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Pakistan-US Science and Technology Cooperation Program                                                            
Phase 2 (2006 Deadline) 

Establishment of Virtual Trainer Lab for Improving Minimally Invasive Surgery Skills of Post-Graduate Trainees and Faculty of the Surgery Department of Rawalpindi Medical College and Allied Hospitals
*and* Multitasking of Telemedicine/E-health Training Center

Ronald Merrell, Virginia Commonwealth University, Richmond
Asif Zafar Malik, Holy Family Hospital, Rawalpindi
Pakistani Funding (MoST):  $270,000
US Funding:   $213,000
Project Dates: March 1, 2007 - March 31, 2011

Project Overview

This project included two separate but related components aimed at building Pakistani capacity in the healthcare sphere. The first involved laparoscopic or minimally invasive surgery, which has become very popular in the last 15 years. Because many operations that were once performed “open” are now done almost exclusively laparoscopically, skills training in this area is becoming necessary for many surgical subspecialties. The current goal of simulator training is to help trainees acquire the skills needed to perform complex, minimally invasive surgical procedures prior to practicing them on living patients. Unfortunately, minimally invasive surgery training facilities were previously unavailable in most of the teaching hospitals of Pakistan. During this project, a virtual training laboratory has been established at Surgical Unit II, Holy Family Hospital (HFH), in collaboration with the Medical Informatics and Technology Applications Consortium at Virginia Commonwealth University (VCU). The lab, which includes box trainers, virtual reality simulators, and full procedural simulators, is now being used to train surgical residents. The operating rooms and training lab have been linked together and also to minimally invasive training centers in the United States.

The second project component focused on expanding an existing joint telemedicine training program at HFH. Pakistan is one of the most densely populated countries in the world, but the doctor-to-patient ratio is only 1 to 1,555, and there is just one specialist available for every 15,000 citizens. Moreover, the majority of the population resides in rural areas, while medical facilities are concentrated in the urban areas. One solution to bridge this rural-urban disparity is to build new hospitals in rural areas and send specialists to those areas, but this is difficult for a variety of reasons. The other feasible solution is using telemedicine to address the limited availability of specialists at remote sites. The implementation of telemedicine requires health professionals trained in this field, which was previously unknown in Pakistan. In 2003, the partners involved in this project received a grant under the Pakistan-US Science and Technology Cooperation Program in its previous form to provide telemedicine training to medical personnel in Rawalpindi and Islamabad. During that six-month project, 45 doctors and nurses from various institutions were trained, and they are now pursuing telemedicine projects in their own institutions. During the current project, medical personnel from throughout Pakistan were trained at the telemedicine/E-health training center established at HFH. In addition, this facility is being utilized to provide telemedicine training and tele-rehabilitation services to paraplegic victims of the October 2005 earthquake.

Major Results

  • Established a virtual training laboratory at HFH that allows Pakistani surgeons to learn and practice minimally invasive surgical procedures on simulators before operating on real patients
  • Provided training to medical personnel from throughout Pakistan at the telemedicine / E-health training center
  • Worked with the Pakistani Ministry of Information Technology to extend satellite connectivity for telemedicine activities to 15 districts in Pakistan
  • Led to the development of public - private partnership 

Progress Report Summaries

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