The Future of Simulation

 

4:00PM  The Future of Simulation
Bryan Bergeron, MD, President, Archetype Technologies, Inc., bergeronbryan@yahoo.com  
Moderator:
 Dan Hoch, MD, Neurologist, Massachusetts General Hospital; Assistant Professor, Harvard Medical School, dbhoch@partners.org

A simulation can be defined as the use of a model to create a situation that a user would be unable to experience or interact with in real life.  In medicine, simulations are an important part of physician training, allowing doctors to practice procedures without the risk of killing somebody. 

      

Simulations have a long history in human society.  Some people argue that cave paintings of animals created around 20,000 B.C.E. were simulated hunts.  The first simulation in the modern sense of the word was an “airplane cockpit” that appeared in 1923.  Since the 1970s, simulations have become an increasingly common part of daily life.  Many are marketed to consumers as games, and many others are used for military purposes.  A number of different medical simulations have been created as well.  Some, such as mannequins on which surgeons can practice, involve extensive hardware.  Others, such as programs that allow doctors to look at avatars and ask them questions, involve extensive software.  At this point, graphics are no longer a challenge for the makers of simulations.  What makes creating realistic simulations tricky is the difficulty of writing the code that determines how the graphics should respond to user input.

      

When designing a simulation, it is important to define what the simulation is meant to teach.  Certain games, for example, simulate actions such as playing sports or musical instruments but do not teach people to do the real thing.  Simulations must be carefully designed to not include anything that will create a potentially confusing disconnect with reality. 

If the past is any indication, the future of simulation is unpredictable.  Revolutionary new technologies will emerge and change the field in ways that cannot be foreseen.  Simulations may become more invisible and begin to blend into everyday life.  Perhaps products will even be designed to allow users to create their own simulations.  

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5:00PM  Surgical Simulation: It's Not Only for Training
Dwight Meglan, PhD, SimQuest, dmeglan@mindspring.com 
Moderator: Ryan Bardsley
, Senior Systems Manager, Medical Simulation, CIMIT, rbardsley@partners.org

A simulation can be defined as a mathematical model of the known world whose results are consistent with known outcomes.  As of now, many programs and devices have been created to simulate medical conditions and procedures, but very few are marketed commercially.  Most medical stimulations exist only as prototypes.  Although many companies are involved in this industry, there is little coordination between them.  Perhaps this disorganization will be resolved as simulations come to play a greater role in both medical training and medical practice.    

      

Simulations can be classified as either top-down or bottom-up, depending on how they function.  Top-down simulations mimic a bit of reality using whatever mathematical system seems most convenient.  These simulations can be effective and valuable, but they are inherently task-specific.  Bottom-up simulations, which are based on biophysical principles, are more desirable.  Simulations of this type can be generalized because they translate known biomechanics into engineering mechanics and use meaningful internal variables. 

      

As technologies such as parallel processing and quantum computing are developed, computer power is becoming available to perform complex and realistic physical calculations.  Someday, bottom-up simulations may be able to produce patient-specific predictions.  Patient-specific simulations would require a lot of input data, but if created, they would allow surgeons to simulate procedures and test their effectiveness before trying them on a living patient.  In this way, simulations may come to play an important role in medical care in addition to the role they already play in physician training.   

 

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