Process Modeling of Ultrasound-guided Needle Placement Interventions

提要。加拿大医科大学正在向各级培训中的基于能力的医学教育(CBME)模式过渡。能力的实现需要练习，出于患者安全和学习者舒适的原因，练习的早期阶段最好在模拟环境中进行。所有医生都需要展示的技能之一是超声引导的针头放置(USNP)，在手术中放置导管端口，注射麻醉剂。这些手术的主要目标是在超声可视化下将针插入靶点，同时保留周围组织。USNP是极其困难的，因为它需要同时掌握多种技能。虽然USNP是每个加拿大新医生的必备技能，但几乎完全缺乏计算和工程方法和工具来支持医学教育工作者为USNP开发CBME项目。对USNP过程建模的研究极其匮乏，这严重阻碍了医学教育工作者向CBME医学教育模式的强制性过渡。 研究计划。我们希望通过四个主题来填补这些空白：i)描述USNP工作流程的通用过程模型，ii)将USNP工作流程自动分割为基本程序步骤的方法，iii)设计量化绩效指标的框架，以及iv)计算机辅助USNP培训信息的安全存档和检索的数据管理框架。 结果。拟议计划的科学贡献将是开发正式的分析方法和软件工具，旨在支持医学教育研究人员创建CBME培训计划。该计划的社会成果具有潜在的重大意义；支持开发符合CBME标准的计算机辅助培训系统的研究将影响未来医生的能力，从而影响所有加拿大人的健康。至少20名HQP将接受工程和计算机科学研究方面的培训。

Synopsis. Canadian medical universities are in the process of transitioning to a Competency- based Medical Education (CBME) model at all levels of training. Achievement of competence requires practice, and for reasons of patient safety and learner comfort, the early stages of practice are best done in a simulated environment. One of the skills that all medical doctors are required to demonstrate is ultrasound-guided needle placement (USNP), in procedures catheter port placement, anesthetic injections. The primary goal in these procedures is to insert a needle to target under ultrasound visualization, while sparing surrounding tissues. USNP is extremely difficult because it requires simultaneous mastery of multiple skillsets. While USNP is a mandatory skill for every new Canadian physician, there is a near complete lack of computing and engineering methodology and tools to support medical educators in the development of CBME programs for USNP. Research on the USNP process modeling is extremely scant, thus critically hindering medical educators in the mandatory transition to the CBME medical education model. Research program. We aspire to fill these blanks through four themes: i) generalized process model for describing USNP workflows, ii) methods for automatic segmentation of USNP workflows into elementary procedural steps, iii) framework for designing quantitative performance metrics and, iv) data management framework for secure archival and retrieval of computer-assisted USNP training information. Outcomes. The scientific contribution of the proposed program will be the development of formal analytical methodology and software tools that aims to support medical education researchers in creating CBME training programs. The societal outcome from the program is potentially significant; research that supports the development of CBME-compliant computer-assisted training systems will impact the competence of future medical doctors and as a result on the health of all Canadians. A least 20 HQP trained will be trained in engineering and computer science research.