Online virtual world of resources and the cardiac anaesthesiologist.

“Morning will come, it has no choice” says Marty Rubin, a well-known philanthropist and spiritual guru. Every morning brings with it hope and promise. This moment becomes memorable, when we CONNECT with NATURE. Similarly, work will keep overflowing in the Cardiac Anaesthesiologists schedule. To keep us overflowing with joy and work, we need to CONNECT while learning and tasking with others. Communication amongst anesthesiologists becomes easy through a plethora of social networking sites, which integrate tools such as mobile connectivity, instant messaging, blogging, pictures/videos, websites, simulation, e-learning, and online reading materials on APPS [Figure 1] which all aid in sharing, facilitating information and disseminating for teaching and training it. To anesthesiologists today, online resources are a magic potion that insists on diversity – ranging from APPS to blogs to simulations.

Figure 1

The virtual anesthesiologist is in 2017's technologically most advances with a host of opportunities available to him/her

Simulation-based education is a rapidly developing method of supplementing and enhancing the clinical education of medical students.[1] Simulation takes many forms from simple skills training module to computerized full-body mannequins so that the need of learners at each stage of their education can be targeted. Simulation in health care provides many advantages – from freedom to error and learning from mistakes to customizing learning; it allows detailed feedback and evaluation and creates opportunities for deliberate practice of new skills without involving real patients. With technology being given a push by the government, anesthesiologists in India cannot be far behind! Simulation available to the anesthesiologists varies from that in hemodynamic monitoring, venous cannulation, pain blocks and crisis management in the operating rooms, echocardiography, extracorporeal membrane oxygenation, and difficult airway management [Figure 2] in cardiac surgical patients.

Figure 2

Advanced difficult airway care simulation[5]

Innumerable resources of the Internet are available as hot links on the World Wide Web for anesthesiologists.[2] High-end websites, offering high educational value for anesthesiology such as Cochrane Database, the US National Library of Medicine, Medline (PubMed), Google Scholar, and Research Gate provide a rapid flux of information. Interactive blogs, news groups/forums, society/associations and their journal with most of them now being on social media with APPS so that all are mobile/tablet friendly, is now top priority for any journal editor. This enhances visibility, and easy access is reached to millions. The University of Virginia (www.hsl.virginia.edu) has listed 72 titles in e-journals under the category of anesthesiology as top-rated journals. The top websites in cardiac anaesthesia includes SCA - Society of Cardiovascular Anesthesiologists (https://www.scahq.org), Annals of Cardiac Anaesthesia (www.annals.in), Journal of Cardiothoracic and Vascular Anesthesia (www.jcvaonline.com), EACTA (www.eacta.org), Cardiothoracic anesthesiology – Wikipedia (https://en.wikipedia.org/wiki/Cardiothoracic anesthesiology), pie.med.utoronto.ca/CA. However, the top ten sites in Cardiac Anaesthesiology are listed in Table 1 and includes APPS, journals, websites and books.[2]

Table 1

Top ten Cardiac Anesthesia sites

Anaesthesia and Analgesia (anesthesia – analgesia.org)

British Journal of Anaesthesia (bja.oxfordjoiurnals.org)

Cardiothoracic Anesthesiology (Thoracic) Cleveland Clinic (my.clevelandclinic.org)

The Online Resources - Duke Anesthesiology (anesthesiology.duke.edu)

Virtual Anaesthesia – Textbook.com (Virtualanaesthesiatextbook.com)

American Society of Anesthesiologists (asahq.org)

Annals of Cardiac Anaesthesia (ww.annals.in)

Journal of Cardiothoracic and Vascular Anesthesia (www.jcvaonline.com)

Cardiac Anaesthesia at Amazon (www.amazon.in/books)

Cardiothoracic anesthesiology – Wikipedia (https://en.wikipedia.org/wiki/Cardiothoracic anesthesiology)

Virtual Worlds for Learning and Practicing Critical Care Medicine

Cardiac anaesthesia and critical care medicine are a cohesive unit. The virtual world of e-learning technologies are based on massive, multiplayer, online gaming. They are three-dimensional (3D) virtual environments in which many participants can be electronically connected, so they can role-play, communicate, and interact in real time through the Internet.[3]

Virtual reality simulator systems have been developed for anesthesia and trauma management. These early systems enable individuals to learn and practice problem identification and remediation in compact disk-read only memory computer-assisted learning. Similarly, the Research Triangle Institute model implemented by Kizakevich et al. is based on the mathematic algorithms developed in The Body Simulation software by Smith.[4]

To an anesthesiologist, the 3D virtual game entitled “Pulse” which teaches resuscitation skills in an emergency room or “Air Medic Sky One” from the Netherlands which is all about teamwork and patient safety has created an enthusiasm about online learning among the residents. 3D computer graphics in echocardiography, in the real world with voice control are upcoming technologies that aim to enhance online team training and assessment.

This issue of ACA covers a host of original and review articles telling us about the advances made internationally and nationally in cardiac anesthesia such as “Stroke post TAVI” by Partha Thirumala, “Entropy for Cerebral oximetry” by Milo Engorgen, and Artificial Intelligence in mitral valve analysis by Feroze Mahmood et al. or the article from Japan on “Factors causing multiple ventricular arrhythmias during PAC catheterization” are all novel technologies which aim to radically alter the way, we will now proceed in cardiac anesthesia, in the years to come. “Patient Prosthesis mismatch” as a review by Kathirvel Subramaniam et al. and “modifying risks to improve outcomes in cardiac surgery” by Chakravarthy et al. are all neoteric trendsetters helping us move toward technical advancements. Great cooperation is needed between the game developers and medical educators so that only high-quality serious games are developed.

What we as anesthesiologists need now is a concerted effort to improve the quality of research and implement the existing new virtual online resources into appropriate learning processes among the trainees. With small steps, we hope to go a thousand miles into the “virtual journey of online resources.” Enjoy reading this issue of ACA on i-pad and android tablet apps.[5]