VR in the OR Visualizing the Future of Medical Education Dr Shafi Ahmed at Exponential Medicine



I guess the person say is sort of ladies and gentlemen but also to my wonderful and colorful Dutch colleagues Dharma SH in Henan together right along those lines this is true right we all experience the same problems and nothing has changed of course we have a big problem of course 2/3 of the population as highlighted by the global Commission a year ago said that they don't have access to safe and affordable surgery with about basic requirements appendicectomy zone sections and management orthopedic fractures which was save lives and so that saves morbidity around the grand scheme of things huge variation of course in resource in implementation and of course surgical practice I was inspired yesterday when Ralph Simon and curated the session on global health by the team from village health in Burundi who highlighted this problem they're dealing with the problems in some way so we have a problem we've quantified the problem how do we manage it need to disrupt we need to democratize social education to provide the 2 million extra surgeons required around the world to make it fair and equitable but also to perform 150 million actual operations per year around the globe how do we do that that's the problem I think we will have a moral obligation to somehow provide a solution or two to that problem we've all seen this picture before of course be Roth back 1870 holding center stage in the operating theatre of course and theater it resonates because of the theater we quit theater robbing operating room because that's where the action happened of course huge amount of people watching over people's shoulders trying to get a view into the operative field that we haven't changed for hundreds of years we've accepted this dogma and this tradition this is my own Hospital through London look at that 1920 huge amount of people run operating theatres hearts think how he was going to get trained in that environment but yet we accept it we don't challenge it we carry endlessly perpetuating the myth that we can train people better in this fashion a year ago I asked the question we've got to change things we've stuck we don't move on we're happy with our lives and surgery and we do the same things over over again because our forefathers taught us we were carrying the same thing again so challenging dogma tradition has been part all of our mantra in designing new ways of teaching the world has changed of course and this is the key it's connected and that connection is the key for us to scale up education to provide the solution to the global problem the companies are helping us so Google as I'm sure you realize Project loon are putting balloons into the cloud giving people high speed Wi-Fi access to parts the globe that needed Facebook not been done by Google her launching present Aquila a drone they'll fly at 60,000 feet across the globe and work on and giving out again high speed access to remote parts the world Mark Zuckerberg went to Africa recently for those very reasons how do you connect people so they're helping us design the future and we as clinician the surgeons has to work out a way of managing that for ourselves Facebook can put their money in virtual reality big time oculus rift they bought it out for 2.1 billion dollars from chap called palmer luckey a few years ago and in fact they're putting cable down called Project Maria with Microsoft from North America to Europe because they know that's the future they going to connect people better and you'll need much higher bandwidth that is possible at the moment so you have the biggest comes the world wanting to help us go forward and be shame if we could use that to our advantage let's go back two years about two years ago made 2014 I use the Google glass I'm sure some you see the story about is to use a simple technique a wearable technology and which was streamed live to the world to train people in different manner normally it's a one to one or one to two teaching or training what about one to many once when is the key you got a scale up if we leave a lot of surges in the future we have to empower them and train them in a different modality so I use the Google glass we create an app there students around the world and trainees could access the app and actually text message on their mobile phone which would appear on my glass as I was training them you could teach people from every part of the globe that one experiment allowed me to teach 14,000 people in one day okay not one or two this is what we have to think about is scaling up big time we have the power and they liked it they enjoyed it you're connecting people look at that and the bottom right-hand corner or strainer you think it's a first world country 5,000 would tune in because if you're more part of the world that we live in then we're connected so suddenly embracing all of mankind is different way just by a simple idea about wearable tech connections add a new craft and John Lawson I went to Dubai about about a year and a half ago what a great conference they fact I made to train this man who's called John Sculley the CEO of Apple who sack Steve Jobs to do a remote operation using wearable tech so even he understood the principles of getting out to the market and obviously he had a phone company that was going to be accessible going forward so it's people to understand this global problem and how to deal with it it's about a month ago my team of virtual medics have launched a global medical school platform to be able to teach anyone around the world for free accessing the best people around the world to teach them because of wearable technology and connections I mean will I want you all to part that community to come and help us and we want people to be trained by the very best around the world so you don't engage and offer that free service to everyone that needs it we shouldn't lose trained by geography or resources it's really part the key message that were giving you today let's go back ladies and gentlemen I want to imagine something for me I imagine that you're a surgical trainee in Tanzania you're restrained by geography you in a rural setting but you want some training you want to improve the standards of your healthcare system as every doctor does you want to previous Sanders or at least improve the basic health care of a system imagine you're a surgeon maybe an attending in Bangladesh a population of 150 million but was a very poor infrastructure of training and teaching but yet also you want to improve your standards like we all have to do how to do that resource is a problem travel with geography is a problem we could have come some of these ideas imagine your school kit in a inner-city area of sort of a poor area of poor district again you want to be a surgeon you want to train to be a medic you want to access the information we like to know what it's like and immerse yourself you have every right to do that education is basically fundamental right for everybody wakil access that free education around the world you can be a school teacher who is a rare area but he feels or he/she feels that their student shouldn't be restrained by their geography you want the very best for your children like all skins wattage do of course Naveen Jain said earlier you got to be big craze for entrepreneur I think I'm off the scale in this regard having had the whole world watched my operation two years ago I invite them again back in April the 14th 2016 to the world's first virtuality operation we record in 360 things have moved on AR via have evolved ethics evolved and now we've got solutions for the problem I persuade our hospitals by itself the biggest trust in the UK looking after 2 million patients big Trust to pop and we're strapped for cash of no money yet I persuaded them to give me some money all right to buy Google cardboard so everybody every staff member had a goo cardboard let's disrupt this like really crazy the pharmacist the physios the people working in their basement the nurses all had access to live feed you know well it's me something let's work out where we're going with the hospital around me we create an app called V I know our one click on on the phone two clicks to go into VR mode or 360 suddenly you're immersed two clicks that's what it takes for you to access training from around the world isn't that simple isn't that great this camera hovers high above the operating table at the Royal London husband bringing the images of surgery the places far beyond vor it's a world's first operation to be streamed live in 360 degree video via a company called medical realities dr. Jaffe Ahmed hopes it'll transform medical training worldwide well I think in the past we've done in 2d videos which are unavailable this is a bee 360 merci so people round the world using low-cost technology with a Google cardboard wear headset and smartphone and map its access live operations and training with students all over the whole world watching the operation begins okay we're live the surgery to remove a tumor in the colon may be routine but for those watching it's anything but students using VR headsets and smartphones can view in any direction and zoom in on the operating theater as dr. Ahmed narrates live they could even ask questions really great the kids I've been in theaters before and it's often really difficult to have a good view going on so often you'll push to the background and you can't see anything dr. Ahmed believes this technology giving others the experience of what it's really like to be in the o.r is just the beginning in time that we have to feedback be wearing gloves for example body suits you can touch feel things in the virtual world and ultimately imagine time we have virtual surgeon we prop into virtual theater virtual patient virtual instruments into a virtual operation before ever gates operating theater fully and that learning experience with vital it's the the most immersive simulation we can think of the surgery was a success and now the plan is to create a library of other surgeries shot with a 360 degree view the patient the 62 year old British man says while some time it took some time for him to agree to it he finally did knowing the experience would benefit medical students around the world he went viral we had 55,000 people watching the operation live so you could train that many people in 4,000 cities five many people are twittering about the whole process and a 40 countries simple reach but from simple idea and if that we interesting thing is the Chinese phoned us about about 10 minutes before the feet and they sent it to 1.2 billion people we have no idea how he watched it because the hundres of thousands because they was front page headlines on China and national TV because they understood big country had access information they would use these type techniques to help train their trainees and obviously fortunate Daniel managed to make it to the theater with me and supporting me he's been very supportive my ideas and my vision for future surgical education I'm really grateful truly it's a lot of my heart for your support Daniel so it can be that simple could it be a free app into a smartphone into a cardboard box which would cost literally nothing at all we have to think about simple solutions although high tech but low cost that's the way you penetrate the market and make healthcare more equitable fair right the company I worked medic realities with a developing with a company in the UK a nice haptic feedback because VR itself they said apps need to see Jie photorealism you need to have access to form controls needs for touch fuel this glove allows you to touch feel and add temperature so you will the flicker an iphone you can feel an IceCube immediately or hot flame that's we need to get to and we working the whole idea of haptic feedback in our solution I have to use the word single out at some point during this talk otherwise I won't be here right so I at Wired health early this year I talked about the future about surgical robots replacing surgeons okay this is really about the future and how things would change in the next 10 15 20 years where you'd be actually being operated on by a robot no question it's going to happen it raised huge controversy on Twitter okay what's the ethics behind all of this a week later the first robot came out that could join – it's about together okay it's happening already and that operation was unbuttoned a surgeon less leaked but our position it's what happening a is coming in it will change our lives of course now one of the things keep out all of this was really important and we've had not had much mention of this during this to last 2 or 3 days is patients there are partners ok we have taken one out journey with us new innovation without them we're nothing at all they have to buy into the idea my patients here this one in the middle is watching her own operation virtual reality can believe it her cancer operation her husband the guy on the right who added live via operation his family watch the operation life as I was doing it with rest of the world we can discuss the ethics of that and going forward a lunch break but this is what we need we want them to take us forward in this whole process what about the humor psyched about the patients what about the surgeons well this is great because we're training people also the I run was called the international surgical training program at the world crowns of England I've trained 60 surgeons from 25 countries last two years so it's about V is for AI is about human it's about traveling is about training it's the whole gamut they were offering so that the world becomes a better place and workable that's what we have to do now this is for Laurence a noose okay and I spoken on TV a few weeks ago he'll the end of the youngster they get some of the staff sorry out to you for a dirt and mealy and to piss all new Devon connect Tate Amelia this be those gentlemen thank you very much this is terrific work it's gonna globalize and democratize surgical education what other layers might you put in there let's say the AI piece they can tell you up you're about to pick the wrong call about a gallbladder clip yeah I think AI is fundamental it will train you in the improve efficiency of movement etc well excuse don't see like the team working around you they are can be built into that make you much better and we worried about the technical skills all the time it's more technical skills it's about how you behave in a team how you make judgments that's where AI interface will be really useful and what could this community here on online help you with to get this the next level I want you to get these face out there I want you use our platform I want people to engage I want people from all parts ok let's let's teach let's use your platform for free let's just we can sort out the the this sort of issue around soft and hardware and just teach why not we teach all the time but why teach one or two people when you can actually impact rest of the world make sense yes you're part of this absolutely great thanks so much thank you very much [Applause]

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