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Virtual
Haptic Back links OMM, engineering
Unique
technology trains osteopathic medical students to diagnose
back problems
By Nick
Piotrowicz
In
today’s medical schools, students often supplement their
early clinical experiences with high-tech training such as
human patient simulators. The Virtual Haptic Back (VHB),
however, is the first and only simulation technology that
trains medical students to use palpation.
Haptics is a
technology that interfaces with users through the sense of
touch, in this case, helping medical students practice
palpation—using the sense of touch to diagnose a
condition—in a virtual environment.
According to
John Howell, Ph.D., associate professor emeritus of
physiology, the VHB technology is particularly valuable to
learning the hands-on techniques of osteopathic manipulative
therapy (OMT), since palpation can be very difficult to
master. This simulation, supported by the Osteopathic
Heritage Foundations and Ohio University’s Interdisciplinary
Institute for Neuromusculoskeletal Research, allows students
to build their confidence before entering the clinical
setting.
And it
started with a chance encounter.
Back in
1999, Howell gave his lab research associate, Robert
Conatser, a day off to chaperone his child’s field
trip—to the haptics lab of Robert Williams, Ph.D., a
professor of mechanical engineering in the Russ College of
Engineering.
“There I
told him, ‘We could teach your medical students how to
better feel someone’s back,’” Williams said. “I actually had
bad lower back problems, and OMT has been wonderful to me,
so I wanted to give back.”
OMT is a therapy that applies stretching,
gentle pressure and resistance to the musculoskeletal system
in order to diagnose, treat and prevent a wide range of
illnesses and injuries. The subtle science of palpation
remains the OMT doctor’s primary tool.
“When it
comes to palpation, there is no objective gold standard
against which they can compare their experiences,” Howell
said. “Typically, students first training in OMT are
uncertain as to whether they really felt something or what
exactly they felt.”
To use the
VHB, a medical student sits in front of a large computer
screen and puts each index finger inside thimble-like
extensions of two robotic mobile arms, called PHANTOM Omni
IIIs®.
When they touch the life-size image of a human back on the
screen with their index fingers, the Omni’s three motors
kick in and push back. The effect is beyond convincing;
though the screen image is two-dimensional, it’s as though
the students can actually feel the contours of a real human
back.
“Less than a
millimeter of precision can be obtained and even fractions
of a newton of force,” Williams said. “It’ll never replicate
a human perfectly, but neither does it need to. The
confidence-building and skill training can be achieved,
especially for younger students, without 100 percent
realism.”
When a
student thinks they have found the problem area, like a
tense or knotted muscle, they step on a foot pedal. A voice
on the computer lets them know if they are correct.
The VHB has made traveling demos to Cleveland
Clinic South Pointe Hospital, the West Virginia School of
Osteopathic Medicine, and the 2009 American Osteopathic
Association’s 114th Conference and Exposition in
New Orleans. Williams and Howell intend to market a portable
unit of the VHB to other osteopathic medical educators.
“One of the things the students have told us
is that in the haptic back lab, there are no distractions,”
Howell said. “They can really concentrate on what their
fingers are telling them.” |
