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Baheti A.R.,Simulation and Training Environment Laboratory | Hafey R.,Simulation and Training Environment Laboratory | Pai S.,Simulation and Training Environment Laboratory | Gomez J.,Simulation and Training Environment Laboratory | And 2 more authors.
IEEE/ASME Transactions on Mechatronics | Year: 2012

Fiber-optic intubation is an emergency procedure that can be performed to intubate a patient when the patient has serious difficulty in breathing normally. The existing simulators for fiber-optic intubation procedure provide haptic feedback to the user when there is a contact with the vocal cord section, but they do not capture the grazing effect of the endoscope along the inner walls of the airway. The grazing on the inner walls of the airway, if not well controlled, could lead to unnecessary trauma for the patient. Hence, there is a need to provide this force feedback in a fiber-optic intubation simulator. We have built a fiber-optic intubation simulator with force feedback. This system is composed of a software simulation coupled with a physics-based simulation that enhances the visual experience. The software simulation is connected to a haptic feedback device. The device provides force feedback when contact is made with any section of the airway. The force feedback varies based on the position of contact and intensity of contact. We use a proportional and derivative (PD) controller to obtain force feedback at the vocal cord section and a variable magnetic field to capture the grazing effect of the endoscope along the inner walls of the airway. The movements of the endoscope are captured using rotary encoders (that read the insertion and the tip bend) and a compass module (that reads the twist angle of the endoscope along the long axis). These movements are used to navigate the virtual airway using a virtual endoscope. When collisions are encountered, the physics library evaluates the position of contact and the force with which contact is made. Force feedback is generated due to the interaction of the solenoids with the permanent magnets at the tip of the endoscope. This information helps the software to actuate the right combination of solenoids. The simulator will help to train all aspects of fiber-optic intubation, namely 1) developing the necessary psychomotor skills to successfully navigate the airway with minimal or no damage to the airway or vocal cords; and 2) cognitive skills to perform the procedure fast and effectively. © 2011 IEEE. Source


Damle L.F.,MedStar Washington Hospital Center | Tefera E.,MedStar Research Institute | McAfee J.,Simulation and Training Environment Laboratory | Loyd M.K.,Simulation and Training Environment Laboratory | And 4 more authors.
Journal of Pediatric and Adolescent Gynecology | Year: 2015

Study Objective: Develop a Pediatric and Adolescent Gynecology (PAG) curriculum, appropriate pelvic model for teaching examination skills, and an objective structured clinical examination (OSCE) for evaluation. Compare OSCE performance between residents with clinical training in PAG vs those that completed the curriculum vs those without either experience. Design: Prospective cohort study. Setting: Obstetrics and Gynecology (Ob/Gyn) residency program in an urban academic center. Participants: Senior Ob/Gyn residents. Interventions: A simulation-based teaching curriculum was created to teach PAG skills. A pediatric mannequin with anatomic pre-pubertal genitalia was developed for teaching and assessment of skills. Main Outcome Measures: Performance on a PAG-based OSCE as assessed by 2 observers using a 40 point checklist. Results: 17 residents participated in the OSCE; 5 completed the curriculum, 6 completed a clinical rotation, and 6 were controls. The teaching curriculum group had the highest median composite OSCE score (75.0%) compared to the clinical group (73.1%) and control group (55.3%). There was no statistical difference between the scores of the teaching and clinical groups, but the teaching group scored statistically higher than controls (P=.0331). Scores for each OSCE component were compared. The teaching and clinical groups outperformed controls on assessment and procedures. There was no difference in scores on history taking or physical examination. Conclusion: An interactive teaching curriculum incorporating simulation and a realistic pediatric pelvic model can be used to teach PAG clinical skills. Using an OSCE to evaluate skills shows that residents completing the curriculum perform as well as those with clinical experience and better than controls. © 2015 North American Society for Pediatric and Adolescent Gynecology. Source


Baheti A.R.,Simulation and Training Environment Laboratory | Millo Y.,Simulation and Training Environment Laboratory | Desai J.P.,University of Maryland University College
2010 IEEE Haptics Symposium, HAPTICS 2010 | Year: 2010

The existing simulators for fiber-optic intubation procedure provide haptic feedback to the user when there is contact with the vocal-cord section, but they do not capture the grazing effect of the endoscope along the inner walls of the airway. The grazing on the inner walls of the airway, if not well controlled, could lead to unnecessary trauma for the patient. Hence, there is a need to provide this force feedback in a fiber-optic intubation simulator. We have built a force feedback device that incorporates both the force feedback when contact is made with the vocal-cord section as well as grazing of the endoscope along the inner walls of the airway. We use a PD controller to obtain force feedback at the vocal-cord section and a variable magnetic field to replicate the frictional force feedback caused by the grazing of the endoscope along the inner walls of the airway. The movements of the endoscope are captured using rotary encoders (which read the insertion and the tip bend) and a magnetometer (which reads the twist angle of the endoscope along the long axis). We performed tests based on the intensity of contact of the endoscope against the vocal-cords and the inner walls of the airway. Changes in the intensity of grazing at the inner walls of the airway were observed by actively varying the coil current in the magnet. The simulator will help to train all aspects of fiber-optic intubation which involves contact with the vocal-cords as well as grazing the surface of the airway. ©2010 IEEE. Source

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