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891	Abschlussbericht VRmed - Virtual Reality in der medizinischen Lehre: Ein Projekt der Medizinischen Fakultät der Universität Leipzig, Referat Lehre, Bereich Medien Lachky, Alexander, Eckardt, Franziska, Stange, Ingmar, Schwarzer, Max-Philip 13 December 2021 (has links) The advance of digitization influences medical sciences in various areas, increasingly including medical education. Therefore the Teaching Department of the Medical Faculty of the University of Leipzig constantly considers new technical developments and their possibilities for use in medical teaching. The focus is on the fact that teaching should be supplemented and explicitly not replaced by digital media. Virtual reality (hereinafter referred to as 'VR') represents a technology that can be expected to offer promising potential. In order to determine to what extent VR represents an added value for the study of human medicine and which hardware and software is suitable, the project VRmed – Virtual Reality in Medical Teaching was initiated in the Media section of the Teaching Department of the MF. This was funded as part of the Digital Fellowship Program by the University Didactic Center Saxony and the Working Group E-Learning of the LRK Saxony. The present report represents the final report of the project, which was created on its own initiative. In order to investigate the question of implementation possibilities for medical studies, four VR glasses (three different models) and four VR applications were purchased. Two simulation applications and two anatomy applications were selected as applications. The former are i:medtasim and StepVR applications. In addition, the anatomy applications 3D Organon VR Anatomy and Medicalholodeck were purchased. The initially extensive multi-stage evaluation with lecturers and students could not be implemented in 2020/2021 due to the pandemic-related restrictions and was therefore only applied in limited extent. Thus, hardware and software were evaluated qualitatively and in depth in the context of three presentation events by lecturers and media didactics. In particular, the simulation applications are considered to be helpful and useful extensions for teaching. The anatomy application 3D Organon VR Anatomy could also be used profitably in medical studies, especially in the early semesters. With regard to i:medtasim, there are initial considerations to include this in the curriculum as part of a medical elective. Another perspective is the establishment of a VR lab in which students and lecturers can freely use the technology. It should also be noted that VR is associated with many technical challenges and both the setup and the first use require expertise. In addition, the purchase is cost-intensive and hardware and software develop very quickly. Nevertheless, the potentials and the added value predominate. VR can be used to meet a wide range of learning types, practice scenarios bridge the gap between theory and practice, and students and lecturers can connect to technical developments.:1. Einleitung 2. Theoretische Hinführung 3. VR an Medizinischen Fakultäten und Universitäten außerhalb des Standorts Leipzig 4. Projektbeschreibung VRmed – Virtual Reality in der medizinischen Lehre Leipzig 5. VR Hardware und Software für den medizinischen Einsatz 6. Evaluation 7. Fazit und Ausblick 8. Literaturverzeichnis 9. Online-Quellen Anhang A) Projektstrukturplan B) Zeitplan C) Poster D) Evaluationsprotokolle / Das Voranschreiten der Digitalisierung beeinflusst die Medizin in verschiedenen Bereichen, weshalb deren Relevanz auch im Medizinstudium zunimmt. Daher werden im Referat Lehre der Medizinischen Fakultät der Universität Leipzig stetig neue technische Entwicklungen und deren Möglichkeiten für den Einsatz in der medizinischen Lehre betrachtet. Im Fokus steht, dass die Lehre ergänzt und explizit nicht durch digitale Medien ersetzt werden soll. Virtual Reality (im Folgenden „VR“) stellt dabei eine Technologie dar, die in der ersten Auseinandersetzung vielversprechende Potentiale erwarten lässt. Um festzustellen, inwiefern VR einen Mehrwert für das Humanmedizinstudium darstellt und welche Hard- und Software dabei in Frage kommt, wurde im Bereich Medien des Referats Lehre der MF das Projekt VRmed – Virtual Reality in der medizinischen Lehre initiiert. Dies wurde im Rahmen des Digital Fellowship-Programms vom Hochschuldidaktischen Zentrum Sachsen und dem Arbeitskreis E-Learning der LRK Sachsen gefördert. Der hier vorliegende Bericht stellt den Abschlussbericht des Projektes dar, welcher aus Eigenantrieb erstellt wurde. Um der Frage nach Implementierungsmöglichkeiten für das Medizinstudium nachzugehen, wurden vier VR-Brillen (drei verschiedene Modelle) und vier VR-Anwendungen angeschafft. Als Anwendungen wurden zwei Simulationsanwendungen und zwei Anatomieanwendungen ausgewählt. Bei ersterem handelt es sich um die Anwendungen i:medtasim und StepVR. Zudem wurden die Anatomieanwendungen 3D Organon VR Anatomy und Medicalholodeck eingekauft. Die zunächst umfangreich angelegte mehrstufige Evaluation mit Dozierenden und Studierenden konnte aufgrund der pandemiebedingten Einschränkungen in den Jahren 2020/2021 nicht umgesetzt werden und wurde eingegrenzt. Somit wurde Hard- und Software im Rahmen von drei Präsentationsveranstaltungen von Dozierenden und Mediendidaktiker:innen qualitativ und tiefgehend evaluiert. Insbesondere die Simulationsanwendungen werden als hilfreiche und sinnvolle Erweiterungen für die Lehre eingeschätzt. Auch die Anatomieanwendung 3D Organon VR Anatomy könnte im Medizinstudium, insbesondere in die frühen Semester, gewinnbringend eingesetzt werden. Bezüglich i:medtasim existieren erste Überlegungen, dies im Rahmen eines humanmedizinischen Wahlfachs in das Curriculum einzubinden. Eine weitere Perspektive ist die Etablierung eines VR-Labs, in dem Studierende und Dozierende die Technik frei nutzen können. Es bleibt auch festzuhalten, dass VR mit vielen technischen Herausforderungen verbunden ist und sowohl das Einrichten als auch die erste Nutzung Expertise bedürfen. Zudem ist die Anschaffung kostenintensiv und Hard- und Software entwickeln sich sehr schnell. Dennoch überwiegen die Potentiale und der Mehrwert. Durch VR kann vielfältigen Lerntypen begegnet werden, durch Übungsszenarien wird eine Brücke zwischen Theorie und Praxis geschlagen und Studierende wie auch Dozierende können an technische Entwicklungen anschließen.:1. Einleitung 2. Theoretische Hinführung 3. VR an Medizinischen Fakultäten und Universitäten außerhalb des Standorts Leipzig 4. Projektbeschreibung VRmed – Virtual Reality in der medizinischen Lehre Leipzig 5. VR Hardware und Software für den medizinischen Einsatz 6. Evaluation 7. Fazit und Ausblick 8. Literaturverzeichnis 9. Online-Quellen Anhang A) Projektstrukturplan B) Zeitplan C) Poster D) Evaluationsprotokolle info:eu-repo/classification/ddc/610 ddc:610
892	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

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Abschlussbericht VRmed - Virtual Reality in der medizinischen Lehre: Ein Projekt der Medizinischen Fakultät der Universität Leipzig, Referat Lehre, Bereich Medien

Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital