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Medical Education December 24, 2018

Touch-sensor technology seen as a path for improving surgical training

By Patricia Hannon

A Stanford surgeon, educator and inventor has worked to advance the science of touch.

Stanford surgeon Carla Pugh, MD, PhD, was a medical student and resident at Howard University when something occurred to her that would change the course of her career.

"Before I could operate on a tumor, I needed to know how densely it was attached. A CT scan couldn't tell me - the only way I'd know was through my hands," Pugh told us in a story about her research for Stanford Medicine magazine. "I realized I wouldn't truly learn how to diagnose with my hands just by watching my instructors, and I wanted to find a better way."

Now, Pugh holds three patents and is known expert in haptic - or touch-sensor - measurement, diagnostics and training. She has created sophisticated sensor, video and motion-tracking technology to capture a clinician's touch-sensing movements and effectiveness.

A mannequin with sensors inside the mouth, throat and windpipe, for instance, can measure a clinician's intubation skills. The procedure involves inserting a tube into and airway to help a patient breathe when under anesthesia, or in an emergency. A poorly executed intubation could cause complications that include an inability to open the airway or vocal cord injury.

Pugh's sensor technology can collect information during intubation training and give immediate feedback about how the procedure went, where it might have gone wrong and how long it took. Such data helps trainees, but also experienced clinicians who want to improve their skills.

Pugh also partnered with the Israel Institute of Technology to develop a fabric- force-sensor bra to capture clinical data during a breast exam. Since joining Stanford Medicine a year ago as a professor of general surgery and director of the Technology Enabled Clinical Improvement Center, Pugh has also collaborated with faculty members in the mechanical engineering and chemical engineering departments on advancing the technology.

In addition, she's working with colleagues in the Graduate School of Education, where she earned a PhD in education and technology in 2001, on incorporating the technology into training.

Pugh and her colleagues plan to engage industrial and systems engineers, social scientists and other experts to determine the best approaches to using the haptic data in training.

"Nationwide, trainees are telling us they want this information," Pugh said. "There's a lot more work to be done - but the audience is ready."

Photo by Timothy Archibald

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.

hannon-patty

Associate editor

Patricia Hannon

Senior associate editor Patricia Hannon helps edit Stanford Medicine magazine as well as the Stanford Medicine News Center; she is also a manager of special projects. She is a San Jose State University graduate in journalism and anthropology, and a Pulitzer Prize-winning journalist who joined Stanford Medicine in 2017 from The (San Jose) Mercury News and Bay Area News Group. She is an expert in digital publishing, newsroom operations and managing crisis communications, having navigated a Bay Area-wide team of breaking news editors, reporters and photographers through the organizational shift into a digital-first publishing model. In her more than 20-year tenure in newsrooms in the Bay Area and South Carolina, she managed teams covering a variety of topics including government, law enforcement, education, religion, health and natural disasters. A San Jose native and fifth-generation Californian, she enjoys live music, especially when her two musician sons are performing; hiking in the spectacular Bay Area parks; traveling with or to visit friends and family; and supporting the San Francisco Giants, win or lose.