Virtual Reality Simulation of Liver Biopsy with a Respiratory Component

International audienceThe field of computer-based simulators has grown exponentially in the last few decades, especially in Medicine. Advantages of medical simulators include: (1) provision of a platform where trainees can practice procedures without risk of harm to patients; (2) anatomical fidelity; (3) the ability to train in an environment wherein physiological behaviour is observed, something that is not permitted where in-vitro phantoms are used; (4) flexibility regarding anatomical and pathological variation of test cases that is valuable in the acquisition of experience; (5) quantification of metrics relating to task performance that can be used to monitor trainee performance throughout the learning curve; and (6) cost effectiveness. In this chapter, we will focus on the current state of the art of medical simulators, the relevant parameters required to design a medical simulator, the basic framework of the simulator, methods to produce a computer-based model of patient respiration and finally a description of a simulator for ultrasound guided for liver biopsy. The model that is discussed presents a framework that accurately simulates respiratory motion, allowing for the fine tuning of relevant parameters in order to produce a patient-specific breathing pattern that can then be incorporated into a simulation with real-rime haptic interaction. Thus work was conducted as part CRaIVE collaboration [1], whose aim is to develop simulators specific to interventional radiology

Web-based medical training system and surgical simulator for interventional neuroradiology procedures

Master'sMASTER OF SCIENC

Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training

Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training

Exploration, design and application of simulation based technology in interventional cardiology

Medical education is undergoing a vast change from the traditional apprenticeship model to technology driven delivery of training to meet the demands of the new generation of doctors. With the reduction in the training hours of junior doctors, technology driven education can compensate for the time deficit in training. Each new technology arrives on a wave of great expectations; sometimes our expectations of true change are met and sometimes the new technology remains as a passing fashion only. The aim of the thesis is to explore, design and apply simulation based applications in interventional cardiology for educating the doctors and the public. Chapters 1and 2 present an overview of the current practice of education delivery and the evidence concerning simulation based education in interventional cardiology. Introduction of any new technology into an established system is often met with resistance. Hence Chapters 3 and 4 explore the attitudes and perceptions of consultants and trainees in cardiology towards the integration of a simulation based education into the cardiology curriculum. Chapters 5 and 6 present the “i-health project,” introduction of an electronic form for clinical information transfer from the ambulance crew to the hospital, enactment of case scenarios of myocardial infarction of varied levels of difficulty in a simulated environment and preliminary evaluation of the simulation. Chapter 7 focuses on educating the public in cardiovascular diseases and in coronary interventional procedures through simulation technology. Finally, Chapter 8 presents an overview of my findings, limitations and the future research that needs to be conducted which will enable the successful adoption of simulation based education into the cardiology curriculum.Open Acces

Effectiveness of a Brief Teaching Scenario in a Phantom-Based Learning Model for Students to Achieve Ultrasound-Guided Vascular Access—a Prospective Study

For students, early hands-on experience is very limited and often non-existent during study time. Thus, we aimed to evaluate the progress of inexperienced medical students in successfully establishing an ultrasound-guided vessel access. One brief, condensed single teaching lesson in a prior to post-teaching scenario was performed using an inexpensive, self-made phantom model. In this prospective study, medical students (n = 11) with no experience in ultrasound imaging performed an ultrasound-guided vessel access simulated by a gelatin-based phantom model. Success rates and time of procedures were measured. Afterwards, participants underwent dedicated supervised teaching in a single lesson (duration 30 min) with both theoretical information given and practical training skills shown. Then, every student performed the very same procedure again and results were compared with paired t test. Success rate of guide wire placement rose from 36.4 (4/11) to 100%. Mean number of attempts significantly decreased with 2.5 SD1.3 before and 1.2 SD0.4 after teaching (p < 0.05). Overall time to successful guide wire placement improved from 291 SD8 to 151 SD37 s (p < 0.05). With already limited training time and opportunities available during medical education, short and simple, but highly effective training tools are invaluable. With the help of an inexpensive, self-made gelatin-based phantom model for ultrasound-guided vascular access, medical students demonstrate significantly improved practical puncture skills after only one brief, condensed teaching lesson and thus an important progress with regard to their future clinical routine. The performance of ultrasound-guided vascular access can be highly improved for inexperienced medical students by applying one short teaching session using an inexpensive, self-made phantom model