Collaborative Learning in Medicine over Internet2

1. Collaborative Learning in Medicine over Internet2 Patricia Youngblood, PhD, Associate Director for Evaluation SUMMIT (Stanford University Medical Media & Information Technologies) Parvati Dev, PhD, Director Information Resources and Technology Stanford University School of Medicine

2. Global Collaborations • HAVnet Project: CSIRO Haptic Workbench-Australia: • Chris Gunn (CSIRO) & Dr. LeRoy Heinrichs (Stanford) • Wallenberg Global Learning Network (WGLN)-Sweden: • Virtual Labs, Dr. Cammy Huang • WebSP, Dr. Uno Fors, Jenn Stringer • Virtual Emergency Department, • Drs. LeRoy Heinrichs, Sakti Srivastava, Pat Youngblood, Phillip Harter (Stanford) • Drs. Li Tsai, Carl-Johan Wallen, Leif Hedman (Sweden) • AIM e-Learning Project-Southeast Asia & Africa: • Pauline Brutlag (Stanford) • Apeejay CME Project-India: • Drs. Parvati Dev, Sakti Srivastava, Cammy Huang Stanford University

3. Relevant Disciplines & Learners • Anatomy and surgery education for medical students, residents and practicing surgeons in Australia and California (HAVnet) • Physiological simulations for informatics & biology students in Sweden and California (Virtual labs) • Interactive patient cases for nutrition education for medical students in Sweden and California (WebSP) • Training in EMCRM (emergency medicine crisis resource management) for medical students & residents in Sweden and California (Virtual ED) • Vaccine education for immunization managers in Southeast Asia & Africa (AIM) • Continuing medical education for medical practitioners in India (Apeejay CME) Stanford University

4. Why Internet2? • The student who will enter medical school in 5-10 years can absorb multiple channels of information Dynamic charts Second screen lecture Communal note taking messaging Stanford University

5. Learning Resources over I2 • Rich media, including 3D stereo images, animations, video & haptics • Interactive patient cases for PBL • Collaborative, distributed learning • Surgical simulation • Virtual emergency department • 3D modeling • Wireless access to media resources Stanford University

6. HAVnet Project Anatomy test bed: Dr. Sakti Srivastava • Collaborative teaching & learning • Collaborative content development • Korea, Canada, Egypt • Large media collections are available around the world • Over 3000 stereo images of dissection • At Stanford and Wisconsin • Interactive rotation and dissection • Bandwidth up to 40Mbps per stream Stanford University

7. Collaborative teaching & learning Stanford University

8. HAVnet Project Clinical skills test bed: Dr. LeRoy Heinrichs • Laparoscopic/endoscopic surgical simulation • Validation of simulators: • SLS • AAGL • Surgical Science, Sweden • Imperial College, London • Haptic Workbench: CSIRO, Australia Stanford University

9. Haptic applications • “Haptic” is the sense of touch and kinesthesis • Touch and feel virtual anatomy • Touch across the Internet • Follow a remote guided movement • Sensitive to delay Stanford University

10. CSIRO Haptic Workbench • Provides learners the opportunity to learn surgical skills from a master surgeon • Users manipulate shared graphics and feel the force feedback of the remote user’s actions • Each haptic workstation provides co-location of the user’s hand with the virtual object • Network transfers updates between users regarding the state of the object/environment • Advantages: • Excellent for surgical planning & development of technical skills of surgery • Users can practice the real thing, make mistakes and learn from their mistakes HAVnet website:http://havnet.stanford.edu Stanford University

11. Virtual ED • Multiple users • One 3D space Stanford University

12. Virtual ED • Virtual reality simulation of an Emergency Department • Simulation-based learning over the Internet • Advantages: • distributed training for health care teams; • debrief of the learning experience with a live instructor; • lower cost than full scale simulation training facilities. • Requires reliable, high quality audio • Users give it high ratings for ‘realism’ • Provides practice for team leader and team members with a wide range of trauma cases • Provides a more ‘standardized’ patient management experience for assessing team skills Stanford University

13. AIM e-Learning Project • Provides up-to-the-minute content for immunization managers in SE Asia & Africa • Media-rich graphics & animations • Interactive quizzes, case studies, & calculators • Downloadable documents • Accessibility for low-bandwidth connections & small screen resolutions • Delivered over the internet or CD-Rom • Extensive assessment of users’ needs • XML site architecture for easy updating • Multi-language support • Contact aim-inform@lists.stanford.edu Stanford University

14. Apeejay Education Society • Continuing medical education for medical practitioners in India (Apeejay CME) • ACME project will develop, deliver and certify a variety of CME programs • Uses Internet based, distributed technologies to reach practitioners at a time & location of their choice • First course will be “In Vitro Fertilization & Assisted Reproductive Techniques” • Courses will incorporate both web-based & simulation-based learning http://www.apeejay.edu/heducation.htm Stanford University

15. Lessons Learned • Collaboration can be encouraged through the grant application process (RFP, subcontracts) • Importance of “people” networking • Get yourself a LeRoy Heinrichs! • Find colleagues who share your enthusiasm for a particular teaching & learning application • 3D modeling • Surgical simulation • 3D virtual worlds • Provide at least a 50% FTE support person at remote locations • Keep communicating—in person, over email, video and teleconferencing, and “in the world” • Testing, testing, testing • Start small & with collaborators nearby (your time zone?) Stanford University

16. Stanford SUMMIT Biocomputation Surgery Anatomy Biomechanical Engineering Computer Science Electrical Engineering Informatics Univ. of Wisconsin Immersion Corp. Barco Corp. Texas Tech University University of Pittsburgh CSIRO, Australia Univ. of Michigan - Visible Human Collaboratory The Team Stanford University

17. Websites: • Stanford HAVnet Project (California): http://havnet@stanford.edu • CSIRO Haptic Workbench (Australia): http://www.ict.csiro.au/e-health • WGLN Projects (Sweden): • Virtual Labs • WebSP • Virtual ED: http://simtech.stanford.edu • AIM e-Learning (Southeast Asia, Africa): http://summit.stanford.edu/research/aim_frame.html • Apeejay CME (India): http://www.apeejay.edu/heducation.htm Stanford University

18. http://www.internet2.edu/http://summit.stanford.edu/ Questions pat@summit.stanford.edu parvati@stanford.edu