Design and Think-Aloud Study of an Immersive Interface for Training Health Professionals in Clinical Skills
Resumo
Virtual simulation has been used for decades to improve the practice of technical skills by physicians. However, an important aspect of medical education is learning and practicing non-technical skills, which are commonly taught in role-playing sessions. Using VR simulation for such kind of training would optimize supervision time and allow for training in multiple scenarios. In this paper, we introduce a framework and application to support healthcare professionals in learning multi-step procedures and assess students’ and candidates’ readiness. The framework is an immersive system that allows users to perform general healthcare tasks in a natural environment. It does not require constant monitoring by an expert, making it accessible to larger groups of students and candidates with reduced time and personnel resources. The design also considers individual adaptation to virtual reality by providing in-game ergonomics and interaction accuracy settings. The system was tested through a user study with a pediatrician scenario and underwent a preliminary evaluation in a major hospital.
Palavras-chave:
Haptics, Haptic Displays, Simulation, Interactive Learning, Teaching, Wearable Devices, HCI
Referências
Gerry Altmiller, Francisco Jimenez, Jack Wharton, Cheryl Wilson, and Natalie Wright. 2022. HIV and Contact Tracing: Impact of a Virtual Patient Simulation Activity. Clinical Simulation in Nursing 64 (2022), 58–66. https://doi.org/10.1016/j.ecns.2021.12.005
Isabela Bianchi, Alexandre Lazaretti Zanatta, and Rafael Rieder. 2020. Augmented Reality in Medical Teaching-Learning Process Content: A Systematic Review. In 2020 22nd Symposium on Virtual and Augmented Reality (SVR). 129–133. https://doi.org/10.1109/SVR51698.2020.00032
Ted Boren and Judith Ramey. 2000. Thinking aloud: Reconciling theory and practice. IEEE Transactions on Professional Communication 43, 3 (2000), 261–278.
Gordon Caldwell. 2019. The process of clinical consultation is crucial to patient outcomes and safety: 10 quality indicators. Clinical Medicine 19, 6 (2019), 503–506. https://doi.org/10.7861/clinmed.2019-0263 arXiv: https://www.rcpjournals.org/content/19/6/503.full.pdf
Laurent Chaby, Abdelkader Benamara, Marco Pino, Etienne Prigent, Brian Ravenet, Jean-Claude Martin, Hubert Vanderstichel, Anne-Sophie Rigaud, and Mohamed Chetouani. 2022. Embodied Virtual Patients as a Simulation-Based Framework for Training Clinician-Patient Communication Skills: An Overview of Their Use in Psychiatric and Geriatric Care. Frontiers in Virtual Reality 3 (2022), 827312. https://doi.org/10.3389/frvir.2022.827312
Jean Rémy Chardonnet, Mohammad Ali Mirzaei, and Frédéric Merienne. 2021. Influence of navigation parameters on cybersickness in virtual reality. Virtual Reality 25, 3 (2021), 565–574. https://doi.org/10.1007/s10055-020-00474-2
Betty Chou and Victoria L. Handa. 2006. Simulators and Virtual Reality in Surgical Education. Obstetrics and Gynecology Clinics of North America 33, 2 (2006), 283–296. https://doi.org/10.1016/j.ogc.2006.01.007
Sandeep Ganni, Meng Li, Sanne MBI Botden, Samir Ranjan Nayak, Bhaskar Rao Ganni, Anne-Francoise Rutkowski, Richard HM Goossens, and Jack Jakimowicz. 2020. Virtual operating room simulation setup (VORSS) for procedural training in minimally invasive surgery–A pilot study. Indian Journal of Surgery 82 (2020), 810–816.
J. Gerup, C.B. Soerensen, and P. Dieckmann. 2020. Augmented reality and mixed reality for healthcare education beyond surgery: an integrative review. Int J Med Educ 11 (2020), 1–18. https://doi.org/10.5116/ijme.5e01.eb1a arXiv: [link].
Christian Gießer, Julian Knode, Armin Gruenewald, Tanja Joan Eiler, Vanessa Schmuecker, and Rainer Brueck. 2021. SkillsLab+ - Augmented Reality Enhanced Medical Training. In 2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR). 194–197. https://doi.org/10.1109/AIVR52153.2021.00043
T. P. Grantcharov, V. B. Kristiansen, J. Bendix, L. Bardram, J. Rosenberg, and P. Funch-Jensen. 2004. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. British Journal of Surgery 91, 2 (2004), 146–150. https://doi.org/10.1002/bjs.4407
Tobias Huber, Markus Paschold, Christian Hansen, Hauke Lang, and Werner Kneist. 2018. Artificial Versus Video-Based Immersive Virtual Surroundings: Analysis of Performance and User’s Preference. Surgical Innovation 25, 3 (2018), 280–285. https://doi.org/10.1177/1553350618761756 arXiv: https://doi.org/10.1177/1553350618761756 PMID: 29504470.
Tobias Huber, Tom Wunderling, Markus Paschold, Hauke Lang, Werner Kneist, and Christian Hansen. 2018. Highly immersive virtual reality laparoscopy simulation: development and future aspects. International journal of computer assisted radiology and surgery 13 (2018), 281–290.
Francisco A Jimenez. 2022. Can Virtual Patient Simulation Be Used in Substitution of Traditional Clinical Hours in Undergraduate Nursing Education? A Review of the Evidence. White Paper (2022), 15.
Beres Joyner and Dr Louise Young. 2009. Teaching medical students using role play: Twelve tips for successful role plays. Medical Teacher 28, 3 (2009), 225–229. https://doi.org/10.1080/01421590600711252 arXiv: https://doi.org/10.1080/01421590600711252 PMID: 16753719.
A. J. Kleinheksel. 2014. Transformative learning through virtual patient simulations: Predicting critical student reflections. Clinical Simulation in Nursing 10, 6 (2014), e301–e308. https://doi.org/10.1016/j.ecns.2014.02.001
Richard L. Lammers, Matthew Davenport, Frederick Korley, Sharon GriswoldTheodorson, Michael T. Fitch, Aparna T. Narang, Laura V. Evans, Anita Gross, Edgar Rodriguez, Kimberly L. Dodge, Claus J. Hamann, and W. Clay Robey. 2008. Teaching and assessing procedural skills using simulation: metrics and methodology. Academic Emergency Medicine 15, 11 (Nov 2008), 1079–1087. https://doi.org/10.1111/j.1553-2712.2008.00233.x Epub 2008 Sep 26.
Alexander Libin, Manon Lauderdale, Yuri Millo, Christine Shamloo, Rachel Spencer, Brad Green, Joyce Donnellan, Christine Wellesley, and Suzanne Groah. 2010. Role-Playing Simulation as an Educational Tool for Health Care Personnel: Developing an Embedded Assessment Framewo. Cyberpsychology, Behavior, and Social Networking 13, 2 (2010), 217–224. http://doi.org/10.1089/cyber.2009.0040
Abel J. Lungu, Wout Swinkels, Luc Claesen, Puxun Tu, Jan Egger, and Xiaojun Chen. 2021. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Review of Medical Devices 18 (2021), 47–62. Issue 1. https://doi.org/10.1080/17434440.2021.1860750
M. Müller, J. Jürgens, M. Redaèlli, K. Klingberg, W.E. Hautz, and S. Stock. 2018. Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open 8, 8 (23 Aug 2018), e022202. https://doi.org/10.1136/bmjopen-2018-022202
Debra Nestel and Tanya Tierney. 2007. Role-play for medical students learning about communication: Guidelines for maximising benefits. BMC Medical Education 7, 1 (2007), 3–. https://doi.org/10.1186/1472-6920-7-3
Dixit Bharatkumar Patel, Yong Pei, Mitesh Vasoya, and Paul J. Hershberger. 2023. Computer-Supported Experiential Learning-Based Tool for Healthcare Skills. IEEE Computer Graphics and Applications 43, 2 (2023), 57–68. https://doi.org/10.1109/MCG.2023.3242921
Laura Raya, Juan Jesus Ruiz, Marc Fabian, Adrian Ron, Javier Garcia, and Cristina Verdu. 2023. Development of a Virtual Reality Tool for the Treatment of Pediatric Patients in the ICU. IEEE Computer Graphics and Applications 43, 2 (2023), 69–77. https://doi.org/10.1109/MCG.2023.3239676
M. Reznek, P. Harter, and T. Krummel. 2002. Virtual reality and simulation: Training the future emergency physician. Academic Emergency Medicine 9, 1 (2002), 78–87. https://doi.org/10.1197/aemj.9.1.78
Ganesh Sankaranarayanan, Baichun Li, Kelly Manser, Stephanie B Jones, Daniel B Jones, Steven Schwaitzberg, Caroline GL Cao, and Suvranu De. 2016. Face and construct validation of a next generation virtual reality (Gen2-VR©) surgical simulator. Surgical endoscopy 30 (2016), 979–985.
Sebastian Streuber, Patrick Saalfeld, Katja Podulski, Florentine Hüttl, Tobias Huber, Holger Buggenhagen, Christian Boedecker, Bernhard Preim, and Christian Hansen. 2020. Training of patient handover in virtual reality. Current Directions in Biomedical Engineering 6, 1 (2020), 20200040. https://doi.org/10.1515/cdbme-2020-0040
Jacob Stuart, Karen Aul, Michael Bumbach, Anita Stephen, and Benjamin Lok. 2021. Building a Handoff Communication Virtual Experience for Nursing Students Using Virtual Humans. CIN: Computers, Informatics, Nursing 39, 12 (December 2021), 1017–1026. https://doi.org/10.1097/CIN.0000000000000760
Tuo Wen, David Medveczky, Jie Wu, and et al. 2018. Colonoscopy Procedure Simulation: Virtual Reality Training Based on a Real Time Computational Approach. BioMedical Engineering OnLine 17 (2018), 9. https://doi.org/10.1186/s12938-018-0433-4
Michael Zyda. 2005. From visual simulation to virtual reality to games. Computer 38, 9 (2005), 25–32. https://doi.org/10.1109/MC.2005.297
Isabela Bianchi, Alexandre Lazaretti Zanatta, and Rafael Rieder. 2020. Augmented Reality in Medical Teaching-Learning Process Content: A Systematic Review. In 2020 22nd Symposium on Virtual and Augmented Reality (SVR). 129–133. https://doi.org/10.1109/SVR51698.2020.00032
Ted Boren and Judith Ramey. 2000. Thinking aloud: Reconciling theory and practice. IEEE Transactions on Professional Communication 43, 3 (2000), 261–278.
Gordon Caldwell. 2019. The process of clinical consultation is crucial to patient outcomes and safety: 10 quality indicators. Clinical Medicine 19, 6 (2019), 503–506. https://doi.org/10.7861/clinmed.2019-0263 arXiv: https://www.rcpjournals.org/content/19/6/503.full.pdf
Laurent Chaby, Abdelkader Benamara, Marco Pino, Etienne Prigent, Brian Ravenet, Jean-Claude Martin, Hubert Vanderstichel, Anne-Sophie Rigaud, and Mohamed Chetouani. 2022. Embodied Virtual Patients as a Simulation-Based Framework for Training Clinician-Patient Communication Skills: An Overview of Their Use in Psychiatric and Geriatric Care. Frontiers in Virtual Reality 3 (2022), 827312. https://doi.org/10.3389/frvir.2022.827312
Jean Rémy Chardonnet, Mohammad Ali Mirzaei, and Frédéric Merienne. 2021. Influence of navigation parameters on cybersickness in virtual reality. Virtual Reality 25, 3 (2021), 565–574. https://doi.org/10.1007/s10055-020-00474-2
Betty Chou and Victoria L. Handa. 2006. Simulators and Virtual Reality in Surgical Education. Obstetrics and Gynecology Clinics of North America 33, 2 (2006), 283–296. https://doi.org/10.1016/j.ogc.2006.01.007
Sandeep Ganni, Meng Li, Sanne MBI Botden, Samir Ranjan Nayak, Bhaskar Rao Ganni, Anne-Francoise Rutkowski, Richard HM Goossens, and Jack Jakimowicz. 2020. Virtual operating room simulation setup (VORSS) for procedural training in minimally invasive surgery–A pilot study. Indian Journal of Surgery 82 (2020), 810–816.
J. Gerup, C.B. Soerensen, and P. Dieckmann. 2020. Augmented reality and mixed reality for healthcare education beyond surgery: an integrative review. Int J Med Educ 11 (2020), 1–18. https://doi.org/10.5116/ijme.5e01.eb1a arXiv: [link].
Christian Gießer, Julian Knode, Armin Gruenewald, Tanja Joan Eiler, Vanessa Schmuecker, and Rainer Brueck. 2021. SkillsLab+ - Augmented Reality Enhanced Medical Training. In 2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR). 194–197. https://doi.org/10.1109/AIVR52153.2021.00043
T. P. Grantcharov, V. B. Kristiansen, J. Bendix, L. Bardram, J. Rosenberg, and P. Funch-Jensen. 2004. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. British Journal of Surgery 91, 2 (2004), 146–150. https://doi.org/10.1002/bjs.4407
Tobias Huber, Markus Paschold, Christian Hansen, Hauke Lang, and Werner Kneist. 2018. Artificial Versus Video-Based Immersive Virtual Surroundings: Analysis of Performance and User’s Preference. Surgical Innovation 25, 3 (2018), 280–285. https://doi.org/10.1177/1553350618761756 arXiv: https://doi.org/10.1177/1553350618761756 PMID: 29504470.
Tobias Huber, Tom Wunderling, Markus Paschold, Hauke Lang, Werner Kneist, and Christian Hansen. 2018. Highly immersive virtual reality laparoscopy simulation: development and future aspects. International journal of computer assisted radiology and surgery 13 (2018), 281–290.
Francisco A Jimenez. 2022. Can Virtual Patient Simulation Be Used in Substitution of Traditional Clinical Hours in Undergraduate Nursing Education? A Review of the Evidence. White Paper (2022), 15.
Beres Joyner and Dr Louise Young. 2009. Teaching medical students using role play: Twelve tips for successful role plays. Medical Teacher 28, 3 (2009), 225–229. https://doi.org/10.1080/01421590600711252 arXiv: https://doi.org/10.1080/01421590600711252 PMID: 16753719.
A. J. Kleinheksel. 2014. Transformative learning through virtual patient simulations: Predicting critical student reflections. Clinical Simulation in Nursing 10, 6 (2014), e301–e308. https://doi.org/10.1016/j.ecns.2014.02.001
Richard L. Lammers, Matthew Davenport, Frederick Korley, Sharon GriswoldTheodorson, Michael T. Fitch, Aparna T. Narang, Laura V. Evans, Anita Gross, Edgar Rodriguez, Kimberly L. Dodge, Claus J. Hamann, and W. Clay Robey. 2008. Teaching and assessing procedural skills using simulation: metrics and methodology. Academic Emergency Medicine 15, 11 (Nov 2008), 1079–1087. https://doi.org/10.1111/j.1553-2712.2008.00233.x Epub 2008 Sep 26.
Alexander Libin, Manon Lauderdale, Yuri Millo, Christine Shamloo, Rachel Spencer, Brad Green, Joyce Donnellan, Christine Wellesley, and Suzanne Groah. 2010. Role-Playing Simulation as an Educational Tool for Health Care Personnel: Developing an Embedded Assessment Framewo. Cyberpsychology, Behavior, and Social Networking 13, 2 (2010), 217–224. http://doi.org/10.1089/cyber.2009.0040
Abel J. Lungu, Wout Swinkels, Luc Claesen, Puxun Tu, Jan Egger, and Xiaojun Chen. 2021. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Review of Medical Devices 18 (2021), 47–62. Issue 1. https://doi.org/10.1080/17434440.2021.1860750
M. Müller, J. Jürgens, M. Redaèlli, K. Klingberg, W.E. Hautz, and S. Stock. 2018. Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open 8, 8 (23 Aug 2018), e022202. https://doi.org/10.1136/bmjopen-2018-022202
Debra Nestel and Tanya Tierney. 2007. Role-play for medical students learning about communication: Guidelines for maximising benefits. BMC Medical Education 7, 1 (2007), 3–. https://doi.org/10.1186/1472-6920-7-3
Dixit Bharatkumar Patel, Yong Pei, Mitesh Vasoya, and Paul J. Hershberger. 2023. Computer-Supported Experiential Learning-Based Tool for Healthcare Skills. IEEE Computer Graphics and Applications 43, 2 (2023), 57–68. https://doi.org/10.1109/MCG.2023.3242921
Laura Raya, Juan Jesus Ruiz, Marc Fabian, Adrian Ron, Javier Garcia, and Cristina Verdu. 2023. Development of a Virtual Reality Tool for the Treatment of Pediatric Patients in the ICU. IEEE Computer Graphics and Applications 43, 2 (2023), 69–77. https://doi.org/10.1109/MCG.2023.3239676
M. Reznek, P. Harter, and T. Krummel. 2002. Virtual reality and simulation: Training the future emergency physician. Academic Emergency Medicine 9, 1 (2002), 78–87. https://doi.org/10.1197/aemj.9.1.78
Ganesh Sankaranarayanan, Baichun Li, Kelly Manser, Stephanie B Jones, Daniel B Jones, Steven Schwaitzberg, Caroline GL Cao, and Suvranu De. 2016. Face and construct validation of a next generation virtual reality (Gen2-VR©) surgical simulator. Surgical endoscopy 30 (2016), 979–985.
Sebastian Streuber, Patrick Saalfeld, Katja Podulski, Florentine Hüttl, Tobias Huber, Holger Buggenhagen, Christian Boedecker, Bernhard Preim, and Christian Hansen. 2020. Training of patient handover in virtual reality. Current Directions in Biomedical Engineering 6, 1 (2020), 20200040. https://doi.org/10.1515/cdbme-2020-0040
Jacob Stuart, Karen Aul, Michael Bumbach, Anita Stephen, and Benjamin Lok. 2021. Building a Handoff Communication Virtual Experience for Nursing Students Using Virtual Humans. CIN: Computers, Informatics, Nursing 39, 12 (December 2021), 1017–1026. https://doi.org/10.1097/CIN.0000000000000760
Tuo Wen, David Medveczky, Jie Wu, and et al. 2018. Colonoscopy Procedure Simulation: Virtual Reality Training Based on a Real Time Computational Approach. BioMedical Engineering OnLine 17 (2018), 9. https://doi.org/10.1186/s12938-018-0433-4
Michael Zyda. 2005. From visual simulation to virtual reality to games. Computer 38, 9 (2005), 25–32. https://doi.org/10.1109/MC.2005.297
Publicado
06/11/2023
Como Citar
NEGRÃO, Matheus Dias; FERREIRA, Wesley; BOHRER, Betania; FREITAS, Carla M. D. S.; MACIEL, Anderson; NEDEL, Luciana.
Design and Think-Aloud Study of an Immersive Interface for Training Health Professionals in Clinical Skills. In: SIMPÓSIO DE REALIDADE VIRTUAL E AUMENTADA (SVR), 25. , 2023, Rio Grande/RS.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2023
.
p. 157–165.
