Real-Time Visualisation and Analysis of Internal Examinations – Seeing the Unseen
Internal examinations such as Digital Rectal Examination (DRE) and bimanual Vaginal Examination (BVE) are routinely performed for early diagnosis of cancer and other diseases. Although they are recognised as core skills to be taught on a medical curriculum, they are difficult to learn and teach due to their unsighted nature. We present a framework that combines a visualisation and analysis tool with position and pressure sensors to enable the study of internal examinations and provision of real-time feedback. This approach is novel as it allows for real-time continuous trajectory and pressure data to be obtained for the complete examination, which may be used for teaching and assessment. Experiments were conducted performing DRE and BVE on benchtop models, and BVE on Gynaecological Teaching Assistants (GTA). The results obtained suggest that the proposed methodology may provide an insight into what constitutes an adequate DRE or BVE, provide real-time feedback tools for learning and assessment, and inform haptics-based simulator design.
KeywordsInternal Examinations Digital Rectal Examination Bimanual Vaginal Examination Prostate Cancer Rectal Cancer Vaginal Abnormalities Cervix Abnormalities
- 3.American Cancer Society. Prostate Cancer: Early Detection (2013)Google Scholar
- 4.Henderson, J.T., Harper, C.C., Gutin, S., et al.: Routine bimanual pelvic examinations: practices and beliefs of US obstetrician-gynecologists. Am. J. Obstet. Gynecol. 208, 109.e1-7 (2013)Google Scholar
- 6.Wang, N., et al.: Using a prostate exam simulator to decipher palpation techniques. Simulation in healthcare. Journal of the Society for Simulation in Healthcare 5(3), 60–152 (2010)Google Scholar
- 7.Pugh, C.: Use of a Mechanical Simulator to Assess Pelvic Examination Skills. JAMA: The Journal of the American Medical Association 286(9), 1021-a-1023 (2001)Google Scholar
- 9.Gale, C.: Can a CTA be developed that is likely to be useful for teaching vaginal examination? MEd in Surg. Edu. Thesis. Imperial College London, Faculty of Medicine (2012)Google Scholar