• Vol. 34 No. 8, 499–504
  • 15 September 2005

An Intelligent Tutoring System for Trauma Management (Trauma-Teach): A Preliminary Report



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Trauma-Teach is an interactive software for tutoring surgical trainees on medical trauma management procedures. Users of the system interact with a virtual patient suffering from trauma injuries. The task of the user is to stabilise the virtual patient, discover the underlying injuries and decide on an appropriate management plan. Artificial intelligence techniques are used to simulate the patient’s pulmonary and cardiovascular systems in real time, determine the responses and results of treatments and diagnostics accordingly, model the patient deterioration if wrong actions are taken, and give a measure of reality to the system by selecting actual trauma cases from the hospital’s database.

In Singapore, trauma1-7 is the leading cause of hospitalisation and the fifth leading cause of morbidity and mortality.8,9 Common causes of trauma include road traffic accidents, industrial accidents, falls and recreational activities. In treating the trauma patient, it is essential that the processes of resuscitation and the identification of life-threatening injuries are carried out rapidly and accurately so that the injuries can be managed in a time-sensitive manner. Adopting the Advanced Trauma Life Support protocol and subsequent diagnostic and therapeutic adjuncts, a management plan should be arrived at quickly, preferably within the first 15 to 45 minutes of the patient’s arrival at the emergency department of the hospital. Knowledge of the pathophysiology of trauma, experience in the varied presentations of the multiply injured patient and the application of critical therapeutic procedures are crucial to this rapid decision making process and a successful outcome in managing such a patient. Teaching this decision making and management process in a manner that is safe to the patient yet appropriate to the training needs of the surgical trainee is difficult as time is short and there is no room for error in such situations. In order to overcome these shortcomings, several computer-aided instruction (CAI) packages or computer programmes that simulate trauma scenarios have been introduced.10,11 The drawback of these packages is that they generally lack the realism and variability seen in the clinical presentations of the trauma patients. As the scenarios are fixed in these programmes, repeated use leads to familiarity and training effectiveness is lost.

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