Arterial Line Placement Simulator

Currently, there are many medical simulators that provide a means to train operators on various medical procedures like arterial or venous access, patient care, or simply anatomical models. There are many factors that determine the efficacy of a particular medical simulator in teaching a medical procedure. This project reports the details in developing a medical simulator for teaching arterial access at radial artery. The objective of this project was to learn the aspects of creating a model feasible for teaching this procedure. A comprehensive study was conducted evaluating the kinematics, anatomy, and physiology of the human arm. A model was produced and presented to our clients. Medical practitioners will further validate this model

Virtual environments for medical training : graphic and haptic simulation of tool-tissue interactions

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2004.Includes bibliographical references (leaves 122-127).For more than 2,500 years, surgical teaching has been based on the so called "see one, do one, teach one" paradigm, in which the surgical trainee learns by operating on patients under close supervision of peers and superiors. However, higher demands on the quality of patient care and rising malpractice costs have made it increasingly risky to train on patients. Minimally invasive surgery, in particular, has made it more difficult for an instructor to demonstrate the required manual skills. It has been recognized that, similar to flight simulators for pilots, virtual reality (VR) based surgical simulators promise a safer and more comprehensive way to train manual skills of medical personnel in general and surgeons in particular. One of the major challenges in the development of VR-based surgical trainers is the real-time and realistic simulation of interactions between surgical instruments and biological tissues. It involves multi-disciplinary research areas including soft tissue mechanical behavior, tool-tissue contact mechanics, computer haptics, computer graphics and robotics integrated into VR-based training systems. The research described in this thesis addresses many of the problems of simulating tool-tissue interactions in medical virtual environments. First, two kinds of physically based real time soft tissue models - the local deformation and the hybrid deformation model - were developed to compute interaction forces and visual deformation fields that provide real-time feed back to the user. Second, a system to measure in vivo mechanical properties of soft tissues was designed, and eleven sets of animal experiments were performed to measure in vivo and in vitro biomechanical properties of porcine intra-abdominal organs. Viscoelastic tissue(cont.) parameters were then extracted by matching finite element model predictions with the empirical data. Finally, the tissue parameters were combined with geometric organ models segmented from the Visible Human Dataset and integrated into a minimally invasive surgical simulation system consisting of haptic interface devices inside a mannequin and a graphic display. This system was used to demonstrate deformation and cutting of the esophagus, where the user can haptically interact with the virtual soft tissues and see the corresponding organ deformation on the visual display at the same time.by Jung Kim.Ph.D

Contextualising simulation: the use of patient-focused hybrid simulation for clinical skills education

This thesis documents a research programme into the use of Patient-Focused Hybrid Simulation (PFHS) for clinical skills education. PFHS is an approach to simulating clinical skills that combines a simulated patient (SP) with a part-task trainer (PTT) embedding the simulation of procedural skills within a more holistic clinical context, potentially overcoming some of the shortcomings of single modality simulation. Although promising, there remains limited evidence supporting its use. Two studies were conducted using a mixed-method approach. The first study was based on the simulation of the management of a traumatic skin laceration and consisted of two parts: 1) investigating the use of PFHS as a means of introducing clinical challenge by modifying the clinical context in which a procedure is performed; 2) exploring clinician’s perception of the use of PFHS and PTT for assessing of clinical competence. These findings suggest that by changing the clinical context in which a procedure is performed, PFHS can potentially be used to objectively simulate challenge. It also demonstrated that PFHS when compared to PTT simulations was better able to induce authentic clinical behaviour within the simulation. Central to this is the presence of a human being (SP). The second study compared the use of PFHS to patients for the training and assessment of cardiovascular examination skills. Within the limitations of this study, no significant difference was observed between PFHS and real patient-trained students in terms of their post-training performance of cardiovascular examination on real patients. There also appeared to be degree of concurrent validity between assessment of competency with PFHS and with real patients when conducted as an Objective Structured Clinical Examination (OSCE). The work presented provides additional evidence to the existing literature to support the use of PFHS in clinical skills education. However, it also raises a multitude of questions particularly of how PFHS as well as simulation in general should be used and future directions for simulation research.Open Acces

Tribology of Medical Devices

Importance of tribology in a number of medical devices and surgical instruments is reviewed, including artificial joints, artificial teeth, dental implants and orthodontic appliances, cardiovascular devices, contact lenses, artificial limbs and surgical instruments. The current focus and future developments of these medical devices are highlighted from a tribological point of view, together with the underlying mechanisms

Liver Biopsy

Liver biopsy is recommended as the gold standard method to determine diagnosis, fibrosis staging, prognosis and therapeutic indications in patients with chronic liver disease. However, liver biopsy is an invasive procedure with a risk of complications which can be serious. This book provides the management of the complications in liver biopsy. Additionally, this book provides also the references for the new technology of liver biopsy including the non-invasive elastography, imaging methods and blood panels which could be the alternatives to liver biopsy. The non-invasive methods, especially the elastography, which is the new procedure in hot topics, which were frequently reported in these years. In this book, the professionals of elastography show the mechanism, availability and how to use this technology in a clinical field of elastography. The comprehension of elastography could be a great help for better dealing and for understanding of liver biopsy