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French AJ. Simulation and Modeling Applications in Global Health Security. ADVANCED SCIENCES AND TECHNOLOGIES FOR SECURITY APPLICATIONS 2020. [PMCID: PMC7123972 DOI: 10.1007/978-3-030-23491-1_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats. This chapter focuses on the application of modeling and simulation to support Global Health Security planning, preparedness and operations.
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A Taxonomy Guide for Surgical Simulation. COMPREHENSIVE HEALTHCARE SIMULATION: SURGERY AND SURGICAL SUBSPECIALTIES 2019. [DOI: 10.1007/978-3-319-98276-2_3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Shetty K, Poo SXW, Sriskandarajah K, Sideris M, Malietzis G, Darzi A, Athanasiou T. "The Longest Way Round Is The Shortest Way Home": An Overhaul of Surgical Ward Rounds. World J Surg 2018; 42:937-949. [PMID: 29067515 PMCID: PMC5843677 DOI: 10.1007/s00268-017-4267-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Ward rounds, a keystone of hospital surgical practice, have recently been under the spotlight. Poor-quality ward rounds can lead to a greater number of adverse events, thereby cascading to an increased financial strain on our already burdened healthcare systems. Faced with mounting pressures from both outside and inside health organizations, concerted efforts are required to restore it back into prominence where it can no longer take a backseat to the other duties of a surgeon. Methods The nucleus of this narrative review is derived from an extensive literature search on surgical ward rounds. Results In this review, we focus on the need for reforms, current characteristics of surgical ward rounds, obstacles encountered by competing interests and proposed solutions in delivery of effective ward rounds that can meet with newly laid guidelines. Conclusion Ward rounds should be standardized and prioritized to improve patient care.
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Affiliation(s)
- Kunal Shetty
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Stephanie Xiu Wern Poo
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | | | | | - George Malietzis
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Thanos Athanasiou
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
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Petrucci AM, Chand M, Wexner SD. Social Media: Changing the Paradigm for Surgical Education. Clin Colon Rectal Surg 2017; 30:244-251. [PMID: 28924397 DOI: 10.1055/s-0037-1604252] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The role of social media (SoMe) in surgical education is emerging as a tool that augments and complements traditional learning. As SoMe usage has steadily increased in our personal and professional lives, it is no surprise that it has permeated into surgical education. Different SoMe sites offer distinct platforms from which knowledge can be transmitted, while catering to various learning styles. The purpose of this review is to outline the various SoMe platforms and their use in surgical education. Moreover, it will discuss their effectiveness in teaching and learning surgical knowledge and skills as well as other potential roles SoMe has to offer to improve surgical education.
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Affiliation(s)
- Andrea M Petrucci
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
| | - Manish Chand
- University College London, London, United Kingdom
| | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
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Zahedi FM, Walia N, Jain H. Augmented Virtual Doctor Office: Theory-based Design and Assessment. J MANAGE INFORM SYST 2016. [DOI: 10.1080/07421222.2016.1243952] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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A Real-Time Local Flaps Surgical Simulator Based on Advances in Computational Algorithms for Finite Element Models. Plast Reconstr Surg 2016; 137:445e-452e. [PMID: 26818334 DOI: 10.1097/01.prs.0000475793.38984.7e] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This article presents a real-time surgical simulator for teaching three- dimensional local flap concepts. Mass-spring based simulators are interactive, but they compromise accuracy and realism. Accurate finite element approaches have traditionally been too slow to permit development of a real-time simulator. METHODS A new computational formulation of the finite element method has been applied to a simulated surgical environment. The surgical operators of retraction, incision, excision, and suturing are provided for three-dimensional operation on skin sheets and scalp flaps. A history mechanism records a user's surgical sequence. Numerical simulation was accomplished by a single small-form-factor computer attached to eight inexpensive Web-based terminals at a total cost of $2100. A local flaps workshop was held for the plastic surgery residents at the University of Wisconsin hospitals. RESULTS Various flap designs of Z-plasty, rotation, rhomboid flaps, S-plasty, and related techniques were demonstrated in three dimensions. Angle and incision segment length alteration advantages were demonstrated (e.g., opening the angle of a Z-plasty in a three-dimensional web contracture). These principles were then combined in a scalp flap model demonstrating rotation flaps, dual S-plasty, and the Dufourmentel Mouly quad rhomboid flap procedure to demonstrate optimal distribution of secondary defect closure stresses. CONCLUSIONS A preliminary skin flap simulator has been demonstrated to be an effective teaching platform for the real-time elucidation of local flap principles. Future work will involve adaptation of the system to facial flaps, breast surgery, cleft lip, and other problems in plastic surgery as well as surgery in general.
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Singh P, Aggarwal R, Pucher PH, Darzi A. Development, Organisation and Implementation of a Surgical Skills 'Boot Camp': SIMweek. World J Surg 2016; 39:1649-60. [PMID: 25665671 DOI: 10.1007/s00268-015-2972-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is evidence of increased mortality and reduced efficiency in hospitals due to the annual changeover of junior doctors. This paper describes a framework to develop an intensive simulated week that will recreate experiences and situations that junixor surgical interns will likely face in their first weeks after graduation. METHODS To provide evidence-based recommendations, a systematic review of published literature using the keywords 'surg*', 'boot', 'camp' was performed. Reports of the development, implementation or evaluation of a simulated skills course or 'boot camp' to prepare incoming surgical interns were analysed. RESULTS Eighteen relevant articles were identified. Subjects on internship preparation courses have identified 'hands-on' training sessions to be very useful. In particular, mock pages have been identified as being valuable and didactic lectures have been identified as the weakest parts of the course. We first consider the end-users of the course and their associated learning needs. We subsequently discuss resources required and propose a strategy for the organisation of a course and selection of teaching faculty. Finally, we consider the costs involved in running a course. CONCLUSIONS This paper proposes a framework for the development, organisation and implementation of an intensive simulation course to prepare graduating medical students for their role as junior surgical intern. Facilitating the step change in responsibility from student to surgical intern may improve patient safety in addition to reducing the associated anxiety for the clinician.
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Affiliation(s)
- Pritam Singh
- Academic Surgical Unit, Division of Surgery, Department of Surgery & Cancer, Imperial College London, St. Mary's Hospital, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK,
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Olasky J, Sankaranarayanan G, Seymour NE, Magee JH, Enquobahrie A, Lin MC, Aggarwal R, Brunt LM, Schwaitzberg SD, Cao CGL, De S, Jones DB. Identifying Opportunities for Virtual Reality Simulation in Surgical Education: A Review of the Proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) Conference: VR Surgery. Surg Innov 2015; 22:514-21. [PMID: 25925424 DOI: 10.1177/1553350615583559] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To conduct a review of the state of virtual reality (VR) simulation technology, to identify areas of surgical education that have the greatest potential to benefit from it, and to identify challenges to implementation. BACKGROUND DATA Simulation is an increasingly important part of surgical training. VR is a developing platform for using simulation to teach technical skills, behavioral skills, and entire procedures to trainees and practicing surgeons worldwide. Questions exist regarding the science behind the technology and most effective usage of VR simulation. A symposium was held to address these issues. METHODS Engineers, educators, and surgeons held a conference in November 2013 both to review the background science behind simulation technology and to create guidelines for its use in teaching and credentialing trainees and surgeons in practice. RESULTS Several technologic challenges were identified that must be overcome in order for VR simulation to be useful in surgery. Specific areas of student, resident, and practicing surgeon training and testing that would likely benefit from VR were identified: technical skills, team training and decision-making skills, and patient safety, such as in use of electrosurgical equipment. CONCLUSIONS VR simulation has the potential to become an essential piece of surgical education curriculum but depends heavily on the establishment of an agreed upon set of goals. Researchers and clinicians must collaborate to allocate funding toward projects that help achieve these goals. The recommendations outlined here should guide further study and implementation of VR simulation.
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Affiliation(s)
- Jaisa Olasky
- Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA
| | | | - Neal E Seymour
- Tufts University School of Medicine, Springfield, MA, USA
| | - J Harvey Magee
- University of Maryland Medical Center, Baltimore, MD, USA
| | | | - Ming C Lin
- The University of North Carolina at Chapel Hill, NC, USA
| | - Rajesh Aggarwal
- University of Pennsylvania Medical School, Philadelphia, PA, USA
| | | | | | | | - Suvranu De
- Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Daniel B Jones
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Beyer-Berjot L, Patel V, Ziprin P, Taylor D, Berdah S, Darzi A, Aggarwal R. Enhanced recovery simulation in colorectal surgery: design of virtual online patients. Surg Endosc 2014; 29:2270-7. [PMID: 25398195 DOI: 10.1007/s00464-014-3941-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/07/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND The aim of the present study was to design virtual patients (VP) involving enhanced recovery programs (ERP) in colorectal surgery, in order to train surgical residents in peri-operative care. Indeed, ERP have changed perioperative care and improved patients outcomes in colorectal surgery. Training, using online VP with different pre- and post-operative cases, may increase implementation of ERP. METHODS Pre- and post-operative cases were built in the virtual world of Second Life™ according to a linear string design method. All pre- and post-operative cases were storyboarded by a colorectal surgeon in accordance with guidelines in both ERP and colorectal surgery, and reviewed by an expert in colorectal surgery. RESULTS Four pre-operative and five post-operative cases of VP undergoing colorectal surgery were designed, including both simple and complex cases. Comments were provided through case progression to allow autonomic practice (such as "prescribed", "this is not useful" or "the consultant does not agree with your decision"). Pre-operative cases involved knowledge in colorectal diseases and ERP such as pre-operative counseling, medical review, absence of bowel preparation in colonic surgery, absence of fasting, minimal length incision, and discharge plan. Post-operative cases involved uneventful and complicated outcomes in order to train in both simple implementation of ERP (absence of nasogastric tube, epidural analgesia, early use of oral analgesia, perioperative nutrition, early mobilization) and decision making for more complex cases. CONCLUSION Virtual colorectal patients have been developed to train in ERP through pre- and post-operative cases. Such patients could be included in a whole pathway care training involving technical and non-technical skills.
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Affiliation(s)
- Laura Beyer-Berjot
- Department of Surgery and Cancer, St. Mary's Campus, Imperial College Healthcare NHS Trust, London, UK,
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Richardson-Hatcher A, Hazzard M, Ramirez-Yanez G. The cranial nerve skywalk: A 3D tutorial of cranial nerves in a virtual platform. ANATOMICAL SCIENCES EDUCATION 2014; 7:469-478. [PMID: 24678025 DOI: 10.1002/ase.1445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 02/28/2014] [Accepted: 03/01/2014] [Indexed: 06/03/2023]
Abstract
Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways is difficult using two-dimensional (2D) illustrations alone. Three-dimensional (3D) models aid the teacher in describing intricate and complex anatomical structures and help students visualize them. The study of the cranial nerves can be supplemented with 3D, which permits the students to fully visualize their distribution within the craniofacial complex. This article describes the construction and usage of a virtual anatomy platform in Second Life™, which contains 3D models of the cranial nerves III, V, VII, and IX. The Cranial Nerve Skywalk features select cranial nerves and the associated autonomic pathways in an immersive online environment. This teaching supplement was introduced to groups of pre-healthcare professional students in gross anatomy courses at both institutions and student feedback is included.
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Affiliation(s)
- April Richardson-Hatcher
- Department of Anatomy and Neurobiology, University of Kentucky, College of Medicine, Lexington, Kentucky
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Virtual-world hospital simulation for real-world disaster response: Design and validation of a virtual reality simulator for mass casualty incident management. J Trauma Acute Care Surg 2014; 77:315-21. [PMID: 25058260 DOI: 10.1097/ta.0000000000000308] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mass casualty incidents are unfortunately becoming more common. The coordination of mass casualty incident response is highly complex. Currently available options for training, however, are limited by either lack of realism or prohibitive expense and by a lack of assessment tools. Virtual worlds represent a potentially cost-effective, immersive, and easily accessible platform for training and assessment. The aim of this study was to assess feasibility of a novel virtual-worlds-based system for assessment and training in major incident response. METHODS Clinical areas were modeled within a virtual, online hospital. A major incident, incorporating virtual casualties, allowed multiple clinicians to simultaneously respond with appropriate in-world management and transfer plans within limits of the hospital's available resources. Errors, delays, and completed actions were recorded, as well as Trauma-NOnTECHnical Skills (T-NOTECHS) score. Performance was compared between novice and expert clinician groups. RESULTS Twenty-one subjects participated in three simulations: pilot (n = 7), novice (n = 8), and expert groups (n = 6). The novices committed more critical events than the experts, 11 versus 3, p = 0.006; took longer to treat patients, 560 (299) seconds versus 339 (321) seconds, p = 0.026; and achieved poorer T-NOTECHS scores, 14 (2) versus 21.5 (3.7), p = 0.003, and technical skill, 2.29 (0.34) versus 3.96 (0.69), p = 0.001. One hundred percent of the subjects thought that the simulation was realistic and superior to existing training options. CONCLUSION A virtual-worlds-based model for the training and assessment of major incident response has been designed and validated. The advantages of customizability, reproducibility, and recordability combined with the low cost of implementation suggest that this potentially represents a powerful adjunct to existing training methods and may be applicable to further areas of surgery as well.
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Martin-Suarez A, Benito JC, Pérez-Blanco JS, Millan MDCG, Castañeda AZ, Gomez HZ, Martin CM. Scientific Knowledge Transfer Training Through a Virtual World. JOURNAL OF INFORMATION TECHNOLOGY RESEARCH 2014. [DOI: 10.4018/jitr.2014040103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to use the virtual world Second Life (SL) to perform a knowledge transfer training to Pharmacy students. The presentation of assignments of different subjects was organized as scientific congress communications. The activities were carried out at the facilities created at the USALPHARMA Island in SL. The content and format of these works, together with their oral presentation and interventions in debates were evaluated. These experiences provided adequate learning results and a high level of student satisfaction. This teaching strategy can foster development of creativity, critical thinking, communication, co-teamwork and digital competence. Likewise, it can facilitate teacher-student relations and relations among the students themselves. It also implies significant savings in time and money, since real facilities and equipment and physical movement of people are not involved. All of this encourages us to recommend this platform to host all kinds of conferences or scientific conferences.
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Affiliation(s)
- Ana Martin-Suarez
- Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Salamanca, Spain
| | - Juan Cruz Benito
- Research Group in Interaction and eLearning (GRIAL), University of Salamanca, Salamanca, Spain
| | | | | | | | - Hinojal Zazo Gomez
- Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Salamanca, Spain
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García-Peñalvo FJ, Cruz-Benito J, Maderuelo C, Pérez-Blanco JS, Martín-Suárez A. Usalpharma: a cloud-based architecture to support quality assurance training processes in health area using virtual worlds. ScientificWorldJournal 2014; 2014:659364. [PMID: 24778593 PMCID: PMC3980777 DOI: 10.1155/2014/659364] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 02/02/2014] [Indexed: 11/30/2022] Open
Abstract
This paper discusses how cloud-based architectures can extend and enhance the functionality of the training environments based on virtual worlds and how, from this cloud perspective, we can provide support to analysis of training processes in the area of health, specifically in the field of training processes in quality assurance for pharmaceutical laboratories, presenting a tool for data retrieval and analysis that allows facing the knowledge discovery in the happenings inside the virtual worlds.
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Affiliation(s)
- Francisco J. García-Peñalvo
- GRIAL Research Group, Department of Computer Science and Automatics, University of Salamanca, Paseo de Canalejas 169, 37008 Salamanca, Spain
| | - Juan Cruz-Benito
- GRIAL Research Group, Department of Computer Science and Automatics, University of Salamanca, Paseo de Canalejas 169, 37008 Salamanca, Spain
| | - Cristina Maderuelo
- Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Faculty of Pharmacy, Campus M. Unamuno, 37007 Salamanca, Spain
| | - Jonás Samuel Pérez-Blanco
- Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Faculty of Pharmacy, Campus M. Unamuno, 37007 Salamanca, Spain
- IBSAL Salamanca Institute for Biomedical Research, University Hospital of Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain
| | - Ana Martín-Suárez
- Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Faculty of Pharmacy, Campus M. Unamuno, 37007 Salamanca, Spain
- IBSAL Salamanca Institute for Biomedical Research, University Hospital of Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain
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Ghanbarzadeh R, Ghapanchi AH, Blumenstein M, Talaei-Khoei A. A decade of research on the use of three-dimensional virtual worlds in health care: a systematic literature review. J Med Internet Res 2014; 16:e47. [PMID: 24550130 PMCID: PMC3958677 DOI: 10.2196/jmir.3097] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/06/2014] [Accepted: 01/10/2014] [Indexed: 11/21/2022] Open
Abstract
Background A three-dimensional virtual world (3DVW) is a computer-simulated electronic 3D virtual environment that users can explore, inhabit, communicate, and interact with via avatars, which are graphical representations of the users. Since the early 2000s, 3DVWs have emerged as a technology that has much to offer the health care sector. Objective The purpose of this study was to characterize different application areas of various 3DVWs in health and medical context and categorize them into meaningful categories. Methods This study employs a systematic literature review on the application areas of 3DVWs in health care. Our search resulted in 62 papers from five top-ranking scientific databases published from 1990 to 2013 that describe the use of 3DVWs for health care specific purposes. We noted a growth in the number of academic studies on the topic since 2006. Results We found a wide range of application areas for 3DVWs in health care and classified them into the following six categories: academic education, professional education, treatment, evaluation, lifestyle, and modeling. The education category, including professional and academic education, contains the largest number of papers (n=34), of which 23 are related to the academic education category and 11 to the professional education category. Nine papers are allocated to treatment category, and 8 papers have contents related to evaluation. In 4 of the papers, the authors used 3DVWs for modeling, and 3 papers targeted lifestyle purposes. The results indicate that most of the research to date has focused on education in health care. We also found that most studies were undertaken in just two countries, the United States and the United Kingdom. Conclusions 3D virtual worlds present several innovative ways to carry out a wide variety of health-related activities. The big picture of application areas of 3DVWs presented in this review could be of value and offer insights to both the health care community and researchers.
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Affiliation(s)
- Reza Ghanbarzadeh
- School of Information and Communication Technology, Griffith University, Gold Coast, Queensland, Australia.
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Flowers MG, Aggarwal R. Second Life™: a novel simulation platform for the training of surgical residents. Expert Rev Med Devices 2013; 11:101-3. [PMID: 24308733 DOI: 10.1586/17434440.2014.863706] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A virtual world is a three-dimensional, computer-generated, simulated environment. Human users create "avatars," or virtual projections of themselves, in order to explore this virtual environment and interact with the objects and structures inside it. Second Life™ is one such virtual world accessible freely via the internet, which has been used to construct a virtual hospital complete with reception areas, changing rooms, offices, and hospital wards. Early pioneering studies have demonstrated the advantages of using virtual worlds in the education of surgical residents in a number of ways, from introductions to the clinical environment, initial patient assessment, and managing adverse outcomes, to gaining informed consent, hospital-wide training, and medical device development.
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Affiliation(s)
- Michael G Flowers
- Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
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