3,301 research outputs found

    Robotic simulators for tissue examination training with multimodal sensory feedback

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    Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

    The application of virtual reality and augmented reality in oral & maxillofacial surgery

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    Background: Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery. Methods: We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included. Results: We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training. Conclusion: Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education

    Proof of concept of a workflow methodology for the creation of basic canine head anatomy veterinary education tool using augmented reality

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    Neuroanatomy can be challenging to both teach and learn within the undergraduate veterinary medicine and surgery curriculum. Traditional techniques have been used for many years, but there has now been a progression to move towards alternative digital models and interactive 3D models to engage the learner. However, digital innovations in the curriculum have typically involved the medical curriculum rather than the veterinary curriculum. Therefore, we aimed to create a simple workflow methodology to highlight the simplicity there is in creating a mobile augmented reality application of basic canine head anatomy. Using canine CT and MRI scans and widely available software programs, we demonstrate how to create an interactive model of head anatomy. This was applied to augmented reality for a popular Android mobile device to demonstrate the user-friendly interface. Here we present the processes, challenges and resolutions for the creation of a highly accurate, data based anatomical model that could potentially be used in the veterinary curriculum. This proof of concept study provides an excellent framework for the creation of augmented reality training products for veterinary education. The lack of similar resources within this field provides the ideal platform to extend this into other areas of veterinary education and beyond

    The Effect of Augmented Reality Treatment on Learning, Cognitive Load, and Spatial Visualization Abilities

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    This study investigated the effects of Augmented Reality (AR) on learning, cognitive load and spatial abilities. More specifically, it measured learning gains, perceived cognitive load, and the role spatial abilities play with students engaged in an astronomy lesson about lunar phases. Research participants were 182 students from a public university in southeastern United States, and were recruited from psychology research pool. Participants were randomly assigned to two groups: (a) Augmented Reality and Text Astronomy Treatment (ARTAT); and (b) Images and Text Astronomy Treatment (ITAT). Upon entering the experimental classroom, participants were given (a) Paper Folding Test to measure their spatial abilities; (b) the Lunar Phases Concept Inventory (LPCI) pre-test; (c) lesson on Lunar Phases; (d) NASA-TLX to measure participants’ cognitive load; and (e) LPCI post-test. Statistical analysis found (a) no statistical difference for learning gains between the ARTAT and ITAT groups; (b) statistically significant difference for cognitive load; and (c) no significant difference for spatial abilities scores

    Augmented reality system for digital rectal examination training and assessment: system validation

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    Background: Digital rectal examination is a difficult examination to learn and teach because of limited opportunities for practice; however, the main challenge is that students and tutors cannot see the finger when it is palpating the anal canal and prostate gland inside the patients. Objective: This paper presents an augmented reality system to be used with benchtop models commonly available in medical schools with the aim of addressing the problem of lack of visualization. The system enables visualization of the examining finger, as well as of the internal organs when performing digital rectal examinations. Magnetic tracking sensors are used to track the movement of the finger, and a pressure sensor is used to monitor the applied pressure. By overlaying a virtual finger on the real finger and a virtual model on the benchtop model, students can see through the examination and finger maneuvers. Methods: The system was implemented in the Unity game engine (Unity Technologies) and uses a first-generation HoloLens (Microsoft Inc) as an augmented reality device. To evaluate the system, 19 participants (9 clinicians who routinely performed digital rectal examinations and 10 medical students) were asked to use the system and answer 12 questions regarding the usefulness of the system. Results: The system showed the movement of an examining finger in real time with a frame rate of 60 fps on the HoloLens and accurately aligned the virtual and real models with a mean error of 3.9 mm. Users found the movement of the finger was realistic (mean 3.9, SD 1.2); moreover, they found the visualization of the finger and internal organs were useful for teaching, learning, and assessment of digital rectal examinations (finger: mean 4.1, SD 1.1; organs: mean 4.6, SD 0.8), mainly targeting a novice group. Conclusions: The proposed augmented reality system was designed to improve teaching and learning of digital rectal examination skills by providing visualization of the finger and internal organs. The initial user study proved its applicability and usefulness

    Virtual and Augmented Reality in Medical Education

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    Virtual reality (VR) and augmented reality (AR) are two contemporary simulation models that are currently upgrading medical education. VR provides a 3D and dynamic view of structures and the ability of the user to interact with them. The recent technological advances in haptics, display systems, and motion detection allow the user to have a realistic and interactive experience, enabling VR to be ideal for training in hands-on procedures. Consequently, surgical and other interventional procedures are the main fields of application of VR. AR provides the ability of projecting virtual information and structures over physical objects, thus enhancing or altering the real environment. The integration of AR applications in the understanding of anatomical structures and physiological mechanisms seems to be beneficial. Studies have tried to demonstrate the validity and educational effect of many VR and AR applications, in many different areas, employed via various hardware platforms. Some of them even propose a curriculum that integrates these methods. This chapter provides a brief history of VR and AR in medicine, as well as the principles and standards of their function. Finally, the studies that show the effect of the implementation of these methods in different fields of medical training are summarized and presented

    MIXED REALITY IN MEDICAL SIMULATION: A COMPREHENSIVE DESIGN METHODOLOGY

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    AbstractIn the medical education field, the use of highly sophisticated simulators and extended reality (XR) simulations allow training complex procedures and acquiring new knowledge and attitudes. XR is considered useful for the enhancement of healthcare education; however, several issues need further research.The main aim of this study is to define a comprehensive method to design and optimize every kind of simulator and simulation, integrating all the relevant elements concerning the scenario design and prototype development.A complete framework for the design of any kind of advanced clinical simulation is proposed and it has been applied to realize a mixed reality (MR) prototype for the simulation of the rachicentesis. The purpose of the MR application is to immerse the trainee in a more realistic environment and to put him/her under pressure during the simulation, as in real practice.The application was tested with two different devices: the headset Vox Gear Plus for smartphone and the Microsoft Hololens. Eighteen students of the 6th year of Medicine and Surgery Course were enrolled in the study. Results show the comparison of user experience related to the two different devices and simulation performance using the Hololens

    Augmented Dissection

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    Dissection has long been the primary method to gain greater insight into the structures and functions of the human body. It requires careful step-by-step analysis, retrieval of stored information, and spatial navigation to successfully explore our inner makings. Many facilities and campuses nationwide are not equipped for cadavers, and in particular, online laboratory settings are often devoid of hands-on dissection altogether. Anatomy 4D is an augmented reality (AR) mobile application that allows for human body exploration through enhanced dissection. Its application in laboratory settings may be a viable means of resolving hands-on dissection limitations. To investigate this idea, college anatomy students utilized the AR mobile application to dissect the heart organ in an action research study. Students performed activities individually, by creating personalized deliverables to share, and collaboratively, by contemplating connections through discussion. In better determining the impact of AR dissection in enhancing identification of human body structures among learners, pre and post assessments were conducted. Overall results indicated AR utilization for human organ exploration was positive with a marked increase of recognition after lesson activities and numerous indications of personal satisfaction from the use of mobile learning technology, constructivist design, and peer collaboration

    Microscope Embedded Neurosurgical Training and Intraoperative System

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    In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results. In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point. The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery. This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient. The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability. Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery. All the components are open source or at least based on a GPL license
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