The goal of this study is to develop, explore the effectiveness, and implement the novel training method of dynamic haptic robotic training (DHRT). This method utilizes a commercially available haptic robot that can be programed to apply forces to the resident's hand to mimic an actual needle insertion. We postulate this training method will allow residents to more efficiently build their skills, obtain greater proficincy in less time and will better ensure that a proficient skill level is reached before the residents ae allowed to perform these interventions on patients. This proposed goal will be accomplished through the completion of the three specific aims.
Specific Aim 1 : Develop accurate needle insertion model and implement into haptic robotic device. In this aim ex vivo bovine liver experiments will be conducted to characterize the noise in the force upon needle insertion into soft tissue. This information will form a needle insertion model that will be programed into a haptic robotic device to simulate the haptic feel of needle insertion. This simulator will be evaluated by expert vascular surgeons and then modified accordingly to ensure accuracy in needle insertion simulation.
Specific Aim 2 : Develop and Optimize the Dynamic Haptic Robotic Training (DHRT) Program Hypothesis (H1) We hypothesize that our DHRT program will improve CVC insertion competence and success rates better than traditional CVC simulators because it allows for the development of the complex cognitive and psychomotor needed to successfully perform CVC procedures. The needle force data acquired in Aim 1 will be integrated with novel visual simulations of human anatomical configurations (e.g. vessel wall location, size variation, and wall thickness) in a graphical user interface that will provide both haptic and visual feedback to surgeons. The DHRT program will be experimentally tested by quantitatively and qualitatively comparing the program method to the baseline static simulation models currently used Specific Aim 3: Assess long-term improvements in CVC insertions and patient safety after incorporation of the DHRT program in the educational curricula at Hershey Medical Center Hypothesis (H2): A dynamic haptic robotic training program can reduce complications rates among patients undergoing CVC procedures at Hershey Medical Center (HMC), improve confidence, and offer a more accurate assessment of resident CVC skills than current state of the art phantom based training methods alone. To validate this hypothesis CVC complication rates and resident confidence will be compared among residents who receive the traditional phantom training (Year 1) and residents who receive the DHRT training method (Year 2).

Public Health Relevance

The goal of this study is to develop, explore the effectiveness, and implement the novel training method of dynamic haptic robotic training (DHRT) for central venous catheter (CVC) placement. This novel method continuously evaluates the medical resident's cognitive and dexterity skills and prescribes tasks to build these skills and feedback of performance to provide understanding for areas of improvement. This standardized method of learning can help to reduce complications in CVC insertion. 1

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Biomedical Computing and Health Informatics Study Section (BCHI)
Program Officer
Lee, Albert
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Pennsylvania State University
Engineering (All Types)
Biomed Engr/Col Engr/Engr Sta
University Park
United States
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Pepley, David F; Yovanoff, Mary A; Mirkin, Katelin A et al. (2018) Integrating Cadaver Needle Forces Into a Haptic Robotic Simulator. J Med Device 12:0145011-145015
Chen, Hong-En; Yovanoff, Mary A; Pepley, David F et al. (2018) Can Haptic Simulators Distinguish Expert Performance? A Case Study in Central Venous Catheterization in Surgical Education. Simul Healthc :
Yovanoff, Mary A; Chen, Hong-En; Pepley, David F et al. (2018) Investigating the Effect of Simulator Functional Fidelity and Personalized Feedback on Central Venous Catheterization Training. J Surg Educ 75:1410-1421
Pepley, David Frederick; Sonntag, Cheyenne Cassel; Prabhu, Rohan Sunil et al. (2018) Building Ultrasound Phantoms With Modified Polyvinyl Chloride: A Comparison of Needle Insertion Forces and Sonographic Appearance With Commercial and Traditional Simulation Materials. Simul Healthc 13:149-153
Yovanoff, Mary; Pepley, David; Mirkin, Katelin et al. (2017) Personalized Learning in Medical Education: Designing a User Interface for a Dynamic Haptic Robotic Trainer for Central Venous Catheterization. Proc Hum Factors Ergon Soc Annu Meet 61:615-619
Pepley, David F; Gordon, Adam B; Yovanoff, Mary A et al. (2017) Training Surgical Residents With a Haptic Robotic Central Venous Catheterization Simulator. J Surg Educ 74:1066-1073
Pepley, David; Yovanoff, Mary; Mirkin, Katelin et al. (2016) A Virtual Reality Haptic Robotic Simulator for Central Venous Catheterization Training. J Med Device 10:0309371-309372
Yovanoff, Mary; Pepley, David; Mirkin, Katelin et al. (2016) IMPROVING MEDICAL EDUCATION: SIMULATING CHANGES IN PATIENT ANATOMY USING DYNAMIC HAPTIC FEEDBACK. Proc Hum Factors Ergon Soc Annu Meet 60:603-607