Dynamic Haptic Robotic Training for Central Venous Catheter Insertion

项目摘要/摘要 该项目的目标是降低中环较高的机械和感染并发症发生率 通过制定和实施加强培训来放置静脉导管(CVC) 方法；具体地说，通过动态触觉机器人训练(DHRT)和 高级DHRT(DHRT+)。在PIS原始R01进展的基础上，拟议的目标将是 通过完成三个具体目标来实现。 具体目标1通过整合 混合现实智能托盘，先进的测试表面，高功能保真度虚拟 超声波成像。在这一目标中，将追求全程培训的新概念，其中 CVC程序的所有4个关键步骤都是自动训练的。此外，优化的高保真实景 时间虚拟超声图像将通过高级建模进行开发。这些东西的保真度 将通过量化衡量和专家小组评估来评估进展情况。 具体目标2制定、实施和评估适应性反馈和 住院医师学习和手术操作的评估。在这一目标下，最优化的发展 将通过专家和驻地测试对绩效指标和评估战略进行调查。在……里面 此外，还将探讨自适应反馈的结构、类型、组件和时间的影响。 具体目标3评估DHRT+系统对患者的广泛整合影响 将其纳入住院医师课程的结果和手术效果 好时医疗中心(好时，宾夕法尼亚州)和锡达斯-西奈医疗中心(洛杉矶，加利福尼亚州)。在……里面 DHRT和DHRT+培训的最终目标、长期技能转移和对患者安全的影响将 被评估。具体地说，625名居民将在他们进入医院的第一年期间接受监测 分别是好时医疗中心和锡达斯-西奈医疗中心。机械和 他们在诊所的前5次监督下的CVC手术中遇到的程序并发症将是 评估过了。此外，还将记录住院患者首次出现机械和感染并发症的比率。 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.