SimCEC: A Collaborative VR-Based Simulator for Surgical Teamwork Education

Traditionally, the evaluation of surgical procedures in virtual reality (VR) simulators has been restricted to their individual technical aspects disregarding the procedures carried out by teams. However, some decision models have been proposed to support the collaborative training evaluation process of surgical teams in collaborative virtual environments. The main objective of this article is to present a collaborative simulator based on VR, named SimCEC, as a potential solution for education, training, and evaluation in basic surgical routines for teams of undergraduate students. The simulator considers both tasks performed individually and those carried in a collaborative manner. The main contribution of this work is to improve the discussion about VR simulators requirements (design and implementation) to provide team training in relevant topics, such as users’ feedback in real time, collaborative training in networks, interdisciplinary integration of curricula, and continuous evaluation.

[1]  M. Schijven,et al.  Systematic review of serious games for medical education and surgical skills training , 2012, The British journal of surgery.

[2]  Rajesh Aggarwal,et al.  Simulation for ward processes of surgical care. , 2013, American journal of surgery.

[3]  Mark Lehto,et al.  A review of: “Virtual Reality Technology” Grigore Burdea and Philippe Coiffet John Wiley & Sons, Inc., 1994 , 1996 .

[4]  Nick Sevdalis,et al.  Teamwork in the operating theatre: cohesion or confusion? , 2006, Journal of evaluation in clinical practice.

[5]  Liliane dos Santos Machado,et al.  A Collaborative and Immersive VR Simulator for Education and Assessment of Surgical Teams , 2015, 2015 XVII Symposium on Virtual and Augmented Reality.

[6]  Ronei Marcos de Moraes,et al.  Enhancing Collaboration on a Cloud-Based CVE for Supporting Surgical Education , 2016, 2016 XVIII Symposium on Virtual and Augmented Reality (SVR).

[7]  D. Baldwin,et al.  Some historical notes on interdisciplinary and interprofessional education and practice in health care in the USA , 2007, Journal of interprofessional care.

[8]  Sriram Dasu,et al.  Assessing the performance of surgical teams , 2009, Health care management review.

[9]  Liliane dos Santos Machado,et al.  Modelagem do Comportamento Hemodinâmico de um Paciente Virtual Cirúrgico baseado em Sistema Especialista Fuzzy. , 2016 .

[10]  Abdennour El Rhalibi,et al.  Agents-based modeling for a peer-to-peer MMOG architecture , 2005, CIE.

[11]  Zeng Wen-qi,et al.  Virtual Reality technology in modern medicine , 2010, 2010 International Conference on Audio, Language and Image Processing.

[12]  S. M. García,et al.  2014: , 2020, A Party for Lazarus.

[13]  R. M. Satava,et al.  Accomplishments and challenges of surgical simulation , 2001, Surgical Endoscopy.

[14]  Paulo Vinicius de Farias Paiva,et al.  A Virtual Environment for Training and Assessment of Surgical Teams , 2013, 2013 XV Symposium on Virtual and Augmented Reality.

[15]  Christopher J. Martin,et al.  Virtual reality simulators: Current status in acquisition and assessment of surgical skills , 2002, ANZ journal of surgery.

[16]  Alfred Cuschieri,et al.  Nature of Human Error: Implications for Surgical Practice , 2006, Annals of surgery.

[17]  Ryan Henson Creighton Unity 3D game development by example : beginner's guide: lite : get up and running as a Unity game developer , 2010 .

[18]  Liliane dos Santos Machado,et al.  ASSESSMENT OF COLLABORATIVE MEDICAL TRAINING BASED ON VIRTUAL REALITY USING POSSIBILISTIC NETWORKS , 2011 .

[19]  Grigore C. Burdea,et al.  Force and Touch Feedback for Virtual Reality , 1996 .

[20]  A. Darzi,et al.  Objective assessment of technical skills in surgery , 2003, BMJ : British Medical Journal.

[21]  Susan E. Sheridan,et al.  WHO Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care , 2005 .

[22]  Eckehard G. Steinbach,et al.  Smooth object state updates in distributed haptic virtual environments , 2013, 2013 IEEE International Symposium on Haptic Audio Visual Environments and Games (HAVE).

[23]  Ryan Henson Creighton Unity 4.x game development by example beginner's guide : a seat-of-your-pants manual for building fun, groovy little games quickly with Unity 4.x , 2013 .

[24]  Rosilene Jara Reis,et al.  Virtual Reality Environments in Surgical Training - Introducing the Pre, Trans and Postoperative Virtual Environment (OPVIR) Ambientes de Realidade Virtual Aplicados ao Ensino da Cirurgia - Apresentação do Ambiente Virtual Pré-, Trans- e Pós-cirúrgico (OPVIR) , 2010 .

[25]  Shervin Shirmohammadi,et al.  An end-to-end communication architecture for collaborative virtual environments , 2001, Comput. Networks.

[26]  Ronei Marcos de Moraes,et al.  Simultaneous assessment of teams in collaborative virtual environments using Fuzzy Naive Bayes , 2013, 2013 Joint IFSA World Congress and NAFIPS Annual Meeting (IFSA/NAFIPS).

[27]  Robert V. Binder,et al.  Testing Object-Oriented Systems: Models, Patterns, and Tools , 1999 .

[28]  Alvaro Uribe-Quevedo,et al.  Hand tracking as a tool to quantify carpal tunnel syndrome preventive exercises , 2016, 2016 7th International Conference on Information, Intelligence, Systems & Applications (IISA).

[29]  R. Ruddle The Effect of Translational and Rotational Body-Based Information on Navigation , 2013 .

[30]  Liliane dos Santos Machado,et al.  A NEW ARCHITECTURE FOR ASSESSMENT OF MULTIPLE USERS IN COLLABORATIVE MEDICAL TRAINING ENVIRONMENTS BASED ON VIRTUAL REALITY , 2012 .

[31]  Eleni Stroulia,et al.  MeRiTS: Simulation-Based Training for Healthcare Professionals , 2011, MMVR.

[32]  Luis Rueda,et al.  Progress in pattern recognition, image analysis and applications : 12th Iberoamerican Congress on Pattern Recognition, CIARP 2007 Viña del Mar-Valparaiso, Chile, November 13-16, 2007 : proceedings , 2007 .

[33]  Michael Zyda,et al.  Networked virtual environments - desgin and implementation , 1999 .

[34]  K Walshe,et al.  Rules and guidelines in clinical practice: a qualitative study in operating theatres of doctors’ and nurses’ views , 2005, Quality and Safety in Health Care.

[35]  Arch G. Mainous,et al.  Randomized Controlled Trials: A Systematic Review of Laparoscopic Surgery and Simulation-Based Training , 2014, Global journal of health science.

[36]  Bruno Arnaldi,et al.  Short Paper: #SEVEN, a Sensor Effector Based Scenarios Model for Driving Collaborative Virtual Environment , 2014, ICAT-EGVE.

[37]  Philippe Coiffet,et al.  Virtual Reality Technology , 2003, Presence: Teleoperators & Virtual Environments.

[38]  Fahad Alotaibi,et al.  Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection , 2015, International Journal of Computer Assisted Radiology and Surgery.

[39]  S Undre,et al.  Developing observational measures of performance in surgical teams , 2004, Quality and Safety in Health Care.

[40]  Alvaro Uribe-Quevedo,et al.  Customization of a low-end haptic device to add rotational DOF for virtual cardiac auscultation training , 2016, 2016 7th International Conference on Information, Intelligence, Systems & Applications (IISA).

[41]  Mithra Vankipuram,et al.  Collaborative virtual reality based advanced cardiac life support training simulator using virtual reality principles , 2014, J. Biomed. Informatics.

[42]  J. Loversidge Faculty Perceptions of Preparation of Medical and Nursing Students for Interprofessional Collaboration , 2012 .

[43]  Liliane dos Santos Machado,et al.  Multiple Assessment for Multiple Users in Virtual Reality Training Environments , 2007, CIARP.

[44]  N. Falchikov,et al.  Student Peer Assessment in Higher Education: A Meta-Analysis Comparing Peer and Teacher Marks , 2000 .

[45]  R. Satava,et al.  Virtual Reality Simulation for the Operating Room: Proficiency-Based Training as a Paradigm Shift in Surgical Skills Training , 2005, Annals of surgery.

[46]  Eleni Stroulia,et al.  Healthcare Training Enhancement Through Virtual Reality and Serious Games , 2014 .

[47]  Eduardo Salas,et al.  Does Team Training Improve Team Performance? A Meta-Analysis , 2008, Hum. Factors.

[48]  P. Maurette [To err is human: building a safer health system]. , 2002, Annales francaises d'anesthesie et de reanimation.

[49]  Jean-Pierre Jessel,et al.  3D Real-Time Collaborative Environment to Learn Teamwork and Non-technical Skills in the Operating Room , 2016, ICL.

[50]  Nick Sevdalis,et al.  Observational Teamwork Assessment for Surgery (OTAS): Refinement and Application in Urological Surgery , 2007, World Journal of Surgery.

[51]  Wm. LeRoy Heinrichs,et al.  CliniSpaceTM: A Multiperson 3D Online Immersive Training Environment Accessible through a Browser , 2011, MMVR.

[52]  Anne P. Massey,et al.  Collaborative Virtual Environments : Exploring the Link between Collaborative Behaviors and Team Performance , 2011 .

[53]  Cara J Hamann,et al.  Teaching and assessing procedural skills using simulation: metrics and methodology. , 2008, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[54]  A. Greiner,et al.  Health Professions Education: A Bridge to Quality , 2003 .

[55]  B. Mol,et al.  Multidisciplinary Team Training in a Simulation Setting for Acute Obstetric Emergencies: A Systematic Review , 2010, Obstetrics and gynecology.

[56]  J Rosen,et al.  Objective laparoscopic skills assessments of surgical residents using Hidden Markov Models based on haptic information and tool/tissue interactions. , 2001, Studies in health technology and informatics.

[57]  Y. Donchin,et al.  A look into the nature and causes of human errors in the intensive care unit , 2022 .

[58]  Liliane S. Machado,et al.  A FUZZY LOGIC BASED ASSESSMENT TOOL FOR VR SIMULATED MEDICAL ENVIRONMENTS , 2010 .

[59]  T. Grantcharov,et al.  Randomized clinical trial of virtual reality simulation for laparoscopic skills training , 2004, The British journal of surgery.

[60]  E. Larson,et al.  The impact of physician-nurse interaction on patient care. , 1999, Holistic nursing practice.

[61]  Bernard C. K. Choi,et al.  Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness. , 2006, Clinical and investigative medicine. Medecine clinique et experimentale.

[62]  Richard M Satava,et al.  Surgical competence and surgical proficiency: definitions, taxonomy, and metrics. , 2003, Journal of the American College of Surgeons.

[63]  Gábor Székely,et al.  Objective Surgical Performance Assessment for Virtual Hysteroscopy , 2007, MMVR.

[64]  J. Paige Surgical team training: promoting high reliability with nontechnical skills. , 2010, The Surgical clinics of North America.

[65]  Liliane dos Santos Machado,et al.  Using fuzzy hidden Markov models for online training evaluation and classification in virtual reality simulators , 2004, Int. J. Gen. Syst..

[66]  Steve Benford,et al.  Collaborative virtual environments , 2001, CACM.

[67]  David R. Michael,et al.  Serious Games: Games That Educate, Train, and Inform , 2005 .