Intelligent training system integrated in an echocardiography simulator.

Computer simulators play an important role in medical education. We have extended our simulator EchoComJ with an intelligent training system (ITS) to support trainees adjusting echocardiographic standard views. EchoComJ is an augmented reality application that combines real three-dimensional ultrasound data with a virtual heart model enabling one to simulate an echocardiographic examination. The ITS analyzes the image planes according to their position, orientation and the visualization of anatomical landmarks using fuzzy rules. An adaptive feedback is provided that colors the specific anatomic landmarks within the contours of the virtual model based on the quality of the image plane.

An enabling system for echocardiography providing adaptive support through behavioral analysis.

Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality. Especially for beginners, the most critical point during an echocardiographic examination is the steering of the ultrasound probe to navigate between different cardiological standard planes (sensorimotor skill) without loosing orientation. These transitions or "standard trajectories" can roughly be described by specific movement patterns. We propose an enabling system based on an Augmented Reality simulator for two-dimensional echocardiography imitating this apprenticeship [1]-[3]. During a simulated ultrasound examination the system monitors the activities of the trainee and analyzes the motion pattern of the ultrasound probe. The simulator reacts by mapping the motion patterns onto cognitive orientation demands and providing adaptive feedback in the form of context sensitive help (animations). It partly takes the role of the critical teacher.