Real-Time Simulation for Safer Vascular Stenting – The Training Application

1. Real-Time Simulation for Safer Vascular Stenting – The TrainingApplication EvanthiaTripoliti1, AntoniosI. Sakellarios1, Michael Peroulis2, Euripides G.M. Petrakis1 , Michalis Zervakis1 1Technical University of Crete (TUC), Dept. of Electronic and Comp. Engineering, Chania 2University Hospital of Ioannina, Department of Surgery, Vascular Surgery Unit, Ioannina, Greece

2. Outline • Purpose • State of the art • The training application • Evaluation • Conclusions

3. 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)

4. 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 Society for Cardiovascular Angiography and Interventions (SCAI) NHS WeBSurg Simbionix/ Therenva/ CAE/ Mentice

5. The training applicatione-learning approach

6. The training applicatione-learning approach

7. The training applicationUser Groups Experts in vascular medicine User groups Trainees Qualified vascular surgeons Medical students

8. The training applicationFunctionality

9. The training applicationArchitecture LAMS: Learning Activity Management System

10. The training applicationSteps of the Scenario Medical background Info from health record 1. Introducing the scenario 2. Introducing the patient 3. Patient examination Clinical examination proposed by the trainee Clinical examination made by the expert Results of the clinical examination 4. Therapeutical approach 5. Treatment plan 6. Imaging Examination Proposed by the trainee Followed by the expert Proposed by the trainee Feedback by the expert Video Specific frames of the video Imaging Assessment 7. AimaSimul http://www.scsitaly.com/company/about-b3c 8. Treatment decision 9. Material selection Model of the artery Stent positioning Fracture risk assessment Proposed by the trainee Followed by the expert Selection of endovascular materials 10. Angioplasty report

11. 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

12. 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.

13. 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 applicationEvaluation

14. The training applicationEvaluation Evaluation 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

15. The training applicationEvaluation Evaluation of User Interfaces mock-ups Adequacy of the provided data Clearness of the various scenario steps Presentation of the data

16. The training applicationEvaluation Evaluation of User Interfaces mock-ups Access to online references Ability to see other students’ answers Add synchronous/ collaborative learning functionality

17. The training applicationEvaluation Evaluation of User Interfaces mock-ups Potential of the final application to train the learner Appropriateness of the tool to train the learner in decision making Achievement of the educational objectives

18. The training applicationEvaluation Evaluation of User Interfaces mock-ups Participation in the further evaluation of the application Application to be part of the training for gaining clinical competence Would you recommend the final application to a colleague?” Time spent on a single tutorial of this type

19. The training applicationEvaluation

20. 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.