Mendes Helena Catarina Margarido, Costa Cátia Isabel Andrade Botelho, da Silva Nuno André, Leite Francisca Pais, Esteves Augusto, Lopes Daniel Simões
Instituto Superior Técnico, Universidade de Lisboa, Portugal.
Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal.
Comput Med Imaging Graph. 2020 Jun;82:101731. doi: 10.1016/j.compmedimag.2020.101731. Epub 2020 Apr 21.
Conventional needle insertion training relies on medical dummies that simulate surface anatomy and internal structures such as veins or arteries. These dummies offer an interesting space to augment with useful information to assist training practices, namely, internal anatomical structures (subclavian artery and vein, internal jugular vein and carotid artery) along with target point, desired inclination, position and orientation of the needle. However, limited research has been conducted on Optical See-Through Augmented Reality (OST-AR) interfaces for training needle insertion, especially for central venous catheterization (CVC). In this work we introduce PIÑATA, an interactive tool to explore the benefits of OST-AR in CVC training using a dummy of the upper torso and neck; andexplore if PIÑATA complements conventional training practices.. Our design contribution also describes the observation and co-design sessions used to collect user requirements, usability aspects and user preferences. This was followed by a comparative study with 18 participants - attending specialists and medical residents - that performed needle insertion tasks for CVC with PIÑATAand the conventional training system. The performance was objectively measured by task completion time and number of needle insertion errors. A correlation was found between the task completion time in the two training methods, suggesting the concurrent validity of our OST-AR tool. An inherent difference in the task completion time (p =0.040) and in the number of errors (p = 0.036) between novices and experts proved the construct validity of the new tool. The qualitative answers of the participants also suggest its face and content validity, a high acceptability rate and a medium perceived workload. Finally, the result of semi-structured interviews with these 18 participants revealed that 14 of them considered that PIÑATA can complement the conventional training system, especially due to the visibility of the vessels inside the simulator. 13 agreed that OST-AR adoption in these scenarios is likely, particularly during early stages of training. Integration with ultrasound information was highlighted as necessary future work. In sum, the overall results show that the OST-AR tool proposed can complement the conventional training of CVC.
传统的针刺训练依赖于模拟表面解剖结构和内部结构(如静脉或动脉)的医学模型。这些模型提供了一个有趣的空间,可以用有用的信息进行扩充,以辅助训练实践,即内部解剖结构(锁骨下动脉和静脉、颈内静脉和颈动脉)以及针的目标点、期望倾斜度、位置和方向。然而,针对用于针刺训练的光学透视增强现实(OST-AR)界面,特别是用于中心静脉置管(CVC)的研究有限。在这项工作中,我们介绍了PIÑATA,这是一种交互式工具,用于使用上半身和颈部模型探索OST-AR在CVC训练中的益处;并探讨PIÑATA是否补充了传统训练实践。我们的设计贡献还描述了用于收集用户需求、可用性方面和用户偏好的观察和协同设计会议。随后,对18名参与者(主治专家和住院医生)进行了一项比较研究,他们使用PIÑATA和传统训练系统执行CVC的针刺任务。通过任务完成时间和针刺错误数量对表现进行客观测量。发现两种训练方法的任务完成时间之间存在相关性,这表明我们的OST-AR工具具有同时效度。新手和专家在任务完成时间(p = 0.040)和错误数量(p = 0.036)上的固有差异证明了新工具的结构效度。参与者的定性回答也表明了其表面效度和内容效度、高接受率和中等感知工作量。最后,对这18名参与者进行的半结构化访谈结果显示,其中14人认为PIÑATA可以补充传统训练系统,特别是由于模拟器内部血管的可见性。13人同意在这些场景中采用OST-AR是可能的,特别是在训练的早期阶段。与超声信息的集成被强调为未来必要的工作。总之,总体结果表明,所提出的OST-AR工具可以补充CVC的传统训练。
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