ENHANCING MEDICAL CAPABILITY IN DEEP SPACE: A COMPARISON OF TRADITIONAL AND JUST IN TIME TRAINING METHODS
Advisor:
Kristin Mount, MAMS, Research Faculty, University of Illinois at Chicago
Committee:
Sam Bond, MS, Clinical Assistant Professor, University of Illinois at Chicago
Cristian Luciano, PhD, Research Assistant Professor, University of Illinois at Chicago
Content Experts:
Jimmy Wu, Senior Biomedical Engineer at the Translational Research Institute for Space Health and Instructor at Baylor College of Medicine
Frank Radja, Certified Orthopedic Technician, University of Illinois Hospital and Health Sciences System
Overview
Medical autonomy will be essential for humans on board exploration class missions due to the limited availability of ground communication and lack of opportunities to return to earth in the event of an emergency.
An Augmented Reality (AR) Just-In-Time Training (JITT) interface, complete with 3D visualizations of procedural steps, may prove to be a valuable component of an on-board medical support system. The aim of this project was to develop a prototype AR JITT training module and assess its effectiveness in enabling scientifically literate individuals to complete a wrist splinting procedure with accuracy, confidence, and speed. The results achieved by participants who received AR JITT training will be compared to those of individuals who were trained using traditional classroom methods.
With an enhanced understanding of the benefits and shortcomings of AR JITT, future training approaches can be better designed to serve as an alternative to classroom training, therefore considerably reducing training requirements and the medical risk associated with exploration class missions.
Study Design
The study will be conducted in two phases and will include two participation groups: an experimental group and a control group. During phase one, the control group received classroom training on a wrist splinting procedure. The experimental group was given an opportunity to become familiar with the AR headset by completing a non-medical AR JITT activity but did not receive wrist splinting training at this time.
During phase 2, approximately five weeks after phase 1, both groups will be asked to splint the wrist of a manikin and complete a survey. The experimental group will use the AR JITT module while population one will rely only on their knowledge from the classroom training and a written protocol. The study setting, sample, and analytical methods were chosen to best simulate the learning experience of both astronauts trained in a classroom and astronauts trained through AR JITT. Graduate students studying various scientific disciplines were recruited to participate in this study due to their availability and level of education.
Methods
Following thorough literature review of research in space medicine, AR in medicine, learning theory, and splinting techniques, I developed a scenario and wrist splinting protocol in collaboration with Certified Orthopedic Technician Frank Radja. This protocol was used create a low fidelity wireframe of the AR JITT training module.
The AR JITT training modules were developed using the passthrough AR capabilities of an Oculus Rift with an attached ZED Mini stereo camera. Through this set up, the user could see video feed of their real environment inside the headset. Before beginning the development of the final module, I learned Unity, C#, and became familiarized with the ZED Mini Camera and SDK by experimenting with the prefabricated scenes and spatial mapping capabilities as seen below.
Phase 1
Control Group
Frank Radja, OTC, hosted the classroom training session, which included a brief discussion of arm anatomy, a splinting overview and a demonstration of how to bend, fit, and wrap a SAM splint onto a manikin arm. He concluded the session with a demonstration of how to ensure proper fit and a description of common splint-related complications.
Experimental Group
During phase 1, the experimental group completed two activities using the Oculus Rift and ZED Mini pair. Activity 1 included a short prefabricated game from the ZED SDK package during which the participant battled a virtual drone. Through the second activity, participants were presented with the challenge of using virtual elements to complete a task in real life. They were provided with background information and step-by-step instructions on how to draw the molecular structure of chlorophyll b on a whiteboard.
PHASE 2
control group
Approximately five weeks later, subjects returned for the Phase 2 and were asked to splint the wrist of the manikin and complete a survey that collected data on their perception of their performance, their understanding of the splinting procedure, and feedback on their training experience. The control group was provided with a written splinting protocol and all the same materials they saw during the demonstration.
Experimental group
The experimental group was provided with the AR JITT training module but no written protocol. They completed the same splinting procedure using the headset and the AR module, which guided them through relevant splinting background information, the application procedure, and a complication overview. These participants filled out the same survey as the control group.
The same technologies and principles were applied to the Phase 2 AR JITT module. Major changes between the two included the addition of the Leap Motion controller in order to enable hand tracking and a rearrangement of the navigation controls and instructions to make better use of the 3D space and limit the need for head movement.
RESULTS
Overall, the differences between AR JITT and classroom training in terms of accuracy and comprehension were found to be non-existent or statistically insignificant. However, there were some statistically significant differences between to the two groups in that the AR JITT group was slower to complete the procedure but rated their perceived experiences higher.
DISCUSSION
Findings provide insight into the advantages and disadvantages of AR JITT, which can be applied to the development of future training platforms. The increased levels of confidence, overall positive participant experience, and reduced total training times observed through the implementation of rudimentary AR JITT module lay a promising foundation for the advantages that could be amplified in more advanced modules. This project also indicates that it will be important to be aware that AR JITT could slow the delivery of care, facilitate unrealistic confidence levels, and include technical flaws that could inhibit procedural performance. As AR technology continues to improve, future researchers will be able to apply the conclusions drawn through this study to new iterations of AR JITT interfaces to provide deep space mission crew members with equal, or potentially superior, medical capabilities in comparison to classroom training.
Space exploration has historically been a major catalyst of innovative solutions that reach beyond the initial intended purpose and have huge impacts on life on Earth. These proposed capabilities could eventually be applied to medical scenarios in similarly austere locations on Earth. JITT seamlessly integrated into the real world could revolutionize rural, military, and wilderness medicine in addition to space.
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