Virtual PalpationVirtual Palpation
If you know your way around a cow's reproductive tract, you remember how awkward it was in the beginning for your brain and fingers to make sense of what you felt and what it meant. Imagine trying to teach that to someone else when neither they nor you can see what's going on. Internal palpations are some of the most difficult skills to learn and to teach, as the examinations are unsighted or blind,
February 1, 2010
If you know your way around a cow's reproductive tract, you remember how awkward it was in the beginning for your brain and fingers to make sense of what you felt and what it meant.
Imagine trying to teach that to someone else when neither they nor you can see what's going on.
“Internal palpations are some of the most difficult skills to learn and to teach, as the examinations are unsighted or blind,” explains Sarah Baillie, a senior lecturer in the United Kingdom's (UK) acclaimed Royal Veterinary College (RVC). “The trainee cannot see and copy the instructor's examination and, similarly, the instructor cannot see or feel what the trainee is doing, which makes providing effective guidance and feedback very difficult.”
Baillie knew the challenge before joining the RVC faculty in 2006. She did plenty of what she terms “cow-side teaching” during the 20 years of her private veterinary practice. It was while retraining in computer science — Baillie earned her doctorate in the subject in 2006 — that she began to envision what is known today as the Haptic Cow.
The Haptic Cow
It is a virtual reality simulator utilizing haptic (touch feedback) technology. In this case, a haptic device (Phantom®) is positioned inside a fiberglass model of a cow's hindquarters. This device, made by Massachusetts-based SensAble Techonologies, provides force feedback based on the student's touch, literally pushing back on their finger to deliver the specific feeling of a cow's assorted reproductive anatomy.
In other words, the Haptic Cow offers students the lifelike feel of a real reproductive tract as they palpate computer-generated virtual objects representing the uterus, ovaries, pelvis and abdominal structures. An instructor follows the student's hand movements inside the Haptic Cow via computer monitor.
Virtual reality and the ability to program a sense of touch with haptic technology also means instructors can present students with as many different reproductive tracts as there are cows. Besides learning anatomy basics, for instance, students feel how the location and texture of the uterus changes at different stages of pregnancy.
The practicality of the Haptic Cow is proving its mettle for teaching. In a validation study, 16 veterinary students — novices in bovine palpation — were divided into two groups. One group was trained with the Haptic Cow; the other received only traditional training. The students were divided into pairs and asked to locate the uterus in four different live cows; they had five minutes for each cow.
All the students haptically trained were able to successfully locate the uterus in one or more of the cows. Only one student trained traditionally was able to do so. All told, those trained with the haptic device were successful 56% of the time. The success rate for traditionally trained students was less than 3%.
The Haptic Cow is also filling a void as veterinary student enrollment increases in the UK and practical learning opportunities decline.
Baillie says another popular teaching use of the Haptic Cow comes through a group role-play tutorial dubbed the Simulated Fertility Visit. RAV staff serve as the farmer; students serve as veterinarians called upon to palpate cows for pregnancy and fertility problems.
“The students get to think on their feet and practice communication skills and history taking, and have to make a diagnosis and decide on the treatment or action plan,” Baillie explains. “All must be delivered in a way that the farmer understands. This way of using the simulator represents a safe, trial-and-error learning environment; and obviously, mistakes do not carry serious consequences.”
Baillie's inventive practicality earned her the prestigious Most Innovative Teacher of the Year award in 2009 from the Times Higher Education Awards Program.
“She is a visionary in the use of haptics for improving clinical education,” says David Chen, chief technology officer of SensAble Technologies. “She has developed a truly remarkable simulator that will allow better training of veterinary students while limiting the health risks to animals. We're proud to be associated with her pioneering work, and happy that she was chosen to receive this high honor.”
Not yet in U.S.
Though the Haptic Cow hasn't arrived in the U.S. yet, four of the UK's veterinary colleges use it or other haptic applications that Baillie developed.
There's also a Haptic Horse, which helps students learn about equine palpation for colic, as well as a Haptic Cat that helps students learn feline abdominal palpation.
Now, there's even a fully automatic Haptic Cow simulation that doesn't require instructor supervision.
“The haptic device drags the student's hand along the path of an examination recorded by a veterinarian. I have shown that students trained with this version were significantly better at finding the uterus in cows than a control group,” Baillie says.
For veterinary students, these applications teach the perceptual and manual skills at the root of common clinical techniques and diagnostic procedures.
For the rest of us, such learning could spare plenty of cussing.
In simple terms, haptic technology enables a person to interact with computer-generated virtual objects through the sense of touch. For everyday use, think of a mobile phone with an on-screen keyboard that not only reacts to your touch, but reacts back, making it feel as though you're pressing real keys. More sophisticated uses of haptic technology include simulators such as the Haptic Cow, which make it possible for a virtual reproductive tract to feel like the real thing.
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