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Expert system, Web based distance education or Virtual reality for surgeons?

Expert system, Web based distance education or Virtual reality for surgeons? -- Posted by Preetha Vijayakumar on 10-18-04 19:35

---

I am a student in healthcare administration. We had a discussion in
the class recently "What is the best method for "Continuing
education" program for surgeons in a hospital?" Three methods we
discussed- artificial intelligence/expert system, web-based distance
education and virtual reality. The following is my view on the topic
and I encourage you to share your views.

As the administrator of continuing education in a hospital system I
would select the "Virtual Reality" technology for continuing
education for the surgeons, provided my department's budget permits me
to invest enough on the technology. I would like to discuss about the
other two systems that was under consideration before justifying my
choice.

First, I would like to discuss about the intelligence/expert system.
An expert system is a computer software, which imitates the thinking
and approach of an expert, in this case an expert surgeon. Most of the
expert system is an inquiry consisting of symptoms and signs and labs
(or any of these) is compared against all known medical conditions in
the database. The advantages of the expert system are as follows:
1. The computer can store far more information than a human
2. The computer does not forget or make mistakes
3. Data can be kept up-to-date
4. The expert system is always available 24 hours a day and will never
retire
5. The system can be used at a distance over a network
6. Through expert system the surgeons can get a very specific answer
to a very specific question.
7. It has consistency, completeness, timeliness and breadth of
knowledge.

On the other side of the coin:
1. Expert system lacks the "human touch". There are some decisions
that has to be based not just on the medical facts but also on other
aspects that a computer system does not consider like time, cost,
availability of resources, etc.
2. My primary reason for rejecting the expert system is that it is
more like a "solution provider" for a problem than a means for
"educating" the surgeon.

The expert system can be only used to provide an automated second
surgical opinion for areas where surgery is often over prescribed.

The web based distance education is a good choice for continuing
education of the surgeons, considering their busy schedule and
emergency calls. Using the web-based technology will allow them to
learn, where ever they want and when ever their time permits. The
surgeons can always retrieve the information they were interested in.
Web based continuing education is less expensive too. Considering the
fact that the hospital has residency programs, most of the necessary
infra structure and computer systems will be already available for web
based education. But we have to admit the fact that if an individual
surgeon is really interested in getting more information he/she will
be involved in additional reading and web usage for collecting
information. And these surgeons alone would take the web-based
education seriously. The other group of surgeons who will be
interested in web based education would be surgeons who do not know
where to get the input from and those who do not have the time to look
for additional reading. I feel that others will not take it seriously.
So web based education will not have the participation of all the
surgeons and 100 percent commitment. The primary reason for me to
reject web based education pattern for surgeons is that it can only
provide the theoretical input that a surgeon needs but surgeons need
hands-on practice to operate on a patient and this experience could
not be given by a web based educational program.

We all know that in training there is no alternative to hands-on
practice. Practicing on inanimate tissues, when allowed by their cost
and availability, there is a substantial difference for surgeons
between training with artificial or inanimate and supervised
procedures on a real patient. The science of virtual reality provides
a much closer experience to the real operating room by an entirely new
opportunity in the area of simulation of surgical skills using
computers for training and evaluation.

The term "Virtual Reality" is broadly used and widely interpreted. On
the internet, virtual reality is generally interpreted as artificial
spaces that can be navigated in 3 dimensions and "feels" real. It
cannot replace a field experience. But it can infuse the learning
surgeon into an environment that has all the sights, smells and
feeling the real surgery has. The disadvantages of virtual reality
are:
1. Cost: New technology is expensive. The cost of developing hardware
and software for the application of virtual reality technology is too
great for many institutions to implement at this time. Computer
instrumentation is expensive after introduction but has always
decreased over time; so I suspect as this occurs virtual reality will
eventually become more commonplace in Medicine.
2. Restraint: Presently the equipment used to create a virtual
environment is restrictive and uncomfortable to its users. This would
have to be overcome for more convenient uses in surgical procedures.
The advantages of virtual reality subside the disadvantages of virtual
reality technology for the purpose of continuing education for the
surgeons. The advantages are as follows:
1. Efficiency: Virtual reality simulators are more efficient than
training on real patients. It eliminates the risk of harming the
patient while trying to learn a new skill. It also eliminates the time
restraints on waiting for types of cases to come up and allows the
trainee to practice independently.
2. Interest: As virtual reality technology is interactive and as the
surgeons can evaluate their performance before trying it on a real
patient they will be more interested and
3. Objectivity: Virtual reality can objectively evaluate and measure
technical competence rather than traditional subjective measure of
trainee and mentor.
4. Ethical: Using virtual patients to train on is less offensive than
training on animal models.

Re: Expert system, Web based distance education or Virtual reality for surgeons? -- Posted by Huong Nguyen on 10-28-04 22:19

---

Hi Preetha,

Many great points made! I almost agree with you all. I support the
idea to use vitual reality for surgeons as it's really helpful for
surgeons to practice the their treatment prior to do it on real
patients. This helps them to manage risk with real disease cases.

However, I still think that computers do make mistakes because all
types of information system and applications are designed by groups of
human being. They still have shortage of thinking about the future.
Therefore, technological errors still happen for example, Y2K problem.

Florence Huong Nguyen

preetha_v31@yahoo.com (Preetha Vijayakumar) wrote in message news:<2529f8b3.0410181835.6841fc9e@posting.google.com>...
> I am a student in healthcare administration. We had a discussion in
> the class recently "What is the best method for "Continuing
> education" program for surgeons in a hospital?" Three methods we
> discussed- artificial intelligence/expert system, web-based distance
> education and virtual reality. The following is my view on the topic
> and I encourage you to share your views.
>
> As the administrator of continuing education in a hospital system I
> would select the "Virtual Reality" technology for continuing
> education for the surgeons, provided my department's budget permits me
> to invest enough on the technology. I would like to discuss about the
> other two systems that was under consideration before justifying my
> choice.
>
> First, I would like to discuss about the intelligence/expert system.
> An expert system is a computer software, which imitates the thinking
> and approach of an expert, in this case an expert surgeon. Most of the
> expert system is an inquiry consisting of symptoms and signs and labs
> (or any of these) is compared against all known medical conditions in
> the database. The advantages of the expert system are as follows:
> 1. The computer can store far more information than a human
> 2. The computer does not forget or make mistakes
> 3. Data can be kept up-to-date
> 4. The expert system is always available 24 hours a day and will never
> retire
> 5. The system can be used at a distance over a network
> 6. Through expert system the surgeons can get a very specific answer
> to a very specific question.
> 7. It has consistency, completeness, timeliness and breadth of
> knowledge.
>
> On the other side of the coin:
> 1. Expert system lacks the "human touch". There are some decisions
> that has to be based not just on the medical facts but also on other
> aspects that a computer system does not consider like time, cost,
> availability of resources, etc.
> 2. My primary reason for rejecting the expert system is that it is
> more like a "solution provider" for a problem than a means for
> "educating" the surgeon.
>
> The expert system can be only used to provide an automated second
> surgical opinion for areas where surgery is often over prescribed.
>
> The web based distance education is a good choice for continuing
> education of the surgeons, considering their busy schedule and
> emergency calls. Using the web-based technology will allow them to
> learn, where ever they want and when ever their time permits. The
> surgeons can always retrieve the information they were interested in.
> Web based continuing education is less expensive too. Considering the
> fact that the hospital has residency programs, most of the necessary
> infra structure and computer systems will be already available for web
> based education. But we have to admit the fact that if an individual
> surgeon is really interested in getting more information he/she will
> be involved in additional reading and web usage for collecting
> information. And these surgeons alone would take the web-based
> education seriously. The other group of surgeons who will be
> interested in web based education would be surgeons who do not know
> where to get the input from and those who do not have the time to look
> for additional reading. I feel that others will not take it seriously.
> So web based education will not have the participation of all the
> surgeons and 100 percent commitment. The primary reason for me to
> reject web based education pattern for surgeons is that it can only
> provide the theoretical input that a surgeon needs but surgeons need
> hands-on practice to operate on a patient and this experience could
> not be given by a web based educational program.
>
> We all know that in training there is no alternative to hands-on
> practice. Practicing on inanimate tissues, when allowed by their cost
> and availability, there is a substantial difference for surgeons
> between training with artificial or inanimate and supervised
> procedures on a real patient. The science of virtual reality provides
> a much closer experience to the real operating room by an entirely new
> opportunity in the area of simulation of surgical skills using
> computers for training and evaluation.
>
> The term "Virtual Reality" is broadly used and widely interpreted. On
> the internet, virtual reality is generally interpreted as artificial
> spaces that can be navigated in 3 dimensions and "feels" real. It
> cannot replace a field experience. But it can infuse the learning
> surgeon into an environment that has all the sights, smells and
> feeling the real surgery has. The disadvantages of virtual reality
> are:
> 1. Cost: New technology is expensive. The cost of developing hardware
> and software for the application of virtual reality technology is too
> great for many institutions to implement at this time. Computer
> instrumentation is expensive after introduction but has always
> decreased over time; so I suspect as this occurs virtual reality will
> eventually become more commonplace in Medicine.
> 2. Restraint: Presently the equipment used to create a virtual
> environment is restrictive and uncomfortable to its users. This would
> have to be overcome for more convenient uses in surgical procedures.
> The advantages of virtual reality subside the disadvantages of virtual
> reality technology for the purpose of continuing education for the
> surgeons. The advantages are as follows:
> 1. Efficiency: Virtual reality simulators are more efficient than
> training on real patients. It eliminates the risk of harming the
> patient while trying to learn a new skill. It also eliminates the time
> restraints on waiting for types of cases to come up and allows the
> trainee to practice independently.
> 2. Interest: As virtual reality technology is interactive and as the
> surgeons can evaluate their performance before trying it on a real
> patient they will be more interested and
> 3. Objectivity: Virtual reality can objectively evaluate and measure
> technical competence rather than traditional subjective measure of
> trainee and mentor.
> 4. Ethical: Using virtual patients to train on is less offensive than
> training on animal models.

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