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Immersion Medical

Immersion Medical. Immersion Corporation Overview. Based in San Jose, 3 locations, including Immersion Medical and Canada. Develops and licenses hardware and software related to sense of touch. Leader in Medical simulation with approximately 800 systems in the field worldwide

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Immersion Medical

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  1. Immersion Medical

  2. Immersion Corporation Overview • Based in San Jose, 3 locations, including Immersion Medical and Canada. • Develops and licenses hardware and software related to sense of touch. • Leader in Medical simulation with approximately 800 systems in the field worldwide • Many awards for technology and product including: • 2001 Gold IDEA for industrial design of device • 2002 Dr. Frank H. Netter Award for Special Contributions to Medical Education • 2002 National Tibbetts Award Recognition award for Outstanding Contributions to the SBIR Program

  3. Anatomy of a Simulator • Computer Graphics • 3-D Anatomic Models • Haptics • Content - Didactics • Auditory Responses • Virtual Attending Feedback • Metrics • Database

  4. General Features of Immersion Simulators • Anatomic or pathologic variations • Various degrees of difficulty allows for users to be assessed for improvement • Realistic physiology and complications • Users have to respond to the consequences of their actions • Built-in feedback (virtual attending/professor) • Provides independent learning • Realistic haptics and graphics • Mimics real environment for enhanced learning • Didactic content • Provides independent learning • Quantitative assessment • Objective data for skills assessment and monitoring

  5. AccuTouch Endoscopy Simulator • Bronchoscopy • Flexible Sigmoidoscopy • Colonoscopy • ERCP Pipeline • EGD

  6. AccuTouch Endovascular Simulator • Cardiac Pacing • Right side • Left side • Angiography • Angioplasty • Stenting

  7. CathSim • Peripheral IV - Adult, Pediatric, Geriatric • Phlebotomy • PICC Pipeline • CVC • Thoracentesis • Pericardiocentesis

  8. Other • Hysteroscopy – Myomectomy • Ureteroscopy • Physical Diagnosis

  9. Validation Studies

  10. Studies – Requirement • Colt HG, Crawford SW, Galbraith O. Virtual reality bronchoscopy simulation: A revolution in procedural training. CHEST 2001;120:1333-1339. • Outcome: Novices significantly improved their dexterity and accuracy with both the simulator and the model following simulator training, to the extent that their performance on the simulator after training equaled or surpassed that of the experienced physicians who had received no simulator training.

  11. Studies - Requirement • Sedlack RE, Kolars JC. Colonoscopy curriculum development and performance-based assessment criteria on a computer-based endoscopy simulator. Academic Medicine 2002;77(7):750-751 • Outcome: The authors concluded that simulator-based training would be most beneficial in the early stages of colonoscopy training. Trainees at the Mayo Clinic must now complete 9 hours of simulator training involving approximately 25 virtual procedures, then demonstrate certain performance standards on the simulator before advancing to live-patient colonoscopies.

  12. Studies - Requirement • Garuda, S., Kesharvarzian, A., Losurdo, J.,Brown, M.D. Efficacy of a Computer-Assisted Endoscopic Simulator in Training Residents in Flexible Sigmoidoscopy. Presented at American College of Gastroenterology Seattle, WA; October 18-23, 2002 • Outcome: Use of a simulator reduced the number of procedures required to reach competence in both genders. This study would appear to validate the use of the AccuTouch simulator in reducing the number of patient based procedures required to to achieve skill in performing flexible sigmoidoscopy

  13. Studies – Skill Transference • Rowe, R. & Cohen, R. Virtual reality bronchoscopy simulator (abstract). Anesthesiology. 2000;93(3A):A-1219 • Outcome: Following training on the simulator, subjects showed significant improvement when performing a live bronchoscopy (shorter duration measures, less times lost, fewer collisions, less help from attending) compared with their performance prior to training.

  14. Studies – Skill Transference • Rowe, R. Time evaluation of a virtual reality bronchoscopy simulator (abstract). Anesthesiology. 2000;93(3A):A-1220. • Outcome:The simulator proved effective in fostering procedural efficiency, as all residents performed the live bronchoscopic intubation in less than 90 seconds following training on the simulator (untrained novices typically take more than 5 minutes).

  15. Studies – Skill Transference • Rowe, R., Cohen, R. An evaluation of a Virtual Reality Airway Simulator. Anesthesia & Analgesia 2002: 95:62-6 • Outcome: Performance was markedly improved after the Simulator. Time to completion of successful intubation with a bronchoscope was reduced from 5.15 to 0.88 min (P< 0.001). The number of times that the tip of the bronchoscope hit the mucosa was reduced from 21.4 to 3.0 (P<0.001). The amount of time that the resident spent viewing the mucosa decreased from 2.24 to 0.19 min (P<0.001). The percent of time viewing the channel of the airway increased from 58.5% to 80.4% (P=0.004). This bronchoscopy simulator was very effective in teaching residents the psychomotor skills necessary for fiberoptic intubation.

  16. Studies – Skill Transference • Ost D, DeRosiers A, Britt E, Fein AM, Lesser ML, Mehta AC. Assessment of a bronchoscopy simulator. American Journal of Respiratory and Critical Care Medicine 2001;164:2248-2265. • Outcome: Construct validity was demonstrated for the simulator, with intermediates/ experts performing significantly better than novices for procedure time, collisions, and percentages of segments entered, and experts generating significantly less red-out than novices. Fellows who trained on the simulator performed significantly better in live bronchoscopies (duration, quality score, bronchoscopy nurse score, and amount of meperidine used) than did fellows who underwent conventional training.

  17. Studies – Expert Comparison • Britt EJ, Tasto JL, Merril GL. Assessing competence in bronchoscopy by use of a virtual reality simulator [abstract]. In: Program and Abstracts of the Jubilee 10th World Congress for Bronchology & 10th World Congress for Bronchoesophagology; June 14-17, 1998; Budapest, Hungary. Abstract 0-10. • Outcome:Construct validity was demonstrated for the simulator, which differentiated the three groups of users: beginners had the longest performance times, experts had the shortest times, and intermediates had intermediary times.

  18. Studies – Expert Comparison • Datta VK, Mandalia M, Mackay SD, Darzi AW. Evaluation and validation of a virtual reality based flexible sigmoidoscopy trainer. Gut (Supplement) 2001;48:A97-A98. • Outcome: Construct validity was demonstrated for the simulator, which differentiated procedural performance (procedure time, % mucosa visualized, and efficiency ratio [% mucosa/time]) among the three cohorts according to their experience level.

  19. Studies – Expert Comparison • Mehta AC, Ost D, Salinas SG, Sanchez DE, DeRosiers A, Tasto JL, Britt E. Objective assessment of bronchoscopy skills by a bronchoscopy training simulator. American Journal of Respiratory and Critical Care Medicine 2000;161:A234. • Outcome: Construct validity was demonstrated for the simulator, which differentiated procedural performance(duration, time in red-out, and scope collisions with airway walls) among the three cohorts according to their experience level.

  20. Studies – Expert Comparison • Wong T, Darzi A, Foale R & Schilling RJ. Virtual reality permanent pacing: Validation of a novel computerized permanent pacemaker implantation simulator. Journal of the American College of Cardiology (Supplement) 2001;37(2):493A-494A. • Outcome:Construct validity was demonstrated for the simulator, which differentiated procedural efficiency (less time in procedure and in fluoroscopy, and better visualization of tissues by x-ray) among the three cohorts according to their experience level.

  21. Studies – Expert Comparison • Rawn CL, Reznek MA, Heinrichs WL, Srivastava S, Dev P, Drummel TM. Validation of an IV Insertion Simulator: Establishing a Standard Simulator Evaluation Protocol. Conference Proceedings: Medicine Meets Virtual Reality 2002:pp-pp. • Outcome: Part I: While statistical significance was absent, the CathSim trained student group received higher scores than the mannequin group in all steps of the procedure. • Part II: The expert physicians performed significantly better than the intermediates and novices on five of ten simulator metrics. No other measures showed significance. • Part III: The expert nurses performed significantly better than the intermediates and novices on two simulator metrics. No other measures showed significance. • Expert physicians and nurses rated CathSim as realistic, useful, immersive, beneficial for training students, and easily implemented.

  22. Perfecting the Practice through Medical Simulation Enhanced Multi-dimensional Learning Experience Improved Patient Care Skill Acquisition Increased Competency Skill Development Skill Maintenance Skill Validation Decreased Costs

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