MATADOR – Medical Advanced Training in an Artificial Distributed Environment

Ragnhild Halvorsrud,

Applied Media Technology

Telenor Research and Development

Contents:

• Multitrauma accidents• Emergency care in

Nordic countries - the BEST project

• Why use simulators?• Existing simulators• The DOVRE platform

• MATADOR • Goal/outline/time plan• Medical content• Current status• Comparison• MATADOR partners• Conclusion

Multitrauma accidents• strikes many young,

healthy, and ablebodied persons

• take many lifes

• Age < 35 years: the most frequent cause of death

• can often be effectively treated

• Most errors occur in the initial assessment phase.

http://www.trauma.org

In the emergency room• many groups of medical personnel

• time pressure

• rapid technological changes

• high staff turnover

• chaotic learning situation

No room for learning by doing !!

Hospitals in Nordic countries

• countries with long distances

• harsh weather conditions

• sparse population• many small hospitals• no national standard

for trauma care

The BEST projectThe BEST team visits rural hospitals.

1. Theory based on actual cases. 2. Training session are videorecorded. 3. Observation, review and feedback.

Success factors:

• Courses at each hospital

• Immediate feedback, focus on team performance

Why use simulators in medicine?

• Limited access to real training situations.• Simulation provides a way to gain

competence in emergency situations that seldom occur.

• Reduce the cost of training surgeons.• Reducing the risk to patients.

Existing simulators

http://www.trauma.org

http://www.mdchoice.com/

MDchoice.com – the ultimate medical information finder

http://www.rti.org/vr/w/vmetsum.cfm

Research Triangle Institute, NC, USA

DOVRE

• A tool for distributing 3D-graphics, sound and video

• Developed from scratch using C++• Multi-platform: win32 & Unix

(Linux/IRIX)• API for creating distributed virtual

worlds

(Distributed Object-oriented Virtual Reality Environment)

The EduAction project• using VR to enhance collaborative learning

• developed for pupils in the secondary school

• pupils take the role of interplanetary explorers, looking for planets suitable for new colonies

”Corpus Callosum”, the disaster-ridden planet

http://amt.fou.telenor.no/EduAction/

The DISCOVER projectDistributed training environment for the

offshore and maritime sectors

Haptic devices

• Haptic – related to the sense of touch

• Haptic displays - electromechanical device that deliver force sensation

• PHANToM premium 1.5 - to be integrated in the MATADOR prototype

MATADOR

• The goal is to develop and evaluate a simulation environment for managing acutely traumatized patients.

• Target group: both students and physicians.

• Proposal was presented to Nordunet2.

• 2.6 mill. NOK from Nordunet2.

MATADOR outline

Project tasks

0

5

10

15

20

25

% of resources

System des.

Content des.

User req.

System develop.

Content creation

System eval.

Field trial

Evaluation

Usability

Exploitation

Project manag.

Project plan• Project period: July 2000 – June 2002• Total # manhours: 10200

0200400600800

100012001400160018002000

2000 2001 2002

Content description

System development

Content creation

Evaluation

Scenario walk-through

Description of accident, organ injuries, etc.

wronganswer

Time-out to study procedure

CT/MR/Xray

Decision-making

Feedback

Scenario ii = [1,3]

                

CT/MR/Xray

Decision-making 

Time-out to study procedure

Pilot scenario

7 year old girl on bicycle, hit by car

Unconcious when primary physician arrives, no immediate signs of external injuries

10 min: patient becomes concious, but weak

40 min: unstable vital signs, helicopter arrives

60 min: during transportation, patient develop spasms

65 min: respiration and circulation stop as helicopter arrives at hospital. Attempting heart/lung rescue. Conditions interpreted as head injury. Further treatment stopped.

Current status

Fly-through of a virtual OR

Design and animation:

Ivar Kjellmo

Applied Media Technology

MATADOR versus other simulators

• A multiuser system – training as a team• Advanced 3D-technology

MATADOR session manager

MATADOR partners:• Faculty of Medicine, University of Umeå• Multimedic AS• The Norwegian Medical Association• InterMedia, University of Oslo• Medical Faculty, University of Oslo• Boxer Technologies AS• Telenor R&D

Concluding remarks

• Nordic countries: similarities in culture, language, and health care systems

• A joint Nordic effort would be of substantial benefit

• Towards a Nordic standard?• URL http://amt.fou.telenor.no/MATADOR/