Augmented reality for neurological education simulations

I am laying down a challenge for app developers out there who know more about programming than I do.  This challenge comes from a day-long IAMSE meeting course I attended over the weekend on state-of-the art medical simulation tools.  What I saw was some pretty cool simulation is available today to replicate many physical signs and to help train on various procedures.  These simulations have come a long way from when all Harvey could do was teach you how to pick up a murmur consistent with mitral stenosis.  Now you can check blood pressure, pupillary response, breath sounds, and the mannequin can even talk to you.

The trouble (from a neurologist perspective) is that current simulation is great for cardiopulmonary physiology and simulation, but it leaves a void for the neurological exam.  It can teach laproscopic surgery, mimic a prostate nodule on DRE, and a lot of other things.  But aside from pupils and having the machine shake to mimic a seizure (which I haven't seen, but from the description, it sounds like a very large Tickle-Me-Elmo type of convulsion - ie all trunk movement and not much arm or leg movements), the neurological exam is as yet uncovered.  I think a lot of that comes from the fact that the neurological exam will require pretty advanced robotic arms and legs to mimic things like fine finger movements, and strength testing.  Hence, essentially you can equilibrate an essentially comatose person's exam for the most part.

I see an opportunity for augmented reality to step in while the robotic simulation takes time to become more sophisticated and cheaper.  I could imagine using a real person as a simulated patient sitting in a chair, or a simulation mannequin in a gurney, and have the student hold a tablet up to the person so that the view screen is over the torso.  Then an augmented reality protocol could take the image of the arm from the simulation, and overlay a realistic-looking tremor.  Or you could overlay realistic ataxia with heel to shin testing.  Or you could overlay a realistic tongue deviation, tongue fasiculations, or palate deviation.  Thus, you could more efficiently create a high fidelity simulation with neurological deficits.  I've asked my bioengineer friend about this, and he said it could probably be done, it'd just take money to get off the ground.

So, there's my challenge.  Create an augmented reality neurology exam simulation.  I'd be interested to hear if anyone is already developing something like this, or if someone if any app makers would be interested in making this happen.

Use of Tablets in Medical Education - What we can learn from Manchester

I've been watching a series of presentations by students at Manchester Medical School where they discuss their use of the iPad in their studies.  This is the end result of a project where students where issued an iPad in a pilot project at the beginning of this year.  I don't think any of the presentations in and of themselves is ground-breaking.  What I think is very innovative about this program is to have the students take the technology and apply it to problems they identify.  This is not a top-down approach where an instructor is listing apps the students can use, and then evaluating whether the students do what they are told. 

This is really a problem-solving exercise.  It's learner-centered learning at it's very core.  Give a student a tool which has over 30,000 apps available plus web capability, now the students need to go and figure out how to best use it.  First, they all identified problems they had in the past - forgetting important papers at home, having notes highlighted beyond recognition, and inability to physically lug all those textbooks.  They sifted through the app landscape, and came up with some remarkable ways to use the technology.  This is crowd-sourcing at its best.  This is truly the future of technology in medical education.  It's not about the downloading the coolest toy out there and jamming it into a curriculum to make it do something, its about finding the right tool to use to solve the educational problem in front of you.  The students found ways to get around problems with creating and filing notes, filing reading to do later, communicating log data to their supervisor, and creating study aids for themselves and their classmates.  If all the students at Manchester did this project next year, think of the innovations they could produce.  Now think about all the students in the UK, or across nations.  Again, crowd-sourcing at its best.

As Prof Freemont explains in his introduction to the program, this program is not about one particular format.  They chose the iPad for reasons he outlines, but you could likely accomplish similar feats with an army of portable laptops, android tablets, iPads, or whatever the next new thing will be.  I do appreciate the spirit of their experiment.  And, I'd be happy to come personally see what's going on in Manchester.  Maybe sometime next year during football season.