Telemedicine: History and Success Story of Remote Surgical Education in India

Tele-education by an orthopedic specialist increased the confidence in orthopedics of a general practitioner at a rural solo-practice clinic

Objective: General practitioners in rural clinics are required to deal with musculoskeletal problems, but they often lack the confidence. We aim to confirm changes in their confidence in orthopedic practices after using tele-education. Materials and Methods: We conducted tele-education in orthopedic practices from June 1, 2022, to November 30, 2022. Using a teleconference system, the first author, an orthopedic specialist, provided tele-education training to an independent general practitioner in a rural clinic. We adopted a 7-point Likert scale to assess the general practitioner's confidence levels. In pre- and post-research, the counts and confidence levels in the scale were assessed for 18 types of orthopedic practices each month. Furthermore, we interviewed the general practitioner to examine the factors influencing their confidence. Results: The confidence levels increased for all measurement items. The most experienced orthopedic practice was "Advising on daily care for musculoskeletal problems", with confidence levels increasing from 3 to 6. The least experienced orthopedic practice was "Manipulative reduction of radial head subluxation", with confidence levels increasing from 4 to 5. The factors that influenced the change in confidence levels were regular feedback and unrestricted availability of consultations. Conclusion: Tele-education in orthopedics may enhance general practitioners' confidence in orthopedic practices.

Video-based fully automatic assessment of open surgery suturing skills

Purpose

The goal of this study was to develop a new reliable open surgery suturing simulation system for training medical students in situations where resources are limited or in the domestic setup. Namely, we developed an algorithm for tools and hands localization as well as identifying the interactions between them based on simple webcam video data, calculating motion metrics for assessment of surgical skill.

Methods

Twenty-five participants performed multiple suturing tasks using our simulator. The YOLO network was modified to a multi-task network for the purpose of tool localization and tool–hand interaction detection. This was accomplished by splitting the YOLO detection heads so that they supported both tasks with minimal addition to computer run-time. Furthermore, based on the outcome of the system, motion metrics were calculated. These metrics included traditional metrics such as time and path length as well as new metrics assessing the technique participants use for holding the tools.

Results

The dual-task network performance was similar to that of two networks, while computational load was only slightly bigger than one network. In addition, the motion metrics showed significant differences between experts and novices.

Conclusion

While video capture is an essential part of minimal invasive surgery, it is not an integral component of open surgery. Thus, new algorithms, focusing on the unique challenges open surgery videos present, are required. In this study, a dual-task network was developed to solve both a localization task and a hand–tool interaction task. The dual network may be easily expanded to a multi-task network, which may be useful for images with multiple layers and for evaluating the interaction between these different layers.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11548-022-02559-6.

The Utilization of Augmented Reality Technology for Sustainable Skill Development for People with Special Needs: A Systematic Literature Review

New technologies such as Augmented Reality can be used to enhance the possibility of obtaining new experiences to assist people with special needs. However, in the literature, there are not enough studies conducted on the use of Augmented Reality as an assistive technology, especially for people with special needs. The purpose of this study is to highlight the use of Augmented Reality technology on people with special needs for skill development. This systematic literature review includes recent and high-quality articles from chosen prestige databases between the years 2010 and 2020. The selected studies which fitted the eligibility selection criteria have been analyzed and synthesized. The study findings reveal the importance of using AR technology to assist individuals with special needs in their skill development process, to help them become more independent. We hope this study will enlighten researchers and the developers of AR tools. It has been recommended that more studies be done on the sustainable use of AR as an assistive technology, particularly for children with special needs, to make their life easier.

Is Hybrid Telehealth Model the Next Step for Private Healthcare in India?

Irrespective of geography, the implementation of telehealth has been one of the biggest changes caused by the COVID-19 pandemic. Post the pandemic, telehealth will continue to be part of mainstream health service delivery but in a different format. This commentary investigates the hybrid model of telehealth in India. A hybrid model can help India provide accessible and affordable healthcare to a wider part of its population and support the already growing medical tourism industry. The challenges to this revolve around digital education for patients and providers, integration of technology into existing care pathways, infrastructural investment and in creating seamless systems. It is a scalable and profitable model that must be seriously considered in the post pandemic world.