SBIR-STTR Award

Clear needs exists for a more comprehensive understanding of the nature of laparoscopic surgical skill acquisition and decay, objective metrics with which to assess these skills over time, and simulation-based training that supports rapid acquisition, longitudinal retention, and targeted retraining for sustainment of these critical and perishable skills. The proposed SBIR effort seeks to develop and validate a skill acquisition/decay model, novel objective metrics, and simulation-based training strategies for the prevention of laparoscopic surgical skills attrition. Objective metrics assessed will include advanced simulator-based metrics and metrics derived from instrument tracking, motion tracking, and vision tracking technologies, as well as advanced cognitive assessment technologies capable of assessing learning and cognitive workload. The ultimate goal of this effort is to integrate the resulting system within standardized military medical training curricula for enhanced training and sustainment of these critical skills.

Benefit:
The objective of this SBIR is to provide US military health care providers and their Interagency partners new capabilities to support minimally invasive surgical (MIS) Laparoscopic surgery procedures, reducing the need for extensive retraining and providing new validation methodologies. The proposed research and resulting technology is expected to support rapid acquisition, longitudinal retention, and targeted retraining for sustainment of these critical surgical skills. This research is of particular importance in the military medical domain, as military surgeons often experience extended periods of nonuse of critical surgical skills while on deployment.

Keywords:
skill decay, skill decay, Virtual Training Environment, Laparoscopic Skills, objective metrics, motion tracking

This Subsequent Phase II Proposal is an extension of Phase II contract N00014-11-C-0420. The overall objective of the proposed Subsequent Phase II effort is to develop and provide initial validation for a mobile training platform and framework that will support optimized refresher training for a variety of medical skills. Maintenance of specialized skills during periods of nonuse presents a significant problem within the military medical domain, and there is currently an alarming lack of research and development to support scientifically-grounded retraining pedagogy for such complex skills. Leveraging surgical skill decay research and a prototype glove-based training interface developed under the initial SBIR effort, this effort seeks to develop and validate a Surgical Skills Training and Assessment Instrument (SUSTAIN) mobile app platform, which will enable psychomotor and cognitive skills to be trained and assessed in isolation, as well as in conjunction with multi-dimensional skill components. Additionally, this interface will support interactive instruction, providing additional engagement and motivation, which is lacking in many mobile and web-based training curricula. Options are proposed to transition this technology and extend this capability to the domain of Combat Casualty Care.

Benefit:
The proposed technology will provide a much needed testbed platform to support empirical research related to complex skill retraining, and will provide targeted surgical skills training in a deployable form factor to support refresher training when and where it is needed most, and within the context of app-based training in order to provide both motivation and embedded performance-based feedback. The proposed option effort will specifically address the Combat Casualty Trauma Training initiative, which calls for simulation systems that teach/train skills that include, but are not limited to, cricothyroidotomy and hemorrhage control. Additionally, the proposed effort will lay the groundwork to support app-based mobile training and retraining of a wide variety of surgical and clinical skills, as well as nonmedical maintenance skills training. This effort addresses the Warfighter Performance S&T Focus Area within the 2011 Naval S&T Strategic Plan, with emphasis on the following Objectives: Manpower, Personnel, Training, and Education Warfighter Health and Survivability As part of the ongoing and coordinated effort to ensure the most effective training, and with funding from the DMRDP, the Office of Naval Research (ONR) is interested in modeling and simulation-based adaptive training systems for joint service medical applications. The current research opportunity is driven by two key factors. The first is the recognition that modeling and simulation technologies, having achieved significant positive pay-off for the development, testing, and evaluation communities as well as the military and commercial aviation communities, can be applied to improve performance and reduce overall costs associated with training and education of medical practitioners throughout their careers. The second is the fact that advances in the human performance sciences, e.g., instructional systems design, informatics, computer sciences, artificial intelligence/machine learning, and human interfaces, have created a unique opportunity to develop more effective, robust M&S-based medical training approaches that enhance DoD's healthcare delivery capabilities. The desired technical capabilities must be able to develop and maintain key performance skills among the personnel in the military healthcare's operational system. The proposed effort also seeks to address the Force Health Protection Future Naval Capability (FNC) Pillar, which aims to protect Sailors and Marines by reducing morbidity and mortality when casualties occur 0x9D , by developing a generalizable mobile platform training and assessment framework capable of supporting future medical skills content, including Combat Casualty Care sustainment training.

Keywords:
surgical skills, retention, mobile, Simulation, Assessment, laparoscopic surgery, Training