This review paper discusses the role of haptics within virtual medical training applications, particularly, where it can be used to aid a practitioner to learn and practice a task. The review summarizes aspects to be considered in the deployment of haptics technologies in medical training. First, both force/torque and tactile feedback hardware solutions that are currently produced commercially and in academia are reviewed, followed by the available haptics-related software and then an in-depth analysis of medical training simulations that include haptic feedback. The review is summarized with scrutiny of emerging technologies and discusses future directions in the field.
This paper presents a virtual environment for training femoral palpation and needle insertion, the opening steps of many interventional radiology procedures. A novel augmented reality simulation called PalpSim has been developed that allows the trainees to feel a virtual patient using their own hands. The palpation step requires both force and tactile feedback. For the palpation haptics effect, two off-the-shelf force feedback devices have been linked together to provide a hybrid device that gives five degrees of force feedback. This is combined with a custom built hydraulic interface to provide a pulse like tactile effect. The needle interface is based on a modified PHANTOM Omni end effector that allows a real interventional radiology needle to be mounted and used during simulation. While using the virtual environment, the haptics hardware is masked from view using chroma-key techniques. The trainee sees a computer generated patient and needle, and interacts using their own hands. This simulation provides a high level of face validity and is one of the first medical simulation devices to integrate haptics with augmented reality.
Objectives: Narrow-band imaging (NBI) is a widely available endoscopic imaging technology; however, uptake of the technique could be improved. Teaching new imaging techniques and assessing trainees' performance can be a challenging exercise during a 1-day workshop.To support NBI training, we developed an online training tool (Medimq) to help experts train novices in NBI bronchoscopy that could assess trainees' performance and provide feedback before the close of the 1-day course. The present study determines whether trainees' capacity to identify relevant pathology increases with the proposed interactive testing method. Methods: Two groups of 20 and 18 bronchoscopists have attended an NBI course where they did a pretest and post-test before and after the main lecture, and a follow-up test 4 weeks later to measure retention of knowledge. We measured their ability to mark normal and abnormal 'biopsy size' areas on bronchoscopic NBI images for biopsy. These markings were compared with areas marked by experts on the same images. Results: The first group results were used to pilot the test. After modifications, the results of the improved test for group 2 showed trainees improved by 32% (total class average normalized gain) in detecting normal or abnormal areas. On follow-up testing, Group 2 improved by 23%. Conclusions:The overall class average normalized gain of 32% shows our test can be used to improve trainees' competency in analyzing NBI Images. The testing method (and tool) can be used to measure the follow up 4 weeks later. Better follow-up test results would be expected with more frequent practice by trainees after the course.
International audience— According to medical experts, haptic realism is difficult to achieve, and even more difficult to have inter-expert agreement on the haptic feedback of one simulation. However haptic feedback is important in medical training, and allows educators to share the forces felt during a procedure if they know and trust what a particular virtual simulator will provide to the trainee. A new approach is proposed to refine bio-mechanical models with experts' input, to closely match the forces felt during a simulated procedure with an expert trainer's expectations. By allowing experts to tune a training scenario's haptic feedback as they trial a newly developed case, the experts can replicate their haptic perception and match their expectations with the simulation
Introduction: Studies suggest that 10% of children with an ARI have persistent cough at day 21. There are no studies in Indigenous children who have a high risk of chronic lung disease. We aimed to identify the incidence and outcomes of ARI with cough as a symptom in urban Indigenous children.Methods: This is a prospective study of Indigenous children aged <5 years registered with a primary health service. Children are followed for a period of 12 months via monthly contacts. Children who develop cough as a symptom at any time are followed weekly for 4 weeks to ascertain cough outcomes.Results: To date, 162 children are enrolled, totalling 1065 child-months of observation. Two-hundred ARI episodes with cough have been reported (29.6 episodes/100 child-months at risk). Thirty-four ARIs (17%) have progressed to persistent cough at day 28 in 24 children. Of these, 15 children had 1 episode, 5 had 2, 4 had 3 and 1 had 4 during the follow-up period. The majority of children with persistent cough were diagnosed (by a respiratory physician) with protracted bacterial bronchitis and/or bronchiectasis.Conclusions: The proportion of children developing persistent cough post-ARI is higher than that currently reported (10%) with the majority suggesting protracted bacterial infection.Grant Support: A QUT APA award, a QCMRI Program Grant, UQ Foundation Research Excellence Award, a QUT Indigenous Health Research StartUp Grant and the NHMRC CRE for Lung Health in Aboriginal and Torres Strait Islander Children.Declaration of Interest: None to Declare TO 002 NURSES SUPPORT DELIVERY OF SPIROMETRY TO TOP END RESPIRATORY OUTREACH CLINICS: A REVIEW OF THE SERVICE EXPANSION AND DEVELOPMENT OF SYSTEMS HARWOOD S, O'LOUGHLAN M Royal Darwin HospitalIntroduction/Aim: Chronic lung conditions are a major cause of morbidity and mortality among Indigenous Australians in remote communities across the Northern Territory (NT) Top End. The Royal Darwin Hospital (RDH) respiratory service commenced on site in 2010 and identified a lack of spirometry testing at remote community health clinics. Remote outreach clinic planning prioritized the provision of nurse led spirometry testing so essential for access to early detection, diagnosis and monitoring of chronic lung conditions. We performed a review of the service to monitor the expansion including spirometry numbers and systems used for the performance and recording of spirometry tests obtained from a cohort of 408 clients from 21 remote clinics.Methods: • We performed a retrospective review of spirometry numbers from 21 remote clinics from 2013 to 2015.• We reviewed the current service and the relevant literature, and we consulted with the Alfred Hospital Lung Testing Laboratory to examine their systems.• We analysed the current systems used to record the spirometry data in the health information systems.Results: 1 Numbers expanded from 66 spirometry tests performed in 21 remote clinics in 2013, 210 in 2014 and 132 in 2015; data collection is ongoing. 2 We developed a unit quality assurance programme ...
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