Preamble Emerging Trends in Medical Preamble Emerging Trends in - PDF document

Preamble Emerging Trends in Medical Preamble Emerging Trends in Medical Simulation: Simulation: � � Workshop CDs Workshop CDs Identifying the Needs of the Medical Community Identifying the Needs of the Medical Community � � Workshop website Workshop website and Methods to Address Them and Methods to Address Them http://simcen.usuhs.mil/mmvr2005 http://simcen.usuhs.mil/mmvr2005 � � Presentations and forum Presentations and forum for discussion for discussion Alan Liu Alan Liu Dale Alverson Dale Alverson Mark Scerbo Mark Scerbo "Hey you! Wake up when I'm talking." Mark Bowyer Mark Bowyer http://simcen.usuhs.mil/mmvr2005 http://simcen.usuhs.mil/mmvr2005 MMVR 2005 – Session B Speakers Speakers Schedule Schedule � Alan Liu Alan Liu � – – Project Scientist (Medical Simulation), National Capital Area Project Scientist (Medical Simulation), National Capital Area � Technology and Medical Simulation � Technology and Medical Simulation Medical Simulation Center Medical Simulation Center � A Clinical Perspective � A Clinical Perspective � � Mark Bowyer Mark Bowyer – Surgical Director of the National Capital Area Medical Simulatio Surgical Director of the National Capital Area Medical Simulation n – � Human Factors and Medical Simulation � Human Factors and Medical Simulation Center Center � Advanced Distributed Learning � Advanced Distributed Learning � � Mark Mark Scerbo Scerbo – – Graduate Program Director, Human Factors Psychology doctoral Graduate Program Director, Human Factors Psychology doctoral � Open discussion and conclusion Open discussion and conclusion � program Old Dominion University program Old Dominion University � � Dale Dale Alverson Alverson – Medical Director, Center for Medical Director, Center for Telehealth Telehealth and and Cybermedicine Cybermedicine – Research, Health Sciences Center, University of New Mexico Research, Health Sciences Center, University of New Mexico MMVR 2005 – Session B MMVR 2005 – Session B Outline Outline � � Motivation Motivation � Trends Trends � – Survey of the State of the Art (past and present) – Survey of the State of the Art (past and present) Technology and Medical Simulation Technology and Medical Simulation � What What’ ’s ahead s ahead � � What What’ ’s missing s missing � – And where we need to be And where we need to be – MMVR 2005 – Session B 1

Current Practice Current Practice Why Simulation? Why Simulation? � Animals � Animals � More complex � More complex – Incorrect anatomy Incorrect anatomy – procedures procedures � Cadavers � Cadavers � Shorter patient � Shorter patient – Incorrect physiology – Incorrect physiology interaction time interaction time � � Patients Patients Source: National Institute of Advanced � Reduce medical errors � Reduce medical errors Industrial Science and Technology, Japan – Risk to patient safety – Risk to patient safety � Each other Each other � – Can be painful – Can be painful MMVR 2005 – Session B MMVR 2005 – Session B Medical Simulators The Expectation Gap Medical Simulators The Expectation Gap � � Better visuals Better visuals � Integration with � Integration with � Computer � Computer- -based based � � Accurate tissue Accurate tissue curriculum curriculum “Virtual Virtual” ” patient patient “ models models � More cases More cases � � Ability to mimic some � Ability to mimic some � Haptics Haptics � � More procedures More procedures � tissue properties tissue properties � Procedure specific Procedure specific � � Procedure independent Procedure independent � � Some physiological Some physiological � Gap hardware hardware hardware hardware response response � � Specific tasks Specific tasks � Wider audience � Wider audience � Dexterous and Dexterous and � � Minimally invasive � Minimally invasive – Paramedic, first Paramedic, first – cognitive skills cognitive skills procedures procedures responder responder training training � � Cost (pricey) Cost (pricey) � Cost (cheap) � Cost (cheap) MMVR 2005 – Session B MMVR 2005 – Session B The Expectation Gap The Expectation Gap Why? Why? � Better visuals Better visuals � � Integration with Integration with � � Communications Communications � � Accurate tissue Accurate tissue � curriculum curriculum – How do you quantify – How do you quantify models models � More cases � More cases “doesn “ doesn’ ’t feel right? t feel right?” ” � � Haptics Haptics � � More procedures More procedures � Different expectations � Different expectations � � Procedure specific Procedure specific � Procedure independent � Procedure independent � � Human factors Human factors Gap hardware hardware hardware hardware � � Team dynamics Team dynamics � Specific tasks � Specific tasks � � Wider audience Wider audience � Understanding the � Understanding the � � Minimally invasive Minimally invasive – Paramedic, first – Paramedic, first learning process learning process procedures procedures responder responder � Cost (pricey) Cost (pricey) � Cost (cheap) Cost (cheap) � � MMVR 2005 – Session B MMVR 2005 – Session B 2

Trends in Technology Trends in Technology � Visual feedback Visual feedback � � Tissue models Tissue models � � Instrument simulation Instrument simulation � – Tactile and Haptic feedback Tactile and Haptic feedback – � � Hardware Hardware � Procedure focus � Procedure focus � � Team Team- -based training based training MMVR 2005 – Session B MMVR 2005 – Session B Visual Feedback Visual Feedback Simulating Surgical Instruments Simulating Surgical Instruments Source: Morten BRO-NIELSEN, “VR Simulation of Abdominal Trauma Surgery”, MMVR ‘98 , MMVR 2005 – Session B MMVR 2005 – Session B Surgical Effects Surgical Effects � Cutting Cutting � � Bleeding Bleeding � � Smoke Smoke � Procedicus VIST TM , Mentice AB Image courtesy of Daniel Bielser, Computer Graphics Lab, Gerard Lacy, Haptica ETH Zürich VRMagic GmbH Source: Forschungszentrum Karlsruhe Xitact S.A. Simbionix MMVR 2005 – Session B MMVR 2005 – Session B 3

Verefi Technologies ProMIS (Haptica) Verefi Technologies ProMIS (Haptica) � EndoTower EndoTower � � Optically tracked � Optically tracked � � Can use actual Can use actual � SmartTutor SmartTutor � instruments instruments – Adaptive difficulty Adaptive difficulty – � � Real and virtual Real and virtual level level exercises exercises – Listen to talk on Listen to talk on – � Validated � Validated Saturday Saturday Images courtesy of Randy Haluck, Verefi Technologies Images courtesy of Gerard Lacy, Haptica Ltd. MMVR 2005 – Session B MMVR 2005 – Session B Lapsim (Surgical Science) EYESI (VRMagic) Lapsim (Surgical Science) EYESI (VRMagic) � Basic laparoscopic � Basic laparoscopic � � Intraocular surgery Intraocular surgery skills training skills training – Navigation, Cutting, – Navigation, Cutting, � Basic skills � Basic skills Suturing Suturing – Instrument and object – Instrument and object � Intermediate skills � Intermediate skills manipulation manipulation – Dissection Dissection – � � Tool operation Tool operation – Lower intestine Lower intestine – – Microscope Microscope – manipulation manipulation – Vitrectomy unit Vitrectomy unit – MMVR 2005 – Session B MMVR 2005 – Session B Continuous Curvilinear Continuous Curvilinear Epidural Injection Simulator Epidural Injection Simulator Capsulorhexis Simulator Capsulorhexis Simulator (prototype for any needle procedure) (prototype for any needle procedure) Acknowledgements: Roger Webster 1,3 , Randy Haluck 1,2 , Aaron Benson 1 , Rod Shenk 1,3 1 Verefi Technologies Inc., Hershey, PA USA 17033 2 Department of Surgery, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA USA 17033 Haptic Interface inside the Mannequin provides touch feedback 3 Department of Computer Science, Caputo Hall, Millersville University, Millersville, PA. USA 17551 MMVR 2005 – Session B MMVR 2005 – Session B Slide Courtesy of M.A. Srinivasan, MIT 4