ABSTRACT
We have conducted a telemedicine project between two of Norway's largest hospitals (Rikshospitalet and Ullevål Hospital) with a focus on image-guided surgical and radiological procedures. Video was broadcast using a 34 Mbit/s ATM network. This resulted in changes in the local work practice to accommodate and facilitate the communication. It also required changes to the surgeon's tasks to improve communication with remote viewers. These changes were not trivial and can be viewed as signs of a shift towards a more public kind of surgery and interventional radiology, brought about by new technology.
Subject(s)
Education, Medical, Continuing/methods , Education, Professional/methods , General Surgery/education , Telemedicine/standards , Education, Distance/methods , Education, Medical, Continuing/organization & administration , Education, Professional/organization & administration , Humans , Norway , Telemetry/standardsABSTRACT
BACKGROUND: The introduction of simulators in surgical training entails the need to develop pedagogic platforms adapted to the potentials and limitations provided by the information technology. As a solution to the technical challenges in treating all possible interaction events and to obtain a suitable pedagogic approach, we have developed a pedagogic platform for surgical training, SimMentor. METHODS: In SimMentor the procedure to be practiced is divided into a number of natural phases. The trainee will practice on one phase at a time, however he can select the sequence of phases arbitrarily. A phase is taught by letting the trainee alternate freely between 2 modes: 1: A 3-dimensional animated guidance designed for learning the objectives and challenges in a procedure. 2: An interactive training session through the instrument manipulator device designed for training motoric responses based on visual and tactile responses produced by the simulator. The two modes are interfaced with the same virtual reality platform, thus SimMentor allows a seamless transition between the modes. RESULTS: We have developed a prototype simulator for robotic assisted endoscopic CABG (Coronary Artery Bypass Grafting) procedure by first focusing on the anastomosis part of the operation. Tissue, suture and instrument models have been developed and integrated with a simulated model of a beating heart comprises the elements in the simulator engine that is used in construction a training platform for learning different methods for performing a coronary anastomosis procedure. CONCLUSION: The platform is designed for integrating the following features: 1) practical approach to handle interactivity events with flexible-objects 3D simulators, 2) methods for quantitative evaluations of performance, 3) didactic presentations, 4) effective ways of producing diversity of clinical and pathological training scenarios.
