Computer-based simulation can improve C-arm training

Computer-based training and e-learning are often discussed within the context of improving teaching and education in medicine and in radiology.^1,2 When such approaches were evaluated in a prospective study, case-based computer-based training was shown to improve students’ problem-solving ability.³ It’s important to note the authors identified interactivity as potentially key to the success of computer-based training.

A high degree of interactivity can be achieved by the use of simulation combined with real-life cases. In one such program, a simulator was used to help dental students interpret spatial information on radiographs.⁴ An evaluation performed immediately after training showed that the simulator improved these skills.

Another example of computerbased training is the virtusMED system, designed to help trainees understand the principles of (multimodal) tomographic imaging and improve their spatial understanding of medical images and human anatomy (Figure 1).⁵

The system adopts ultrasound imaging as a metaphor to explore volumetric images reconstructed from thin-slice CT, MRI, ultrasound, or cryosectional images. Trainees use a virtual ultrasound probe to generate slice images of arbitrary position and orientation, and these are then displayed together with anatomical 3D models in a virtual scene on the computer screen. The system is being used in continuing medical education courses and for medical student education.

Interventional radiology is another area where simulators are often used with computer-based training.⁶

One particular example that combines simulation with computer-based training is safe and efficient operation of a C-arm and mobile image intensifier. Such systems are essential for controlling and monitoring the surgical treatment of emergency, trauma, and orthopedic patients.

Their intensive intraoperative use means that both patients and operating room personnel may be exposed to high doses of ionizing radiation.^7-11 This is despite technical advances that have improved radiation protection, such as apertures, digital imaging, and laser localizing beams.^12,13 Safe C-arm operation consequently presumes that individuals are trained to handle the device correctly, can make the correct adjustments as required by the surgical situation, and can minimize the exposure of patients, surgeons, and operating room personnel to ionizing radiation.