Alverson Dale C, Saiki Stanley M, Jacobs Joshua, Saland Linda, Keep Marcus F, Norenberg Jeffrey, Baker Rex, Nakatsu Curtis, Kalishman Summers, Lindberg Marlene, Wax Diane, Mowafi Moad, Summers Kenneth L, Holten James R, Greenfield John A, Aalseth Edward, Nickles David, Sherstyuk Andrei, Haines Karen, Caudell Thomas P
Center for Telehealth, University of New Mexico, USA.
Stud Health Technol Inform. 2004;98:7-12.
Medical knowledge and skills essential for tomorrow's healthcare professionals continue to change faster than ever before creating new demands in medical education. Project TOUCH (Telehealth Outreach for Unified Community Health) has been developing methods to enhance learning by coupling innovations in medical education with advanced technology in high performance computing and next generation Internet2 embedded in virtual reality environments (VRE), artificial intelligence and experiential active learning. Simulations have been used in education and training to allow learners to make mistakes safely in lieu of real-life situations, learn from those mistakes and ultimately improve performance by subsequent avoidance of those mistakes. Distributed virtual interactive environments are used over distance to enable learning and participation in dynamic, problem-based, clinical, artificial intelligence rules-based, virtual simulations. The virtual reality patient is programmed to dynamically change over time and respond to the manipulations by the learner. Participants are fully immersed within the VRE platform using a head-mounted display and tracker system. Navigation, locomotion and handling of objects are accomplished using a joy-wand. Distribution is managed via the Internet2 Access Grid using point-to-point or multi-casting connectivity through which the participants can interact. Medical students in Hawaii and New Mexico (NM) participated collaboratively in problem solving and managing of a simulated patient with a closed head injury in VRE; dividing tasks, handing off objects, and functioning as a team. Students stated that opportunities to make mistakes and repeat actions in the VRE were extremely helpful in learning specific principles. VRE created higher performance expectations and some anxiety among VRE users. VRE orientation was adequate but students needed time to adapt and practice in order to improve efficiency. This was also demonstrated successfully between Western Australia and UNM. We successfully demonstrated the ability to fully immerse participants in a distributed virtual environment independent of distance for collaborative team interaction in medical simulation designed for education and training. The ability to make mistakes in a safe environment is well received by students and has a positive impact on their understanding, as well as memory of the principles involved in correcting those mistakes. Bringing people together as virtual teams for interactive experiential learning and collaborative training, independent of distance, provides a platform for distributed "just-in-time" training, performance assessment and credentialing. Further validation is necessary to determine the potential value of the distributed VRE in knowledge transfer, improved future performance and should entail training participants to competence in using these tools.
对于未来的医疗保健专业人员而言，医学知识和技能的更新速度比以往任何时候都要快，这对医学教育提出了新的要求。TOUCH项目（统一社区健康的远程医疗外展）一直在开发方法，通过将医学教育创新与高性能计算和嵌入虚拟现实环境（VRE）、人工智能及体验式主动学习中的下一代互联网2的先进技术相结合，来加强学习。模拟已被用于教育和培训，使学习者能够在虚拟环境中安全地犯错，从这些错误中学习，并最终通过避免这些错误来提高表现。分布式虚拟交互环境可通过远程使用，以实现参与动态的、基于问题的、临床的、基于人工智能规则的虚拟模拟学习和参与。虚拟现实患者被编程为随时间动态变化，并对学习者的操作做出反应。参与者使用头戴式显示器和追踪系统完全沉浸在VRE平台中。使用操纵杆完成对象的导航、移动和操作。通过互联网2访问网格使用点对点或多播连接来管理分布，参与者可通过此进行交互。夏威夷和新墨西哥州（NM）的医学生在VRE中合作参与解决问题和管理一名模拟的闭合性颅脑损伤患者；分工、交接物品并作为一个团队开展工作。学生们表示，在VRE中有犯错和重复操作的机会对学习特定原则非常有帮助。VRE在VRE用户中创造了更高的表现期望并引发了一些焦虑。VRE培训是足够的，但学生们需要时间来适应和练习以提高效率。这一点在西澳大利亚和新墨西哥大学之间也得到了成功证明。我们成功展示了能够将参与者完全沉浸在分布式虚拟环境中，而不受距离限制，以便在为教育和培训设计的医学模拟中进行协作团队互动。在安全环境中犯错的能力受到学生们的欢迎，并对他们对相关原则的理解以及记忆产生积极影响。将人们作为虚拟团队聚集在一起进行交互式体验学习和协作培训，不受距离限制，为分布式“即时”培训、表现评估和认证提供了一个平台。需要进一步验证以确定分布式VRE在知识转移、改善未来表现方面的潜在价值，并且应该让参与者接受使用这些工具的能力培训。
