360 degrees of neurological amazingness

It was an ordinary day, and I was looking at my Facebook feed, and a friend had posted a video he made while snowboarding. Being on vacation, and a little bored, I clicked on it expecting to see a snowboarding epic move or an epic fall or something. What I saw was the guy's mitten and the trail ahead. Not that cool, I thought, until I touched the screen and panned around. He had captured a 360 video that the user can pan around. I could look at the sky, the trees reflection in his goggles, his board, or the trail ahead. It was very cool.

Why am I talking about this on a medical education post? Because, I looked and these cameras are now affordable. The one he bought is a little over $300. From a quick web search, there are now a bunch of camera options to shoot in 360. Couple that with virtual reality headsets which are also dramatically decreasing in price, and there are a lot of opportunities to develop medical educational materials in ways never possible before.

Here's a couple of examples from Mythbusters diving with sharks, and USA Today flying with the Blue Angels. You may have already seen videos like this where you can pan and zoom, or if you have VR googles, you can just look around.

Imagine showing patient videos to students where the student actually feels like they are in the room with you as you examine a patient. We share videos in movement disorders frequently of unusual tremors and movements.Imagine being able to look like you would in an actual patient visit at a life-size patient. Imagine if you couple this with augmented reality programs that can allow the learners to interact with the patients, and we are not that far from simulation situations that truly do simulate real life.

Affordable 360 cameras are now on the market. Couple with more affordable VR headsets, and the possibilities for VR or augmented reality to teach medical students has opened way up. Now it's up to you all to go out there and buy some toys, and start making cool stuff.

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.