School of Graduate Studies

School of Graduate Studies
School of Graduate Studies

Matthew Holden

Ph.D Student, School of Computing

Matthew Holden

Matthew Holden, Link Foundation Fellow, working on 3D guidance methods for simulation-based training in ultrasound-guided needle placement.

Link Foundation Fellowship comes to Queen's for the first time in Canada

by Natalia Mukhina, June 2017

Matthew Holden, a PhD Student at Queen’s School of Computing, has become the first Canadian recipient of the Link Foundation Fellowship in Modeling, Simulation, and Training. His research has been recognised as a perfect fit in the context of the Link Foundation’s mission to support promising, innovative, and well-designed projects in the founders’ fields of interests.

Established in 1953 by Edwin Link, inventor of the flight simulator, and his wife Marion, the Link Foundation bestows the awards in three major areas - energy, simulation, and ocean engineering and instrumentation research - to support doctoral students who demonstrate leadership and excellence in their respective fields. Fellowships are only available to students enrolled at U.S. or Canadian universities.

Matthew Holden investigates ways to assess medical trainees’ competence and to provide them with automated feedback in the process of simulation-based training for ultrasound-guided interventions. As part of the Laboratory for Percutaneous Surgery (the Perk Lab), Holden is doing research within an interdisciplinary environment, at the intersection between certain scholarships, such as computing, education, and medicine.

“Over the last few years the medical schools have been shifting from a time-based model of medical education to a competency-based model,” says Holden.

The time-based model assumes that a trainee practices procedures for a fixed amount of time. “This framework implies that the trainee is told, for example, ‘Practice this for one week’, and at the end of the week the trainee is considered competent. However, in real life things are not so simple,” Holden emphasizes. “A competency-based model means that you have to practice the procedure until you have reached both a cognitive and technical competence benchmark.”

How should the competency of the trainees be assessed to let them progress to real patient encounters? “This is the core question of my research,” responds Holden. “In theory, we can have an expert who stands over your shoulder and watches what you are doing. Unfortunately, it is not feasible for many reasons. Alternatively, there is an option to automate the process of assessment. We can use recent medical imaging and tracking technologies to help assess these trainees automatically and relieve the burden on the experts.”

Those technologies can also be used to guide trainees through the procedure and provide them with objective feedback after the training is over. “The system will tell them, for example, ‘You scored well on this, and you can perform better by taking these steps.’ We also will use a monitor or a holographic display to visualize the anatomy and show trainees what is going on under the skin.”

Some of the technologies developed in the Perk Lab have already been adopted at the Clinical Simulation Centre at Queen’s; however, getting the training system integrated into the actual training setting may be challenging due to the guidelines associated with medical training. “There are already a lot of frameworks and guidelines about how medical personnel should be trained and the competencies they should achieve. Researchers in the field need to think about that when designing training systems.”

Holden credits his colleagues, speaking gratefully about the supportive and encouraging atmosphere in the Perk Lab. “Computers are nice because they behave predictably. You tell them to do something, and they do something,” Holden says while smiling. “But the key is that we can work together in the lab. We have a great team with diverse skills and act collaboratively.”

Holden prefers to use ultrasound as a big imaging modality for many reasons. “While operating with ultrasound you can act in real time, see images immediately, and guide some medical instruments like a needle to a particular target. Ultrasound is not harmful to a patient and not expensive. Yet, I am trying not to be short-sighted. Perhaps in 10 years there will be another imaging modelling that will be even better than ultrasound. New applications are always developing, and researchers in the field will always have new things to train people for.”

In conclusion, Holden walked with me around the lab and showed me some equipment and tools which he uses for doing research. I could manipulate the ultrasound probe on the patient simulator and tried to interpret the images on the monitor. I felt like a medical student while simulating an ultrasound-guided biopsy on the tissue-mimicking phantom. According to Holden, the components of the training system will remain configurable and adaptable to new technologies. “Maybe tomorrow someone invents a new procedure to treat some cancer or other critical disease. With such a system, we will be able to train people to do that new treatment very quickly,” Holden concludes. 

Group of people standing for a photo.

PerkLab members.