Development and validation of a virtual airway skill trainer (VAST)

描述(由申请人提供)：开发和验证虚拟呼吸道技能训练器(Vavast)摘要“呼吸道管理”是手术室(OR)、重症监护病房(ICU)和急诊科(ED)为维持肺部空气供应而最常执行的程序之一。然而，除了由来已久的学徒制模式之外，没有标准化的课程或培训方案。因此，在住院期间很少遇到危及生命的情况，特别是与意外困难的呼吸道相关的情况(无法使用传统方法建立呼吸道)，限制了住院医生在诊所接受培训的机会。预计基于虚拟现实(VR)的训练师，具有视觉和触觉(触摸)反馈，将对呼吸道管理培训非常有价值，使受训者能够在受控环境中获得能力，而不会对患者造成风险；定制学习；以及实时反馈、指导和客观评估。现有的基于VR的模拟器缺乏(1)真实的基于物理的软组织建模；(2)基于活体实验的模型控制的组织反应；(3)真实的物理界面，可以很容易地改变以表示已知导致呼吸道管理困难的患者的各种外部和相关的口咽解剖结构[CaPe10]；(4)认知技能培训，涉及与工作量管理、规划、协调和基于难度水平的决策相关的更高级别的心理功能，以及精神运动(手眼协调和运动技能)技能培训；(5)临床验证。该项目的目标是克服这些障碍，设计、开发和验证虚拟航空技能培训器(Vavast)。已经组建了一个多学科团队，以实现以下具体目标：(SA1)设计和开发虚拟航空技能培训(Vavast)平台。具体地说，我们将开发(1)基于活体实验研究的基于物理学的人体解剖学计算模型；(2)沉浸式3D高清(HD)头盔显示(HMD)系统，以表示临床环境(OR/ICU/ED)；以及(3)创新的带触觉矩阵手套的双手力反馈硬件界面，允许表示与困难呼吸道相关的各种患者解剖。(SA2)通过整合SA1中产生的计算模型和实验数据，为VASH内的气管插管(ETI)和环甲切开(CCT)程序开发模拟场景。Vavast将包括识别错误的实时反馈；指导受训者的视觉、听觉和触觉提示；显示并发症的生理后果；替代程序和设备的影响以及对技能的自动实时评估。(SA 3)在波士顿的贝丝以色列女执事医疗中心(BIDMC)和马萨诸塞州总医院(MGH)进行实验，以确保在VASTER上学习适当的技能，并在VASTER上衡量的绩效反映他们打算衡量的技术技能，以确定VASTH作为培训工具的有效性。

DESCRIPTION (provided by applicant): Development and Validation of a Virtual Airway Skill Trainer (VAST) Abstract "Airway management" is one of the most frequently performed procedures in operating rooms (OR), intensive care units (ICUs) and emergency departments (ED) to maintain air supply to the lungs. Yet, there exists no standardized curriculum or training regimen outside the age-old apprenticeship model. Hence, life- threatening scenarios, particularly those associated with the unexpected difficult airway (when an airway cannot be established using traditional methods), are seldom encountered during residency, limiting the opportunity of residents to train in the clinic. It is anticipated that a virtual reality (VR)-base trainer, with visual and haptic (touch) feedback, will be invaluable for training in airway management, allowing trainees to attain competence in a controlled environment with no risk to patients; customized learning; and real time feedback, mentoring and objective assessment. Existing VR-based simulators lack (1) realistic physics-based soft tissue modeling; (2) tissue response governed by models based on in vivo experiments; (3) realistic physical interfaces which can be easily altered to represent various external, and associated oropharyngeal anatomy of a patient known to cause difficulty with airway management [CaPe10] e.g., receding jaw, excessive soft tissue and large neck circumference; (4) cognitive skill training related to higher level mental functions associated with workload management, planning, coordination, and decision-making based on level of difficulty, in addition to psychomotor (hand-eye coordination and motor skills) skill training; and (5) clinical validation. The goal of this projec is to overcome these barriers and design, develop and validate the Virtual Airway Skill Trainer (VAST). A multidisciplinary team has been assembled to achieve the following Specific Aims: (SA1) Design and develop the Virtual Airway Skill Trainer (VAST) platform. Specifically, we will develop (1) physics-based computational models of human anatomy based upon in vivo experimental studies; (2) an immersive 3D high definition (HD) head mounted display (HMD) system to represent the clinical environment (OR/ICU/ED); and (3) an innovative bi-manual force feedback hardware interface with tactile matrix gloves that allows representation of various patient anatomies associated with the difficult airway. (SA 2) Develop simulation scenarios for endotracheal intubation (ETI) and cricothyrotomy (CCT) procedures within the VAST by integrating the computational models and experimental data generated in SA1. VAST will include real time feedback identifying errors; visual, auditory and haptic cues to guide the trainee; display of physiological consequence of complications; effects of alternate procedures and devices as well as automatic real time assessment of skill. (SA 3) Establish the validity of the VAST as a training tool by conducting experiments at Beth Israel Deaconess Medical Center (BIDMC) and Massachusetts General Hospital (MGH) in Boston to ensure that appropriate skills are being learnt on the VAST and performance measured on the VAST reflect the technical skills they intend to measure.