146 - BodySim: An Interactive Virtual Simulator for Clinical Musculoskeletal Anatomy Education

Poster Board Number: 146
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : INTRODUCTION:
Despite the high prevalence of musculoskeletal issues comprising medical visits, concerns have been raised regarding the inadequacy of clinical musculoskeletal training during medical school. This was reflected in a comparison study of U.S medical students’ Step 2 Clinical Skills scores by Peitzman and Cuddy, where scores were worse on physical examination compared to history-taking sections, with scores noted to be particularly weaker in musculoskeletal domains. To aid with musculoskeletal education, extensive resources have been developed ranging from textbooks, websites, videos, to three-dimensional (3D) anatomy mobile apps. However, these resources are often limited as they focus on either anatomy or pathology, and highlight the need for a more centralized learning resource. For example, 3D anatomy mobile apps and anatomy textbooks provide information regarding musculoskeletal anatomical structures, however, they do not focus on clinical presentations and pathology. Videos demonstrating physical examinations highlight clinical presentations and pathology, however, are often limited in visualizing the underlying anatomy. To address this lack of a comprehensive learning resource in clinical musculoskeletal anatomy education, we developed an interactive virtual simulator for learning clinical anatomy while practicing physical examinations of the lower extremities.

METHODS:
We used a 3D anatomy asset purchased from the Unity Asset Store as the base of our 3D model. We made modifications and added further structures using Blender, which is an open-sourced 3D modeling software. The interactive simulator was developed using Unity, a game engine for developing real-time 3D content.

RESULTS:
An interactive virtual simulator was developed for lower extremity musculoskeletal education. The design of the simulator follows the standard stages of musculoskeletal physical examination: inspection, palpation, range of motion, and special tests. Users are able to rotate and zoom in and out on structures of interest, as well as click on structures to learn about the attachment, innervation, and functions of the muscles. Clicking on structures reveals tenderness or swelling. Dragging limbs indicate passive range of motion and users can elicit commands for active range of motion and special tests. These functionalities are combined to present both normal and pathological states in multiple cases where users can perform a virtual physical examination to identify the leading diagnosis.

CONCLUSIONS:
BodySim is an interactive virtual simulator that provides a comprehensive resource for learning both the anatomy and pathology of lower extremities in the context of physical examination. To the best of our knowledge, BodySim is the first virtual simulator specific to teaching musculoskeletal physical examination and can serve as a foundation for development of further centralized resources for clinical anatomy education.