Haptic feedback can provide an objective assessment of arthroscopic skills.
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ABSTRACT:
SUBMITTER: Chami G
PROVIDER: S-EPMC2504651 | biostudies-other | 2008 Apr
REPOSITORIES: biostudies-other
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Project description:Background and purposePrevious studies have shown that there is a correlation between arthroscopic experience and performance on a virtual-reality (VR) unit. We analyzed the development inexperienced surgeons went through during VR training of shoulder arthroscopy.Methods14 inexperienced surgeons from Silkeborg Regional Hospital were randomized into an intervention group and a control group. 7 experienced surgeons constituted another control group. All were tested twice on insightMIST-an advanced arthroscopic VR trainer-within a period of 6-15 days. The intervention group also received a 5-hour training program on the VR unit.ResultsThe average time for the arthroscopy in the intervention group was reduced from 720 (SD 239) seconds to 223 (SD 114) seconds (p = 0.03 compared to the inexperienced control group). Distance travelled by the camera was reduced from 367 (SD 151) cm to 84 (SD 44) cm in the intervention group (p = 0.02 compared to the inexperienced control group). Depth of collisions was also significantly reduced, whereas distance travelled by the probe and number of collisions were improved in the intervention group, although not statistically significantly.InterpretationVR training is a possible way for young and inexperienced surgeons to achieve basic navigation skills necessary to perform arthroscopic surgery. Further studies regarding the transferability of the skills acquired on the VR unit to the operating theater are desirable.
| S-EPMC3230003 | biostudies-literature
Project description:Gait analysis is a technique that is used to understand movement patterns and, in some cases, to inform the development of rehabilitation protocols. Traditional rehabilitation approaches have relied on expert guided feedback in clinical settings. Such efforts require the presence of an expert to inform the re-training (to evaluate any improvement) and the patient to travel to the clinic. Nowadays, potential opportunities exist to employ the use of digitized "feedback" modalities to help a user to "understand" improved gait technique. This is important as clear and concise feedback can enhance the quality of rehabilitation and recovery. A critical requirement emerges to consider the quality of feedback from the user perspective i.e. how they process, understand and react to the feedback. In this context, this paper reports the results of a Quality of Experience (QoE) evaluation of two feedback modalities: Augmented Reality (AR) and Haptic, employed as part of an overall gait analysis system. The aim of the feedback is to reduce varus/valgus misalignments, which can cause serious orthopedics problems. The QoE analysis considers objective (improvement in knee alignment) and subjective (questionnaire responses) user metrics in 26 participants, as part of a within subject design. Participants answered 12 questions on QoE aspects such as utility, usability, interaction and immersion of the feedback modalities via post-test reporting. In addition, objective metrics of participant performance (angles and alignment) were also considered as indicators of the utility of each feedback modality. The findings show statistically significant higher QoE ratings for AR feedback. Also, the number of knee misalignments was reduced after users experienced AR feedback (35% improvement with AR feedback relative to baseline when compared to haptic). Gender analysis showed significant differences in performance for number of misalignments and time to correct valgus misalignment (for males when they experienced AR feedback). The female group self-reported higher utility and QoE ratings for AR when compared to male group.
| S-EPMC7089541 | biostudies-literature
Project description:BACKGROUND:Pre-recorded videotapes have become the standard approach when teaching clinical communication skills (CCS). Furthermore, video-based feedback (VF) has proven to be beneficial in formative assessments. However, VF in CCS with the use of pre-recorded videos from real-life settings is less commonly studied than the use of simulated patients. To explore: 1) perceptions about the potential benefits and challenges in this kind of VF; 2) differences in the CCC scores in first-year medical residents in primary care, before and after a communication program using VF in a curricular formative assessment. METHOD:We conducted a pre/post study with a control group. The intervention consisted of VF sessions regarding CCS, performed in a small group with peers and a facilitator. They reviewed clinical consultations pre-recorded in a primary care setting with real patients. Before and after the intervention, 54 medical residents performed two clinical examinations with simulated patients (SP), answered quantitative scales (Perception of Patient-Centeredness and Jefferson Empathy Scale), and semi-structured qualitative questionnaires. The performances were scored by SP (Perception of Patient-Centeredness and CARE scale) and by two blind raters (SPIKES protocol-based and CCOG-based scale). The quantitative data analysis employed repeated-measures ANOVA. The qualitative analysis used the Braun and Clarke framework for thematic analysis. RESULTS:The quantitative analyses did not reveal any significant differences in the sum scores of the questionnaires, except for the Jefferson Empathy Scale. In the qualitative questionnaires, the main potential benefits that emerged from the thematic analysis of the VF method were self-perception, peer-feedback, patient-centered approach, and incorporation of reflective practices. A challenging aspect that emerged from facilitators was the struggle to relate the VF with theoretical references and the resident's initial stress to record and watch oneself on video. CONCLUSION:VF taken from real-life settings seems to be associated with a significant increase in self-perceived empathy. The study of other quantitative outcomes related to this VF intervention needs larger sample sizes. VF with clinical patients from real healthcare settings appears to be an opportunity for a deeper level of self-assessment, peer-feedback, and reflective practices.
| S-EPMC7041283 | biostudies-literature
Project description:Background: Chest tube insertion is a standard intervention for management of various injuries of the thorax. Efficient clinical training of this and similar bed-side procedures is equally demanded and improvable. Here, we propose a nouveau means of assessment and feedback using an Objective Structured Assessment of Technical Skills (OSATS) tool. The modified OSATS for chest drain insertion is evaluated in a pilot trial focusing on chest drain insertion. Methods: Participants in the pilot trial were medical students (3rd-6th year of studies, n=9), junior residents (1st-3rd post-graduate year, n=12), senior residents (4th-6th post-graduate year, n=14), and attending surgeons (n=6) from Heidelberg University. Chest drain insertions on a cadaveric porcine model were rated by experts with the modified OSATS score. Participants' performances were videotaped and subsequently rated by two remote experts (video rating). Primary aim was to assess criterion validity of the OSATS to distinguish experience levels. Results: Kruskal-Wallis test showed significant differences between means of scores between four groups stratified by previous experience in chest tube insertion (level 0: 22.1±3.2 vs. level 1: 26.8±2.8 vs. level 2: 35.4±2.2 vs. level 3: 41.0±2.0; p=0.002; p1,3=0.049, p0,3=0.005). However, if groups were stratified by formal professional level, no statistically significant distinction could be made using OSATS. Hence, the OSATS tool showed criterion validity for differentiation between experience levels. Conclusion: In the pilot study, the modified OSATS for chest tube insertion was apt to standardize expert rating and could be used to measure skill and to depict different experience levels. The OSATS will help facilitate training and assessment of chest drain insertion and could therefore improve surgical training for trauma situations. According to our data, the OSATS might be integrated into modern curricula.
| S-EPMC6278238 | biostudies-other
Project description:The word "haptics" refers to technologies designed to stimulate the tactile and kinesthetic senses. Kinesthesia-the sense of motion-is triggered by imposing forces upon the joints, tendons, and muscles to recreate the geometry and stiffness of objects, as may be useful in physical therapy or virtual reality. Here, we introduce a form of kinesthetic feedback by manipulating the mechanical properties of spandex impregnated with a thermoplastic polymer. Heating or cooling this textile-thermoplastic composite just above or below its glass transition temperature (T g) dramatically changes its mechanical properties (corresponding to a decrease in storage modulus from 36 MPa to 0.55 MPa). In the form of a glove, the composite can also be healed after inadvertent overextension in its stiffened state by heating it above its T g. When fitted with thermoelectric devices for active heating and cooling, the flexible or stiffened state of a glove can be perceived by human subjects. As an example of a human-machine interface, the glove is used to control a robotic finger. When the robotic finger makes contact with a wall, a signal is sent to thermoelectric devices in the glove to cool (stiffen the finger) and thus provide kinesthetic feedback to the user.
| S-EPMC6880936 | biostudies-literature
Project description:PURPOSE:Recently, some attempts have been made to integrate lung ultrasound (LUS) teaching into medical curricula. However, current education studies of LUS are extremely heterogeneous due to the lack of evidence-based guidelines on LUS education. In particular, the assessment of competencies is poorly standardized and mostly relies on non-validated scales. A new validated tool, the objective structured assessment of lung ultrasound skills (LUS-OSAUS), has the potential to overcome these limitations. Therefore, we adopted the LUS-OSAUS tool to assess the competencies of a group of LUS-trained undergraduates. Existing no prior practical applications of the LUS-OSAUS, our aim was to investigate the practical utility of this tool and its applicability in the evaluation of US-trained medical students. METHODS:Eight undergraduates (two males, six females) were enrolled on a voluntary basis to receive a theoretical and practical training in LUS. Once completed their training, each student performed an LUS examination on a different patient hospitalized for respiratory symptoms. The same eight patients were also scanned by a senior resident in emergency medicine for a comparison with students' results. Students and the senior resident were tested by an examiner using the LUS-OSAUS tool. We compared the scores obtained by operators in all areas of competence of the LUS-OSAUS, the total scores, and the time needed to complete the sonographic task. RESULTS:Median students' score in the single items of the scale was significantly lower than the ones obtained by the senior resident (4.0 [3.3-5.0] vs. 5.0 [5.0-5.0]; p?<?0.0001). Students scored significantly lower than the senior resident in each item, except for B-line identification, choice of the correct transducer, and suggested focused questions. Median total score was also lower for students compared to the senior resident (70.5 [61.0-74.8] vs. 84.0 [83.5-84.3] (p?=?0.0116). Median time required to complete the examination was significantly higher for students (14.1 [12.8-16.1] vs. 4.7 [3.9-5.2] min, p?=?0.0117). CONCLUSIONS:The LUS-OSAUS tool allowed for a standardized and comprehensive assessment of student's competencies in lung ultrasound, and helped to discriminate their level of expertise from that of a more experienced operator. The scale also specifically tests the theoretical knowledge of trainees, thus making redundant the use of questionnaires designed for this purpose.
| S-EPMC7223719 | biostudies-literature
Project description:Background :While leadership training is increasingly incorporated into residency education, existing assessment tools to provide feedback on leadership skills are only applicable in limited contexts. Objective :We developed an instrument, the Leadership Observation and Feedback Tool (LOFT), for assessing clinical leadership. Methods :We used an iterative process to develop the tool, beginning with adapting the Leadership Practices Inventory to create an open-ended survey for identification of clinical leadership behaviors. We presented these to leadership experts who defined essential behaviors through a modified Delphi approach. In May 2014 we tested the resulting 29-item tool among residents in the internal medicine and pediatrics departments at 2 academic medical centers. We analyzed instrument performance using Cronbach's alpha, interrater reliability using intraclass correlation coefficients (ICCs), and item performance using linear-by-linear test comparisons of responses by postgraduate year, site, and specialty. Results :A total of 377 (of 526, 72%) team members completed the LOFT for 95 (of 519, 18%) residents. Overall ratings were high-only 14% scored at the novice level. Cronbach's alpha was 0.79, and the ICC ranged from 0.20 to 0.79. Linear-by-linear test comparisons revealed significant differences between postgraduate year groups for some items, but no significant differences by site or specialty. Acceptability and usefulness ratings by respondents were high. Conclusions :Despite a rigorous approach to instrument design, we were unable to collect convincing validity evidence for our instrument. The tool may still have some usefulness for providing formative feedback to residents on their clinical leadership skills.
| S-EPMC6194892 | biostudies-other
Project description:Advances in soft robotics provide a unique approach for delivering haptic feedback to a user by a soft wearable device. Such devices can apply forces directly on the human joints, while still maintaining the safety and flexibility necessary for use in close proximity to the human body. To take advantage of these properties, we present a new haptic wrist device using pressure-driven soft actuators called reverse pneumatic artificial muscles (rPAMs) mounted on four sides of the wrist. These actuators are originally pre-strained and release compressive stress under pressure, applying a safe torque around the wrist joints while being compact and portable, representing the first soft haptic device capable of real-time feedback. To demonstrate the functional utility of this device, we created a virtual path-following task, wherein the user employs the motion of their wrist to control their embodied agent. We used the haptic wrist device to assist the user in following the path and study their performance with and without haptic feedback in multiple scenarios. Our results quantify the effect of wearable soft robotic haptic feedback on user performance. Specifically, we observed that our haptic feedback system improved the performance of users following complicated paths in a statistically significant manner, but did not show improvement for simple linear paths. Based on our findings, we anticipate broader applications of wearable soft robotic haptic devices toward intuitive user interactions with robots, computers, and other users.
| S-EPMC7805937 | biostudies-literature
Project description:BACKGROUND: Although interpersonal and communication skills are essential to physician practice, there is a dearth of effective tools to meaningfully teach and assess communication skills. OBJECTIVE: The purpose of our study was to create a standardized tool for evaluation of communication skills for residents across specialties. METHODS: We designed an Objective, Structured Communication Assessment of Residents (OSCAR) tool, consisting of 4 clinical stations, to assess intern communication skills with relationship development, their establishment of case goals, and their organization and time management skills. Interns from 11 training programs completed the stations, with senior residents trained to function as standardized patients. The 4 stations' scenarios were a disruptive patient, handling a phone call for a narcotics refill, disclosing a medical mistake, and delivering bad news. RESULTS: Eighty-three interns completed OSCAR during orientation. The assessment took interns about 40 minutes to complete, and participants were given immediate feedback by the standardized patients. The total possible score for each station was 50. Resident performance was highest for disclosing a medical error (94%, 47 of 50), followed by handling a disruptive patient (90%, 45 of 50), disclosing bad news (86%, 43 of 50), and handling the phone call for the narcotics refill (62%, 31 of 50). Multivariate analysis of variance results indicated differences between residents from US and international medical schools, but there were no significant differences across specialties. Interrater reliability was excellent for each station (> 0.80). CONCLUSIONS: OSCAR is a practical tool for assessing interns' communication skills to provide timely results to program directors.
| S-EPMC3886453 | biostudies-other
Project description:With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping.To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents.A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomographic angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-dimensional immersive virtual reality environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from 3 residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery.Residents thought that the simulation would be useful in preparing for real-life surgery. About two-thirds of the residents thought that the 3-dimensional immersive anatomic details provided a close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They thought the simulation was useful for preoperative surgical rehearsal and neurosurgical training. A third of the residents thought that the technology in its current form provided realistic haptic feedback for aneurysm surgery.Neurosurgical residents thought that the novel immersive VR simulator is helpful in their training, especially because they do not get a chance to perform aneurysm clippings until late in their residency programs.
| S-EPMC4340784 | biostudies-literature