[[alternative]]Assess the Effectiveness of Gesture-based Evaluation in Wearing Isolation Gown

[[abstract]]感染防治是當今醫學重要的課題之一，而正確的穿戴個人防護裝備是最基本的必修技能。利用影像識別技術來協助檢測個人防護裝備是否被正確穿戴可以減低人力成本並落實感染防治，但卻很少被研究。在這裡我們執行了一個研究來探討以體感技術協助正確穿脫隔離衣的可行性，並分析其問題及限制，並評估成效。28位護理人員被納入研究，並在體感偵測儀器面前執行穿脫隔離衣。我們採用基於手勢系統，因為其可近性及較低的成本。基於手勢系統可偵測關節骨架的位置變化，適用於以大動作為主的穿脫隔離衣程序。我們將整個穿脫隔離衣的過程細分成數個動作程序，並設定其關節動作的範圍及時間，用以當作判別穿戴正確性的標準。每位受測者的動作均會完整錄影，並進行事後之專家檢驗，來跟Kinect系統的判定結果做交叉比對及分析。實驗結果發現Kinect判定與專家判定有不錯的相符性，即專家檢驗與Kinect偵測皆通過與不通過為16人，佔總數之57.1%。在不相符之處有四個主要導致偵測偏差的問題，分別是(1)Kinect偵測敏感性不足，導致受測者重複程序動作，(2)Kinect提早偵測受測者程序動作，(3)受測者未確實執行程序動作，及(4)受測者執行程序動作Kinect偵測逾時。在研究觀察中，我們亦發現體感偵測技術能提升受測者學習的動機，並引發其學習興趣。我們結論認為基於手勢系統可以成功地用來識別穿脫隔離衣正確性的學習評量工具，並納入感染防治體系內。其具有引發學習動機及興趣的優點，但於動作識別上仍有限制，須加以精進。[[abstract]]Infection control is an important topic in contemporary medicine, and correctly wearing personal protective equipment is the most basic essential skill. Using image recognition system to aid the detection of the adequacy of wearing personal protective equipment could lower labour cost and implement infection control, but the concept has not been well tested. Here we conducted a pilot study to investigate the feasibility of using the gesture-based technique to aid the interpretation of correctly putting on and taking off isolation gowns, and analyzed its advantages and limitation. Thirty specialist nurses were enrolled in the study, practising wearing and removing isolation gown before a gesture-based detection machine. We adopted gesture-based system owing to its accessibility and relatively low cost. The gesture-based system could detect the joint movement, which is suitable for detecting procedures containing large movements like wearing isolation gown. We divided the course of wearing and removing isolation gown into several movement segments and set the criteria of time and joint moving ranges for machine judgement of the procedure adequacy. Every subject was fully recorded during the test for later expert reviews, by which the results from the gesture-based system were cross-compared and analyzed. The results showed that there was a good consistency, which includes 16 nurses (57.1%) between the judgements from experts and Kinect system. Four major causes of the inconsistency parts were (1) Kinect low sensitivity of movement detection, leading to repeated processes, (2) too early initiation of the detection procedure in movement segments, (3) nurses did not complete the movements set for each segment, and (4) Kinect overtime during tasks. In questionnaire afterwards, we found that gesture-based techniques could effectively enhance the nurses’ learning motivation and interests. We concluded that gesture-based system could be an effective assessment tool in the learning course of equipping isolation gown and be implemented into the infection control system. It showed the advantage of motivating learning and inducing interests. However, there were several limitations that needed to be improved before its incorporation into daily practice