Training and practice for present and future orthopaedic surgeons
In France, training to be a doctor takes six years. However to go on to become a surgeon, takes at least another seven years.
Generally, medicine is a field that comprises many theoretical concepts. The problem is that providing opportunities for putting theory into practice can be tricky for medical students, even those who are potentially the most brilliant.
This is the driving factor behind the TELEOS project. The idea is to provide trainee orthopaedic surgeons the opportunity to practice theoretical skills using a computer system to help them.
The advantages of TELEOS explained
The project aims to take advantage of technology to enhance vocational training in orthopaedic surgery. TELEOS provides a powerful learning environment, whereby trainee (or even trained) surgeons can perfect surgical techniques, through practice, repetition and relevant educational feedback. An example might be placing a pin in a patient’s pelvis, to rectify problems caused by disease or breakage. Normally, experience would have to be acquired in a ‘live’ environment, within an operating theatre. One can expect associated risks, so if the trainee gets into difficulties, there is little opportunity to understand what they need to do to rectify the situation. The qualified supervising surgeon will, quite simply, have to intervene. Someone’s life is at stake and there can be no room for error. So a trainee that has experience practising techniques with TELEOS can expect less intervention when getting to grips with real life situations in the operating theatre. Their skills have been honed.
The screen shots above, taken from TELEOS, show how the simulator allows the trainee to position the pin in the pelvis, with appropriate visual feedback (X rays during the process and transparency of tissues after the validation)
TELEOS allow them to place their pin on a simulator, then processes an epistemic diagnosis of the users and finally provide them with the most appropriate feedback (another problem to solve, a clinical case or a segment of a course to consult).
What makes the project so different?
The project team comprises experts from different fields all living and working in Grenoble - psychologists, medical educationalists, computer scientists, didacticians. But, as Lucile Vadcard explains, inspiration comes from way beyond.
‘We work as a tight knit team, but having access to the experience and knowledge of education researchers from across Europe, through the Kaleidoscope network, has been an invaluable bonus to all of us. We have been able to find out about other teams doing similar research activities within other countries. Thanks to our participation in Kaleidoscope’s Learning and Technology at Work special interest group, we organised a workshop which brought together others from different backgrounds, but with similar research interests. In the longer term it helps prevent duplication, creates synergies and enables us to identify excellence and state-of-the-art, from a collective perspective. For us, we have been able to look out for future partners with experience in the medical field. We have now been given funding for a specific Kaleidoscope activity which we hope will push the boundaries further forward in terms of the research contribution to ground-breaking medical training.’
The diagram above shows how the TELEOS architecture is made up of three major components: representation of knowledge, diagnosis and didactic decision making. The environment thus calculates the most relevant epistemic feedback to be provided to users according to their problem solving processes.
What difficulties has this project taught us to overcome in the future?
‘Surgeons and staff working in health are really busy people, more often than not under great pressure. It has been a challenge to bring experts together to help us develop this educational system. But work is ongoing’, Lucile adds. ‘The more people able to see the benefit of TELEOS, the better. At the moment we are testing the system to prove its added educational value. We are confident that when it is introduced in hospitals in Grenoble at the end of this year, its benefits will be recognised by the surgeons and trainee surgeons that will use it. We will keep our ears to the ground, in terms of what is going on in research in education technology, so we can stay ahead. Kaleidoscope will help us to do this.’
Is there a message to share with policy-makers?
‘Each project like this addresses different issues. So for example here, we wanted to help trainee and practising surgeons develop their skills on an ongoing basis. But, this is orthopaedics. If we were to undertake a project to help other professional domains, we would necessarily need to identify different partners to optimise the chances of a usable, effective outcome. Kaleidoscope provides us with a view across Europe – it helps us make decisions in building project teams that will, ultimately, save time and money. Not only this, it also enables us to build a momentum generally in research and education – there is something to learn from every project, person, partnership – we should not have to waste effort trying to find the potential contributions.
We believe strongly in the power of interdisciplinarity for TEL research. Kaleidoscope has helped us to put together, since the early steps of the project, teams which deal with technological aspects of TEL and teams which deal more with human aspects of TEL. Powerful learning environments will emerge demonstrating a real synergy between educational, computer and social sciences.'
Who is on the TELEOS team?
This case study can only be presented thanks to the various project members involved, drawing together experts from different disciplines:
Computer scientists – Vanda Luengo and Dima Mufti-Alchawafa, MeTAH, Grenoble, France
Didactician – Lucile Vadcard, MeTAH, Grenoble, France
Psychologist – Michel Dubois, LPS, Grenoble, France
Surgeon – Jérôme Tonetti, Grenoble Hospital, France
Educational scientist – Mireille Bétrancourt, TECFA, Genève, Switzerland