57.03 Silicone-rubber as a Viable, Cheaper Alternative to Current Commercial Simulated Bowels

Posted on January 18, 2018

K. M. Bell1, B. Wise1, C. Kwan1, A. Witt1, C. M. Pugh1  1University Of Wisconsin,Surgery,Madison, WI, USA

Introduction:
Surgical residency programs have relied on cadaveric animal tissue, to practice and teach surgical procedures and techniques. The drawbacks to using animal tissue are short shelf life, sporadic availability, and costs of manpower and management needs. For training purposes, commercial synthetic tissue and virtual reality simulators are also used, but can be very expensive. The aim of this study is to determine if our fabricated silicone-based bowels are valuable for surgical education and competitive with commercial products. We hypothesize that silicone-based bowels can be a useful training tool for general surgery residents and can be more cost effective than commercial products.

Methods:
General Surgery residents (N=6) evaluated three synthetic bowel prototypes. Two synthetic small bowels (Model B and C) were fabricated using cellulose fiber sheets, cotton fiber mesh, and silicone rubbers in different concentrations, to replicate the serosa, muscularis and mucosa. Cost for these models is $5. A third, commercial small bowel was purchased (Model A) for $60. Participants blindly selected what they felt to be most realistic from a covered basin and those choices were documented. Next, participants performed a suturing task on all three samples and evaluated the bowel’s realism using a Likert based survey. Favorable responses were denoted as ‘average’, ‘accurate’, or ‘highly accurate’. Unfavorable responses included ‘highly inaccurate’ and ‘inaccurate’.

Results:
83% of participants had previously used synthetic bowel for learning purposes, and 50% of participants reported performing 1 to 5 bowel Enterotomy repairs per month in the operating room. During the blind identification test, 66% of participants selected one of the silicone-based rubber bowels (B or C), over the commercial bowel (A) as feeling the most realistic. Model A tended to have more favorable responses regarding mechanical functionality of the bowel, with ten-out-of-ten of the favorable survey responses. Model B had seven-out of ten favorable responses, and Model C had a five-out-of-ten favorable responses. All the participants answered ‘accurate’ or ‘highly accurate’ in response to the survey statements confirming that simulation could highlight the strengths or weaknesses in their technical skill.

Conclusion:
The silicone-based bowels, models B and C, were more likely to be selected in the blind identification test. When the favorable properties of model B and C are combined, we will be able to produce a prototype that is financially, tactically, and mechanically competitive to the current commercial products. This study shows that silicone based rubber bowels have value for surgical education, and that with advancement; they can be a viable replacement to cadaveric animal tissue, commercial prototypes, and other, more costly training products.

57.01 Use of Google Glass for Patient Information Presentation for Emergency Response and Training

Posted on January 18, 2018

S. Ganapathy1, S. Raju1, M. C. McCarthy1  1Wright State University,Department Of Industrial And Human Factors Engineering; Department Of Trauma Care And Surgery,Dayton, OH, USA

Introduction:
Small screen devices are becoming ubiquitous in the medical field; especially in the fields of surgery and trauma care. This research focuses on developing guidelines for wearable augmented device, e.g. Google Glass ™, to improve human decision making during transfer of care, and user experience and reduce cognitive workload. The display being a small form factor poses a challenge in presenting information and at the same time making sure that there is no cognitive overload to the user. This could potentially help medical responder in the trauma care center to prepare for treatment materials such as medicine, diagnostic procedures, bringing in specialized doctors or consulting the advice of experienced doctors and calling in support staff as required.

Methods:
An empirical study was conducted to determine the effect of information presentation of patient vitals on Google Glass ™ device for improved transfer-of-care. The pool of participants included physicians and residents from the Department of Trauma and Surgery, Boonshoft School of Medicine, Miami Valley Hospital.  Six residents (3 junior & 3 senior) participated as novice and 6 physicians as residents. The experiment was divided into two parts –visual search task and patient vitals simulation task. Visual search task was conducted and user interface elements such as object size, color, and target location were tested for their influence on visual search. This test also used EEG information to detect the brain areas active during target search. In the patient vitals simulation, the participants were presented with different UI screens and their experience was evaluated.

Results:
Results indicate that there was significant difference in the response time for physicians and residents (F (5,141), p-value < 0.001, ηp2= 0.031). When residents were further analyzed based on their experience, the response time was significantly different for junior residents when compared to senior residents and doctors (F (2,141), p-value < 0.001, ηp2= 0.211). The user response shows that UI1 was comparatively better in the design of screen layout and content on the screen than UI3 and UI2. The EEG data showed that there was more activity in the T8 channel area which included the temporal region as well as the temporal-parietal area and parietal area. Past research shows that the superior parietal lobe was associated with visual search.

Conclusion:
Results indicate that wearable augmented devices can enhance visualization for emergency response without additional mental workload and aid in decision making. Wearable augmented device provides ubiquitous information especially in multitasking scenarios where user can have access to information on an “as needed” basis. The mean channel data shows that for residents the prefrontal area was active and all participants had temporal cortex active. Expert participants pointed out that trending patient vitals data could improve experience which can be achieved through large screen AR devices. Using NASA-TLX for the user’s perceived cognition and at the same time comparing it with brain signals give research insight in designing future products.
 

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