How MIREIA Means to Shape Education in Medicine
This Alliance seeks to improve the training of medical students and residents in the field of medical and surgical education. The consortium's clinical HEIs (Higher Education Institutions) will contribute to defining the project's clinical requirements and needs, providing the necessary pedagogical material, and validating the tools developed with the participation of target groups.
In the same way, the HEIs will benefit from the technological developments and knowledge generated by the technological HEIs and companies in the consortium, which will provide added value to their training services. Besides learning contents based on actual clinical cases, the HEIs will have different tools to create and share their own modelbased contents for medical and surgical training in technical and non-technical skills.
This will broaden the range of training solutions offered by these institutions, as well as reach a wider number of students. The HEIs will have the possibility to implement in their training programs all the innovative tools for medical education developed in the project. This will allow them to offer a higher quality formative service, ubiquitous, based on cuttingedge technology, and adapted to the students’ needs. This will position them as reference centres at European level in medical education.
Technological HEIs will also incorporate the tools to enrich their engineering education programmes. This Alliance will create a network for the exchange of knowledge and learning content for medical training, which will encourage the flow of knowledge between European institutions by making use in their training activities of the tools developed in this project.
A little info on the current state of the issue
The needs identified in this project are mainly based on (1) the extensive experience of clinical partners working in medical and surgical education, (2) the experience of technical partners in medical technology, (3) previous European initiatives such as S4Game, EASIER, MIS-SIM, FUSIMO, KTS, SurgTTT and MISTELA, and (4) published evidence.
Traditionally, the implementation of new technologies for medical training has been based mainly on the development of e-learning platforms for learning non-technical skills and on the application of simulation technologies for training technical skills [1-3]. The introduction of portable VR and AR devices has gained great importance in training and surgical care [4,5]. The recent emergence of hybrid technology such as MR, which combines many of the benefits of VR and AR, makes it possible to integrate training material more effectively into the user’s environment in the form of holograms and enables interaction with them .
It would therefore be appropriate to exploit the great potential of these XR technologies for education and training by providing the necessary tools for the creation and exchange of content. Throughout our previous experience, we have identified that a critical problem in the implementation of these educational solutions is that they generally offer content that is poorly interactive, not very personalized, sometimes far removed from the actual clinical experience , or not available as an OER for the whole European community in clinical or surgical training. 3D anatomical models can be useful to shorten the learning curve of medical students and residents, who may benefit from 3D reconstructions based on real-case preoperative images such as computed tomography (CT) and magnetic resonance imaging (MRI) studies or surgical videos [7,8].
However, there is a lack of specific guidelines on how to carry out this process in an efficient and cost-effective way for its application in medical-surgical training.
With this in mind, this Alliance proposes an innovative methodology integrating tools and guidelines to develop learning contents for medical students and residents who wish to improve their technical and/or non-technical skills. The tools include the visualization and interaction through XR technologies of 3D anatomical models generated from preoperative studies or through a semi-automatic tool for the creation of intracorporeal 3D anatomical models. Anatomical models, with and without pathologies, can be edited to be printed in 3D following the guidelines established by the consortium. Depending on the type of 3D printing method, these models can be applied as training models in medical and surgical anatomy, or as a training model with widely used laparoscopic box trainers. In addition, tutors and medical professionals will be able to provide training material from their clinical experiences, such as preoperative studies, 3D models generated from these studies, and videos of surgical procedures that learners will be able to consult ubiquitously. Additionally, mentors will have a tool for the creation of personalized virtual training environments for technical and non-technical skills that make use of the 3D models.
These virtual scenarios will be provided to residents to support their training in MIS.
1. Oropesa I et al. (2016) MISTELA: Application of a pedagogical model for online learning of MIS nontechnical skills in Europe Br J Surg 103(S1):6.
2. Sánchez-Peralta LF et al. (2010). Construct and face validity of SINERGIA laparoscopic virtual reality simulator. Int J Comput Assist Radiol Surg. Jul;5(4):307-15.
3. Nickel F et al. (2013). Virtual reality does not meet expectations in a pilot study on multimodal laparoscopic surgery training. World J Surg 37(5):965-73.
4. Sutherland J et al. (2019). Applying Modern Virtual and Augmented Reality Technologies to Medical Images and Models. Journal of Digital Imaging, 32(1), 38–53.
5. Kowalewski KF et al. (2016) Development and validation of a sensor- and expert model-based training system for laparoscopic surgery: the iSurgeon. Surg Endosc. 31(5):2155-2165.
6. Sánchez-Margallo FM et al. (2018). Application of mixed reality technology for surgical training in urology. 26th international European Association of Endoscopic Surgery congress.
7. Yang T et al. (2019) Impact of 3D printing technology on the comprehension of surgical liver anatomy. Surg Endosc 33:411–417.
8. Rethy A et al. (2018) Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training. Int J Comput Assist Radiol Surg 13:61–72.
This Alliance will provide an innovative methodology incorporating tools and guidelines to support the early stages of medical and surgical education through learning content and customized training environments based on immersive XR visualization technologies and 3D printing technologies. To this end, the following objectives will be addressed:
To define common guidelines for the creation of 3D models based on actual clinical cases and the experience of clinicians such as 3D anatomical models (with and without pathologies) based on pre-operative studies, intraoperative 3D anatomical models and virtual scenarios for MIS training..
Automated Models creation
To develop a tool for the semi-automatic creation of custom intraoperative 3D models for training in medical and surgical anatomy. This innovative solution will allow tutors to generate intraoperative 3D anatomical models intuitively and semi-automatically, through an endoscopic camera, for later use as educational material. A content repository will be provided to store, manage and share models..
To implement and/or integrate a set of authoring tools to create learning contents for medical and
surgical education using immersive XR technology. Mentors will use these tools to make use of medical imaging studies, 3D anatomical models and surgical videos to provide content tailored to the training needs of the medical students or residents.
3D printing methodology
To define methodological guidelines for 3D printing of anatomical models for their use as training models in medical and surgical anatomy or in laparoscopic box trainers as physical models to train technical skills.
xr methodological guidelines
To define methodological guidelines to develop learning contents for XR applications to learn and train technical and non-technical skills.
portfolio of learning content
To develop, based on case studies of interest (medical anatomy, laparoscopy and flexible endoscopy), a portfolio of exemplary learning contents in different contexts (box trainers/VR simulators/immersive environments, etc.) making use of 3D models generated during the project.
To validate the tools and learning contents developed in the project with end users in (at least) four European countries with three use cases (anatomy, laparoscopy and flexible endoscopy).