No one wants their surgeon to learn on them.
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In the past, surgeons practiced on animals and fruit:
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“As recently as five to 10 years ago, we bought chicken feet from grocers in Chinatown markets and had our residents practice techniques of tendon repair by suturing chicken flexor tendons,” says Dr. Donald Bae, an orthopedic surgeon at Boston Children’s Hospital.
He said the tendons in chicken feet aren’t easy to get to, but once you find them, they feel a lot like human tendons. Plus, they’re super cheap.
But today, 3D printing, realistic mannequins, and virtual reality are transforming how surgeons learn. Last summer, the University of Tennessee College of Medicine in Chattanooga became the final medical school in the U.S. and Canada to stop using live animals to teach surgical skills to students.
Instead of live pigs, UTC surgery students will practice on surgery simulators that mimic the organs and skin of human bodies, complete with bleeding, breathing, and blinking.
Below we’ll discuss the benefits of surgery simulators and give you four options for free surgery simulators to get you started.
The benefits of surgery simulators
From trainee surgeons to established surgeons learning a new technique, a surgery simulator is an excellent way to learn in a low-risk environment. Training with simulators reduces accidents.
According to the Institute of Medicine, every year 44,000 to 98,000 people die due primarily to medical mistakes.
Studies have shown that students using simulators perform better and retain more of what they learned than their colleagues who use more traditional methods of medical training. In fact, in one test of medical proficiency, the 20 students who used high-tech simulators vastly outperformed the students who used traditional training.
Another study showed that simulators are effective at helping students learn laparoscopic suturing “through repetitive practice in a non-threatening environment” before they practice on patients.
Compared to older methods, training with a simulator:
- Costs less
- Is faster
- Requires fewer staff members
- Requires less staff time
- Prevents more medical accidents
Types of surgery simulators
Most surgery simulators fall into one of two categories: mannequins and screen-based simulators:
Mannequins
Mannequins are also called trainers (or Human Patient Simulators by simulation company METI). These can be full-body mannequins or just part of the body, and can include lungs, airways, vascular systems, lumbars, and pelvises.
Mannequins are great because they offer haptic feedback. When you’re really holding a scalpel and cutting into something that feels like a body, you learn what that feels like.
Several studies have tried to determine whether haptic feedback really helps a simulator teach laparoscopic suturing. Some showed some difference but others showed no significant difference.
Screen-based simulators or simulations
The other kind of surgery simulator is a screen-based surgery simulator. This can be combined with a mannequin, as one learns laparoscopic suturing, for example.
What the student sees: A screen that resembles what they’d see on a real laparoscopic surgery. What the student feels: Their hands work with real tools on a mannequin. (Source)
Combining visual simulation with force-feedback technology allows a surgeon to experience both kinds of feedback when practicing. TechCrunch points to companies like ImmersiveTouch and Medical Realities as providers of “cutting-edge simulators.”
One huge advantage screen-based surgery simulators have over mannequins is that they can automatically, consistently, and objectively measure the surgeon’s performance and proficiency gains over time and can track global statistics for medical simulators linked together.
Screen-based simulation has come a long way. A screen-based simulator for lower gastrointestinal endoscopy training was shown to help the surgeons who used it perform better and lower their patient discomfort scores in live colonoscopies.
Another example is virtual-reality-based surgery simulators. VR-related research articles in the Pubmed database have exploded over the last 10 years, from 204 publications in 2004 to 720 publications in 2014. Some studies show VR simulators are as effective as box trainers in teaching laparoscopic suturing.
For companies creating VR training simulators for healthcare professionals check out Next Galaxy and VR HealthNet, zSpace, OramaVR, and SimX.
Free screen-based surgery simulators
1. Touch Surgery
Touch Surgery is a free app available for download in the Google Play and iTunes stores.
After choosing your position (attending surgeon, trainee surgeon, etc.), you choose your specialty: ear, nose, and throat, emergency, cardiology, etc.
I said I was a trainee specializing in emergency surgery.
Then you can choose your lesson. To test, I chose chest tube insertion.
Once I downloaded the lesson, the helpful tutorial walked me through how to use it. For the chest tube insertion, first the app asks you which position you could put the patient in. I guessed at random because I am not a doctor. When I finally guessed right, the app asked me what I should do next. This was the fun part. After a hint, I used my finger to drag the patient’s hand to behind his head. You drag and draw and drape and cut with your finger until the surgery is done.
An example of Touch Surgery’s animations (Source)
Correct choices and swipes win you points, while incorrect ones cost you.
At the 2017 Consumer Electronics Show (CES), Touch Surgery teased new augmented reality content. Augmented reality is where you look at a screen that’s showing real life in real time through a camera lens, but with images and text overlaid on the screen. Think “Pokemon Go.” This screen can be a phone, tablet, glasses, or goggles.
For surgeons, augmented reality could mean tips and instruction displayed alongside a patient. Imagine a surgeon picking up the wrong instrument or forgetting a step and an alert flashing on their screen. Or a surgeon getting an objective report at the end of surgery telling them what they could do better next time.
2. Surgery Squad
Surgery Squad is a free browser-based Adobe® Flash® Player game. Like Touch Surgery, you can choose from a variety of surgeries and the game takes you through each stage of surgery.
Surgery Squad screenshot (Source)
But whereas Touch Surgery is a tool that can help you practice, Surgery Squad is more like a game you play to review the steps to a surgery. You don’t really make any choices or demonstrate any skill in this game. A voiceover tells you what you’re going to do next, then a giant arrow tells you where to click. There are no points.
3. Buckingham Virtual Tympanum
Screenshot from the Buckingham Virtual Tympanum app (Source)
The Buckingham Virtual Tympanum iPhone app had a prestigious introduction, through a report titled “Interactive iPhone/iPad App for Increased Tympanic Membrane Familiarity” by Sheena Samar, MD et al.
It’s a free iPhone app that teaches users the anatomical details of the tympanic membrane (TM), an inner-ear structure. First the students review the structure by viewing photos of the TM taken with an operating microscope. Then they answer a series of problem-based questions to familiarize them with the normal structure and also any abnormalities. According to iMedicalApps, the study found that using the app correlated strongly positively with higher test scores.
4. Operate Now
While nowhere near as educational as Touch Surgery, Operate Now is a free game that lets your practice very condensed surgeries while at the same time growing a hospital by taking good care of nurses, patients, and other staff. Gaming Cypher gave it 8.5/10 stars, describing the game’s pacing as “nothing less than perfect.”
A screenshot from Operate Now (Source)
Touch, Tap, Play writes that “The comic book-style presentation adds a lot of style and character to it, and it’s quite exciting to follow along.”
One more free surgery-related app to know about
Rapid Recovery is an iPhone app that helps patients undergoing surgery have a better experience and hospitals to improve their processes. If you recommend that patients download the app right after diagnosis they’ll have a chance to learn more about their condition. It also offers patients a checklist of the steps they need to take to prepare for surgery. And the steps they should take, and not take, to speed along their recovery.
Along the way, Rapid Recovery reports on activity and outcomes and sends the anonymous data back to the hospital so you can use it to inform your process improvements.
Are you using surgery simulators?
![Software Software](/uploads/1/2/6/3/126354458/186529867.jpg)
There have never been more ways, or better ways, to learn surgery than there are today. From realistic mannequins to virtual reality, suturing chicken flexor tendons is no longer necessary.
Did I miss any great free surgery simulators in this post? If so, let me know in the comments.
Looking for Medical Practice Management software? Check out Capterra's list of the best Medical Practice Management software solutions.
If you want to run Windows on your Mac there are two ways to do it. One is to partition your main drive using the built-in Bootcamp Assistant and then install Windows on the partition that doesn’t house macOS. You can then boot into whichever operating system you choose.
While that method means running Windows natively and so is optimal in terms of performance, it means you have to reboot every time you want to move between operating systems and you can’t, for example, copy and paste between macOS and Windows. If you want to run Windows and macOS side by side, you’ll need to create a Windows virtual machine for Mac.
What is a virtual machine?
A virtual machine (VM) is a computer that’s created in software and looks and feels just like a real PC. But it runs inside a Mac application. The whole virtual machine, with the operating system and all its applications, is stored inside one big file on your Mac. That means you can have multiple virtual machines on the same Mac. Once you launch it and ‘boot’ the virtual PC, Windows VM on Mac behaves like any other Windows machine, except that it’s running inside a window on your Mac.
If you have two screens connected to your Mac, you can have macOS on one and Windows on the other. Or you can use Mission Control to swipe between them. A virtual machine can share accessories like printers and external storage with your Mac, and you can copy and paste between the two operating systems. You can even set up the virtual machine to use Mac keyboard shortcuts instead of their Windows equivalents.
Can I run a virtual machine on my Mac?
As long as your Mac has an Intel processor (and it will have unless it’s more than 12 years old), in theory it can run a virtual machine. However, running a virtual machine alongside macOS needs lots of memory (at least 8GB in total, and more if you want to run more than one virtual machine) and at least two processor cores. You’ll also need at least 16-20GB of hard drive space, and that’s before you start installing applications and saving files. Most modern Macs should run any of the virtual machine applications described here without a problem.
The other thing you’ll need is a copy of Windows. Virtual machine applications don’t come with Windows installers, so you’ll need to supply your own, along with a licence key.
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Best virtual machine software for Mac
There are three contenders here: Parallels Desktop, VMWare Fusion, and VirtualBox. We’ll discuss Virtual Box in the next section.
Parallels Desktop 13
The latest version of Parallels Desktop has support for features in the latest Macs, like the MacBook Pro’s Touch Bar. It also allows you to make the Windows desktop ‘invisible’ when you’re running apps, so it looks like you’re just running Windows apps in macOS. Or, if you prefer, you can shrink Windows desktop down to a thumbnail preview, so it doesn’t get in the way but you can keep an eye on what it’s doing.
Of course, virtual machines aren’t just about running Windows on your Mac. Parallels Desktop allows you to install Linux, or a different version of macOS, say a beta of the next version if you don’t want to install it on your Mac. If you’ve previously installed Windows on a Boot Camp partition, you can use that partition as a virtual machine, allowing you to boot into it from within Parallels without re-booting your Mac.
Touch Bar support includes functions in Microsoft Office apps, as well as Windows Task Bar.
When it comes to performance, Parallels Desktop is about as good as it gets for virtual machines. That means you can run most applications just fine, but demanding 3D graphics-intensive games, and other apps that place lots of demands on the CPU and GPU are still a bit of a struggle. If you want to run those in Windows, you’re still better off using Boot Camp.
VMWare Fusion
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The other main contender when it comes to running a virtual machine on your Mac is VMWare Fusion. It comes in two versions, Fusion 10, which costs about the same as Parallels Desktop, and Fusion 10 Pro, which is more expensive but adds feature aimed at enterprise customers, such as support for managing virtual servers.
In terms of features, there’s little to choose between Parallels Desktop and Fusion. Like its rival, Fusion allows you to choose between running Windows inside a window on your Mac (or full-screen if you prefer) and in what it calls Unity mode, where the operating system disappears and Windows apps look like they’re running natively on the Mac. That means you can run Windows and Mac apps alongside each other and switch between them seamlessly. You can also copy and paste between Mac and Windows, share peripherals, and map Mac keyboard shortcuts in Windows.
Support for OpenGL and DX10, as well as Apple’s Metal technology means that playing resource-hungry games is theoretically possible. But, as with Parallels, performance in the latest games lags behind Boot Camp and may prove frustrating.
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The latest version of Fusion adds support for the MacBook Pro’s Touch Bar.
Choosing between Parallels Desktop and VMWare Fusion may be as much a matter of a preference for one or the other’s user interface. They have very similar features, and cost almost the same. Fortunately, both offer free trials — Parallels for 14 days and Fusion for 30 days — so you can download each one and try them out before making a decision on which to buy.
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Best free virtual machine software for Mac
If you want to run a virtual machine on your Mac but can’t stretch to the $70 for Parallels or Fusion, there is a third option — VirtualBox. Owned by Oracle and made available as open-source software for personal or educational use, VirtualBox won’t cost you a penny if you fall into either of those two categories.
That’s the good news. The bad news is that VirtualBox, because it’s open source and free lacks all of the polish of Parallels Desktop and VMWare Fusion. While it does the basics competently, it’s much less user friendly and much less easy to use than the other two. And while there is help available online from other users, there’s no official support if you run into problems. And remember, while VirtualBox itself is free, you’ll still need to supply your own copy of Windows. Alternatively, you could use VirtualBox to run Linux on your Mac, instead of Windows.
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Alternatives to a virtual machine
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As we mentioned earlier, the alternative to running a virtual machine on your Mac is to partition your main drive using the built-in Boot Camp Assistant (it’s in the Utilities folder). You can then install Windows or Linux, or another version on macOS, on the other partition.
Boot Camp Assistant is very easy to use and once you’ve set it up, booting into, say, Windows, is just like using it natively on a PC. That means, of course, that you won’t be able to copy and paste between Mac and Windows, and you won’t be able to use external storage that’s formatted in APFS or Mac OS Extended, but Windows will run faster than it does on a virtual machine.
If you plan to use Boot Camp Assistant to partition your main drive, remember to back it up first. Partitioning a drive is not quite major surgery, but it definitely carries the risk of losing data.
How to make space for a virtual machine on your Mac
Depending on how many applications you plan to install on your virtual machine and what you plan to use it for, you may need tens of gigabytes of free space on your Mac. If space is tight, don’t worry, there’s plenty you can do to make room. As a first step, we recommend installing CleanMyMac X. It scans your Mac and looks for files that can be safely deleted. These include “junk” system files like cache files and other temporary files that are still hanging around, as well as language support files, and data in Photos and iTunes you may not need. Once it’s scanned your Mac and found all those files, you can delete them all with a click, or review the results of the scan and decide for yourself what you want to trash.
CleanMyMac can also uninstall files completely, getting rid of all the files that are left if you just drag and app to the Trash, and highlight large and old files that you haven’t opened for a while. Best of all, you can download it free here and give it a try. You’ll be surprised about how much space you can free up.
Virtual machines are the most convenient way of running a second operating system on your Mac. The ones we have highlighted here are the best VMs for Mac, so download one and give it a go.