Medical and veterinary clinicians are surrounded by high tech equipment for diagnostics and surgery, whether it is magnetic resonance imaging, digital x-ray technology, ultrasound or laparoscopy for keyhole surgery, but with the introduction of Google Glass and wearable technologies, commercial devices are offering up new possibilities in medicine.
Early adopters of Google Glass were dubbed ‘explorers’. You had to apply direct to Google for the opportunity to get what was in effect a live beta-test device being developed on the fly. For medics and veterinary surgeons that type of device should have had far too many uncertainties, but surprisingly the draw of having a hands-free method of recording surgical methods was just too good to pass up.
US veterinary schools, especially Ohio State University and Wisconsin, saw an opportunity to get ahead of the curve and try wearables in the operating theatre as a way of showing students a variety of surgical procedures ranging in complexity. Glass works well in sterile surgical conditions because it can be turned on by tilting the head and then operated using voice commands.
Phillip Lerche, an assistant professor working in Ohio State’s clinical anaesthesia and pain management service, wanted to see if he could help students struggling with intubation, ie placing a tube into the windpipe to maintain an open airway. “It is the one thing I find really hard to teach. I know exactly how to do it and I never remember struggling with it. It’s obvious to me where the tube needs to go, but for many students it is not.
“It is a procedure where you cannot really see what the students are seeing. You have to look over their shoulder or get them to move their head, then they are not seeing what you are looking at, so I wondered if Glass would have a specific application for that.”
Lerche admits that he struggled to record a clear video at first because of the placement of the camera (at the right hand corner of the headset) which he believes would work better if it was centrally situated. Still his experience with Glass is positive. “I understand the limitations of the technology. My next steps are to get the students to tell me what they want the video to show.”
The ability to tether the device to a smartphone or tablet has great potential in practical tutorials. “It would be less disruptive, because you could watch a student intubate while they were wearing Glass and give them feedback without having to peek around their shoulder and figure out what they were doing.”
Wisconsin School of Veterinary Medicine employs instructional designer Tyler Gregory to keep faculty members up to date on devices to improve teaching. “I’m sort of the pathfinder,” he says. “I have support to try new technologies from the Dean of our school, so long as they have a demonstrable effect on student instruction. I’ve been very happy with the clinical feedback on Glass. It’s very popular in our surgery department.
“I’m also in charge of our competency-based online learning modules, which are an initiative our Dean started to identify core skills in each clinical service and then create an online or blended learning module. Glass has been used to create these modules. For example, they were worn during the surgical knot tying and suturing module so students can see how knots are tied from the clinician’s point of view.”
Glass has another advantage for veterinary teaching hospitals. Specialised operations such as heart surgery happen in small numbers, so the ability to record procedures that are rarely done is hugely important.
Expanding use in medicine and veterinary applications could be good news for patients and the growing list of potential uses includes:
Rift in reality
Wisconsin is now investing in commercial virtual reality equipment such as the Oculus Rift headset. Videos recorded using Glass or other wearable technologies can be played back in the Rift to get as close to ‘living’ the experience as possible. Augmented reality technologies may also be used to overlay information, such as anatomical information, on a patient or on a specimen when teaching subjects such as basic anatomy and physiology.