eduCRATE - A Virtual Hospital Architecture L ă crimioara STOICU-TIVADARa, Vasile STOICU-TIVADARa1, Dorin BERIANa, Simona DR Ă GANb, Alexandru Ş ERBANa, Corina Ş ERBANb a Politehnica University Timi ş oara, Romania b Victor Babe ş University of Medicine and Pharmacy Timi ş oara, Romania 1 vasile.stoicu-tivadar@aut.upt.ro !
Objec&ves A! new$so'ware$architecture !for!a!3D!immersive environment!–!for! simula1on !of!the! Medical(Prac+ce (student5pa7ent!interac7on)!in! Medical(Educa+on !– improving • technical!and!func7onal! exper%se • problem+solving !and!decision5making!skills • interpersonal!and! communica%ons !skills • team+based !competencies but!applying!the!“ primum&non&nocere ”!principle ! The!suggested!architecture! solves$ several! drawbacks !of the!exis7ng!solu7ons !
Medical(Educa+on ! ! ! ! matches(the(current(working style(of(the(young(genera+on whom!it!is!addressed !
Medical(Educa+on(.(simula+on SIMULATION CENTER A bilities A ttitudes A ptitudes !
Medical(Educa+on(.(simula+on Simulation - technique for practice and learning - can replace and amplify real experiences with guided ones often “immersive” in nature - evoke or replicate substantial aspects of the real world in a fully interactive fashion - may facilitate the development of health professionals’ knowledge, skills, and attitudes , whilst protecting patients from unnecessary risks Lateef&F.&Simula.on1based&learning:& Just%like%the%real%thing . Journal&of&Emergencies,&Trauma,&and&Shock.&2010;&3(4):&3481 352. Ziv&A,&Erez&D,&Munz&Y,&Vardi&A,&Barsuk&D,&Levine&I,&et&al.&The Israel&Center&for&Medical&Simula.on:&a& paradigm%for%cultural change%in%medical%educa5on .&Academic&Medicine.&2006; 81(12):&109111097. Ziv&A,&Wolpe&PR,&Small&SD,&Glick&S.&Simula.on1based&medical educa.on:& an%ethical%impera5ve .&Simula.on&in&healthcare. 2006;&1(4):&2521256. !
Medical(Educa+on(.(simula+on Immersive( simula(on!pla,orms!that!replicate!the!clinical!environment promise!to!revolu(onize!medical!educa(on!by!enabling – !!!!an!enhanced!level!of!safety, – !!!!standardiza(on, – !!!!efficiency across!future! services(of(health0care(training Examples: Kuang Y, Jiang J. The Designing of Training Simulation System Based on Unity 3D. International Conference on Intelligent Computation Technology and Automation; 2011 Mar 28-29; Shenzen: China. Lewis J, Brown D, Cranton W, Mason R. Simulating visual impairments using the Unreal Engine 3 game engine. 1st International Conference on Serious Games and Applications for Health; 2011 Nov 16-18; Braga: Portugal. University of Brighton [Internet]. The Virtual Hospital; [updated 2011 Nov 11; cited 2014 Jan 24]. Available from: http://about.brighton.ac.uk/snm/news/2011/111129-virtual- hospital.php. Keele University [Internet]. Virtual Patient - Keele University; [updated 2013; cited 2014 Jan 24]. Available from: http://www.keele.ac.uk/pharmacy/vp. Imperial College London [Internet]. Game-based Learning for Virtual Patients in Second Life; [updated 2013; cited 2014 Jan 24]. Available from: https://www1.imperial.ac.uk/medicine/elearning/secondlife/ gamebasedlearning. !
Interna'onal*Virtual*Medical*Educa'on !
Medical(Educa+on(–(simula+on Virtual!Immersive!Environments!(VIEs)!3! advantages • Prac7cing!real!world!skills!with! rich-feedback-in-a-safe environment !that!does!not!impact!real!processes!or persons • Mastering!a!technique,!behavior!or!method!through guided-rehearsals !again!and!again!as!many!7mes!as!is needed • Ability!to!prac7ce!in!the!virtual!environment! not accoun5ng-loca5on-or-5me ,!only!having!access!to!a computer !
Medical(Educa+on(–(new(tools Cloud&compu*ng scalable,! depending&on&the actual&needs !)!relieving!the ins1tu1ons!from!the burden!of!purchasing!and maintaining!technology Cogni*ve&systems Internet&of&Things,&etc. !
Drawbacks)of)exis/ng)solu/ons • Lack of flexibility • Hard to edit • No multilingual support (for most of them) • Dependence on a VR provider • Need of high speed Internet connection • No support for expert systems, or other extensions • No possibility/hard to implement medical protocols and guidelines !
To#solve#the#problems#.># a#new#approach:# eduCRATE • # edu ca#on&&&Hippo CRATE s • & modern-services-in-educa3on •&a&virtual&learning&environment – &to&improve& decision4making capacity- and -associa3ve-logic – &providing&medical&students&the opportunity&to&simulate&actual #extending! learning(services situa#ons&encountered&in&the possibili/es !in!medical medical&prac#ce&and&develop educa0on ! the&abili#es&to&work& safer-and #developing! innova/ve(skills more-efficient-as-future in!advanced!technologies!# doctors . !cloud!and!mul0media !
Method • case%based(learning !in!simulated!context ! •!crea1ng!interac1ve!clinical!scenarios!for which!students!will!find!solu1ons – !for!posi1ve!diagnosis – !therapeu1c!management based!on! 3D(immersive(virtual(environments, Medical(Guidelines,(EHR,((and(Cloud(compu=ng !
Benefits • the!Virtual!Hospital!(VH)!applica3on!5!framework!for medical!training – at!the!highest!standards, – for!pa3ent!safety!and – error!management • facilita3ng! collabora've*thinking • increases*mo'va'on*and*self5confidence • Technical*and*func'onal exper'se !training • Problem5solving* and! decision5 making !skills • Interpersonal!and communica'ons !skills!or! team 5 based!competencies !
Technical)challenges •management!and!development!of! complex digital-and-interac0ve-content !based!on scenarios !using!avatars!helping!students!to train!on!a! casuis0c-extracted-from-the-real world ,!emerging!in!VH •! avatars-for-student-and-pa0ent ,!scenery elements,!textures,!etc.!for!realis<c representa<on!of!the!interac<ons!between students!and!pa<ents ! !
Technical)challenges (resource(consuming) • models provided!for pa0ents , students , consul0ng rooms ,!tools, devices,! medical equipment !0!!a virtual!space!for simula4on!of medical!ac4vity !
Clinical'background • interac(on* in!terms!of medical!informa0on!1!based on • !content! guidelines*and medical*scenarios • !the! electronic*healthcare record !of!pa0ents!from!the current!clinical!prac0ce ! !
Novel&es • use of medical protocols and guidelines - with ! standard representations - Arden, GLIF or Asbru • performing simulations following a set of scenarios defined in an external database, according to medical protocols and guidelines • scenarios may be added or modified anytime, giving to the project more flexibility compared with previous solutions, and can easily be adapted to any clinical scenario. • multilingual capacity • use of real eHR • synchronisation of these with the 3D immersive environment and the interaction with the students !
Technologies ! Cloud computing VR applications developing environment (Unity 3d) Guidelines editing and execution environment ( Arden Syntax/ EGADSS/CLIPS - open source , Asbru/ASGAARD, GLIF etc. ) An integrator development environment (Java) W.#Aigner,#K.#Kaiser,#S.#Miksch,#Visualiza7on#Methods#to#Support Guideline=Based#Care#Management.# Computer)based.Medical Guidelines.and..Protocols:.A.Primer.and.Current.Trends, #2008, pp.#140=159. !
„ !
Roles • medical guidelines developers that implement the medical scenarios • editors of virtual reality • administrators of patient medical data • administrators of didactical activity and • Medical STUDENTS Based on student activity -> reports in various forms 2D and 3D graphics particularly useful in self-assessment for progressive improvement of knowledge !
Sequence'Diagram'(par0ally) !
Cloud&compu*ng IBM CloudBurst : • Hardware • Storage • Networking • Virtualization • Service management software ! !
Indicators+of+success Short-term • in terms of technology : the stability of the entire system, robustness, degree of customization, degree to which avatars can hold the student's personality, speed, ubiquitous access to the databases • in terms of education and healthcare : the dynamics of learning, degree in which the system is student-centred (accessibility, usability, responsiveness, accuracy in matching guidelines and scenarios) Medium and long term • better training expressed in • better results of evaluation and • better doctors for the future • healthcare learning services supporting development of a new generation of doctors !
Development •Medical academic staff defines a virtual interaction scenario •Together with a group of engineers, they translate the scenario into medical guideline representation •Physicians populate EHR with fictive patients records •Engineers develop representation models and missing actions •Technical testing •Medical validation •Using system by a pilot group of medical students • Conclusions and adjustments • System uploaded to cloud • Documenting in order to be used by others . !
Recommend
More recommend
