Real-Time Simulation for Safer Vascular Stenting – The Training

ApplicationEvanthia Tripoliti1, Antonios I. Sakellarios1, Michael Peroulis2, Euripides

G.M. Petrakis1 , Michalis Zervakis1

1Technical University of Crete (TUC), Dept. of Electronic and Comp. Engineering, Chania2University Hospital of Ioannina, Department of Surgery, Vascular Surgery Unit, Ioannina, Greece

Outline

Purpose

State of the art

The training application

Evaluation

Conclusions

Purpose

RT3S (http://rt3s.eu/)

RT3S - The training application

(http://www.intelligence.tuc.gr:8080/lams/)

RT3S (http://rt3s.eu/) will transform the planning of endovascular procedures to treat

peripheral arterial disease.

will develop a patient-specific, probabilistic model for peripheral

stent fatigue-fracture, integrated in a real-time, computer-aided

surgery planning application.

will provide advice on fracture-risk and help to both trainee

vascular surgeons and engineers in medical device companies.

RT3S - The training application (http://www.intelligence.tuc.gr:8080/lams/)

provides the experts the opportunity to train their students.

supports trainees gain their endovascular clinical competence.

improves vascular clinician's knowledge.

provides training for endovascular interventions in superficial

femoral artery (SFA)

Simbionix/ Therenva/ CAE/ Mentice

WeBSurg

NHS

Society for Cardiovascular Angiography and Interventions

(SCAI)

State of the art

slides

high-quality visuals, audio and animations

interactive activities and practice questions

case studies

'real-life' scenarios,

operative techniques,

surgical protocols and equipment,

critical cases,

lectures,

surgical videos

Performance Metrics

The training applicatione-learning approach

is a novel tool for designing, managing and delivering

online collaborative learning activities

is e-learning oriented and based-upon the latest e-

Learning standards

provides tutors with a highly intuitive visual authoring environment for creating

sequences of learning

includes activities of increasing difficulty which range from individual tasks and small

group work, to class activities

RT3S training application

The training applicatione-learning approach

can address different user types for different educational

objectives

offers tutors a customizable distance learning solution for

training or examining their students at any time and any

place

realizes a learning experience in a sequence of steps allowing (at each step) interaction with

system modules

helps users to understand concepts such us modeling and

simulation as well as, their utility and significance

RT3S training application

The training applicationUser Groups

Experts in vascular medicine

Trainees Qualified vascular surgeons

Medical students

User groups

Expert in vascular medicine

Prepare educational, training content for their trainees.

TraineesComplete the scenarios in order to become more familiar with various cases and prepare themselves for making decisions for their patients.

Medical Students “Simple” scenarios help them to decide if the endovascular interventionalist competence is what they want to develop in their career.

Qualified vascular surgeons

Difficult patient cases included in the application will be useful for their continuing education.

The training applicationFunctionality

The training applicationArchitecture

LAMS: Learning Activity Management System

The training applicationSteps of the Scenario

1. Introducing the scenario 2. Introducing the patient 3. Patient examination

7. AimaSimulhttp://www.scsitaly.com/company/about-b3c

8. Treatment decision 9. Material selection

10. Angioplasty report

6. Imaging Examination 4. Therapeutical approach 5. Treatment plan

1. Medical background2. Info from health

record1. Clinical examination proposed by the trainee

2. Clinical examination made by the expert

3. Results of the clinical examination

1. Proposed by the trainee

2. Followed by the expert

1. Proposed by the trainee

2. Feedback by the expert1. Video2. Specific frames of the

video3. Imaging Assessment

1. Model of the artery2. Stent positioning3. Fracture risk

assessment

1. Proposed by the trainee

2. Followed by the expert1. Selection of

endovascular materials

The training applicationIMS Learning Design

The training application relies on IMS LD* standard for the

implementation of training scenarios.

Compliance with the IMS LD standard allows educational content developers to model who does what and with

which content in order to achieve learning objectives.

processes to be designed to include several roles, each of which can

be played by several people and it enables their activities to be

specified as “learning flows” or “learning sequences” that are

analogous to workflows.

*IMS Global Learning Consortium - http://www.imsglobal.org

The training applicationIMS Learning Design IMS LD consists of three levels

Level 1: includes the core elements of the meta-language and the

vocabulary for describing people, activities, resources and their

interaction.

Level 2: allows definition of properties and conditions over

elements of the previous level (e.g., introduces greater flexibility by

allowing personalization and more elaborate sequencing such as

branching in a learning scenario).

Level 3: includes more sophisticated learning designs such as

notifications, messaging after learner's response, etc.

The training applicationEvaluation

11 evaluators.

A short description of the

application was provided to

the evaluators.

A scenario has been

developed.

The user completed an

evaluation questionnaire.

The training applicationEvaluationEvaluation of User Interfaces mock-ups

Intuitiveness of the application and easiness to navigate throughout

Look and feel of the application

Approval of the scenario based approach

The training applicationEvaluationEvaluation of User Interfaces mock-ups

Clearness of the various scenario steps

Adequacy of the provided data

Presentation of the data

The training applicationEvaluationEvaluation of User Interfaces mock-ups

Ability to see other students’ answers

Access to online references

Add synchronous/ collaborative learning functionality

The training applicationEvaluationEvaluation of User Interfaces mock-ups

Achievement of the educational objectives

Potential of the final application to train the

learner

Appropriateness of the tool to train the learner in decision

making

The training applicationEvaluationEvaluation of User Interfaces mock-ups

Application to be part of the training for gaining clinical competence

Participation in the further evaluation of the application

Would you recommend the final application to a colleague?”

Time spent on a single tutorial of this type

The training applicationEvaluation

Conclusions

The RT3S training application is a web-based training approach inspired

by the e-Learning paradigm.

It is realized using state-of-art technologies and standards.

The application, in its current form, is geared towards the needs of

trainees gaining their endovascular clinical competence.

It is expandable and ready to accommodate future needs of its users.

The courses are real-life scenarios that endovascular surgeons confront

in their daily clinical practice and supports trainees in improving their

skills in vascular medicine.