OBJECTIVE: Our goal was to develop a system using virtual reality (VR) technology to test the haptic skills of medical students. Currently, surgical skills are learned on live patients in a clinical environment in which the student practices under the close supervision of an experienced surgeon. We are interested in using haptic feedback devices to enhance surgical skills, because simulated touch in a virtual world improves the performance of trainee surgeons. In this study, we evaluated the efficacy of a test that evaluates the surgical skill of medical students by using a VR simulator.
METHODS: We used a microsurgical simulator with a force-feedback system. Its effectiveness in helping 36 medical students to acquire the tactile skills used in microscopic surgery was evaluated experimentally. Operating time and the number of sites of hemorrhage were measured to evaluate surgical aptitude. We also evaluated system performance with respect to reality, immersiveness, and operability as secondary measures. Data were analyzed using descriptive methods.
RESULTS: The operating time and number of hemorrhagic sites were positively correlated. Subject students were clustered into three groups: dexterous, awkward, or clumsy. The relation between the number of hemorrhages in the retina and immersion and operability differed between the group of would-be surgeons and those of would-be internists and pediatricians. All the students commented that the simulator was a useful tool for medical education.
CONCLUSIONS: The VR simulator can be used not only to teach and evaluate subtle tactile and surgical skills relevant to the surgical profession, but also to test the aptitude of medical students. The training transfer from a haptic simulator to actual practice methodology should be quantifiable in the near future. This work has steered medical informatics research into a new type of medical education.

Objective：This study investigated the relationship between posture and voluntary cough strength in healthy people.Methods：The participants were 50 normal adults. We measured cough peak flow (CPF), chest circumferences at maximal inspiratory level and maximal expiratory level, blood pressure, and pulse rate in the supine position, prone position, and prone position with a pillow under the abdomen. The difference between chest circumferences at maximal inspiratory and maximal expiratory levels was calculated and defined as the thoracic expansion difference.Results：CPF and chest circumferences at maximal inspiratory level and maximal expiratory level were significantly higher in the prone position with a pillow under the abdomen than in the supine position. There were no differences in thoracic expansion difference and blood pressure among all the positions. Pulse rate was significantly lower in the supine position compared with the other positions.Conclusion：We concluded that voluntary cough strength would increase in the prone position with a pillow under the abdomen.

Objective：This study investigated the relationship between posture and voluntary cough strength in healthy people.Methods：The participants were 50 normal adults. We measured cough peak flow (CPF), chest circumferences at maximal inspiratory level and maximal expiratory level, blood pressure, and pulse rate in the supine position, prone position, and prone position with a pillow under the abdomen. The difference between chest circumferences at maximal inspiratory and maximal expiratory levels was calculated and defined as the thoracic expansion difference.Results：CPF and chest circumferences at maximal inspiratory level and maximal expiratory level were significantly higher in the prone position with a pillow under the abdomen than in the supine position. There were no differences in thoracic expansion difference and blood pressure among all the positions. Pulse rate was significantly lower in the supine position compared with the other positions.Conclusion：We concluded that voluntary cough strength would increase in the prone position with a pillow under the abdomen.