Surgical education is a long process that has stayed surprisingly similar through the centuries, still predominantly relying on the apprenticeship method to teach future surgeons. With this method, surgical education can take up to 8-10 years to complete. Sheer volume of exposure, rather than specifically designed curricula, is the hallmark of current surgical training programs. But opportunities for learning through work with “real” patients have diminished. Due to several reasons, including competition among increased number of trainees for a space, reduction in working hours and ethical issues regarding practice on living human. So, interest in solutions, specifically designed to teach surgical skills, has increased dramatically. In this new model of surgical education, basic surgical skills are learned and practiced on models and simulators, with the aim of better preparing trainees for the operating room experience. As far as I know, our medical education system is also incorporating non-human modalities in learning like virtual anatomy dissection modules and basic surgical skills lab.
Observation of surgical procedures performed by experts is extremely important for acquisition and improvement of surgical skills. Once a surgeon finishes residency program and attains degree, she/he has to attain competence and expertise by her/himself. If posted in an institute where all types of surgeries are performed including complicated and rare ones; it helps smoother development as a surgeon. However, majority does not get this opportunity and it is not easy for them to manage time and leave from their working place to go for physical training. This is where digitalization can help, for example by using smart glasses. Smart glasses are small computers, which comprise a head-mounted monitor and video camera, and can be connected to the internet. They can be used for remote observation of surgeries by video streaming. Augmented Reality Smart Glasses (ARSGs) are a type of wearable technology that incorporates a display or projection system that overlays digital information onto the wearer’s real-world view.
Smart glasses allow continued focus on the task at hand, with the surgeon continuously aware of what is being filmed; their perspective. Additionally, other benefits such as augmented reality screens and audio transmission allow communication between the surgeon or professor and those outside of the OR. In general ‘No interference with operative sterility, procedural length, nor functioning in the operating room was encountered by clinical personnel’ while streaming. This allows the surgeon to go about their business, without being distracted.
Smart glass technology offer more benefits for trainees and medical students. The point of view (POV) image created by smart glasses shows an image that is incredibly immersive for the viewer, without adding distractions or view-blocking annoyances that are otherwise present in the Operating Room (OR), such as other students or clinical staff that may be in your way, or hands that might be very present when a presentation is viewed from a top-down angle. Additionally, added digital functionalities like zoom and wide-angle help the students through increased visibility as they allow the viewer to get a more clear view of either the detailed operative procedure or the OR environment. Moreover, recorded footage can be re-watched and studied outside the OR. Students ‘highlighted [the first-person perspective videos] perceived realism and its help as a memory aid.’
The benefits of smart glasses are significant; however, there are some disadvantages. One such drawback is that many smart glasses are not developed for specific healthcare use cases. Most popular smart glasses are made for industrial production use cases, with healthcare as an added use case. This means that there are many aspects that must be improved before smart glasses can be fully adapted into surgical workflows. Smart glasses often create shaky and unstable footage, as the wearer moves their head about when picking up instruments or talking to their colleagues. This makes for a sometimes unpleasant and unclear viewing experience. Viewer can reduce the effects caused by the shakiness of the footage by switching seamlessly between zoom and wide-angle cameras. Meaning the viewer could choose to view the footage in wide-angle, when the surgeon is moving about or interacting with his environment, and could use the zoom camera when the surgeon is working on the patient and when detailed footage is required.
We also need to consider factors described in the following studies. Innovation Diffusion Theory (IDT), defined as ‘the degree to which an innovation is perceived as being consistent with the existing values, needs, and past experiences of potential adopters’. Technology Acceptance Model (TAM); two key variables of it, together with attitude, explain and predict individuals’ intention and use of technology, are Perceived Usefulness (PU) and Perceived Ease of Use (PEOU). Perceived ease of use is defined as ‘the degree to which a person believes that using a particular system would be free from effort’; while perceived usefulness refers to ‘the degree to which a person believes that using a particular system would enhance his or her job performance’.