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Virtual Reality Operating Simulators: Gamification in Training Surgeons

Brigg Patten

In an atmosphere not unlike the red-carpet Academy Awards, the Canadian company Conquer Mobile announced the launch of PeriopSim, a mobile application to enable nurses to practice their “parts” in delicate robotic surgeries. The company scheduled the launch to coincide with a nurse convention that occurred in Denver in March, 2015. The operation simulator is the latest in a series of innovative designs made possible by the National Research Council of Canada.

However, the technology has been around since the 1980s. This was also around the time when a lot of advances were made in videogame technology and Atari, one of the leaders in the industry, decided to see if there was a possible application for the technology in training simulators. Young surgeons, who had played video games, had better eye-hand coordination than surgeons who had never played the games. Research has exploded with the current trend toward laparoscopic and robotic surgeries. One of the most common ways to train surgeons is to have them assist other doctors in operations. The training adds to the time the patient spends in the operating room, though. With the simulation applications, surgeons and their teams can train to perform delicate surgeries without a cadaver or a patient. PeriopSim uses gamification examples to make its trainer more attractive to nurses. Some of the modes are timed and scored. With the technology, nurses enter the operating suite with a greater level of confidence.

To make the simulators possible, researchers make virtual maps of the brain, the thorax and other areas of the body. The maps are presented in 3D representation. The system also uses a Stereovision System, a bimanual haptic tool, which is a tool that is operated by either or both hands and simulates the tactile effects of performing surgery, and a complex computer. Dr. Keerit Tauh, a resident at Surrey Memorial hospital, was impressed by the replication of the sensations. He said that the procedure felt very natural and that it was “realistic in terms of depth perception.” The areas that the simulations work best at teaching are eye-hand coordination and the ability to translate the 2D representations into 3D virtual operating “worlds.”

In 2005, the DaVinci Surgical System successfully allowed a surgeon to train for a delicate surgery. The technology continued to improve and, in 2009, Dr. David Clarke removed a benign tumor from the brain of Ellen Wright after practicing on “NeuroTouch.” The patient had so much confidence in the procedure that, prior to her surgery, she asked the surgeon how his rehearsal had gone. The National Research Council brought together professionals from engineering disciplines, medicine and computer sciences to develop the tool and planned to test it in ten Canadian cities over an eighteen-month period. NeuroTouch is patient specific. That is an important development, according to Dr. James Bond, Chief of Thoracic Surgery at Surrey Memorial Hospital. He stated, in a video showcasing the simulator technology, that the ultimate goal would be to be able to practice difficult surgeries in the patient’s own space. That would take into account the relative size of organs and other variables, allowing a doctor to be prepared for what he will find during the actual operation.

Training surgeons has always presented a dilemma, and the opportunity to train them on a simulator, the way pilots train, offers a lot of promise to the medical field. Using the examples of gamification, developers can create training tools that mimic technology that young doctors and nurses grew up with, and are comfortable using. That gives them a huge advantage when it comes to entering the virtual worlds of the operating simulators.

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Bob Gourley writes on enterprise IT. He is a founder and partner at Cognitio Corp and publsher of CTOvision.com