Interactive teaching environment for diagnostic radiography with real-time X-ray simulation and patient positioning

Purpose Traditional undergraduate radiographer training mixes academic lectures and clinical practice. Our goal is to bridge the current disconnection between theory and practice in a safe environment, avoiding the risk of radiation for both practitioners and patients. To this end, this research proposes a new software to teach diagnostic radiography using real-time interactive X-ray simulation and patient positioning. Methods The proposed medical simulator is composed of three main modules. A fast and accurate character animation technique is in charge of simulating the patient positioning phase and adapts their internal anatomy accordingly. gVirtualXRay is an open-source X-ray simulation library and generates the corresponding radiographs in real time. Finally, the courseware allows going through all the diagnostic radiology steps from the patient positioning and the machine configuration to the final image enhancing. Results A face and content validation study has been conducted; 18 radiology professionals were recruited to evaluate our software using a questionnaire. The results show that our tool is realistic in many ways (72% of the participants agreed that the simulations are visually realistic), useful (67%) and suitable (78%) for teaching X-ray radiography. Conclusions The proposed tool allows simulating the most relevant steps of the projectional radiography procedure. The virtual patient posing system and X-ray simulation module execute at interactive rates. These features enable the lectures to show their students the results of good and bad practices in a classroom environment, avoiding radiation risk.

Implementation of a 3D position detection system for a medical simulator

BACKGOROUND AND OBJECTIVE: Cardiovascular disorders are increasing because of poor eating habits, excessive drinking, and lack of exercise. Some of the typical cardiovascular surgical procedures utilize catheters. Catheter-based procedures require the surgeons to have extensive experience and high proficiency at performing vascular interventions. However, the learning period to acquire such proficiency is lengthy and the opportunities for practical training and mastery are insufficient. Therefore, due to insufficient skill, dangerous situations with damage or rupture of the patient’s blood vessels may occur, thereby increasing the risk of medical accidents. Hence, it is necessary to have experience and proficiency for performing vascular interventions. Thus, it is necessary to develop a simulator to shorten learning time and reduce medical accidents. METHODS: In this study, we developed a position detection system for the simulator to use physical models to learn cardiovascular surgical intervention techniques. The developed system uses changes in the output values of a Hall sensor based on the position of a permanent magnet. RESULTS AND CONCLUSIONS: From the changing output values, the distance calculation equation is derived, and the position of the permanent magnet is effectively estimated from the calculations. The performance of the position detecting system was tested, and the results proved that the system could be sufficiently used as a simulator.

Integrated eye tracking on Magic Leap One during augmented reality medical simulation: a technical report

Augmented reality (AR) has been studied as a clinical teaching tool, however eye-tracking capabilities integrated within an AR medical simulator have limited research. The recently developed Chariot Augmented Reality Medical (CHARM) simulator integrates real-time communication into a portable medical simulator. The purpose of this project was to refine the gaze-tracking capabilities of the CHARM simulator on the Magic Leap One (ML1). Adults aged 18 years and older were recruited using convenience sampling. Participants were provided with an ML1 headset that projected a hologram of a patient, bed and monitor. They were instructed via audio recording to gaze at variables in this scenario. The participant gaze targets from the ML1 output were compared with the specified gaze points from the audio recording. A priori investigators planned to iterative modifications of the eye-tracking software until a capture rate of 80% was achieved. Two consecutive participants with a capture rate less than 80% triggered software modifications and the project concluded after three consecutive participants’ capture rates were greater than 80%. Thirteen participants were included in the study. Eye-tracking concordance was less than 80% reliable in the first 10 participants. The investigators hypothesised that the eye movement detection threshold was too sensitive, thus the algorithm was adjusted to reduce noise. The project concluded after the final three participants’ gaze capture rates were 80%, 80% and 80.1%, respectively. This report suggests that eye-tracking technology can be reliably used with the ML1 enabled with CHARM simulator software.

3D software simulator for primary care training

"Medical software simulators are used to teach specific procedures that allow the user to follow only a strict sequence of steps without the possibility of alternative, avoiding considering the consequence of an error and then potentially admitting its tolerance. Usually these applications are a state machine implementation where learners must make a specific action to obtain a specific result. In our work we propose a brand-new approach with a “open world” serious game medical simulator, based on Agent Based Model Paradigm. Starting by these concepts, a user can learn and test his skills in a dynamic environment that changes in real time based on his actions. We provide a configurable starting set of conditions (patient heath state, available medical instruments and drugs) to create, potentially, infinite scenarios; alongside these boundary values the game permits to configure real time events that influence patient in an unpredictable way by the user side."

Prioritizing Design Goals for a Medical Simulator Using Pairwise Comparisons

A simulator is being developed to teach psychomotor skills for the lateral canthotomy and cantholysis procedure to medical providers, filling a current training gap at military medical training facilities. Subject Matter Experts (SMEs) agree on training system design goals; however, there is a lack of consensus on the relative order and magnitude of the priorities of each goal. The designs and implementations to achieve each goal have several interdependencies and tradeoffs, which require a comparison between different sets of design goals. A survey of pairwise comparisons was distributed to SMEs and two methods (a simple method and the Bradley-Terry model) were used to develop a unidimensional scale of prioritizations for each design goal. There was agreement in results across the simple method (calculating the proportion of times an alternative was chosen as preferable) and the Bradley-Terry model. The Bradley-Terry method offered a means to calculate measures of uncertainty, showing nuances where scores may overlap. This prioritization method enabled the research and development team to reconcile differing SME opinions. This also allowed for informed design decisions to ensure that the training system met expectations of SMEs and end users. Future efforts will involve developing scores for relevant sets of demographics to determine if there is concurrence and dissent in priorities.