upstream solutions will help with. With outcomes. So that looks like closing streets down to do the largest zumba class in the. In public, it looks like farmers markets. It looks like sending nurses to the homes of patients in order to provide the care that they need. And then it looks like educating family members about how to. To manage diabetes, how to look out for signs of stroke or heart attack. The technology is not the challenge in this situation. It's people and the setting and education. And so our students think they're going to go into the setting and design technology or design solutions to these unmet clinical needs that they're comfortable with. And what they see through meeting with the nutritionists, through Turing diabetic cancer care, through diabetic care, through seeing amputation surgeries, they realize they've got to do things differently.

Etienne Nichols: I can see definitely how the students are improving and changing and maybe evolving their innovation practices. How would you recommend companies approach this as well? So maybe this is a better question. How do your students plan to take this practice into their future careers as they develop medical devices?

Dr. Matthew Wettergreen: Yeah, what a great question. Because I'm thinking about, if you're listening now and you're working in medical devices, how can you do something that looks like in country, out of context? And what is that helpful for? Understanding the players in healthcare, not just that are around you and accessible, but exist in the healthcare aura, is really important. So we, as individuals working in medical technology, must make sure that we are striving to break our own bubbles. And that means challenging ourselves to. To break assumptions and to validate or refute our own assumptions about what healthcare looks like. We don't want our students to go into med devices and only do value engineering for solutions for low and middle income. We want them to know that it is important to understand the patient perspective, the provider perspective, the payer perspective, and that is fundamentally what is going to make the difference between a solution that works and a solution that can actually go to market and change lives. And that's why we're doing all this with the local, global, and out of context, and also teaching them this design process is that we want them to develop solutions that actually have a chance of going to market, not just clever solutions that use the, the best medical innovation process.

Etienne Nichols: Yeah, I'm curious, when I think about those situations where the person's actually in that setting, even sitting in the lobby, for example, is there any kind of, I can't remember the bias, but observer bias where you're going through and how do you kind of account for that?

Dr. Matthew Wettergreen: Yeah, we talk about a number of biases when we're doing needs finding. What I'm trying to say is that I hope that many companies have opportunities for lunch and learns where employees can do clinical needs finding, at least from a practice standpoint. So when our students go and do clinical needs finding, they write down all of their observations. They don't make conclusions. They don't jump into the solution space even though they want to, even though we all want to. They just write down what's happening. And then there's a sense making process that you go through where you sort out that observer bias, you sort out many other biases that might exist. And this is a collaborative process. And so others are checking your assumptions and your biases and asking why questions. And there's this why and how ladder of abstraction where you can say, well, why did this happen or how did this problem get solved? And you can just keep asking why and why and why. And that can get to the root of some of these observer biases.

Etienne Nichols: Very cool. What are some of the things that you've seen as students put on these multi lens approaches, the changes in their thinking?

Dr. Matthew Wettergreen: Yeah, that's an excellent question. It's not just the students. When we run workshops with faculty around the world as well, we see them also open their eyes to the fact that there are many different factors that need to be considered when, when solving problems. And what we see students doing and faculty is saying, timeout. Before we move forward, we need to talk to someone who is a cardiothoracic surgeon, or we need to talk to a nurse and ask what the problems with inserting a central line are. So we see them actually be mindful and reflective about some of the steps that they need to go through, and we see them make more defensible decisions. I say that a lot to my students. I don't care if you get the answer wrong. I just want to know that you thought through it and to understand how you thought through it. And we can go backwards to where you diverged as long as it was defensible.

Etienne Nichols: Yeah, there, there's a couple of things that we talked about when we first met to discuss this conversation or to kind of prep. Prep for this. And I miss. Said something, and I knew it as soon as it came out. But it's one of those examples of a. An assumption that maybe I don't want to just lump us all, all the Americans in one bucket, but just anybody. When you go out of country, there's this difference in potential level of care in your mind, and maybe that's a prideful thing. But can you address some of that assumption? And do you see that in students? And do you see that in people in the companies as they start approaching this out of country versus out of context change?

Dr. Matthew Wettergreen: Wow.

Etienne Nichols: What a.

Dr. Matthew Wettergreen: What a.

Etienne Nichols: What? Are you putting myself on the spot here?

Dr. Matthew Wettergreen: So you are. I know that you and I have. Have traveled internationally quite a bit. And when, um. When I travel internationally, it's predominantly to sub Saharan Africa. As part of the education team for Rice 360, which is Global health Institute out of rice, that has a number of thrusts that are developing technologies to save babies lives at birth. I'm part of the education team, and my role is to go into universities and to teach faculty how to start programs that look like engineering design programs, like the GMI program that I run, or like Rice University's Oshman engineering design kitchen. And in order to teach faculty how to do engineering design programs, we have to radically transform the way they think about how education is done. Shifting away from the british rote memorization system and into research supported best practices. And that means active learning. That means changing the role of the professor from somebody who's just yapping at the front to somebody who's surrounded by students, and everybody's engaged in a conversation together. That means team based work, not individual. It means giving students practice doing things. These are radical ideas. More radical than just that. Healthcare is the best in the United States, except it's not. And then you go to other countries, and it's hard for you to see that. Getting individuals to change behavior is hard, and it requires a mutually beneficial relationship. And so with students, with faculty, we enter into mutually beneficial partnerships, where it's not just that we're telling you something. We're learning together, we're sharing, and we're growing together. When you see healthcare in other countries, one of the first things you have to do is have humility and empathy and appreciation for how things work and remove the value judgment that is typically held by Americans that our healthcare is the best in the world.

Etienne Nichols: That's a good explanation. I want to go. You mentioned some of the different relationships in the healthcare system. And my wife has been a nurse, a critical care nurse, and she's actually done nursing overseas as well, in Malawi, Africa. And she's seen a few different settings in healthcare. And one of the things she mentions is the hierarchy, at least in the United States. I can't remember what she said about when she was in nursing, but the hierarchy within a hospital setting, and whether right or wrong, I'm not trying to be critical of it, because when a surgeon walks in, he's got to be in control of that room because he's about to do something incredibly serious things. And so when you are observing whatever. Whatever process you're observing and your students are observing, how do you recommend navigating those relationships? Are there any difficulties specific to that?

Dr. Matthew Wettergreen: The hierarchy and the power delta is such a peculiar situation, both in the United States and out of the United States. And luckily, students have this magic power because they're students. They can ask any human any question. And it is part of our cultural DNA in the United States, in Costa Rica, everywhere, that you must help a student. You must help a student learn. And so they're able to navigate this in a way that maybe you and I are not because of our specified hierarchical location. So students are able to ask nurses and doctors questions that can lead to trying to suss out this power delta, as well as continuum of care, in ways that you and I can't. And we try and leverage that as part of the GMI program. Students are, like, thrown out of the nest. We tell them that part of this program is about building connections and a network, because your network is going to ultimately decide the quality of your. Of your career. And so we teach them how to network. We teach them how to interact with individuals. We encourage them to go ask a stranger on LinkedIn to go out for coffee and, um, and. And talk to them for 15 minutes. And so our students, at least, learn how to successfully navigate that power Delta. Um, for you and I and for others in. In medical devices, I think coming to. Coming to a table with humility and, um. And respect, mutual respect is something that you can exude. And, um. And if. And if the. The other party or parties are not willing to reciprocate that you did your best.

Etienne Nichols: Humility always. It never seems to hurt anyway. And there's. There's a difference in being, uh, uh, humble about your knowledge and your curiosity and confident in your competence, I would say so.

Dr. Matthew Wettergreen: Well said. Yeah, absolutely. Um, yes, I agree.

Etienne Nichols: These are out of context, potentially in context out of country. But the thread throughout those, because I would think one of the goals of a global innovator would be to make a global device that can be used in any of these situations. Or, you know, we always have that conversation about, well, you could be good at one thing, but if you're trying to be good at everything, then you're. Then you're really not helpful. And I'm messing up that quote, but you know what I mean. Um, is that ever an issue when you try to do something across all these lenses?

Dr. Matthew Wettergreen: Well, that's an interesting philosophical question that you just asked, which is, is it possible to design one device for the whole world?

Etienne Nichols: Yeah. And I'm guessing that it goes back to the two words, regulatory and quality assurance. People all over the world love. And that is, it depends on the device, I'm sure.

Dr. Matthew Wettergreen: So I think it does depend on the device. Um, I'm really proud of, uh, of some of the technologies that rice 360 has developed for, uh, pediatric, uh, awards, because they've come from a standpoint of what's the least costs that we can put into the development of the device. And they're slim on bells and whistles, and they're maximized on function. Pumani, which is a CPAP, is a perfect example of that, that maybe your readers could look up. Going back to your question about how have these lenses changed the way we think about medical device design, I want to talk about one team that really challenged my belief about what is done in a high income versus a low and middle income. And that team was developing a device to do telemedicine for eye exams. Now, telemedicine is historically done with the most cost involved. It is high technology. It is for individuals who could go to the doctor, but due to their options, choose not to. What we learned when we went to Brownsville is that telemedicine actually should be flipped completely. Telemedicine should be designed for the lowest SES possible. Telemedicine solutions should exist for anyone who can't get to the doctor. That means elderly, that means time constrained, that means cost constrained. Telemedicine solutions should be as low cost as possible and widely available to everybody. Instead of telemedicine being available for the highest income bracket, it should be available for the lowest income bracket. And that's what we learned through working on this retinal scanning device with one of our teams called anoscope.

Etienne Nichols: How do you think that would change the healthcare in general if it were to flip in the United States?

Dr. Matthew Wettergreen: I would be dramatic. It would be dramatic who would go to the doctor and when, and it would shift from. It would create home care. That would be revolutionary. And so many individuals who are unable to go to the doctor on a regular basis or unwilling would now be serviced by devices that were mailed to them, by individuals who would go to them. But everything would turn into many things would turn into point of care. So it would actually retrieve the idea of the doctor that did house calls, the doctor who went door to door and made sure that you personally were well taken care of.

Etienne Nichols: Evan. I have had some arguments with my doctor, actually, and admittedly, this is. That flips where I believe I should have options because I'm busy, whatever. I could go to the doctor, but I just don't want to. And so I actually have talked to him, like, why do you not let me call you on the phone instead of this other thing? I think you're exactly right. Yeah.

Dr. Matthew Wettergreen: I have the same argument as my doctor with my anti malarial.

Etienne Nichols: Was it just the data or the students?

Dr. Matthew Wettergreen: What convinced us that telemedicine should be available for. For most people, uh, was going to see how healthcare is done in Brownsville. Most healthcare is done by physically going to the patient and getting them to take their medicine or. Or see a doctor. Anytime a patient in these colonials actually comes into a caregiver, you knock out many different things. You knock out hypertension, you knock out diabetes, you knock out a physical, because many of them don't have smartphones or are unable to sort of schedule time to go to a doctor. And so you basically do not. You knock out all the healthcare treatment that you can right away before sending them home.

Etienne Nichols: Yeah.

Dr. Matthew Wettergreen: You're not assuming that they're going to come back.

Etienne Nichols: If I were to describe, or if you were to describe the typical innovation process for a medical device company and what you teach, what's the difference in those two?

Dr. Matthew Wettergreen: That's an excellent question. Let me actually tell you a surprising thing about our students. When they come in, most of our students, 90%, when you ask them what they want to do in med devices, they only say R and D. Everybody wants to do R and D. And through this process, or maybe that's not surprising.

Etienne Nichols: That's an engineering problem, I think. Yeah, yeah.

Dr. Matthew Wettergreen: Through this process, we showed them that it is possible to do. To work in med tech with. With. While thinking about content or context. So you could be an accountant working for a medical technology company, and that is the context of healthcare, or you can do the work that is an R and D engineer, and that is the content of doing medtech work. Content and context are important. You don't have to physically be doing prosthetic repair in order to be working in a med tech setting. And after a year, students find steps of the medical innovation process, including quality, including regulatory, that they find interesting. But what we have to also disabuse the students of is that it is unlikely early in their career that they will get this tour of the entire medical device process start to finish. And that very likely they will manage many products at once while doing one step deeply. And so the students see this amazing rainbow unicorn of doing the medical device process, and they want to do that. And we have to explain to them that it's very challenging to be in a role where you get to see everything. And so I think that the incredible delta between what we do in our program and what industry does is that, that people are in predefined roles where they're often working on multiple projects at once in a particular function. Now, the advantage of the students having a 360 view of this whole process is that they know what came first and that they know what's going next. And that makes them conversant with the team that's downstream and conversant with the team that's upstream to ask questions and see clarity. And so they're multilingual in an engineering, design or medical device process, rather than just being singularly focused.

Etienne Nichols: Yeah, the upstream and downstream and even adjacent streams, that's really, really good. And youve already mentioned how potentially companies could start bringing some of that additional across the aisle knowledge, maybe having those brown bag lunches and things. One of the things that I felt like was really powerful because you mentioned the accountant who probably never feels the actual product that were producing, potentially. But if you have a big town hall where you have a customer come in, I use the word customer.

Dr. Matthew Wettergreen: Sure.

Etienne Nichols: I'm started moving away from patient as much, and that's probably going to get me some, you know, some, some flack. But, um, if you have a patient come in and say, this is my story, how your device saved me. You know, they put this pacemaker in, or whatever the case may be, or this, this thing, it allows me to walk and so forth. That's really powerful. And you can, you can start bringing that passion back and, and also the, you know, we talk about the success stories, but maybe we don't talk about the complaints. And maybe that's, as I'm talking, I'm just kind of thinking about other ways you can feel that.

Dr. Matthew Wettergreen: I think that the brown bag lunches are an interesting way of doing this in a short term capacity. But really, companies, if they could find ways to basically give brief training on individual steps of the medical device process, that would help employees become multilingual with the upstream and the downstream of the processes. So maybe three ways that companies could start trying to broaden their perspective and break their own assumptions. Number one, hold a 1 hour clinical needs finding bootcamp where employees and participants practice seeing and share those observations. This doesn't have to be in a clinical setting. It can be in the office setting, or it can be simply out of the office. It doesn't have to be in a clinic. Two, would be a case study of an existing technology which might be useful in another country and not in your local country. And three is to have a care provider from an in country, out of context setting give a talk to employees about what is different about how they apply caregiving principles in a setting such as that.

Etienne Nichols: One, can you go back to the first point and give maybe a. Can you give us this specific example of that observation in office or out of office? Do you have any suggestions there?

Dr. Matthew Wettergreen: Yeah, I do. Sports matches are a wonderful opportunity to sit and just watch, watch how everybody interacts and watch how everybody plays their role. There's the observer, there's the participant, there's the referee. And so you can actually diagram a sports match and then come back and talk about what you saw. It's a fun event for people to do as a group, as a company, and it's also a shared experience. These shared experiences are critical for doing needs. Finding everybody's there. Everybody has a record of it, everybody has a memory of it. You can talk about it, and then you can start to hone or refine the muscle that is your ability to observe without bias.

Etienne Nichols: I like it. I like it. So for the second one, if that case study is made, that distribution, one of the things that I've struggled with is push versus pull communication. I can push communication out there, but I, if I just set something, expect people to read it. That doesn't usually happen. Do you see any issues with that or any suggestions?

Etienne Nichols: Okay, that's a good explanation. And it feels like there's an underlying premise that you understand what's upstream and what's downstream of you. Do you have any kind of, I don't know, a visual or something to share? How do you explain that to individuals?

Dr. Matthew Wettergreen: Wow, that's a really great question. I think you're really challenging me here. So we just rolled off an event that we run in Costa Rica that's week long. The first part of the week is a clinical needs finding experience where all of our students in the graduate program and students from the University of Costa Rica and the Technological Institute of Costa Rica, they all learn how to do clinical needs finding over three days. So there's some curriculum in the morning of day one, and then they do two full days of clinical observation at clinics and at hospitals. And then they come back and they receive some instruction and they formulate needs and need statements. The next half of the week is medical innovation boot camp. And this is a front end medical innovation boot camp for students from Rice University, for students from costa rican universities who are working in engineering or bioengineering who want to join the med tech industry. We created this series of events to build capacity for costa rican students to enter the med tech industry. And with just this six day event, costa rican individuals are getting full time jobs in medtech roles down here in Costa Rica. So the reason I bring up the medical innovation bootcamp is that we teach this collision of product development processes that gives students a tour of several of them. So the Stanford biodesign process, the rice university engineering design process, the FDA waterfall diagram, these are just three to just call out. But we show them many different pdps, mostly just to help them understand how overwhelming it is to pick one. And then we say, we're going to cherry pick from different spots. Now, the reason that we cherry pick from different pdps is the same reason that we do local, global and out of context, is that we want you to see how to execute the steps with many different settings, not just geographical settings, but patient settings and healthcare clinic settings. So we want you to be able to. To use many different opportunities. Uh, or we want you to have a toolbox. And in the toolbox we want you to have a variety of different tools and not just one wrench. Maybe three or four different wrenches, maybe three or four different size screws in order to solve whatever problem you have. Wow.

Etienne Nichols: So your students aren't coming out playing single deck blackjack. They're playing three to three dimensional chess.

Dr. Matthew Wettergreen: Three dimensional chess. That's right.

Etienne Nichols: This has been a great conversation, and I could probably talk to you all day about other things that you might not want to be on camera for. But I want to ask you one last question, and that is, if our audience could take away one thing from this conversation or the one thing that you would love for them to learn, what would that be?

Dr. Matthew Wettergreen: That's a great question at the end. Thank you. First of all, thank you for allowing me to talk to you. I always enjoy whatever topics we're talking about, whether it's visiting Africa or medical device design. If your listeners could take away one thing, it's that we walk through this world with a variety of invisible lenses on. These lenses affect how we see the world. And these lenses were informed by where we were brought up, how we were brought up, sort of cultural norms. They affect how we process the world. They're not wrong. You know, whether you're on time or whether you're late. That's a lens. It's not wrong, but it does create behaviors which process how we, we view the world. So recognize that you're wearing a lens and train yourself to try and take off that lens and put on a new lens. For GMI students, those lenses include local settings in the Texas Medical center, global settings in Costa Rica, and in country out of context in Brownsville, Texas. But for you, that context might be. Might be different. And the lens might be that of your partner. The lens might be that of your childhood. The lens might be that of the patient that you're trying to solve a problem for, or the lens might be the customer that you're trying to do a job for.

Etienne Nichols: Thank you so much, doctor Wettergreen. Where can people find you? Can they reach out to you in different ways? What would be the best way?

Dr. Matthew Wettergreen: Yeah, I'd love to hear from people who are interested in being project partners for the global medical Innovation program. They can reach me at my email, which we can, I'm sure we can share as well as via the website for my program, which is GMI Rice.

Etienne Nichols: Fantastic. We will put those in the show notes so that people can find you and reach out. And thank you so much. Really appreciate all that you're doing. To improve healthcare globally and I hope, wish you the best in your continued efforts. Thank you so much and those of you listening, you belist to the global medical device podcast. Really appreciate your listening and we will see you all next time. Everybody take care. Take care. Thank you so much for listening. If you enjoyed this episode, can I ask a special favor from you? Can you leave us a review on iTunes? I know most of us have never done that before, but if you're listening on the phone, look at the iTunes app. Scroll down to the bottom where it says leave a review. It's actually really easy. Same thing with computer. Just look for that leave a review button. This helps others find us and it lets us know how we're doing. Also, I'd personally love to hear from you on LinkedIn. Reach out to me. I read and respond to every message because hearing your feedback is the only way I'm going to get better. Thanks again for listening and we'll see you next time.