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

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

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