Web-Based Surgical Telementoring. Service design and evaluation of the key features.

Abstract

This thesis provides a detailed outlook on research in telementoring, identifying the fundamental limitations hindering its smooth integration into clinical practice. The findings are based on literature reviews and user involvement, minimizing the gap between research and actual use of the system. To address the identified shortcomings, a service-oriented approach to clinical VC systems was proposed. The implementation was validated through non-clinical experiments regarding the published quality indicators and assessing the readiness of the web technologies supporting the selected workflow. The developed theoretical models visualized the relations between the clinical and educational outcomes of telementoring, defining the methodology for the PhD project. The proposed measurement procedures were followed throughout the studies evaluating the usability of telementoring-capable hardware to ensure that sufficient qualities of mentoring are maintained regardless of the employed infrastructure. The findings demonstrated the feasibility of end-user hardware-agnostic mentoring and provided insights on the influence of the input method on the mentoring process. A highly rated telestrator capacity was investigated to quantify its impact on the mentoring process. The potential for enhancing collaboration between mentors and mentees was studied, and unexpected findings were collected. Minor quantitative improvements and side effects encourage further exploration of collaboration techniques for surgical supervision. This thesis provides in-depth knowledge on the development and deployment of surgical telementoring systems following international regulations and keeping patient safety concerns a top priority. This project aimed to unite the fragmented research on surgical telementoring, bridging technological and clinical perspectives. It brought the best computer science practices into a field mostly dominated by clinical expertise. It stressed the importance of a reusable large-scale infrastructure, delivering sound and comparable clinical research; this is in contrast to the current body of knowledge, which is overwhelmed by highly restrictive and underpowered studies. Research contributions achieved in the scope of this PhD thesis are aligned with national regulations for introducing a safety-critical system into clinical settings. The findings contribute to approving the telementoring service as a medical device to proceed with clinical evaluation.