Development of a Cardiac Auscultation Virtual Reality App

La auscultación cardiaca es un procedimiento que permite diagnosticar la condición del corazón de un paciente haciendo uso de un estetoscopio. Una examinaciOn apropiada con el estetoscopio puede resultar en un adecuado diagnóstico y tratamiento. Habilidades en auscultación cardiaca están en decaimiento entre practicantes y profesionales de áreas relacionadas al cuidado de la salud debido al extenso tiempo requerido de entrenamiento. Herramientas actuales de entrenamiento incluyen maniquíes de simulación y equipamiento de diagnóstico que está tomando un papel con mayor prominencia en la práctica de auscultación cardiaca que el entrenamiento con el estetoscopio. De acuerdo con la Organización Mundial de la Salud, en 2015 los dos causantes más grandes de muerte fueron ataques al corazón y enfermedades cerebrovasculares. La disponibilidad y bajo costos del estetoscopio lo hace una herramienta rentable en el entrenamiento en auscultación cardiaca. Actualmente, dispositivos de realidad virtual disponibles para el consumidor común están permitiendo el desarrollo de experiencias virtuales asequibles que tienen el potencial para complementar otras formas de entrenamiento. En este trabajo se presenta una aplicación móvil que combina elementos multimedia tales como sonidos de ritmos cardiacos e imágenes indicando áreas donde la exploración cardiaca debería ser llevada a cabo. Modelados 3D con animaciones realistas de pacientes con diferentes características físicas para simulación y texto explicativo para el diagnóstico fueron usados para proveer inmersión y realismo. El sistema está basado en el procedimiento de entrenamiento en auscultación cardiaca, haciendo uso de elementos de juego para enganchar y motivar los usuarios en el proceso de aprendizaje.Cardiac auscultation is a procedure that allows diagnosing a patient’s heart condition making use of the stethoscope. Proper examination skills with the stethoscope may result in proper diagnostics and treatment. Auscultation skills are in decay among health care trainees and even professionals, due to the required extensive training. Current training tools include simulation manikins and diagnostics equipment that is taking a more prominent role in auscultation practice than the training with the stethoscope. According to the World Health Organization, in 2015 the top two causes of death were ischaemic heart disease and stroke. The availability and low cost of the stethoscope makes it a cost-effective tool in cardiac auscultation skills. Currently, virtual reality consumer-grade devices are allowing the development of affordable virtual experiences that have the potential to complement other forms of training. In this work a mobile app combines multimedia elements such as heart rhythm sounds and images indicating areas where cardiac exploration should be performed is presented. 3D models with realistic animations of patients with different physical characteristics for the simulation and explanatory text for the diagnosis were used to provide immersion and realism. The system is based on the cardiac auscultation training procedure, making use of game elements in order to engage and motivate users in the learning process.Pregrad

Virtual Reality Simulator for Medical Auscultation Training

© Springer Nature Switzerland AG 2019. According to the Oxford English dictionary, auscultation is “the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis.” In this work, we describe a medical simulator that includes audio, visual, pseudo-haptic, and spatial elements for training medical students in auscultation. In our training simulator, the user is fully immersed in a virtual reality (VR) environment. A typical hospital bedside scenario was recreated, and the users can see their own body and the patient increase immersion. External tracking devices are used to acquire the user’s movements and map them into the VR environment. The main idea behind this work is for the user to associate the heart and lung sounds, as heard through the stethoscope with the corresponding health-related problems. Several sound parameters including the volume, give information about the type and severity of the disease. Our simulator can reproduce sounds belonging to the heart and lungs. Through the proposed VR-based training, the medical student ideally will learn to relate sounds to illnesses in a realistic setting, accelerating the learning process

IoT Based Virtual Reality Game for Physio-therapeutic Patients

Biofeedback therapy trains the patient to control voluntarily the involuntary process of their body. This non-invasive and non-drug treatment is also used as a means to rehabilitate the physical impairments that may follow a stroke, a traumatic brain injury or even in neurological aspects within occupational therapy. The idea behind this study is based on using immersive gaming as a tool for physical rehabilitation that combines the idea of biofeedback and physical computing to get a patient emotionally involved in a game that requires them to do the exercises in order to interact with the game. This game is aimed towards addressing the basic treatment for ‘Frozen Shoulder’. In this work, the physical motions are captured by the wearable ultrasonic sensor attached temporarily to the various limbs of the patient. The data received from the sensors are then sent to the game via serial wireless communication. There are two main aspects to this study: motion capturing and game design. The current status of the application is a single ultrasonic detector. The experimental result shows that physio-therapeutic patients are benefited through the IoT based virtual reality game

The effectiveness of computer-based gaming simulation on nursing students´ knowledge and confidence: a randomized controlled trial

Background: The current pandemic, COVID-19 disease, is a highly contagious viral infection caused by novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For this reason, the Nursing and Midwifery Council have placed greater emphasis on digital simulated learning activities, yet it is not clear whether it is as an effective learning opportunity as on campus simulation. Aim: To evaluate the effectiveness of computer-based gaming simulation on nursing students' knowledge and confidence in Sighthill campus, Edinburgh Napier University, United Kingdom, 2021 Methods: A randomized controlled trial was carried out with 67 undergraduate nursing students between September 2021 and November 2021. Students were randomly assigned to either the computer-based COVID-19 gaming simulation (experimental group) or manikin-based face-to-face COVID-19 simulation (control group). An independent-samples T test and a paired-samples T test performed to detect mean differences (MD) between groups and within a group, respectively, at p < 0.05 and 95% confidence interval (CI). Results: The mean knowledge score for the participants in the control group was significantly higher than the intervention group, 21.4 + 1.6 and 19.8+ 2.1, respectively. A significant statistical difference for confidence was observed between pretest and posttest in the control group, (MD=-0.88, 95% CI (-1.1, -0.6)). The anxiety level of the students in the control group decreased from pretest (2.6 ± 0.6) to post (2.0 ± 0.5), MD=0.55, 95% CI (0.3, 0.7). Conclusion: Overall, computer-based gaming simulation was not as effective as the manikin-based simulation in improving student nurses’ self-efficacy and knowledge acquisition. The manikin-based face-to-face simulation was superior to the computer-based gaming simulation in knowledge acquisition. In the computer-based gaming simulation, whilst there were improvements in self-confidence and anxiety levels, there were no significant statistical differences between pre and posttests. Therefore, computer-based gaming could be an adjunct simulation in situations where in-person simulation is not possible

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of the laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, mobile/electronic health (m-health/e-health), clinical respiratory physiology, exercise and functional imaging

European Respiratory Society International Congress, Barcelona, 2022: Highlights from the Respiratory clinical care and physiology assembly

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging

Effectiveness analysis of traditional and mixed reality simulations in medical training: a methodological approach for the assessment of stress, cognitive load and performance

La simulazione nell'educazione in medicina è considerata un metodo di formazione in grado di migliorare le competenze cliniche e il comportamento degli operatori sanitari e, di conseguenza, la qualità dell'assistenza per il paziente. Inoltre, l'utilizzo di nuove tecnologie come la Realtà Aumentata, offre ai discenti l'opportunità di esercitarsi in un ambiente immersivo. L'opportunità di sperimentare questo innovativo metodo didattico è efficace non solo nel ridurre il rischio di errori e approcci sbagliati ma anche nel provare ansia e stress simili a quelli avvertiti nella pratica reale. La sfida sta nel trovare il giusto equilibrio. I discenti devono infatti provare lo stesso stress che avvertirebbero lavorando ad un vero caso clinico ma, allo stesso tempo, devono essere controllati ed evitati possibili disturbi da stress post-traumatico, verificabili soprattutto nel campo della gestione delle emergenze (pronto soccorso). Inoltre, è fondamentale anche ottenere alte prestazioni e un apprendimento adeguato, evitando sovraccarichi cognitivi che influenzerebbero negativamente l’apprendimento. Tuttavia, ad oggi mancano ancora studi approfonditi sull'impatto che le simulazioni mediche hanno su stress, frustrazione, carico cognitivo e apprendimento dei discenti. Per questo motivo, l'obiettivo principale di questo studio è valutare l'efficacia del training tramite simulazione, analizzando prestazioni, ansia, stress e carico cognitivo durante simulazioni cliniche tradizionali (con manichino) ed avanzate (in realtà mista). A questo scopo, è stato sviluppato un approccio metodologico strutturato e completo per valutare le prestazioni, le condizioni emotive e cognitive degli studenti. Questo comprende l'acquisizione e l'analisi di parametri psicologici (valutazione soggettiva), segnali biometrici (valutazione oggettiva) e prestazioni. Questa indagine consente di evidenziare i punti deboli delle simulazioni e offre l'opportunità di definire utili linee guida per la riprogettazione e l'ottimizzazione delle stesse. La metodologia è stata applicata su tre casi studio: il primo si riferisce a simulazioni ad alta fedeltà per la gestione del paziente in pronto soccorso, il secondo si riferisce a simulazioni a bassa fedeltà per la pratica della rachicentesi. Per il terzo caso studio, è stato progettato e sviluppato un prototipo di simulatore in realtà mista per la rachicentesi, con l'obiettivo di migliorare il senso di realismo e immersione della simulazione a bassa fedeltà. 148 studenti sono stati coinvolti nei primi due casi studio osservazionali, mentre soltanto 36 studenti hanno preso parte allo studio pilota sulla simulazione in realtà mista. In tutti i casi di studio sono state effettuate analisi descrittive delle prestazioni, degli stati cognitivi ed emotivi. Per le simulazioni ad alta e bassa fedeltà, le analisi di regressione statistica hanno evidenziato quali variabili influenzano le prestazioni, lo stress e il carico cognitivo degli studenti. Per lo studio pilota sulla realtà mista, l'analisi della user experience ha sottolineato i limiti tecnici della nuova tecnologia.Simulation in medical education is considered a training method capable of improving clinical competence and practitioners’ behaviour, and, consequently quality of care and patient’s outcome. Moreover, the use of new technologies, such as augmented reality, offers to the learners the opportunity to engage themselves in an immersive environment. The opportunity to experiment with this innovative instructional method is effective not only in reducing the risk of errors and wrong approaches but also in experiencing anxiety and stress as in real practice. The challenge is to find the right stress balance: learners have to feel as if they were practicing in the real stressful clinical case, and, at the same time, post-traumatic stress disorders, verifiable especially in the emergency field, must be controlled and avoided. Moreover, it is fundamental also to obtain high performance and learning, thus avoiding cognitive overloads. However, extensive researches about the impact of medical simulations on students’ stress, frustration, cognitive load, and learning are still lacking. For this reason, the main objective of this study is to assess simulation training effectiveness by analysing performance, anxiety, stress, and cognitive load during traditional (with manikin) and advanced (with augmented reality) clinical simulations. A structured and comprehensive methodological approach to assess performance, emotional and cognitive conditions of students has been developed. It includes the acquisition and analysis of psychological parameters (subjective assessment), biometric signals (objective assessment), and task performance. This investigation allows to point out simulations’ weaknesses and offers the opportunity to define useful optimisation guidelines. The methodology has been applied to three case studies: the first one refers to high-fidelity simulations, for the patient management in the emergency room, the second one refers to low-fidelity simulation for rachicentesis. For the third case study, a prototype of a mixed reality simulator for the rachicentesis practice has been designed and developed aiming at improving the sense of realism and immersion of the low-fidelity simulation. While 148 students have been enrolled in the first two case studies, only 36 students have taken part in the pilot study about mixed reality simulation. Descriptive analysis about performance, cognitive and emotional states have been done in all the case studies. For the high-fidelity and low-fidelity simulations, the statistical regression analysis has pointed out which variables affect students’ performance, stress, and cognitive load. For the pilot study about mixed reality, the user experience analysis highlighted the technical limitations of the new technology

2018 Annual Research Symposium Abstract Book

2018 annual volume of abstracts for science research projects conducted by students at Trinity College

Virtual reality in anatomy education: advantages and challenges

Introduction: Anatomy education has evolved throughout the centuries. In the latest decade, anatomy educators encountered different challenges from limited number of cadavers, high-priced anatomical plastination and models. Recent COVID-19 pandemic has inevitably mold future anatomy pedagogy to better-adapt with the current digital-savvy generation. Despite the emergence of virtual reality (VR) in anatomy teaching & learning (T&L), there is limited comparative analysis being explored. Hence, this study aims to elucidate the advantages and challenges using VR in anatomy education. Methods: A narrative review was conducted for this study. Research question was formulated and bibliographical search performed using Scopus and Science Direct databases. Experimental studies published between 2010-2022, in English language, discussing on application, advantages or disadvantages of VR in anatomy and medical T&L were analysed. Results: A total of twenty-four research articles were retrieved. The literatures suggest VR in anatomy education is beneficial as it is more realistic, hands-on, enhances visualization and enjoyable self-learning tool that increases leaners’ engagement. This is especially in low-spatial ability learners that has difficulty to visualize the location and dimension of anatomical structures. VR may improve teaching effectiveness and level of anatomy knowledge. However, the disadvantages are high-cost equipment and risk of tools malfunction. Some experiencing extraneous cognitive load in learning new modalities, motion-sickness, and headache after using VR headgear. Conclusion: The advantages of VR in anatomy education are extensive and outweigh the challenges. As VR devices are more affordable, the current challenge has moved to exploring ways to utilize this advancement in anatomy teaching effectively

Oral Paper SP63. Learner Centred Communication Masterclasses

Background HYMS 3rd and 4th Year MB ChB students frequently encountered communication challenges on clinical placements, despite extensive communication skills teaching in the first two (university based) years of the course. PresentationCompulsory Communication Masterclasses were introduced for 3rd and 4th year students to provide an opportunity for them to address Communication and Professionalism challenges they have encountered on clinical placement. The student-centred Masterclasses are led by Primary /Secondary Care clinicians working with experienced Simulated Patients. They provide an opportunity for students to role play Communication/Professionalism challenges and receive feedback from their peers, Simulated Patient and tutor to help identify strategies for dealing with similar challenges in their future career. Evaluation Students are required to complete an online evaluation which includes descriptive and Likert scale feedback. Students give consistently positive feedback on these sessions, and highlight appreciating the opportunity to reflect and learn from clinician tutors about real-life communication/ professionalism challenges. This student evaluation informs Staff Development Masterclasses for tutors, tutored by faculty and run similarly to the Student Communication Masterclasses. These provide an opportunity to address challenges that tutors have encountered when tutoring Masterclasses and ensure that tutors deliver a consistently high quality student-learning experience