Surgical telepresence: the usability of a robotic communication platform

INTRODUCTION: The benefits of telepresence in trauma and acute surgical care exist, yet its use in a live, operating room (OR) setting with real surgical cases remains limited. METHODS: We tested the use of a robotic telepresence system in the OR of a busy, level 1 trauma center. After each case, both the local and remote physicians completed questionnaires regarding the use of the system using a five point Likert scale. For trauma cases, physicians were asked to grade injury severity according to the American Association for the Surgery of Trauma (AAST) Scaling System. RESULTS: We collected prospective, observational data on 50 emergent and elective cases. 64% of cases were emergency surgery on trauma patients, almost evenly distributed between penetrating (49%) and blunt injuries (51%). 40% of non-trauma cases were hernia-related. A varied distribution of injuries was observed to the abdomen, chest, extremities, small bowel, kidneys, spleen, and colon. Physicians gave the system high ratings for its audio and visual capabilities, but identified internet connectivity and crowding in the operating room as potential challenges. The loccal clinician classified injuries according to the AAST injury grading system in 63% (n=22) of trauma cases, compared to 54% (n=19) of cases by the remote physicians. The remote physician cited obstruction of view as the main reason for the discrepancy. 94% of remote physicians and 74% of local physicians felt comfortable communicating via the telepresence system. For 90% of cases, both the remote and local physicians strongly agreed that a telepresence system for consultations in the OR is more effective than a telephone conversation. CONCLUSIONS: A telepresence system was tested on a variety of surgical cases and demonstrated that it can be an appropriate solution for use in the operating room. Future research should determine its impact on processes of care and surgical outcomes

Influence of social networking websites on medical school and residency selection process

Background Social networking (SN) has become ubiquitous in modern culture. The potential consequences of revealing personal information through SN websites are not fully understood. Objective To assess familiarity with, usage of, and attitudes towards, SN websites by admissions offices at US medical schools and residency programmes. Methods A 26-question survey was distributed in autumn 2009 to 130 US medical school admissions officers and 4926 residency programme directors accredited by the Accreditation Council for Graduate Medical Education. Results A total of 600 surveys were completed, with 46 (8%) respondents who self-identified as reviewing only medical school applications, 511 (85%) who reported reviewing residency programme applications and 43 (7%) who reported reviewing both. 90/600 (15%) medical schools or programmes maintain profiles on SN websites and 381/600 (64%) respondents reported being somewhat or very familiar with searching individual profiles on SN websites. While a minority of medical schools and residency programmes routinely use SN websites in the selection process (53/600; 9%), more than half of respondents felt that unprofessional information on applicants’ SN websites could compromise their admission into medical school or residency (315/600; 53%). Conclusions SN websites will affect selection of medical students and residents. Formal guidelines for professional behaviour on SN websites might help applicants avoid unforeseen bias in the selection process

Enhancing trauma education worldwide through telemedicine

Abstract Advances in information and communication technologies are changing the delivery of trauma care and education. Telemedicine is a tool that can be used to deliver expert trauma care and education anywhere in the world. Trauma is a rapidly-evolving field requiring access to readily available sources of information. Through videoconferencing, physicians can participate in continuing education activities such as Grand Rounds, seminars, conferences and journal clubs. Exemplary programs have shown promising outcomes of teleconferences such as enhanced learning, professional collaborations, and networking. This review introduces the concept of telemedicine for trauma education, and highlights efforts of programs that are utilizing telemedicine to unite institutions across the world.</p

Enhancing trauma education worldwide through telemedicine

Advances in information and communication technologies are changing the delivery of trauma care and education. Telemedicine is a tool that can be used to deliver expert trauma care and education anywhere in the world. Trauma is a rapidly-evolving field requiring access to readily available sources of information. Through videoconferencing, physicians can participate in continuing education activities such as Grand Rounds, seminars, conferences and journal clubs. Exemplary programs have shown promising outcomes of teleconferences such as enhanced learning, professional collaborations, and networking. This review introduces the concept of telemedicine for trauma education, and highlights efforts of programs that are utilizing telemedicine to unite institutions across the world

Utilizing Telemedicine in the Trauma Intensive Care Unit: Does It Impact Teamwork?

The aim of this study was to examine the impact of a telemedical robot on trauma intensive care unit (TICU) clinician teamwork (i.e., team attitudes, behaviors, and cognitions) during patient rounds.Materials and Methods:Thirty-two healthcare providers who conduct rounds volunteered to take surveys assessing teamwork attitudes and cognitions at three time periods: (1) the onset of the study, (2) the end of the 30-day control period, and (3) the end of the 30-day experimental period, which immediately followed the control period. Rounds were recorded throughout the 30-day control period and 30-day experimental period to observe provider behaviors. For the initial 30 days, there was no access to telemedicine. For the final 30 days, the rounding healthcare providers had access to the RP-7 robot (Intouch Health Inc., Santa Barbara, CA), a telemedical tool that can facilitate patient rounds conducted away from bedside.Results:Using a one-tailed, one-way repeated-measures analysis of variance (ANOVA) to compare trust at Times 1, 2, and 3, there was no significant effect on trust: F(2, 14)=1.20, p=0.16. When a one-tailed, one-way repeated-measures ANOVA to compare transactive memory systems (TMS) at Times 1, 2, and 3 was conducted, there was no significant effect on TMS: F(2, 15)=1.33, p=0.15. We conducted a one-tailed, one-way repeated-measures ANOVA to compare team psychological safety at Times 1, 2, and 3, and there was no significant effect on team psychological safety: F(2,15)=1.53, p=0.12. There was a significant difference in communication between rounds with and without telemedicine [t(25)=−1.76, p\u3c0.05], such that there was more task-based communication during telerounds. Telemedicine increased task-based communication and did not negatively impact team trust, psychological safety, or TMS during rounds. Conclusions: Telemedicine may offer advantages for some teamwork competencies without sacrificing the efficacy of others and may be adopted by intact rounding teams without hindering teamwork

Global Connections: Telemedicine as a Tool to extend Trauma Education

ABSTRACT Introduction Telemedicine is revolutionizing the delivery of trauma care and education. The International Trauma Tele- Grand Rounds is a series that unites institutions worldwide to discuss complex clinical cases and advanced trauma and critical care topics. Materials and methods Multiple remote institutions connect simultaneously to discuss the management of a trauma patient from the prehospital phase to discharge. Weekly, a case is presented in English by one institution on a rotating basis. Key points include mechanism of injury, resuscitation, laboratory and imaging diagnostics, surgical interventions, postoperative patient care, evaluation of treatment decisions and review of the literature. The highly interactive format allows participants to evaluate differences in trauma care across international health systems. Results During 2010 to 2011, 68 sessions were documented. Cases include blunt (42.6%), penetrating (48.5%), blast (7.4%) and crushing (1.5%) traumas. Gunshot wounds were the most frequent (25%). A holistic range of injuries were represented including injuries to major arteries, veins, lungs, heart, pericardium, esophagus, diaphragm, abdominal wall, stomach, intestines, liver, kidneys, pelvis, and the extremities. A variety of surgical and nonsurgical interventions were explored. To date, there have been 42 participating institutions from the United States, Brazil, Colombia, Bahamas, Canada, Mexico, Venezuela, Argentina, Panama, Puerto Rico, Dominican Republic, British Virgin Islands, Spain, Thailand, Turkey and Iraq; ranging from academic medical centers military hospitals, community hospitals, and rural hospitals. In 2011, the series received accreditation by the Accreditation Council for Continuing Medical Education. Conclusion Telemedicine offers a solution to address the disparities in access to trauma care and education. The diversity of institutional settings allows participants to learn from others on how to best treat trauma patients, despite differences in resources and expertise. In addition to serving as an educational tool, the series provides a mechanism for physicians to network and collaborate on future endeavors. How to cite this article Marttos AC, Kuchkarian FM, Rojas DF, Fraga GP, Collet-Silva FS, de Almeida Costa C, Garcia GD, Ginzburg E, Schulman CI, Namias N. Global Connections: Telemedicine as a Tool to extend Trauma Education. Panam J Trauma Critical Care Emerg Surg 2013;2(1):62-66