Minimizing Ionizing Radiation Exposure in Invasive Cardiology Safety Training for Medical Doctors

[+] Author and Article Information
Aric Katz

Faculty of Industrial Engineering and Management Technion-Israel Institute of Technology Haifa 3200003, Israel

Avraham Shtub

Faculty of Industrial Engineering and Management Technion-Israel Institute of Technology, Haifa 3200003, Israel

Ariel Roguin

Interventional Cardiology Rambam Medical Center, and Ruth and Bruce Rappaport Faculty of Medicine Technion-Israel Institute of Technology Haifa 31096, Israel

1Corresponding author.

ASME doi:10.1115/1.4036431 History: Received June 10, 2016; Revised March 24, 2017


Advanced imaging systems, such as C-Arm machines, greatly improve physicians' diagnostic abilities and provide greater precision. Yet, these benefits come with a price of ionizing radiation exposure to medical teams and patients. Exposure to ionizing radiation can lead to physical maladies ranging from skin irritation to cancerous growths. Supplying proper training and skill improvement to operators on how to use this technology safely can help minimize risk of exposure. Previous studies on radiation knowledge among physicians and radiologists presented disturbing results of underestimated risk of exposure. This research is based on an innovation in Simulation-Based Training (SBT), a simulator using the WOZ (Wizard of Oz) concept that was used for training ER physicians and ultrasound technicians. This research integrated WOZ technology with a radiation exposure formula for training how to minimize unnecessary exposure to ionizing radiation. The simulator also incorporates 3D animation graphics, enabling trainees to simulate the control of different factors. Image quality and the operator's radiation exposure levels are also animated, assisting trainees to focus on their exposure based on their device settings. Contrary to previous studies we measured exposure doses to the operator and quantified image quality accordingly. Validation was done on different C-Arm machines. We also built a unique exposure formula and integrated it into our WOZ simulator enabling trainees to visualize their real-time and overall exposure based on their technique. Validation of learning outcomes was done using knowledge exams. Results from our validation exams presented significant improvement and high retention.

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