XR in Surgery. Spatial and embodied computing in digital surgery: Technology, Application, Design

Die Arbeit untersucht die Anwendungsfelder, Darstellungsprinzipien und Funktionsweise von extended reality in der chirurgischen Praxis. Anhand zweier Fallstudien zu mixed und virtual reality werden die Einsatzorte und Praktiken von head-mounted Displays sowie das erforderliche Anwendungswissen herausgearbeitet. An den Beispielen der Einblendung anatomischer Darstellungen ins Sichtfeld des chirurgischen Personals sowie der volumetrischen Darstellung chirurgischer Arbeitsabläufe in einer virtuellen Trainingsumgebung werden zwei konkrete Anwendungsszenarien für den Einsatz von extended reality in der chirurgischen Praxis entwickelt. Darauf aufbauend werden die Chancen und Risiken evaluiert, die sich insgesamt für chirurgische Handlungen und Entscheidungen im Bezug auf die Wahrnehmung, Interpretation und Gestaltung von Bildern der extended reality ergeben.The work investigates the technology, application and design of extended reality in surgical practice. Based on two case studies on mixed and virtual reality, it analyses use of head-mounted displays as well as the required applied knowledge. Using the examples of superimposing anatomical images onto the field of vision of surgical staff and the volumetric representation of surgical workflows in a virtual training environment, two concrete application scenarios for the use of extended reality in surgical practice are developed. Based on these scenarios, the chances and risks are evaluated, which result overall for surgical acting and decision making in terms of perception, interpretation and design of images of extended reality

Diseño de una metodología para la implementación de un sistema de realidad virtual a bajo costo

Tesis (Ingeniero Civil Industrial)Según Webster's New Universal Unabridged Dictionary (1989), La realidad virtual se define como “Ser en esencia o efecto, pero no en hecho.” Una definición muy acertada dentro de la variadas y complejas definiciones existentes. Para el caso actual, se considerará realidad virtual como una simulación de la realidad, en la cual el individuo pueda interactuar con un entorno ficticio de forma inmersiva. Lo anterior generado gracias a técnicas informáticas y computacionales. La RV (realidad virtual) ha evolucionado desde el siglo pasado, pero en estos últimos años ha tenido un avance asombroso. Esto dado a la innovación de nuevas tecnologías y al progreso general de estas. Existen varios sistemas y dispositivos de realidad virtual, algunos de los más importantes y comercializados en el último tiempo tienen que ver con los sistemas HMD (headmounted display: cascos de realidad virtual), otros menos conocidos como guantes de realidad virtual y por último el Cave Automatic Virtual Environment (CAVE) sistema de RV que consiste básicamente en montar una especie de habitación alrededor del usuario y proyectar las imágenes a través de las paredes de material traslucido, creando la sensación de inmersión para él o los individuos dentro de la pequeña habitación (Cruz- Neira, Sandin, & DeFanti, 1993). Los sistemas anteriores son los más populares y desarrollados, pero incluso la interacción con un monitor externo se incluye como realidad virtual. La investigación apuntaría a lograr una efectiva combinación de sistemas de realidad virtual, como podrían ser HMD, CAVE, interfaz de control con la virtualidad y por ultimo una sensación de sonido 3D, con el estudio necesario para determinar la importancia que aportaría cada sistema independientemente y en conjunto para satisfacer las necesidades de inmersión para el usuario, a través de una implementación de bajo costo para que sea posible aplicar la metodología a instituciones universitarias, escuelas o incluso para entusiastas, por lo que cotizar cada producto diferenciando sus ventajas y desventajas será clave para determinar la mejor opción posible en el mercado (tanto en Chile como en otros países), ya que dado las distancias y desinformación tecnológica en algunos casos, los precios tienden a subir más de lo esperado en tecnologías importadas y recientes. Una de las principales características de la realidad virtual es permitir simular situaciones o eventos, en los cuales el usuario ingresa a un mundo ficticio programado y la mente humana termina interpretando todas las señales que recibe por los sistemas visuales y auditivos como reales, es por ese motivo que pueden surgir reflejos instantáneos, miedos, memorias y sensaciones de forma sincera, reflejando en cierta medida el actuar de un individuo en alguna situación en particular. Lo anterior influye para determinar como un propósito esencial para la investigación, implementar un sistema de realidad virtual para simular un sistema de evacuación o 7 eventos que puedan ser evitados con entrenamiento o aprendizaje, como pueden ser; incendios (para evacuación o uso de extintor), terremotos (evacuación), accidentes automovilísticos (enfocado a fallas humanas evitables), entre otros. Estos mundos virtuales y eventos de la vida cotidiana serán simuladores a través del motor de videojuegos de acceso libre Unity3D, que tiene como una de sus características programar juegos para realidad virtual y tiene cierta facilidad de uso para nuevos usuarios, aspectos relevantes si se quiere considerar para realizar variantes al uso del sistema manteniéndolo vigente y por supuesto para facilitar el aprendizaje a futuros alumnos y entusiastas. No obstante, existen otros motores gráficos, incluso más potentes que de igual manera son utilizados para crear videojuegos en realidad virtual, pero varían en su usabilidad y adquisición

The use of virtual patients for developing the evidence informed, shared decision making of clinicians

Background Shared decision-making (SDM) involves a patient and a health professional sharing information to arrive at a decision that aligns with both the best available evidence and the patient’s preferences. Research shows that SDM is not occurring in practice to the extent that it ought to. SDM is proposed as a skill of communication which means that it can be learnt and developed. Virtual Patients (VPs) are computer programs that simulate real-life clinical scenarios; learners take on the role of a health professional to interact with a patient and make decisions. VPs may provide a way for students and professionals to practice SDM. Very few VPs published in the literature focus on SDM or related concepts. Aim To design and evaluate a VP for developing the shared decision-making skills of undergraduate medical and pharmacy students, and General Practice Registrars (GPRs). Method A multi-step design process incorporating patient involvement was followed to create the VP. Mixed-method evaluations of the VP utilising pre- and post-questionnaires and semi-structured interviews were conducted at a series of workshops. The qualitative questionnaire data was analysed using content analysis. Descriptive statistics were used for the majority of the quantitative data; one question was analysed using a Wilcoxon rank test. The interview data was analysed by data-driven thematic analysis. Results The VP was found by workshop participants to be both enjoyable and easy to use. The multiple-choice system of interaction provided useful prompts to the participants as to which words and phrases they could use. In future, an extended feedback activity may be required but the optimal composition of this is unclear. For the pharmacy and medical student evaluations, there was a statistically significant change in the rank position of “Respecting patient choices” when comparing pre- and post-VP (p=0.026 and p=0.038 respectively); in both cases, the median rank changed from 2nd to 1st. The modal suggestion for each evaluation was that it was “Likely” there would be changes in the participants’ practice as a result of the VP; the suggested changes were broadly in line with the aims of the VP. Conclusions The VP was well accepted by the majority of the participants in all of the evaluations. The multiple-choice system had some particular advantages for less experienced consulters but its place with those more experienced is unclear. The VP resulted in positive changes in both the participants reported priorities within a consultation and suggested changes in their practice

The use of virtual patients for developing the evidence informed, shared decision making of clinicians

BackgroundShared decision-making (SDM) involves a patient and a health professional sharing information to arrive at a decision that aligns with both the best available evidence and the patient’s preferences. Research shows that SDM is not occurring in practice to the extent that it ought to. SDM is proposed as a skill of communication which means that it can be learnt and developed.Virtual Patients (VPs) are computer programs that simulate real-life clinical scenarios; learners take on the role of a health professional to interact with a patient and make decisions. VPs may provide a way for students and professionals to practice SDM. Very few VPs published in the literature focus on SDM or related concepts.AimTo design and evaluate a VP for developing the shared decision-making skills of undergraduate medical and pharmacy students, and General Practice Registrars (GPRs).MethodA multi-step design process incorporating patient involvement was followed to create the VP.Mixed-method evaluations of the VP utilising pre- and post-questionnaires and semi-structured interviews were conducted at a series of workshops. The qualitative questionnaire data was analysed using content analysis. Descriptive statistics were used for the majority of the quantitative data; one question was analysed using a Wilcoxon rank test. The interview data was analysed by data-driven thematic analysis.ResultsThe VP was found by workshop participants to be both enjoyable and easy to use. The multiple-choice system of interaction provided useful prompts to the participants as to which words and phrases they could use. In future, an extended feedback activity may be required but the optimal composition of this is unclear.For the pharmacy and medical student evaluations, there was a statistically significant change in the rank position of “Respecting patient choices” when comparing pre- and post-VP (p=0.026 and p=0.038 respectively); in both cases, the median rank changed from 2nd to 1st. The modal suggestion for each evaluation was that it was “Likely” there would be changes in the participants’ practice as a result of the VP; the suggested changes were broadly in line with the aims of the VP.ConclusionsThe VP was well accepted by the majority of the participants in all of the evaluations. The multiple-choice system had some particular advantages for less experienced consulters but its place with those more experienced is unclear. The VP resulted in positive changes in both the participants reported priorities within a consultation and suggested changes in their practice