Comparison of traditional vs. virtual simulation-enhanced training for scaling the cervical cancer surgery workforce in Zambia

传统与虚拟模拟增强培训在扩大赞比亚宫颈癌手术劳动力方面的比较

• 批准号: MR/P025420/1
• 负责人: Richard Sullivan
• 金额: $ 69.07万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP025420%2F1
• 关键词: Comparison; traditional; vs.; virtual; simulation

Proposed workWe will use virtual reality simulation of a surgical procedure to pre-train surgical trainees by helping them acquire the psycho-motor skills, sensory acuity, and to a lesser extent, cognitive planning required to achieve the surgical dexterity necessary to perform cervical cancer surgery. After the have reached surgical proficiency we will use proctor them with a form of web-based tele mentoring technology that allows the surgical trainee who is performing surgery to wear a headset that transmits a live, real-time video feed of the surgical procedure to the monitor of an expert surgical mentor who is offsite. The mentor can provide real-time telestration feedback (drawings on the video feed) to the bedside monitor of the surgical trainee while the surgical procedure is being performed, i.e., the video feed from the trainee is transferred to the mentor and then back to the trainee from the mentor with the latter's telestration, much like commentators illustrating in a football game on a separate screen. We will measure the speed at which surgical trainees acquire and maintain the technical skills necessary to safely effectively perform cervical cancer surgery using the technology above with that when they are trained using traditional methods. We will also compare the economic and financial costs of traditional vs. technology-enhanced training for a surgeon to achieve proficiency in treating cervical cancer.ContextCancer, the world's leading cause of death, is projected to increase at a staggering rate in the next two decades. Most of the new cases, and deaths, will occur in the world's poorest regions. Africa will be hardest hit, as it is estimated that by 2030 cancer will kill one million Africans each year. Within Africa, women will bear the heaviest burden, because cervical and breast cancers are its most common malignancies and causes of cancer-related death. In fact, one in every five of the world's annual cervical cancer deaths takes place in sub-Saharan Africa, making it the global killing field of cervical cancer. A major bottle neck in the care of cancer patients in low and middle income countries is the shortage of surgeons, particularly those with specialized cancer training. A recent report (Lancet Oncology Commission on Global Cancer Surgery - 2105) revealed that only 20% of cancer patients living in middle income countries who need cancer surgery can access it, while in low income countries it's <5%.Potential Applications and Benefits1. Use in the training curriculum for surgeons in LMI countries, includinga. Major shift in the way surgeons are trained in LMI countriesb. Faster, safer and more effective training of surgeons to perform cervical cancer surgeryc. Standardized training for cervical cancer surgery with options to adapt training to individual needs2. Rapid expansion of cancer surgery services in low income settings, leading to a a. Decrease in waiting times for surgery, and associated pain and psychological effectsb. Decrease in fatalistic attitude towards cancer in the community c. Decrease in the economic and societal consequences associated with deaths of young mothers in LMI countries, i.e., institutionalization of children in orphanages, failure of children to complete primary education, drop in economic status of the families etc.3. Scientific proof-of-princple that technology-enhanced surgery training is effective, thus ensuring a. Contribution towards policy changes on the local, national and international levelb. Shaping and enhancing the effectiveness and image of public health servicesc. Attract investments from global businesses for purposes of selling the technologyd. Potential of spin out companies, and the creation of new processes, products and servicese. Increase in donor funding for research and implementation of technology-based surgical training in LMI countries

建议的工作我们将使用虚拟现实模拟的外科手术，以预先培训外科学员，帮助他们获得心理运动技能，感觉敏锐度，并在较小程度上，认知规划所需的实现必要的手术灵活性进行宫颈癌手术。在达到手术熟练程度后，我们将使用普罗克特和基于网络的远程指导技术，该技术允许正在进行手术的外科实习生佩戴耳机，将手术过程的实时视频传输到异地的专家外科导师的监视器上。指导者可以在执行外科手术过程的同时向外科受训者的床旁监视器提供实时远程演示反馈（视频馈送上的绘图），即，来自受训者的视频馈送被传送到指导者，然后从指导者返回到受训者，其中指导者具有后者的远程演示，这很像在单独屏幕上的足球比赛中解说员。我们将测量外科实习生获得和保持必要的技术技能的速度，以安全有效地使用上述技术进行宫颈癌手术，当他们使用传统方法进行培训时。我们还将比较传统与技术增强培训的经济和财务成本，以使外科医生能够熟练治疗宫颈癌。ContextCancer是世界上主要的死亡原因，预计在未来二十年内将以惊人的速度增长。大多数新病例和死亡病例将发生在世界上最贫穷的地区。非洲将受到最严重的打击，因为据估计，到2030年，每年将有100万非洲人死于癌症。在非洲，妇女将承受最沉重的负担，因为宫颈癌和乳腺癌是非洲最常见的恶性肿瘤，也是与癌症有关的死亡原因。事实上，世界上每年每五例宫颈癌死亡中就有一例发生在撒哈拉以南非洲，使其成为宫颈癌的全球杀戮场。低收入和中等收入国家癌症患者护理的一个主要瓶颈是外科医生短缺，特别是那些受过专门癌症培训的外科医生。最近的一份报告（全球癌症手术柳叶刀肿瘤学委员会- 2105）显示，生活在中等收入国家需要癌症手术的癌症患者中，只有20%可以获得手术，而在低收入国家，这一比例<5%。在内陆发展中国家外科医生培训课程中使用，包括a。内陆发展中国家外科医生培训方式的重大转变b。更快、更安全、更有效地培训外科医生进行宫颈癌手术c。宫颈癌手术的标准化培训，可根据个人需求调整培训2。癌症手术服务在低收入环境中的快速扩张，导致了一个。减少手术等待时间，以及相关的疼痛和心理影响b。社区中对癌症的宿命态度减少c。减少与内陆发展中国家年轻母亲死亡有关的经济和社会后果，即，孤儿院的儿童被送入收容机构，儿童无法完成小学教育，家庭经济地位下降等。科学的原理证明技术增强的手术培训是有效的，从而确保。对地方、国家和国际各级政策变化的贡献b。塑造和提高公共卫生服务的成效和形象c。吸引全球企业的投资，以销售技术d。分拆公司的潜力，以及新工艺、产品和服务的创造。捐助者为在内陆发展中国家研究和开展技术性外科培训提供的资金增加

项目成果

The UK's contribution to cancer control in low-income and middle-income countries.

英国对低收入和中等收入国家癌症控制的贡献。

• DOI: 10.1016/s1470-2045(21)00380-6
• 发表时间: 2021
• 期刊: The Lancet. Oncology
• 作者: Stanway S

Cancer in sub-Saharan Africa: a Lancet Oncology Commission.

• DOI: 10.1016/s1470-2045(21)00720-8
• 发表时间: 2022-06
• 期刊: LANCET ONCOLOGY
• 影响因子: 51.1
• 作者: Ngwa, Wilfred;Addai, Beatrice W.;Adewole, Isaac;Ainsworth, Victoria;Alaro, James;Alatise, Olusegun, I;Ali, Zipporah;Anderson, Benjamin O.;Anorlu, Rose;Avery, Stephen;Barango, Prebo;Bih, Noella;Booth, Christopher M.;Brawley, Otis W.;Dangou, Jean-Marie;Denny, Lynette;Dent, Jennifer;Elmore, Shekinah N. C.;Elzawawy, Ahmed;Gashumba, Diane;Geel, Jennifer;Graef, Katy;Gupta, Sumit;Gueye, Serigne-Magueye;Hammad, Nazik;Hessissen, Laila;Ilbawi, Andre M.;Kambugu, Joyce;Kozlakidis, Zisis;Manga, Simon;Maree, Lize;Mohammed, Sulma, I;Msadabwe, Susan;Mutebi, Miriam;Nakaganda, Annet;Ndlovu, Ntokozo;Ndoh, Kingsley;Ndumbalo, Jerry;Ngoma, Mamsau;Ngoma, Twalib;Ntizimira, Christian;Rebbeck, Timothy R.;Renner, Lorna;Romanoff, Anya;Rubagumya, Fidel;Sayed, Shahin;Sud, Shivani;Simonds, Hannah;Sullivan, Richard;Swanson, William;Vanderpuye, Verna;Wiafe, Boateng;Kerr, David
• 通讯作者: Kerr, David

Using low-cost virtual reality simulation to build surgical capacity for cervical cancer treatment

利用低成本虚拟现实模拟建立宫颈癌治疗的手术能力

• DOI: 10.17615/gjg7-a095
• 发表时间: 2019
• 作者: Sullivan, R.