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Does Haptic Feedback Improve Learning and Recall of Spatial Information? A Study Using a Virtual Reality Nasendoscopy Simulation
Abstract
In the literature, haptic training has long been regarded as an effective means of acquiring skills that involve force feedback. This is relevant in the context of haptic virtual reality applications that argue that the addition of haptics increases the effectiveness of the training system. Here we describe an experimental investigation which examines whether haptic feedback increases people’s spatial knowledge of a simulation. In particular, we address the following question: Is visuo-haptic interaction a more effective way of learning spatial information than purely visual interaction? A comparison of two groups of participants (visual versus visuo-haptic) revealed no significant differences in their spatial knowledge of the simulation. The findings are discussed with reference to potential variables which may affect spatial learning such as cognitive load.
Autistic people typically need methodical support as they explore and interact with their immediate surroundings and the objects associated with them, emphasising the importance of spatial knowledge and cognitive skills in improving and understanding their surroundings. The objective of this research paper is to present a conceptual and technical framework that could be of significant assistance in developing spatial ability and cognitive skills in autistic people. This framework is constructed based on aspects of autistic behaviour, spatial cognition, and technical aspects of haptic technology and virtual environments (VE). The framework uses the Model,View, Controller (MVC) pattern as its structural foundation. This paper highlights the important elements required for scholars and designers to create and develop a haptic-based virtual environment (HBVE) for autistic people in order to improve spatial knowledge and cognitive skills. Furthermore, this research also aimed to create an HBVE application based on the proposed framework in order to assess its effectiveness. This research paper evaluates the proposed framework based on end-user perspectives. The findings indicate that the experimental study conducted with autistic people has demonstrated notable progress in enhancing spatial knowledge and cognitive abilities among this population. The experimental implementation of these findings supports the developed framework’s efficacy.
Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%.
A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.
Endoscopic sinus surgery (ESS) is the surgical standard treatment for chronic rhinitis/rhinosinusitis and nasal polyposis. There is a reported complication rate of 5-10% associated with this type of surgery. Simulation has been advocated as a means to improve surgical training and minimize the rates of complication and medical error. This study aimed to show how a virtual reality ESS simulator was developed, with particular emphasis on achieving satisfactory photorealism and surgical verisimilitude.
Sinus computed tomography scans were processed to create a triangle-based three-dimensional mesh model; this was incorporated into a spring-damper model of thousands of interconnected nodes, which is allowed to deform in response to user interactions. Dual haptic handpiece devices were programmed to simulate an endoscope and various surgical instruments. Textures and lighting effects were added to the mesh model to provide an accurate representation of the surgical field. Effects such as vasoconstriction in response to "virtual" decongestant were added.
The final simulated endoscopic view of the sinuses accurately simulates the moist and glossy appearance of the sinuses. The interactive tissue simulation system enables the user to interactively cut and remove tissue while receiving accurate haptic feedback. A working prototype of the simulator has been developed that leverages recent advances in computer hardware to deliver a realistic user experience, both visually and haptically.
This new computer-based training tool for practicing ESS provides a risk-free environment for surgical trainees to practice and develop core skills. The novel use of customized precision force feedback (haptic) devices enables trainees to use movements during training that closely mimic those used during the actual procedure, which we anticipate will improve learning, retention, and recall.
This paper explores the use of haptic feedback to teach an abstract motor skill that requires recalling a sequence of forces. Participants are guided along a trajectory and are asked to learn a sequence of one- dimensional forces via three paradigms: haptic training, visual training, or combined visuohaptic training. The extent of learning is measured by accuracy of force recall. We find that recall following visuohaptic training is significantly more accurate than recall following visual or haptic training alone, although haptic training alone is inferior to visual training alone. This suggests that in conjunction with visual feedback, haptic training may be an effective tool for teaching sensorimotor skills that have a force- sensitive component to them, such as surgery. We also present a dynamic programming paradigm to align and compare spatiotemporal haptic trajectories.
In this paper we investigate a use of haptics for skills training
which we call haptic guidance. In the haptic guidance paradigm, the
subject is physically guided through the ideal motion by the haptic
interface, thus giving the subject a kinesthetic understanding of what
is required. Subjects learned a complex 3D motion under three training
conditions (haptic, visual, haptic and visual) and were required to
manually reproduce the movement under two recall conditions (with
vision, without vision). Performance was measured in terms of position,
shape, timing, and drift. Findings from this study indicate that haptic
guidance is effective in training. While visual training was better for
teaching the trajectory shape, temporal aspects of the task were more
effectively learned from haptic guidance. This supports a possible role
for haptics in the training of perceptual motor skills in virtual
environments
This tutorial focuses on the sense of touch within the context of a fully active human observer. It is intended for graduate students and researchers outside the discipline who seek an introduction to the rapidly evolving field of human haptics. The tutorial begins with a review of peripheral sensory receptors in skin, muscles, tendons, and joints. We then describe an extensive body of research on "what" and "where" channels, the former dealing with haptic perception of objects, surfaces, and their properties, and the latter with perception of spatial layout on the skin and in external space relative to the perceiver. We conclude with a brief discussion of other significant issues in the field, including vision-touch interactions, affective touch, neural plasticity, and applications.
[english] Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.
Background
Virtual reality (VR) simulators provide an alternative to real patients for practicing surgical skills but require validation to ensure accuracy. Here we validate the use of a virtual reality sinus surgery simulator with haptic feedback for training in Otorhinolaryngology - Head & Neck Surgery (OHNS).Methods
Participants were recruited from final year Medical Students, Interns, Resident Medical Officers (RMOs), OHNS Registrars and Consultants. All participants completed an online questionnaire after performing four separate simulation tasks. These were then used to assess face, content and construct validity. ANOVA with post-hoc correlation was used for statistical analysis.ResultsThe following groups were compared: a) Medical Students / Interns, b) RMOs, c) Registrars and d) Consultants. Face validity results had a statistically significant (p<0.05) difference between the Consultant group and others while there was no significant difference between medical student/intern and RMOs. Variability within groups was not significant. Content validity results based on Consultant scoring and comments indicated that the simulations need further development in several areas in order to be effective for Registrar-level teaching. However students, interns and RMOs indicated that the simulations provide a useful tool for learning OHNS related anatomy and as an introduction to ENT specific procedures.Conclusions
The VR simulations have been validated for teaching sinus anatomy and nasendoscopy to Medical Students, Interns and RMOs. However, they require further development before they can be regarded as a valid tool for more advanced surgical training.This article is protected by copyright. All rights reserved.
Recent theoretical accounts of working memory proposed a distinction between passive storage and active processing of visuo-spatial information. These hypotheses are based on empirical evidence showing that individual differences in visuo-spatial abilities are frequently modulated by this variable. However, results from age differences studies are not clear, and this research was designed to specifically investigate the level of competence of elderly people in tasks measuring visuo-spatial working memory and, in particular, passive and active components of the system. Three groups of participants (mean ages were approximately 22, 66, and 76) were tested in eight cognitive tasks tapping passive storage and active manipulation in various aspects of visuo-spatial and verbal processing. Results showed that elderly people are selectively impaired in active tasks, and these tasks were also more sensitive in detecting differences within the older group. These data highlight the need for theoretical models of working memory that take into account this distinction while defining the architecture of the system.
Two experiments employed dual task techniques to explore the role of working memory in route learning and subsequent route retrieval. Experiment 1 involved contrasting performance of two groups of volunteers respectively learning a route from a series of map segments or a series of visually presented nonsense words. Both groups performed learning and recognition under articulatory suppression or concurrent spatial tapping. Both concurrent tasks had an overall disruptive effect on each learning task. However, spatial tapping disrupted route recognition rather more than did articulatory suppression, while the nonsense word recognition was impaired more by articulatory suppression than by concurrent spatial tapping. Experiment 2 again used dual task methodology, but explored route learning by asking volunteers to follow the experimenter through the winding streets of a medieval European town centre. Retrieval involved following the same route while the experimenter followed and noted errors in navigation. Overall the results partially replicated those of Experiment 1 in that both concurrent tasks interfered with route learning. However, volunteers with high spatial ability appeared more affected by the concurrent spatial tapping task, whereas low spatial subjects appeared more affected by the concurrent articulatory suppression task. Results are interpreted to suggest that different aspects of working memory are involved in learning a route from a map with a greater emphasis on visuo-spatial resources, but in tasks set in real environments where many cues of a varied nature are available, only high spatial ability subjects appear to rely heavily upon the visuospatial component of working memory. Copyright © 2002 John Wiley & Sons, Ltd.
Force feedback coupled with visual display allows people to interact intuitiv ely with complex virtual environments. For this synergy of haptics and graphics to flourish, however, haptic systems must be capable of modeling environments with the same richness, complexity and interactivity that can be found in existing graphic systems. To help meet this challenge, we have developed a haptic rendering system that allows for the efficient tactile display of graphical information. The system uses a common high-level framework to model contact constraints, surface shading, friction and tex ture. The multi- level control system also helps ensure that the haptic device will remain stable even as the limits of the renderer's capabilities are reached.
To evaluate the role of force feedback with applications to minimally invasive surgery (MIS). Two research hypotheses were tested using our automated laparoscopic grasper.
Conventional laparoscopic tools do not have the ability of providing force feedback to a surgeon when in use with or without robotic surgical systems. Loss of haptic (force and tactile) feedback in MIS procedures is a disadvantage to surgeons since they are conventionally used to palpating tissues to diagnose tissues as normal or abnormal. Therefore, the need exists to incorporate force feedback into laparoscopic tools.
We have developed an automated laparoscopic grasper with force feedback capability to help surgeons differentiate tissue stiffness through a haptic interface device. We tested our system with 20 human subjects (10 surgeons and 10 nonsurgeons) using our grasper to evaluate the role of force feedback to characterize tissues and answer 2 research hypotheses.
Our experiments confirmed 1 of our 2 research hypotheses, namely, providing both vision and force feedback leads to better tissue characterization than only vision feedback or only force feedback.
We have validated 1 of our 2 research hypotheses regarding incorporating force feedback with vision feedback to characterize tissues of varying stiffness.
The dual-task paradigm was used to determine whether the spatial, visual and verbal components of working memory are engaged in the processing of spatial descriptions. Participants listened to route or survey descriptions of urban-like spatial environments and then drew corresponding maps. The position of each new landmark was described either in terms of the direction to move toward this landmark (route descriptions) or its relative location with regard to the previously mentioned landmark (survey descriptions). Route and survey descriptions resulted in similar recall performance in the absence of an interfering task and landmarks were consistently less well recalled than their associated moves/locations. The pattern of interference resulting from the secondary tasks indicated that the processing of landmarks called upon both the visual and spatial components of working memory in the route perspective, whereas the processing of moves/locations essentially relied on the spatial component in both the route and the survey perspectives. The verbal component of working memory was only involved in the processing of landmarks in the survey perspective. The results suggest that distinct cognitive processes support memory for route and survey descriptions, and that distinct working memory resources support the processing of landmarks and landmark positions.