title: Inheriting the Learner's View: A Google Glass-Based Wearable Computing Platform for Improving Surgical Trainee Performance.
abstract: BACKGROUND
  It is speculated that, in operative environments, real-time visualization of the trainee's viewpoint by the instructor may improve performance and teaching efficacy. We hypothesized that introduction of a wearable surgical visualization system allowing the instructor to visualize otherwise "blind" areas in the operative field could improve trainee performance in a simulated operative setting.
  
  
  METHODS
  A total of 11 surgery residents (4 in general surgery training and 7 in an integrated 6-year cardiothoracic surgery program) participated in the study. Google (Mountain View, CA) Glass hardware running proprietary software from CrowdOptic (San Francisco, CA) was utilized for creation of the wearable surgical visualization system. Both the learner and trainer wore the system, and video was streamed from the learner's system in real time to the trainer, who directed the learner to place needles in a simulated operative field. Subjects placed a total of 5 needles in each of 4 quadrants. A composite error score was calculated based on the accuracy of needle placement in relation to the intended needle trajectories as described by the trainer. Time to task completion (TTC) was also measured and participants completed an exit questionnaire.
  
  
  RESULTS
  All residents completed the protocol tasks and the survey. Introduction of the wearable surgical visualization system did not affect mean time to task completion (278 ± 50 vs. 282 ± 69 seconds, p = NS). However, mean composite error score fell significantly once the wearable system was deployed (18 ± 5 vs. 15 ± 4, p < 0.05), demonstrating improved accuracy of needle placement. Most of the participants deemed the device unobtrusive, easy to operate, and useful for communication and instruction.
  
  
  CONCLUSIONS
  This study suggests that wearable surgical visualization systems allowing for adoption of the learner's perspective may be a useful educational adjunct in the training of surgeons. Further evaluations of the efficacy of wearable technology in the operating room environment are warranted.
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Zachary E
authors.initials: ZE
authors.lastname: Brewer
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Hutchinson C
authors.initials: HC
authors.lastname: Fann
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: W David
authors.initials: WD
authors.lastname: Ogden
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burdon
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California; Department of Cardiothoracic Surgery, Permanente Medical Group, San Francisco, California. Electronic address: ahmad.y.sheikh@kp.org.
authors.forename: Ahmad Y
authors.initials: AY
authors.lastname: Sheikh
mesh_terms: D000328:Adult; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D003626:Data Display; D004503:Education, Medical, Graduate / Q000379:methods*; D005139:Eyeglasses; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008838:Microcomputers; D009339:Needles
keywords: Interpersonal and Communication Skills; Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; simulation; surgical education; telemedicine; wearable computing