In a classroom in Malawi, students gather around a locally developed medical device, their fingertips tracing the contours of buttons and ports. This simple, hands-on interaction is revolutionizing how a new generation of biomedical engineers learns to design for their own communities.
Imagine a vital signs monitor designed for a well-funded European hospital suddenly placed in a rural Malawian clinic with intermittent power, poor lighting, and nurses responsible for dozens of patients. The device might become unusable—not because of technical failure, but because human factors were overlooked.
This scenario captures a critical challenge in biomedical engineering education across sub-Saharan Africa. For decades, curricula in this field relied heavily on examples and devices from Western contexts, creating a significant gap between classroom learning and the real-world environments where graduates would work.
Now, a revolutionary approach is bridging this gap by putting locally relevant medical devices directly into students' hands.
Human factors engineering is the "science of the interrelationships between humans, their tools, and the environments in which they work." In healthcare, overlooking this discipline can have dire consequences: design-induced medical device error is a notable cause of patient mortality in both low-income and high-income settings 1 .
The stakes are even higher in resource-constrained environments. Too often, the context of local users takes a backseat to the technological perspective of device design, while failing to consider human needs and the voice of the user 1 .
Careful attention to human factors during design can dramatically improve provider safety, productivity, and efficiency, as well as satisfaction and daily experiences—making this perspective critical in biomedical engineering 1 .
At the Malawi University of Business and Applied Sciences (MUBAS), Dr. Alick Vweza faced a significant challenge in building the biomedical engineering human factors course. He noticed students were graduating and designing difficult-to-use medical devices that lacked application of basic human factors concepts 1 .
The course lacked meaningful direct experiences with medical products, and there was a significant gap between course topics and the surrounding clinical context of a low-income setting 1 .
Partner with the IMPALA project—a consortium developing an affordable, durable, and user-friendly vital signs monitoring system specifically for hospitals in Malawi and similar low-income settings 1 .
Conventional vital signs monitors from high-income countries often prove too expensive and incompatible with healthcare systems in low-income settings. The IMPALA device was different—it was being developed specifically for the Malawian context by an international partnership involving both Malawian and European institutions 1 .
The device needed to be simple yet effective in helping healthcare workers detect critical conditions early, despite the challenges of the local environment 1 .
Dr. Vweza integrated the IMPALA device as an extensive case study throughout the Human Factors course. Students were tasked with critically evaluating and making recommendations to improve both the software and hardware of the system 1 6 .
This wasn't a theoretical exercise—the IMPALA project genuinely needed and benefited from this collaboration, harnessing the local expertise of students to improve their design 1 .
Students observed and understood human factors issues firsthand
Identified design improvements for ports, controls, displays, and alarms
Provided actionable feedback to IMPALA project team
The integration of the IMPALA device followed best practices in engineering education, creating an active learning environment where students moved beyond passive reception of information to direct engagement with real-world problems 1 .
| Topic Area | Key Focus Points | Application to IMPALA Device |
|---|---|---|
| Usability Evaluation Methods | Heuristic and cognitive walkthroughs; quantitative task analysis | Students conducted actual usability tests on the IMPALA system |
| Medical Device Use Errors | Root cause analysis; error-proofing designs | Identified potential misuse scenarios specific to local contexts |
| Controls and Displays | Physical and digital controls; touchscreen considerations; auditory displays | Evaluated and suggested improvements to IMPALA's interface |
| User Interface Requirements | Generating requirements for safe, effective products | Created specific UI requirements for the IMPALA system |
| Device Reprocessing | Designing for cleaning and maintenance | Considered how device would be cleaned in local hospital conditions |
| Tool or Resource | Function in Educational Context | Example from MUBAS Case |
|---|---|---|
| Context-Appropriate Medical Devices | Provides relevant case studies for analysis and improvement | IMPALA vital signs monitor designed for local settings |
| Usability Evaluation Methods | Structured approaches to identify design shortcomings | Heuristic and cognitive walkthroughs performed by students |
| Human Factors Principles | Theoretical foundation guiding design improvements | Design principles for controls, displays, and alarms |
| Local Clinical Partnerships | Connects classroom learning to real-world healthcare settings | Collaboration with hospitals that would use IMPALA devices |
| International Research Collaborations | Brings together diverse expertise and perspectives | IMPALA consortium of Malawian and European institutions |
The impact of this hands-on approach was immediately visible in the classroom and extended far beyond it.
| Outcome Area | Specific Results | Long-Term Implications |
|---|---|---|
| Student Engagement | Significantly higher engagement during interactive components compared to lectures | Increased knowledge retention and application |
| Knowledge Translation | Many students successfully applied human factors principles to final-year design projects | Better preparation for professional engineering roles |
| Device Improvement | Valuable design feedback for the IMPALA project | Direct student contribution to improving local healthcare technology |
| Contextual Understanding | Deeper appreciation for local users' needs and environments | Potential for more appropriate medical devices for African settings |
Dr. Vweza and his collaborators observed that students were engaged far more during these interactive components than during traditional lecture components. More importantly, many students successfully translated their knowledge on human factors to their final-year design projects, demonstrating true integration of learning 1 .
The approach also fostered essential skills beyond technical knowledge—problem-solving, critical thinking, and collaboration—through participation in collaborative projects 6 .
The implications of this educational approach extend far beyond a single classroom in Malawi. As countries in sub-Saharan Africa continue to grapple with significant health disparities, the need for a skilled workforce equipped to address these challenges is paramount 6 .
The hands-on, context-sensitive model pioneered at MUBAS offers a template for other programs, especially those in low-income settings, to develop context-appropriate materials and examples 1 . This is particularly important because the current contexts of international biomedical research include the development of public-private partnerships and research institutions across Africa, suggesting that scientific activities are growing in the region 4 .
Similar initiatives are emerging elsewhere in sub-Saharan Africa, creating a network of context-aware biomedical engineering programs.
The Enhanced Advanced Biomedical Research Training for Mozambique (EABRTM) program has worked to train a new generation of biomedical researchers, enhancing administrative research infrastructure and supporting the implementation of new bioscience programs .
The hands-on device-based approach to teaching human factors represents more than just a pedagogical improvement—it symbolizes a broader shift in how we prepare biomedical engineers to serve their communities.
By training students in practical, user-focused design principles, educational programs can help cultivate a new generation of biomedical engineers committed to improving healthcare delivery in their communities 6 . These future professionals will be better equipped to design technologies that account for:
As this educational model spreads, it promises to transform not just classrooms but entire healthcare landscapes across sub-Saharan Africa. By nurturing creativity, critical thinking, and problem-solving abilities, educators can better prepare the next generation of engineers and innovators 6 .
The journey of integrating hands-on activities into the biomedical engineering curriculum serves as a call to action for educators and institutions around the world. In answering this call, we contribute not only to enhanced educational experiences but to a healthier, more equitable future for all 6 .
The innovative work at Malawi University of Business and Applied Sciences demonstrates that when students can touch, test, and improve technology destined for their own communities, education becomes not just about learning principles—but about transforming realities.