The Development and Validation of a Dynamic Haptic Robotic Trainer for Central Venous Catheterization
Open Access
- Author:
- Yovanoff, Mary A
- Graduate Program:
- Industrial Engineering
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- July 17, 2017
- Committee Members:
- Scarlett Miller, Thesis Advisor/Co-Advisor
- Keywords:
- Surgical Training
Haptic Feedback
Internal Jugular Catheterization
Self Efficacy
Medical Education
Robotic Training - Abstract:
- High-tech simulators are gaining popularity in surgical training programs due to their potential for improving clinical outcomes. However, most simulators are static in nature and only represent a single anatomical patient configuration. This is problematic because it limits a resident’s opportunity to practice adapting their skills to challenging but common patient cases. Virtual Reality (VR) simulation may have an advantage over these static simulators because they can present variations in patient anatomies. However, few studies have explored the impact of VR simulators on Central Venous Catheterization (CVC) procedures. This is important because 39% of patients who receive CVC’s experience adverse effects and these complications can be attributed to variations in patient anatomy. The purpose of this thesis was to design and develop a user interface and personalized learning system for a Dynamic Haptic Robotic Trainer (DHRT) that can present variations in anatomy and provide consistent objective feedback on performance, validate the DHRT system as an effective method for training the surgical skills necessary to place an Internal Jugular (IJ) CVC, explore the relationship between, self-ratings of performance, and subjectively measured ratings of performance and objectively- measured ratings of performance, and explore the impacts of the Dynamic Haptic Robotic Training system on CVC self-efficacy and CVC procedural skills when compared to current manikin based simulators. This was accomplished through four empirical studies conducted with a total of 56 medical professionals including: 26 medical students, 26 first year surgical residents and 4 expert surgeons. Specifically, two studies were conducted as part of this thesis during the design and development of the system. Feedback provided to novices during surgical skills training sessions was analyzed and used for the development of a graphical user interface and learning feedback system for the DHRT system. These studies also empirically and methodically identified 4 objective metrics for evaluating surgical skill proficiency in placing an IJ CVC. Two empirical studies explored the effectiveness of the DHRT system and manikin trainer for improving skill gains and self-efficacy in CVC insertion procedures. Overall, this thesis work identified a methodology for systematically collecting and analyzing verbal and written feedback provided to novices during surgical skills training sessions and provides an empirical basis for the development of a graphical user interface and learning feedback system for the DHRT System for ultrasound-guided internal jugular catheterization based on this feedback. This thesis provides an empirical basis for the validation of a virtual reality haptic training system for surgical procedures when paired with observer feedback, and contributes to the knowledge base of skill evaluation for IJ CVC placement. Additionally, this provides empirical evidence that showed that the DHRT and Personalized Learning Interface System is an effective method for improving self-efficacy on CVC procedures, provides evidence that suggests surgical residents may not have a strong ability to accurately self-asses their performance, and provides empirical evidence that showed that the DHRT and Learning Interface System was an effective method for improving objectively measured skills used in CVC procedures by providing direct, specific feedback.