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How Doctors are Using Smartphone Apps for Surgical Training

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Jun 23, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    Training surgeons is a particularly challenging task, with few alternatives comparing to operating on a live human. Though they aren’t equivalent to a true operation, simulations of surgery present a risk-free environment for physicians and students to hone their craft. Many are beginning to leverage modern technology to create evidence-supported medical simulations, with Osso VR using virtual reality to train and assess physicians in operation. Others are beginning to utilize smartphones in surgical training, providing free apps that simulate many operations. With an estimated 257.3 million smartphone users in the U.S. in 2018, these apps have the potential to benefit a large audience of doctors. In this article, we take a closer look at two companies that are releasing these surgical simulation apps.

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    Level Ex
    Level Ex is a Chicago startup that currently offers the following four applications for different disciplines:

    • Airway Ex for anesthesiologists, CRNAs, and airway specialists
    • Gastro Ex for gastroenterologists and colorectal surgeons
    • Pulm Ex for pulmonologists and critical care specialists
    • Cardio Ex for general, EP, and interventional cardiologists
    All of Level Ex’s games are interactive, providing scoring feedback based on efficiency and damage to the patient. Once the player achieves an adequate score, they can progress through the modules. These units simulate various procedures and techniques, allowing the user to deal with internal bleeding, stent inflation, cauterization of wounds, and much more.



    Each case simulated through Level Ex is submitted by physicians, some of whom being members of the company’s advisory board, while others are current practitioners. In addition to being able to practice various techniques, physicians can also receive continuing medical education (CME) credit through the apps. Such credits are required by physicians to maintain their professional licenses, and Level Ex offers a convenient and efficient way for doctors to receive accreditation.

    The company was founded by Sam Glassenberg in 2015. Glassenberg, like Justin Barad of Osso VR, began his career in the video game industry. He began his work making Star Wars games with LucasArts, went on to lead the DirectX team at Microsoft, then became the CEO of FTX Games, where he developed games for movies like Mission: Impossible and The Hunger Games.

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    Glassenberg developed the first surgical simulation app in 2012 for his father, an anesthesiologist. He requested Glassenberg to use his video game expertise to simulate a difficult procedure for his colleagues. Two years after uploading this game to the app store, Glassenberg was surprised to see that the app had been played by 100,000 doctors.

    After seeing the evident demand for such services, Glassenberg assembled an elite team of developers to create Level Ex. The company has since grown to have over 150 physician advisors. In 2018, over 3 million cases were played by 350,000 healthcare professionals through the Level Ex apps. Launching the Cardio Ex app just three months ago, Level Ex is expanding rapidly and benefiting hundreds of thousands of physicians.



    Touch Surgery
    Touch Surgery is a London-based company that also offers a smartphone application for surgical training. With one central app for 14 different specialties, Touch Surgery has over 200 procedure simulations available. The company strives to use technology to enable surgeons to provide safe care to all patients. Their interactive simulator is designed for healthcare professionals and provides an extremely in-depth guide of each procedure.

    After going through the step-by-step surgical guide for an operation, the user can instantly test their knowledge on the app. The award-winning app is used by surgeons globally and is assisting in training residents and medical device representatives as well. Touch Surgery has the backing of Johnson & Johnson subsidiary Ethicon as well, with a strategic collaboration forming between the two in 2016.

    Peer-reviewed research has found that students using Touch Surgery outperformed those receiving traditional education on standardized testing. Other researchers have praised the app for providing an efficient training tool that students and surgeons can use without supervisors, training centers, or time constraints. In addition, an article published in the Journal of Surgical Education found that Touch Surgery has the potential to better educate medical students in low/middle income countries.


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