Nigel John's Story
The objective of Nigel’s Fellowship was to enable doctors to train on virtual patients, and for it to become an accepted tool in the international medical education curriculum.
A virtual patient is a computerised database containing patient-specific image data, physiology, and pathology models that can be interacted with in real time using natural senses and skills. This would be as good as training on a real patient and would provide a completely safe training environment where mistakes can be made without any harm coming to the patients.
During his four-week Fellowship in 2013, Nigel established collaborations with world leading groups in Australia and Singapore to pilot basic research themes that lead the way for the deployment of a computer simulated virtual patient. He worked at Australian e-Health Research Centre in Brisbane, and the Fraunhofer Project Centre for Interactive Digital Media at Nanyang Technological University, Singapore. Many other research groups in Australia involved in development of virtual patient technology were also visited.
The Fellowship provided a wealth of ideas and excellent contacts for creating new projects that will contribute to achieving the overall goal of creating a virtual patient.
An important challenge is if the computer-generated patient needs to be identical to a real patient, or whether a simplified model would be sufficient. The look, feel, sound and smell of a patient must be accurately modelled. The feel can be tackled using force feedback joysticks so that when a virtual patient is touched, the sensation, for example, of a needle penetrating skin and other soft tissue can be felt. Following the Fellowship, Nigel has worked with the group in Singapore to explore new ways of modelling force interaction within a patient.
The Australian e-Health Research Centre has developed solutions for training endoscopy procedures such as colonoscopy. After the Fellowship, Nigel collaborated with them to develop a new mechanism for tracking the depth of insertion of the endoscope into a virtual patient. This project is aimed at a high fidelity solution using the actual surgical endoscope that is used on real patients.
Nigel and his team at Bangor, and now Chester University, have started many other related projects. One of the latest is to use a tablet computer to provide a training tool for neurosurgeons. The trainees can practice inserting a cannula through the brain of a virtual patient and attempt to puncture the ventricles – a fluid filled organ in the centre of the brain. This tool was tested at a neurosurgical “boot camp” at Manchester in September 2014, and demonstrated that it does help improve the expertise of the trainees.
There is still much work to be done to deliver a complete virtual patient that can be used for any training scenario. Nigel and his team are ensuring that the UK is at the forefront of this work.
“The Fellowship has been invaluable in broadening knowledge of what is going on in this field internationally, and stimulating many new ideas and collaborations”.