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Data-driven transformation of surgical education for proficiency-based performance_002.jpg


Under the leadership of the three clinical partners Kantonsspital St.Gallen, Centre Hospitalier Universitaire Vaudois and Balgrist University Hospital, endorsed by the Swiss Surgical Societies, in the PROFICIENCY project novel standardized and proficiency-based surgical training curricula are defined and interfaced to simulation tools. The four implementation partners VirtaMed AG, Microsoft Switzerland, OramaVR SA and Atracsys LLC, develop these innovative training tools in collaboration with ETHZ, University Hospital Balgrist/UZH and ZHAW. These simulation tools are ranging from online virtual reality simulation, augmented box trainers, high-end simulators, to augmented-reality-enabled open surgery and immersive remote operation room participation. The sum of these developments introduces a fully novel, integrative training paradigm, installed and demonstrated on two example surgical modalities, laparoscopy and arthroplasty, while fully generalizable to other interventions. This will set new standards both in Switzerland and abroad.

The chart above shows the summary of the PROFICIENCY project with its three interdependent subprojects that are described in more details below.

In Subproject 1, we are advancing surgical training for laparoscopic surgery through the development of standardized, procedure-driven modules. These modules cover a range of essential skills including general procedures, appendectomy, cholecystectomy, and right hemicolectomy. They are seamlessly integrated into the laparoscopic surgery curriculum hosted on a learning platform.


Our approach to surgical training is evolving with data-driven methodologies, embracing concepts like adaptive learning and deliberate practice. These principles are ingrained not only within the learning platform but also within the connected simulators. The tool, ConnectTM, serves as the bridge between simulators and the learning platform. It facilitates real-time data transfer and analysis during trainee practice sessions, enabling instant and tailored feedback. Leveraging AI-driven analysis, these data insights predict each trainee's learning trajectory, optimizing their training experience. A distinctive asset of the new simulation environment is the chance to train complications during operations and provides guidance on their management. This comprehensive approach significantly enhances patient safety.

Furthermore, we are developing an assessment tool based on benchmarks set by expert surgeons. This tool evaluates each trainee's proficiency level, ensuring a comprehensive understanding of their skills when starting to work on patients.

In Subproject 2, we're pioneering a diverse array of simulation- and proficiency-based training solutions. At the heart of this initiative is ConnectTM, seamlessly integrating simulation solutions with the learning platform curriculum.

Our portfolio spans various modalities to cater to diverse training needs. First, we offer an online simulation solution accessible via web interface or compatible with off-the-shelf VR headsets. This platform excels in cognitive training, offering immersive experiences tailored to individual learning styles. Next, our mobile augmented box trainer provides an affordable solution for honing motor skills. Its versatility and accessibility make it an invaluable tool for trainees at all levels. Finally, our high-end simulator offers a comprehensive training experience, combining cognitive and motor skill development in a sophisticated environment.

By aligning simulation modalities with specific training objectives and content, our solutions ensure targeted and effective learning outcomes. While initially applied to laparoscopy training, we're also exploring concept studies for arthroscopy, expanding our reach into additional surgical domains.

In subproject 3 the cadaver- and simula-tion-based training for hip arthroplasty is developed. Thereby, Augmented Reality (AR) is combined with a novel created physical training setup, an AR-based guidance and instruction module as well as a performance assessment module using Artificial Intelligence (AI). Additionally, a remote teaching approach for open and endoscopic surgery is created using cutting-edge Virtual Reality (VR)/AR-visualization. These AR-enabled training solutions are interfaced with the ConnectTM targeting to an accelerated learning curve of the trainees.


Furthermore, a virtual surgery participation solution is setup using a Hololens device and a VR-based solution for the VR visualization. This enables participants to immerse into a virtual operation room where the real data is displayed in real-time on the virtual operation room table.

*AR Augmented Reality / OR Operation Room / VR Virtual Reality

The contribution of the project partner VirtaMed: Revolutionizing The Way Medical Skills Are Taught.

© Copyright VirtaMed AG.

The contribution of the project partner VirtaMed: Revolutionizing The Way Medical Skills Are Taught.

© Copyright ORamaVR S.A.

The contribution of the project partner Microsoft in cooperation with the Balgrist University Hospital

Successful first-ever holographically navigated spine surgery at Balgrist University Hospital.

© Copyright Microsoft / Balgrist University Hospital

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