Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation

BACKGROUND

Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient.

METHODS

The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience.

RESULTS

The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study.

CONCLUSIONS

All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.

Enhancing Industrial Communication with Ethernet/Internet Protocol: A Study and Analysis of Real-Time Cooperative Robot Communication and Automation via Transmission Control Protocol/Internet Protocol

This study explores the important task of validating data exchange between a control box, a Programmable Logic Controller (PLC), and a robot in an industrial setting. To achieve this, we adopt a unique approach utilizing both a virtual PLC simulator and an actual PLC device. We introduce an innovative industrial communication module to facilitate the efficient collection and storage of data among these interconnected entities. The main aim of this inquiry is to examine the implementation of Ethernet/IP (EIP), a relatively new addition to the industrial network scenery. It was designed using ODVA's Common Industrial Protocol (CIP™). The Costumed real-time data communication module was programmed in C++ for the Linux Debian platform and elegantly demonstrates the impressive versatility of EIP as a means for effective data transfer in an industrial environment. The study's findings provide valuable insights into Ethernet/IP's functionalities and capabilities in industrial networks, bringing attention to its possible applications in industrial robotics. By connecting theoretical knowledge and practical implementation, this research makes a significant contribution to the continued development of industrial communication systems, ultimately improving the efficiency and effectiveness of automation processes.

Robotic Medtronic Hugo™ RAS System Is Now Reality: Introduction to a New Simulation Platform for Training Residents

The use of robotic surgery (RS) in urology has grown exponentially in the last decade, but RS training has lagged behind. The launch of new robotic platforms has paved the way for the creation of innovative robotics training systems. The aim of our study is to test the new training system from Hugo™ RAS System-Medtronic. Between July 2020 and September 2022, a total of 44 residents from urology, gynaecology and general surgery at our institution participated in advanced robotic simulation training using the Hugo™ RAS simulator. Information about sex, age, year of residency, hours spent playing video games, laparoscopic or robotic exposure and interest in robotics (90.9% declared an interest in robotics) was collected. The training program involved three robotic exercises, and the residents performed these exercises under the guidance of a robotics tutor. The residents' performance was assessed based on five parameters: timing, range of motion, panoramic view, conflict of instruments and exercise completion. Their performance was evaluated according to an objective Hugo system form and a subjective assessment by the tutor. After completing the training, the residents completed a Likert scale questionnaire to gauge their overall satisfaction. The rate of the residents' improvement in almost all parameters of the three exercises between the first and the last attempts was statistically significant (p < 0.02), indicating significant progress in the residents' robotic surgical skills during the training. The mean overall satisfaction score ± standard deviation (SD) was 9.4 ± 1.2, signifying a high level of satisfaction among the residents with the training program. In conclusion, these findings suggest that the training program utilizing the Hugo™ RAS System is effective in enhancing robotic surgical skills among residents and holds promise for the development of standardized robotics training programs in various surgical specialties.

Development and face validation of ultrasound-guided renal biopsy virtual trainer

The overall prevalence of chronic kidney disease in the general population is ∼14% with more than 661,000 Americans having a kidney failure. Ultrasound (US)-guided renal biopsy is a critically important tool in the evaluation and management of renal pathologies. This Letter presents KBVTrainer, a virtual simulator that the authors developed to train clinicians to improve procedural skill competence in US-guided renal biopsy. The simulator was built using low-cost hardware components and open source software libraries. They conducted a face validation study with five experts who were either adult/pediatric nephrologists or interventional/diagnostic radiologists. The trainer was rated very highly (>4.4) for the usefulness of the real US images (highest at 4.8), potential usefulness of the trainer in training for needle visualization, tracking, steadiness and hand-eye coordination, and overall promise of the trainer to be useful for training US-guided needle biopsies. The lowest score of 2.4 was received for the look and feel of the US probe and needle compared to clinical practice. The force feedback received a moderate score of 3.0. The clinical experts provided abundant verbal and written subjective feedback and were highly enthusiastic about using the trainer as a valuable tool for future trainees.

The Surgical Skill of a Novice Trainee Manifests in Time-Consuming Exercises of a Virtual Simulator Rather Than a Quick-Finishing Counterpart: A Concurrent Validity Study Using an Urethrovesical Anastomosis Model

OBJECTIVE

The purpose of this study is to determine an optimal training curriculum using a robotic virtual simulator (RVS) that enables unexperienced trainees to perform a complex task in a hands-on setting.

PATIENTS AND METHODS

This study was conducted in 2 phases. In the RVS phase, 43 participants sequentially completed 12 exercises consistent with all primary exercises in the EndoWrist manipulation and advanced needle-driving category, until the overall score reached more than 80% by repeated practice. In the hands-on phase using a robotic surgical system, 10 randomly selected trainees performed 8 sutures once, simulating urethrovesical anastomosis, and the console time was recorded.

RESULTS

The median total time and total attempts for the RVS phase was 195.2 minutes and 54 times, respectively. The trainees were divided by median total time, and times to accomplish each RVS exercise were then compared between the early- and the late-completion groups; among 12 exercises trained, 6 exercises (prolonged course) requiring significantly more time in the late-completion group were identified. The prolonged course occupied 88.18% of the total time and 77.61% of the total attempts. For participants the in hands-on phase, a multiple linear regression model showed that the time to accomplish the prolonged course was a single independent predictor of the console time (R(2) = 0.524, B = 0.05; p = 0.018).

CONCLUSION

After establishment of a high standard cutoff score, the time spent for the prolonged course showed a significant association with console time in hands-on training simulating urethrovesical anastomosis, implying educational efficacy of training involving time-consuming exercise in performance of a complex task.

Development and evaluation of a virtual slaughterhouse simulator for training and educating veterinary students

Veterinary surgeons working on farms and food-processing establishments play a fundamental role in safeguarding both public health and the welfare of animals under their care. An essential part of veterinary public health (VPH) undergraduate training in the UK involves students undertaking placements within abattoirs, a practice that remains vital to the educational experience of future veterinary professionals. However, several issues have adversely affected the ability of students to gain such extramural placements. For this reason, the Virtual Slaughterhouse Simulator (VSS) was developed to strengthen and enhance undergraduate VPH teaching at the Royal (Dick) School of Veterinary Studies, enabling students to explore a realistic abattoir work environment with embedded educational activities. The aim of this research project was to evaluate the VSS as a teaching and learning tool for training and educating veterinary students. Ninety-eight final-year veterinary students engaged with the prototype VSS, followed by assessment of their knowledge and behavior when faced with a "real-life" abattoir situation. Further evaluation of their experiences with the VSS was carried out using questionnaires and focus groups. The results of this investigation show that there is the potential for the VSS to enhance the student learning experience in basic abattoir procedures. This innovative tool provides a visually based learning resource that can support traditional lectures and practical classes and can also be used to stimulate interactive problem-solving activities embedded in the relevant context.