Further training in endoscopy using virtual reality: the Virtual Gastro Tutor (VIGATU)
Priv.-Doz. Dr. med. Alexander Hann, Prof. Dr. med. Alexander Meining, Dr. med Daniel Fitting, Monika Engelke, Prof. Dr. rer. nat. habil. Timo Ropinski, Julian Kreiser, Prof. Dr. Tina Seufert, Jun. Prof Dr. Claudia Schrader, Dr. Melina Klepsch, Benjamin Mühling
Screening colonoscopy for primary prevention of colorectal cancer is one of the most frequently performed endoscopic examinations. The procedure is highly standardized through international quality guidelines.
However, training in endoscopy is still based on an apprenticeship model. The apprentice learns the trade at the side of the instructor, on the patient. The skills learned thus often depend on the types of patient treated at the center involved. Diagnostic and therapeutic standards are also presented in a trainer-specific manner by the instructors. The time available for training is limited by their availability and by the numbers of examinations carried out in the center. External validation established guidelines usually only takes place occasionally.
Although competence-based simulator training — focusing on physician and non-physician medical trainees — has been shown to be effective, in practice it fails to be implemented due to the high costs of endoscopy simulators and the curricular teaching time needed to impart information from the guidelines. By contrast, Virtual Reality (VR) allows cost-effective simulation of the entire endoscopy setting with flexible scheduling, independently of location.
The VIGATU project (“VIrtual GAstro TUtor”) is therefore aiming to develop a VR-based teaching–learning system that will enable both physicians and nonphysician specialists to acquire the knowledge and skills needed to carry out guideline-compliant screening colonoscopy. The main focus is on content that is important for both professional groups: equipment, preparatory measures, sedation, complications, and simulation of a screening colonoscopy, including doctor–nurse communication.
For sustainable use, the VR-based teaching–learning system is being developed as a modular VIGATU software program, and it will be made available together with cost-effective head-mounted displays (HMDs) to participating certified centers that provide continuing medical education in the field of endoscopy and to certified further training institutes for nonmedical professions (nursing and medical assistants). The project is supported by the German professional associations — the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the German Society for Endoscopy Professions (DEGEA).
The project is being funded by the German Federal Ministry of Education and Research in the framework of the funding guideline “Digital Media for Vocational Training in the Health Professions (DigiMed).”
Experts from the various specialist medical fields, nursing science, psychology and educational studies, and media informatics, along with a company specializing in the design of 3D environments, are all involved in implementing the project.
If you like our research and think that you can contribute with creative ideas to our team, we will be very happy to receive your application or ideas.
Please send this via email to PD Dr. med. A. Hann (firstname.lastname@example.org).
Illustrations and video
The virtual colonoscopy room on the right was modeled on the procedure room in Würzburg University Hospital.
Example of first implementation of the colonoscopy room in VR using VIGATU.
An endoscope handle, with the model seen in reality on the left and as the VR implementation on the right, with valves.
CO2 insufflator: in reality on the left and as the VR simulation on the right.
The endoscope supply connector: in reality on the left, and as the VR simulation on the right.
Würzburg University Hospital
Department of Medicine II, Gastroenterology
Bildungswerk e.V., Herne
University of Ulm
Institute of Media Informatics
Research Group on Visual Computing
Psychology and educational studies
University of Ulm
Institute of Psychology and Education
Department of Teaching and Learning Research