Extended reality in surgical education: A systematic review

Collaborative Forensic Autopsy Documentation and Supervised Report Generation Using a Hybrid Mixed-Reality Environment and Generative AI

Forensic investigation is a complex procedure involving experts working together to establish cause of death and report findings to legal authorities. While new technologies are being developed to provide better post-mortem imaging capabilities-including mixed-reality (MR) tools to support 3D visualisation of such data-these tools do not integrate seamlessly into their existing collaborative workflow and report authoring process, requiring extra steps, e.g. to extract imagery from the MR tool and combine with physical autopsy findings for inclusion in the report. Therefore, in this work we design and evaluate a new forensic autopsy report generation workflow and present a novel documentation system using hybrid mixed-reality approaches to integrate visualisation, voice and hand interaction, as well as collaboration and procedure recording. Our preliminary findings indicate that this approach has the potential to improve data management, aid reviewability, and thus, achieve more robust standards. Further, it potentially streamlines report generation and minimise dependency on external tools and assistance, reducing autopsy time and related costs. This system also offers significant potential for education. A free copy of this paper and all supplemental materials are available at https://osf.io/ygfzx.

Assessing the knowledge, attitude and perception of Extended Reality (XR) technology in Pakistan's Healthcare community in an era of Artificial Intelligence

Background and objectives

The Extended Reality (XR) technology was established by combining elements of Virtual Reality and Augmented Reality, offering users the advantage of working in a virtual environment. The study aimed to evaluate medical professionals' and students' knowledge, attitudes, and practices regarding using XR technology in Pakistan's healthcare system and identify its benefits, drawbacks, and implications for the system's future.

Methodology

A cross-sectional study was executed by circulating a self-structured online questionnaire among the Medical Community across Major Cities of Pakistan using various social media platforms as available sampling. The sample size was calculated to be 385 using RAOSOFT. Cronbach's alpha was calculated as 0.74. The Exploratory Factor Analysis (EFA) conducted on the dataset was validated using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's Test of Sphericity. The KMO value of 0.752 indicates adequate sampling, and Bartlett's Test was significant (χ2 (435) = 2809.772, p < 0.001), confirming the suitability of the data for factor analysis. Statistical analysis was done using SPSS-25, and data description was done as frequency and percentage. Pearson correlation and regression analysis kept p-value < 0.05% significant.

Results

Approximately 54.8% of 406 participants conveyed their familiarity with XR technologies. The majority of participants (83.8%) believed that using XR technology effectively enhanced medical education and patient care in Pakistan. Regarding clinical outcomes, 70.8% believed XR improved the efficiency of procedures and 52.8% agreed XR would lead to more device-dependent systems and eradicating human error (32.4%). Major barriers to XR integration included ethical and privacy issues (63.9%), lack of technological advancements in Pakistan (70%), and lack of ample knowledge and training of XR among health care professionals (45.8%). Hypothesis testing revealed a low positive but significant correlation between the use of AI-based healthcare systems and the increasing speed and accuracy of procedures (r = 0.342, p < 0.001), supporting Hypothesis 1. Similarly, a very low positive yet significant correlation was observed between the augmentation of diagnostic and surgical procedures and addressing data security and ethical issues for implementing XR (r = 0.298, p < 0.001), supporting Hypothesis 2. Lastly, a correlation between the mean Attitude (MA) score and the mean Perception (MP) score was found to be moderately positive and significant (r = 0.356, p < 0.001). Hence, the hypothesis 3 was supported.

Conclusion

XR technology has the potential to enhance medical education and patient care in Pakistan, but its adoption faces significant challenges, including ethical concerns, technological gaps, and inadequate training. The study's findings highlight the need to address these issues to maximize the benefits of XR in healthcare.

Simulation-based training in robotic surgery education: bibliometric analysis and visualization

Simulation-based robotic surgery training may help surgeons gain operative skills and experience in the simulation environment. This bibliometric analysis examined the development of simulation-based training for robotic surgical education. Articles pertaining to robotic surgical simulation training that were included in the Web of Science Core Collection up to April 25, 2024, were included. The temporal patterns in published paper numbers were evaluated using Microsoft Excel software, and the data regarding co-authorship and keyword co-occurrence were analyzed and visualized using the VOSviewer and SCImago Graphica tools. A total of 594 papers on simulation-based training for robotic surgical education were evaluated in this study. The United States and United Kingdom were the leading contributors in this field. The most published authors were Professor Ahmed Kamran (23 publications) and Prokar Dasgupta (22 publications). The highest number of papers was published in the journal titled "Surgical Endoscopy and Other Interventional Techniques." The most common keywords were "virtual reality," "curriculum," "robotic surgery simulator," "assessment," and "learning curve." Our study offers a detailed overview of international research on simulation-based training for robotic surgical education, including the publishing countries, institutions, authors, journals, and research hotspots. It also methodically summarizes the state of knowledge in the area, and provides definite directions and concepts for further in-depth analysis.

Exploration of the application of augmented reality technology for teaching spinal tumor's anatomy and surgical techniques

Background

Augmented reality (AR) technology is gradually being applied in surgical teaching as an innovative teaching method. Developing innovative teaching methods to replicate clinical theory and practical teaching scenarios, simulate preoperative planning and training for bone tumor surgery, and offer enhanced training opportunities for young physicians to acquire and apply clinical knowledge is a crucial concern that impacts the advancement of the discipline and the educational standards for young orthopedic physicians.

Objective

This study explores the application effect of augmented reality technology in anatomy teaching and surgical clinical teaching for spinal tumor.

Methods

The method utilizes virtual reality and augmented reality technology to present a spinal tumor model and the surgical process of percutaneous vertebroplasty. We conducted a random selection of 12 students forming into the augmented reality teaching group and 13 students forming into the traditional teaching group among the 8-year medical students from Peking Union Medical College and Tsinghua University, ensuring that the age and learning stage of the students in both groups were similar. Two groups of students were taught using traditional teaching methods and augmented reality technology-assisted teaching methods, respectively. A questionnaire survey was conducted after class to assess the quality of course instruction, student motivation in learning, their proficiency in anatomical structures, their comprehension of spinal tumor growth and metastasis, and their understanding and proficiency in percutaneous vertebroplasty.

Results

This study was the first to apply augmented reality technology in teaching, using spinal tumors and percutaneous vertebroplasty as examples, a head-mounted augmented reality device was used to create learning scenarios, presenting the complex three-dimensional spatial structure intuitively. The two groups of students differ significantly in their rating of teaching quality, enthusiasm for learning, knowledge of anatomical features, understanding of spinal trabecular structure, and understanding of steps in percutaneous vertebroplasty. The augmented reality technology-assisted teaching system demonstrates outstanding advantages.

Conclusion

Augmented reality technology has great potential and broad prospects in teaching bone tumors, which can help improve the visualization, interactivity, and three-dimensional spatial sense of medical teaching in spinal tumor. The application and development prospects of using augmented reality technology for anatomy instruction, surgical teaching, and simulation training are extensive.

Early introduction of simulation in the medical curriculum: the MedInTo perspective

Despite the increasing body of evidence supporting the use of simulation in medicine, a question remains: when should we introduce it into the medical school's curriculum? We present the experience and future perspectives of the MD program in Medicine and Surgery of University of Turin-MedInTo. Since its launch, MedInTo has been dedicated to integrating innovative teaching approaches at the early stages into the medical curriculum. Herewith, we describe a case-based approach for our activities, which includes the utilization of simulation for emergency medical care training for students and the integration of virtual and augmented reality technology. Dedicated surgical training activities using virtual-augmented reality and life-like simulator for students are also described.