BACKGROUND: Surgical training is going high-tech. Using synchronized audio and life-size video, surgical students can be in a classroom and feel like they are in the operating room. The technology is being used at Barrow Neurological Institute in Phoenix, Ariz. Robert Spetzler, M.D., neurosurgeon and director of Barrow Neurological Institute, says the synchronized audio and video linkup between the class room makes intimate interactions possible like never before. "When they ask me a question, it’s not where I can’t see somebody that’s asking a question," says Dr. Spetzler. "I can actually make eye contact, and get a feel for the question, and it’s much more of a personal relationship." Steven Papadopoulos, M.D., is also an instructor at Barrow. "We really wanted to create a unique educational environment where the surgeon and the student would have a shared presence, without having to be in the same room, have an intimate dialogue between each other so they could share knowledge," says Dr. Papadopoulos. He says it’s remarkable for students to walk into a room and suddenly be part of the operating room. "But I can tell you from my perspective, it’s even more remarkable that I can walk into the operating room where I work, and all of a sudden, I’m in a classroom," he says.

TECHNOLOGY: This technology allows each student in the classroom to get an unobstructed view of the surgical field. In an operating room, those students would be crowded around the patient, each vying for the best view. Now, microscopic cameras highlight every nuance of the procedure for the students. Videoconference screens bring the students and the teacher face to face. "When you share presence, it’s a two way street, and it’s like you and me talking to each other, sharing our thoughts, sharing our insights, and that’s what we tried to create. To be able to create that seriously, you need pristine video, and you need pristine audio," says Dr. Papadopoulos.

OTHER USES: Dr. Spetzler says this kind of technology can be used for more than training new surgeons. It can also be used to facilitate surgical consultations from any location. "For somebody who is in another part of the world, where they are not exposed to the procedures, the technology, the nuances of what occurs here, it is a relatively inexpensive way to hook up and be in the operating room without flying all the way over here," says Dr. Spetzler. Dr. Papadopoulos says the uses are nearly limitless. "You can be in an environment where you need to bring in the expert to you in some rural setting, in some remote setting across the world, where you need to have an expert standing next to you in your operating room, giving you some advice, or in your emergency room bed, or next to the ICU bed, any number of environments," he says.

LIMITS: Dr. Spetzler says, while this technology is useful as a training tool, it is still not the same as actually being with a patient during surgery. "I don’t see this as the answer to modern medicine. I think this is one more step in our ability to train, to exchange information, that enhances, in the final end, the care of the patient," he says.