Exercise/recreation facility for a lunar or Mars analog

The University of Idaho, NASA/USRA project for the 1990-91 school year is an exercise/recreation station for an Earth-based simulator of a lunar or martian habitat. Specifically, a stationary bicycle that will help people keep fit and prevent muscular atrophy while stationed in space was designed. To help with motivation and provide an element of recreation during the workout, the bicycle is to be enhanced by a virtual reality system. The system simulates various riding situations, including the choice of a mountain bike or a road bike. The bike employs a magnetic brake that provides continuously changing tension to simulate actual riding conditions. This braking system is interfaced directly with the virtual reality system. Also, integrated into the virtual reality display will be a monitoring system that regulates heart rate, work rate, and other functions during the course of the session

Initial validation of a virtual-reality learning environment for prostate biopsies: realism matters!

: Introduction-objectives: A virtual-reality learning environment dedicated to prostate biopsies was designed to overcome the limitations of current classical teaching methods. The aim of this study was to validate reliability, face, content and construct of the simulator. Materials and methods: The simulator is composed of a) a laptop computer, b) a haptic device with a stylus that mimics the ultrasound probe, c) a clinical case database including three dimensional (3D) ultrasound volumes and patient data and d) a learning environment with a set of progressive exercises including a randomized 12-core biopsy procedure. Both visual (3D biopsy mapping) and numerical (score) feedback are given to the user. The simulator evaluation was conducted in an academic urology department on 7 experts and 14 novices who each performed a virtual biopsy procedure and completed a face and content validity questionnaire. Results: The overall realism of the biopsy procedure was rated at a median of 9/10 by non-experts (7.1-9.8). Experts rated the usefulness of the simulator for the initial training of urologists at 8.2/10 (7.9-8.3), but reported the range of motion and force feedback as significantly less realistic than novices (p=0.01 and 0.03 respectively). Pearson's r correlation coefficient between correctly placed biopsies on the right and left side of the prostate for each user was 0.79 (p<0.001). The 7 experts had a median score of 64% (59-73), and the 14 novices a median score of 52% (43-67), without reaching statistical significance (p=0,19). Conclusion: The newly designed virtual reality learning environment proved its versatility and its reliability, face and content were validated. Demonstrating the construct validity will require improvements to the realism and scoring system used

Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery

Background The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. Methods A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. Results 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons’ performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. Conclusions The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator

3D sound for simulation of arthroscopic surgery

Arthroscopic surgery offers many advantages compared to traditional surgery. Nevertheless, the required skills to practice this kind of surgery need specific training. Surgery simulators are used to train surgeon apprentices to practice specific gestures. In this paper, we present a study showing the contribution of 3D sound in assisting the triangulation gesture in arthroscopic surgery simulation. This ability refers to the capacity of the subject to manipulate the instruments while having a modified and limited view provided by the video camera of the simulator. Our approach, based on the use of 3D sound metaphors, provides interaction cues to the subjects about the real position of the instrument. The paper reports a performance evaluation study based on the perception of 3D sound integrated in the process of training of surgical task. Despite the fact that 3D sound cueing was not shown useful to all subjects in terms of execution time, the results of the study revealed that the majority of subjects who participated to the experiment confirmed the added value of 3D sound in terms of ease of use

Visuo-spatial ability in colonoscopy simulator training

Visuo-spatial ability is associated with a quality of performance in a variety of surgical and medical skills. However, visuo-spatial ability is typically assessed using Visualization tests only, which led to an incomplete understanding of the involvement of visuo-spatial ability in these skills. To remedy this situation, the current study investigated the role of a broad range of visuo-spatial factors in colonoscopy simulator training. Fifteen medical trainees (no clinical experience in colonoscopy) participated in two psycho-metric test sessions to assess four visuo-spatial ability factors. Next, participants trained flexible endoscope manipulation, and navigation to the cecum on the GI Mentor II simulator, for four sessions within 1 week. Visualization, and to a lesser degree Spatial relations were the only visuo-spatial ability factors to correlate with colonoscopy simulator performance. Visualization additionally covaried with learning rate for time on task on both simulator tasks. High Visualization ability indicated faster exercise completion. Similar to other endoscopic procedures, performance in colonoscopy is positively associated with Visualization, a visuo-spatial ability factor characterized by the ability to mentally manipulate complex visuo-spatial stimuli. The complexity of the visuo-spatial mental transformations required to successfully perform colonoscopy is likely responsible for the challenging nature of this technique, and should inform training- and assessment design. Long term training studies, as well as studies investigating the nature of visuo-spatial complexity in this domain are needed to better understand the role of visuo-spatial ability in colonoscopy, and other endoscopic techniques

Trends in virtual reality technologies for the learning patient

NextMed convened the Medicine Meets Virtual Reality 22 (MMVR 22) conference in 2016. Since 1992, the conference has brought together a diverse group of researchers to share creative solutions for the evolving challenge of integrating virtual reality tools into medical education. Virtual reality (VR) and its enabling technologies utilize hardware and software to simulate environments and encounters where users can interact and learn. The MMVR 22 symposium proceedings contain projects that support a variety of learners: medical students, practitioners, soldiers, and patients. This report will contemplate the trends in virtual reality technologies for patients navigating their medical and healthcare learning. The learning patient seeks more than intervention; they seek prevention. From virtual humans and environments to motion sensors and haptic devices, patients are surrounded by increasingly rich and transformative data-driven tools. Applied data enables VR applications to simulate experience, predict health outcomes, and motivate new behavior. The MMVR 22 presents investigations into the usability of wearable devices, the efficacy of avatar inclusion, and the viability of multi-player gaming. With increasing need for individualized and scalable programming, only committed open source efforts will align instructional designers, technology integrators, trainers, and clinicians. Curriculum and InstructionCurriculum and Instructio

Re‐defining the virtual reality dental simulator: Demonstrating concurrent validity of clinically relevant assessment and feedback

Introduction Virtual reality (VR) dental simulators are gaining momentum as a useful tool to educate dental students. To date, no VR dental simulator exercise has been designed which is capable of reliably providing validated, meaningful clinical feedback to dental students. This study aims to measure the concurrent validity of the assessment, and the provision of qualitative feedback, pertaining to cavity preparations by VR dental simulators. Methods A cavity preparation exercise was created on a VR dental simulator, and assessment criteria for cavity preparations were developed. The exercise was performed 10 times in order to demonstrate a range of performances and for each, the simulator feedback was recorded. The exercises were subsequently three‐dimensionally printed and 12 clinical teachers were asked to assess the preparations according to the same criteria. Inter‐rater reliability (IRR) between clinical teachers was measured using a free‐marginal multirater kappa value. Clinical teacher assessment responses were compared with the VR simulator responses and percentage agreements calculated. Results IRR values for each exercise ranged from 0.39‐0.77 (69.39‐88.48%). The assessment of smoothness (κfree0.58, 78.79%) and ability to follow the outline (κfree0.56, 77.88%) demonstrated highest agreement between clinical teachers, whilst the assessment of undercut (κfree0.15, 57.58%) and depth (κfree 0.28, 64.09%) had the lowest agreement. The modal percentage agreement between clinical teachers and the VR simulator was, on average, 78% across all exercises. Conclusion The results of this study demonstrate that it is possible to provide reliable and clinically relevant qualitative feedback via a VR dental simulator. Further research should look to employ this technique across a broader range of exercises that help to develop other complex operative dental skills

Shipboard Crisis Management: A Case Study.

The loss of the "Green Lily" in 1997 is used as a case study to highlight the characteristics of escalating crises. As in similar safety critical industries, these situations are unpredictable events that may require co-ordinated but flexible and creative responses from individuals and teams working in stressful conditions. Fundamental skill requirements for crisis management are situational awareness and decision making. This paper reviews the naturalistic decision making (NDM) model for insights into the nature of these skills and considers the optimal training regimes to cultivate them. The paper concludes with a review of the issues regarding the assessment of crisis management skills and current research into the determination of behavioural markers for measuring competence