Abstract
In the radiologic sciences program, radiation is a major factor that causes students to practice positions in another way. The technique is called simulation. Simulation allows the student to go through an experience without it being a real event but still lets the student get an idea how it would be if it was real. There are a few different types of simulations that can be used. The different types are 3-D printing, virtual simulation, motion tracking, interactive human anatomy, mannequins and phantoms.
Types of Simulation in Radiography
The phrase “practice makes perfect” is commonly known, but radiation exposure is not beneficial to the patient. In the radiological sciences program, they use a technique called simulation. Simulation is a way that students can go through an experience without it being a real event. Simulations can help give the students another way of learning so that they can be prepared if it would happen in a real-life event. Simulation can also provide a safe environment for students to learn from their mistakes and improve skills through repetition. Simulation is a way for students to practice on each other without exposing radiation and to help students learn better with positioning. Simulation have higher retention for students and can help change the behavior of the students for future encounters (So, Chen, Wong & Chan, 2019). The different types of simulations are 3-D printing, virtual simulation, motion tracking, interactive human anatomy, mannequins and phantoms.
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3-D Printing
3-D printing is one type of simulation which involves taking a digital design to create a 3-D physical object layer by layer (Spence, 2019). Many different processes, materials and equipment are used to create a 3-D printing image. Students can use 3-D printing to help learn anatomy. Many positions in radiology rely on students feeling bony landmarks. 3-D printing can help students see and feel for the bony landmarks. This would improve the student positioning of patients better.
Virtual Reality
Virtual reality is common, but mostly known for video games. It brings that person into a virtual world (Russel & Spence, 2018). The person isn’t just reading the information from a textbook but now using that information in a real-life situation. Health care now has virtual reality software, especially used for the radiologic sciences program. It creates a safe way for students to practice. It can be frustrating for teachers to teach the student the skill and not be able to show the student how it should be properly done.
Virtual simulation can be a very helpful learning technique (Russel & Spence, 2018). Virtual simulation can let the student practice the procedural steps and can generate an image that will provide feedback without exposing the patient to unwanted radiation. The students don’t need to be concerned about adding additional radiation to a patient. With that being said the student can relax and focus and know it will be okay if they make a mistake.
Motion Tracking
Motion tracking has been used a lot in movies and computer game developments (Alghamdi, 2015). Motion tracking works by placing markers at the joints of an actor and the motion of that person is captured by a camera. The way this can be used for the radiologic sciences program is that the markers are placed on a student and the student will get into a position that they need to practice. Then the computer will generate an image and the student can see it. This can help the student feel what it is like to be in a position that they will make a patient get into. The student will take better care of the patient since they know how it feels. The only problem with this is that it takes time to set up and needs to be handled with great care.
Interactive Human Anatomy
Interactive human anatomy is another simulation involving computers. It is a human visualization platform from BioDigital Inc. that is a web-based program (Spence, 2019). It allows the person using the program to manipulate a virtual anatomic model into many different positions. The BioDigital human visualization can have the student manipulate skeletal models into radiographic projections and positions being studied. Any model that the user creates can be saved if needed in the future.
Male and female anatomy can be viewed from a variety of different views (Spence, 2019). Each body system is labeled and dissectible for east configuration for any educational need. The user can make customized views of any desired anatomy. It allows them to adjust tissue layers, dissect structures, highlight and annotate. The program also includes cases that have pathological conditions. Many of the cases are related to radiology including bone fractures, gout and osteoarthritis. Many radiologic students struggle with learning positioning and anatomy. The students can label the main structures and submit their images for grading. The students can video them describing the anatomy.
Many health programs use the Anatomage Table which is 3-D to help the students (Spence, 2019). It allows the user to manipulate a life-sized digital cadaver. This table is about the size of an operating room table. The user can see all the anatomy through a touch screen in a 360-degree perspective. The Anatomage Table features 4 gross anatomy models and more than 20 high-resolution regional anatomy models. It also contains more than 1,000 pathologic cases. These cases are also related to radiology like human visualization but include dislocations and healthy anatomy images. The Anatomage Table can be connected to a flat-screen monitor and it can mirror the teacher or the student. A large group of students can do learning activities. The Anatomage Table has been shown to improve students’ grades. The teachers can write on the table with pen and tag structures of interest with pins. The images can be saved and used for quizzes and exams.
Mannequins and Phantoms
Everyone has heard of mannequins. People use them for many things (Alghamdi, 2015). One of the most common is the use of mannequins for automobile studies but the medical field has many useful reasons for them, also. The goal of the mannequin is to have a realistic person to simulate on. Mannequins are life-size that have flexible joints which resemble human joints. The mannequin should have human qualities such as soft tissue and anatomical landmarks that can be felt on the skin. The base of the skull and the tip of the pelvis is important. Anatomical landmarks are attached to the mannequin. The anatomical landmarks can be felt by the person using the mannequin through the skin. The mannequin needs to be light enough so that one or two people can carry and move the mannequin without having a lifting device. A mannequin is composed of a lightweight aluminum skeleton structure and has polysilicon skin, which gives a realistic shape of a human. They have sensors inside the mannequin that the orientation of all the joints are connected to a computer. This will be used to generate an x-ray image. The skeleton structure is connected by multiple-axis joints with rotation sensors and or radio frequency transmitters. The joints are to act like human joints such as shoulders, elbows, wrists, knees and ankles. The rotation sensors are connected to the computer system. The mannequin is manipulated by the user into the imaging modality model. The angular information of each sensor is fed to the posture interface.
Imaging Modality Model and Interface
The imaging modality model and interface accept input of imaging parameters from the user (Alghamdi, 2015). Parameters include filtration, tube voltage and tube current of x-ray generator in the case of simulating x-ray based imaging modalities. This data is supplied to the physics simulator to generate virtual radiation particles. The control of these functions can be incorporated into the graphic user interface (GUI). GUI can reflect a specific look and shape of a standard normal digital x-ray.
Posture Interface
The posture interface reads the data from the rotation sensors and or radio frequency position system (Alghamdi, 2015). A visual representation of the mannequin and imaging modality are displayed on the screen for the user. When the user is happy with the simulation configuration that includes the mannequin posture data and imaging parameters, the posture interface will forward the data to the computational phantom generator and physical simulator.
Computational Phantom Generator
The computational phantom generator is to construct a computational phantom (Alghamdi, 2015). It starts with the data from the posture interface which provides information of the selected joints in the mannequin. This also includes the corresponding joints in the computational phantom. This has a built-in reference phantom. They can real scans from a real patient in supine position. This gets 3-D image gets segmented so that the tissue and organs are individually identified. The mannequin’s dimension and joint positions come from this reference phantom making the selected joints in the mannequin reflect the joints in the reference phantom.
Physics Simulator
The physics simulator is the last step and it uses the data from the imaging modality model to create the appropriate models of the radiation source and detectors (Alghamdi, 2015). It generates and tracks virtual radiation particles through the imager and computational phantom geometry. The particle generation depends on the radiation source. The user chooses the kVp and mAs. The physical simulator is generating virtual photons at energies, positions and directions relevant to the study. The simulator then tracks the photons through the geometry using a combination of Monte Carlo and deterministic techniques. When the photon enters the imaging detector, a score will be registered; the process is continued until a sufficient number of photons satisfy the statistical benchmark of slandered Monte Carlo scoring criteria. Realistic images can be created so that students can observe the effect of patient posture and their choice of radiation source and imager. Students can be familiar with the choice of anode-filter combination, kVp and mAs setting in x-ray-based imaging. All images are converted into DICOM format for storage and display by PACS.
Discussion
Simulation in the radiologic sciences program provides students with a helpful learning tool. They have many different types of simulation. They have 3-D printing, virtual reality, motion tracking, interactive human anatomy, mannequins and phantoms. Mannequins and phantoms have 6 stages. Start with the mannequin then go to the imaging modality model and interface, then go to the posture interface, then go to the computational phantom generator then last is the physics simulator.
References
- Alghamdi, A. A. (2015). Simulation system for radiology education integration of physical and virtual realities: Overview and software considerations. Journal of Health Specialties, 3(3).144-152. doi:10.4103/1658-600X.159890
- Hing Yu So, Phoon Ping Chen, George Kwok Chu Wong, & Tony Tung Ning Chan. (2019). Simulation in medical education. The Journal of the Royal College of Physicians of Edinburgh, 49(1). 52-57. doi:10.4997/JRCPE.2019.112
- Russel, A., & Spence, B. (2018). Virtual simulation in radiologic science education. Radiologic Technology, 90(2). 169-171. Retrieved from http://search.ebscohost.com.mcneese.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=132750219&site=eds-live
- Spence, B. (2019). Practical applications in radiography education. Radiologic Technology, 90(4). 369–386. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134820184&site=eds-live
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