27
COM Outlook . Spring 2014
ter and Emergency Preparedness,” he
added. “In addition, we graduate more
physicians with a joint M.P.H. degree
than any other college of osteopathic
medicine and offer an accredited
online Spanish version of our Master
of Public Health Program. All these are
innovations that have added to our es-
teem and the impact we make, which
is illustrated by the amount of credit
we get from other institutions—both
M.D. and D.O.—that point to us as
an example of excellence. We’ve also
had a tremendous impact on reducing
cigarette smoking in our catchment
area through our AHEC Program and
the involvement of our students.”
Looking Forward
with Excitement
While it’s difficult to truly prognos-
ticate what the future holds in store
for NSU-COM, there are some trends
that help foretell the college’s immi-
nent trajectory. “What I envision in
the next 10 years is us venturing into
more exciting and in-depth areas,” Dr.
Silvagni stated. “For example, I see us
delving deeper into patient and com-
puter simulation for procedures and
skills prior to rotations as clinical edu-
cation challenges, such as increased
legal and governmental oversight and
the competition from the increasing
number of medical schools, make it
harder to find the high-quality clinical
sites we need to train our third- and
fourth-year students.
“Consequently, I see us following
the path of industries such as aviation
and freighters/cruise ships, where
simulation assumes a significant
proportion of the learning so you
don’t have to utilize the institution or
actual patients in the initial learning
process,” he added. “Essentially, pro-
cedures and interview techniques can
be practiced quickly and frequently,
allowing students to really hone their
skills before interacting with a hu-
man patient. That’s why I anticipate
simulation playing an increasingly
larger role in medical education. For
example, through these new com-
puterized models and mannequins,
child-delivery techniques can be
taught and practiced repeatedly so
you don’t have to be on an OB/GYN
rotation and hope there’s a large
number of births or a complicated
delivery while you’re there.”
According to Dr. Silvagni, “These
advances in simulation will help take
the pressure off our clinical sites. Of
course, the enhanced use of simula-
tion will have to be a hybrid program
because medical students who are not
being introduced to an actual clinical
environment from day one would be
a negative,” he stated. “I see a better
blend of academics, combining clini-
cal training along with technology.”
In terms of additional trends, Dr.
Silvagni envisions “an increase in
the use of genetics and genomes in
medical education. The pharmaceuti-
cal world is beginning to establish
the selection of medications based on
the genetic makeup of a person. For
example, it is known that certain anti-
hypertensives will work better if you
have a certain genetic composition,”
he explained. “I also see more op-
portunities in the global community
because our world is shrinking. There
are no longer diseases isolated to a
specific region or country, but there
is still an endemic quality to them. So
we need to learn more about other
health care systems and see a broader
range of cases so we will be familiar
with them. Part of the excitement of
the future of medical education is that
some things you can foresee, while
others are still unknown to us.”
Although no one is exactly sure of
what the future portends, Dr. Silvagni
can say with absolute certainty that his
decision to become NSU-COM’s dean
was one of the wisest he’s ever made.
“I came to NSU because I thought it
was a university that was in its infancy,
but with an infrastructure to leap
forward—and it has actually exceeded
my expectations,” he admitted. “Aca-
demia is traditionally known as being
like a mega oil tanker that you’re
trying to turn 180 degrees, which
takes considerable time and many
miles to achieve. Both the college
and the university have progressed at
rocket speed for the academic world
in regard to the changes we’ve made
during the years I’ve been at NSU.
“NSU was founded with a progres-
sive idea and a unique approach to
education,” he concluded. “It grew
in spite of setbacks and naysayers
and pushback, and it continued to
focus on innovation and progressive
thinking, as it continues to do today.
I’m extremely proud to be affiliated
with Nova Southeastern University
and extremely pleased that I made
the choice to come here when the
position was offered to me. I can’t
think of any other university medi-
cal school in the country—M.D. or
D.O.—that would have afforded us
the opportunity to do the kinds of
things we’ve done here. For me, it
was the right place at the right time
at the right university with the right
leadership allowing us to recruit the
right faculty members and the right
students. It was just meant to be.”
