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Medical modeling and simulation research at Old Dominion University receives a complimentary review in a feature article published by Mechanical Engineering magazine. The comments of Mark Scerbo, professor of psychology and a human factors expert, figure prominently in the article.

Together with several photographs, the 3,500-word article tells how ODU's Virginia Modeling, Analysis and Simulation Center (VMASC) and human factors psychologists have teamed with faculty at Eastern Virginia Medical School (EVMS) to move to the forefront of several branches of medical modeling and simulation.

The headline, "Virtual OR," notes the article's focus on the simulated operating room that is one of the latest projects of the ODU-EVMS team. But the writer also delves into other research done under the auspices of the National Center for Collaboration in Medical Modeling and Simulation, which the two institutions run.

Hector Garcia, visualization lab manager for VMASC and the researcher most involved with ODU's Cave Automatic Virtual Environment (CAVE), is also quoted in the article. The third simulation researcher identified by the magazine is Dr. Leonard Weireter, professor of surgery at EVMS, and a collaborator with Garcia and Scerbo.

Three main thrusts of the research are explored: (1) evaluation of existing simulation instruments that are commercially available; (2) development of marketable simulation devices, such as one to teach the cleaning of a wound; and (3) development of room-sized simulations, such as the virtual OR, that can be created in the CAVE.

Mechanical Engineering's online version of the article, which appeared in the November edition of the print magazine, is at

Compared with other "lives-in-the-balance" professionals such as airplane pilots and soldiers, physicians have been exposed to very little simulation training. Pilots have been required for years to qualify on flight simulators before they fly modern jets. But only in 2004 did the U.S. Food and Drug Administration establish its first virtual-reality training requirement for a specific surgical procedure. The rule requires surgeons to demonstrate mastery of a simulated carotid artery stent implant before they try the procedure in an actual operating room.

"This action taken by the FDA is an historical event of unimaginable proportions," Scerbo wrote in a paper he presented at last year's annual meeting of the international Human Factors and Ergonomics Society. "It is the first time in the history of medicine that performance-based competency measures will determine who can and cannot perform a medical procedure."

The traditional "see one, do one, teach one" apprentice training of physicians, Scerbo said, does not expose residents to a standard set of medical conditions and procedures, or to standard performance measures. Also, he pointed out, the American Medical Society's accreditation council recently established an 80-hour work-week limit for residents, which actually represents a cutback in apprentice training hours for the typical resident.

He believes the time is ripe for simulation medical training. "Simulation offers the opportunity to study the practice of medicine from a more scientific perspective," he said. "It will never replace the apprentice system, but it can make the system much better."

Weireter emphasizes the value of a "controlled environment" during medical training. "Much like a flight simulator where the trainer can mimic situations, we can induce situations we want to drill an individual or team on," he said.

Tell-tale sounds heard through a stethoscope that a physician needs to be able to recognize can be simulated. So can other symptom-recognition requirements and dexterity feats.

The virtual operating room can simulate more than a physician's core duties, Scerbo added. It can expose trainees to real-world team-building challenges and pitfalls brought about by cultural, gender and age differences. It also can be a test lab to study task sequencing and other aspects of how people learn in a stressful environment. Scerbo believes the basic virtual reality created to simulate an operating room can be adapted to simulate an emergency room.

"With VMASC and our Center for Collaboration in Medical Modeling and Simulation, we could have in this region a medical training simulation facility that is one of a kind, that people would come from all over to use," Scerbo said.

A presentation about the virtual OR was given by Scerbo, Garcia, Weireter and other colleagues including Lee Belfore, ODU associate professor of electrical and computer engineering, at the Interservice/Industry Training, Simulation and Education Conference in Orlando, Fla., in early December.

"This is a highly visible venue with attendance numbers that exceed 15,000," Scerbo said. "Medical simulation is a small, but growing part of this meeting, so it was significant to be included in the program."

VMASC also had an exhibit at the conference promoting modeling and simulation in Hampton Roads.

This article was posted on: December 13, 2006

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