Basic Building blocks of Surgery(BBOS)

Our module teaches the psychomotor skills of exploratory laparotomy to novice surgical practitioners.

Our module comprises a smartphone application and a suite of low-cost technologies for bridging the gap between this application and the physical world to enable self-assessment.

The application will provide access to open source designs to produce the equipment required for this module. It will also allow users to purchase, rent and/or loan the equipment.

The content will be built from a repository of existing, video-based training material. This content will be enriched with interactivity to incorporate the self‑assessment technologies.

In addition to existing e-learning-based self-assessment technologies, our module will include: augmented reality, still and video image analysis, speech-recognition and “smart” surgical models and instrumentation to bridge the gap between the real-world and the smartphone application thereby enabling self-assessment.

We plan to implement these same technologies in other skills development modules in later phases of development.

The module takes an existing repository of training videos and replaces the real-world trainer with a suite of real-world-to-application bridges that enable self-assessment-based psychomotor skills development.

The module will comprise a smartphone application and equipment including surgical instruments and consumables, one-or-more training models, and, optionally, additional low-cost sensors and cameras.

The application will enable the user (individual or institution) to access designs for the construction of the equipment where possible, and the option to purchase/rent/loan the equipment.

The smartphone camera will the primary real-world-to-application bridge.

The models and instruments will be enhanced with low-cost image recognition targets that will allow the user (with a partner if necessary) to capture stills/video of their training to enable machine-learning-based the assessment of metrics such as hand position, tissue stretch and position, and economy of movement.

Augmented reality will be used to allow learners to overlay training images/video with their own work. These overlays can be computationally assessed, and learners may additionally assess their own performance.

Voice recognition will be used to assess the learner’s ability to verbalize psychomotor steps.

Low-cost Bluetooth devices will be mounted to surgical instruments and transmit the instrument position and state (e.g. open/closed) to the application for analysis.

The module will teach the building blocks of surgery required to perform a safe laparotomy and closure in a modular fashion. This includes laparotomy, incisions, tissue manipulation and suturing.

The scope of this will be expanded as we progress through the competition to include first the management of common laparotomy emergency findings and later to other Global Surgery Bellwether procedures and the associated prerequisite surgical skills.

In its initial format, our project serves health care practitioners required to carry out laparoscopic surgeries in resource constrained environments. Longer term, as we apply our self-assessment technologies to other modules, we envisage our project providing surgical training to a broad spectrum of the Bellwether procedure practitioners.

We acknowledge that there is a spectrum of resource constrained environments and we intend to have our application automatically adapt to the equipment available to each user. That said, we have set a baseline requirement of access to a smartphone (a highly cost effective and accessible technology platform) and periodic internet access.

Our team has extensive experience developing training material and programs globally and has direct access to surgical trainers and practitioners across the skills spectrum. The project is focused on converting proven training programs into the self-assessment format and has been and will continue to be based on engagement with these experts from across the education ecosystem.

• Damon Bizos - Surgical gastroenterologist and with an interest in medical education and skills training.
• Raphael Smith - Biomedical, mechanical, electronic and software engineer.
• Heidi Wilson – Biomedical and mechatronics engineer.
• Carol Hartmann - Anatomist with a special interest in blended education.
• Christos Profyris - Specialist neurosurgeon with an interest in skills teaching.
• Tamsanqa Mazibuko - Orthopaedic surgeon with interest in pelvic trauma.