title: Virtual reality: new method of teaching anorectal and pelvic floor anatomy.
abstract: OBJECTIVE
  A clear understanding of the intricate spatial relationships among the structures of the pelvic floor, rectum, and anal canal is essential for the treatment of numerous pathologic conditions. Virtual-reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereoscopic-vision, viewer-centered perspective, large angles of view, and interactivity. We describe a novel virtual reality-based model designed to teach anorectal and pelvic floor anatomy, pathology, and surgery.
  
  
  METHODS
  A static physical model depicting the pelvic floor and anorectum was created and digitized at 1-mm intervals in a CT scanner. Multiple software programs were used along with endoscopic images to generate a realistic interactive computer model, which was designed to be viewed on a networked, interactive, virtual-reality display (CAVE or ImmersaDesk). A standard examination of ten basic anorectal and pelvic floor anatomy questions was administered to third-year (n = 6) and fourth-year (n = 7) surgical residents. A workshop using the Virtual Pelvic Floor Model was then given, and the standard examination was readministered so that it was possible to evaluate the effectiveness of the Digital Pelvic Floor Model as an educational instrument.
  
  
  RESULTS
  Training on the Virtual Pelvic Floor Model produced substantial improvements in the overall average test scores for the two groups, with an overall increase of 41 percent (P = 0.001) and 21 percent (P = 0.0007) for third-year and fourth-year residents, respectively. Resident evaluations after the workshop also confirmed the effectiveness of understanding pelvic anatomy using the Virtual Pelvic Floor Model.
  
  
  CONCLUSIONS
  This model provides an innovative interactive educational framework that allows educators to overcome some of the barriers to teaching surgical and endoscopic principles based on understanding highly complex three-dimensional anatomy. Using this collaborative, shared virtual-reality environment, teachers and students can interact from locations world-wide to manipulate the components of this model to achieve the educational goals of this project along with the potential for virtual surgery.
authors.affiliation: Division of Colon and Rectal Surgery, Cook County Hospital, School of Biomedical and Health Information Sciences, University of Illinois, 1835 West Harrison Street, Chicago, IL 60612, USA.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Dobson
authors.forename: Russell K
authors.initials: RK
authors.lastname: Pearl
authors.forename: Charles P
authors.initials: CP
authors.lastname: Orsay
authors.forename: Mary
authors.initials: M
authors.lastname: Rasmussen
authors.forename: Ray
authors.initials: R
authors.lastname: Evenhouse
authors.forename: Zhuming
authors.initials: Z
authors.lastname: Ai
authors.forename: Gregory
authors.initials: G
authors.lastname: Blew
authors.forename: Fred
authors.initials: F
authors.lastname: Dech
authors.forename: Marcia I
authors.initials: MI
authors.lastname: Edison
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Silverstein
authors.forename: Herand
authors.initials: H
authors.lastname: Abcarian
mesh_terms: D001003:Anal Canal / Q000033:anatomy & histology* / Q000601:surgery; D003107:Colorectal Surgery / Q000193:education*; D003198:Computer Simulation; D018961:Educational Technology; D004724:Endoscopy; D006801:Humans; D007396:Internship and Residency; D008953:Models, Anatomic; D010336:Pathology / Q000193:education*; D017773:Pelvic Floor / Q000033:anatomy & histology* / Q000601:surgery; D012007:Rectum / Q000033:anatomy & histology* / Q000601:surgery; D014584:User-Computer Interface