RESUMO
Optical colonoscopy is the gold standard procedure to detect colorectal cancer, the fourth most common cancer in the United Kingdom. Up to 22%-28% of polyps can be missed during the procedure that is associated with interval cancer. A vision-based autonomous soft endorobot for colonoscopy can drastically improve the accuracy of the procedure by inspecting the colon more systematically with reduced discomfort. A three-dimensional understanding of the environment is essential for robot navigation and can also improve the adenoma detection rate. Monocular depth estimation with deep learning methods has progressed substantially, but collecting ground-truth depth maps remains a challenge as no 3D camera can be fitted to a standard colonoscope. This work addresses this issue by using a self-supervised monocular depth estimation model that directly learns depth from video sequences with view synthesis. In addition, our model accommodates wide field-of-view cameras typically used in colonoscopy and specific challenges such as deformable surfaces, specular lighting, non-Lambertian surfaces, and high occlusion. We performed qualitative analysis on a synthetic data set, a quantitative examination of the colonoscopy training model, and real colonoscopy videos in near real-time.
RESUMO
BACKGROUND: Medical ethics education is crucial for preparing medical students to face ethical situations that can arise in patient care. Instances of ethics being integrated into biomedical science education to build the connection between human science and ethics is limited. The specific aim of this study was to measure student attitudes towards an innovative curriculum design that integrates ethics education directly into a biomedical science course in pre-clinical medical curriculum. METHODS: In this cross-sectional study, three ethics learning modules were designed and built in a biomedical science course in the pre-clinical curriculum. All students of Class of 2024 who were enrolled in the course in 2021 were included in the study. Each module integrated ethics with basic science topics and was delivered with different teaching modalities. The first module used a documentary about a well-known patient with severe combined immunodeficiency disease. The second module was delivered through a clinical scenario on HIV infection. The third module used small group discussion and debate on the topic of blood transfusion. For evaluation, students were asked to self-identify the ethical challenges associated with each module and complete reflective writing to assess their knowledge and attitude. Quantitative and qualitative analyses were conducted on student perceptions of each module. RESULTS: Likert scale ratings on the usefulness of each module revealed significantly higher ratings for the small group discussion/debate module, seconded by the documentary and lastly the case scenario only modules. Narrative analysis on student feedback revealed three themes: General favorable impression, Perceived learning outcomes, and Critiques and suggestion. Common and unique codes were identified to measure the strengths and weaknesses of each module. Overall, students' perception of the curriculum design was extremely positive. CONCLUSIONS: This curriculum design enabled us to highlight foundational biomedical sciences and clinical conditions with ethical dilemmas that physicians are likely to face in practice. Students found value in the modules, with a preference for the most active learning method. This study provides insight on a novel approach for integrating medical ethics into biomedical science courses that can be tailored to any institution. Strategies learned include utilizing active learning modalities and discussion.
