Dynamic Haptic Robotic Training for Central Venous Catheter Insertion

项目总结/摘要 该项目的目标是降低中央的高机械和感染并发症发生率 通过开发和实施强化培训，放置静脉导管（CVC） 方法;具体来说，通过动态触觉机器人训练（DHRT）和 高级DHRT（DHRT+）。在PI原始R 01进展的基础上，建议的目标将是 通过实现三个具体目标。 具体目标1通过整合一个 混合现实智能托盘、高级测试表面和高功能保真度虚拟 超声成像在这一目标下，将追求全过程培训的新概念， 自动训练CVC过程的所有4个关键步骤。此外，优化的高保真真实的 时间虚拟超声图像将通过先进的建模开发。这些的忠诚度 将通过定量测量和专家小组评价来评估进展情况。 具体目标2开发、实施和评估适应性反馈的影响， 住院医师学习和手术表现的评估。在这一目标下， 将通过专家和驻地人员的测试来调查业绩衡量标准和评估战略。在 此外，还将探讨自适应反馈的结构、类型、组成部分和时机的影响。 具体目标3评估DHRT+系统对患者的广泛整合影响 通过将其纳入住院医师课程， 好时医疗中心（宾夕法尼亚州好时）和雪松-西奈医疗中心（加利福尼亚州洛杉矶）。在 DHRT和DHRT+培训的最终目标、长期技能转移以及对患者安全的影响将 进行评估。具体而言，625名居民将在他们第一年的进展中接受监测， Hershey Medical Center和Cedars-Sinai Medical Center。机械和 他们在诊所的前5个监督CVC程序中遇到的程序并发症将是 评估。此外，机械和感染并发症的发生率将记录为居民的第一次 CVC患者。

Project Summary/Abstract The goal of this project is to reduce the high mechanical and infectious complication rates of Central Venous Catheter (CVC) placement through the development and implementation of enhanced training methods; specifically, through the innovative concepts of Dynamic Haptic Robotic Training (DHRT) and the advanced DHRT (DHRT+). Building on the progress of the PIs original R01 the proposed goal will be accomplished through the completion of the three specific aims. Specific Aim 1 Develop and implement whole procedure training through the integration of a mixed reality smart tray, advanced testing surface, and high functional fidelity virtual ultrasound imaging. In this aim, the novel concept of whole procedure training will be pursued, where all 4 key steps of the CVC procedure are automatically trained. In addition optimized high fidelity real time virtual ultrasound images will be developed through advanced modeling. The fidelity of these advancements will be assessed through quantitative measurements and expert panel evaluation. Specific Aim 2 Develop, implement, and evaluate the impact of adaptive feedback and assessment on resident learning and surgical performance. In this aim, the development of optimal performance metrics and assessment strategies will be investigated through expert and resident testing. In addition the impact of the structure, type, components, and timing of adaptive feedback will be explored. Specific Aim 3 Assess the wide-spread integration impact of the DHRT+ system on patient outcomes and surgical performance through its incorporation into the residency curricula at Hershey Medical Center (Hershey, PA) and Cedars-Sinai Medical Center (Los Angeles, CA). In the final aim, long-term skill transfer and the impact of patient safety from DHRT and DHRT+ training will be assessed. Specifically, 625 residents will be monitored as they progress through their first year at their respective institutions, Hershey Medical Center and Cedars-Sinai Medical Center. The mechanical and procedural complications they encounter on their first 5 supervised CVC procedures in the clinic will be assessed. In addition, mechanical and infectious complication rates will be recorded for the residents' first CVC patient.