Using the Patient Augmented Reality and Vibratory Array (PARVA) to Improve Patient Experience During In-office Laryngology Procedures; A Virtue Ethics Approach to the Causation and Inflation of the Flint, Michigan Water Crisis

Costanzo, Kathryn "Eve", School of Engineering and Applied Science, University of Virginia
Gutierrez, Claudia, Resident of Medicine -OTLY, University of Virginia
Roecker, Zoe, MD-DMED Student Affairs, University of Virginia
Daniero, James, MD-OTLY Oto - Admin, University of Virginia
Laugelli, Benjamin, EN-Engineering and Society, University of Virginia

My technical and STS works are connected by how they both address aspects of the socio-technical challenge of the performance of laryngeal in-office procedures (IOPs). Unfortunately, studies have shown that up to 40% of patients experience moderate pain during these procedures, which typically results in the request for subsequent procedures to be held in the operating room under general anesthesia. This increases risk (due to anesthesia), cost, and time. My technical work focuses primarily on how to mechanically increase patient comfortability during IOPs, therefore increasing the utilization of IOPs. While my STS work focuses on how surgeons and doctors can gain access to such equipment that is produced through my technical work. Although the technical and STS works differ in approach, they both have the common goal of addressing the discomfort a patient feels during a laryngeal IOP.
For the technical project, my Capstone team and I created a patient augmented reality vibratory array (PARVA) to address the anxiety and discomfort patients feel during an IOP. It is composed of two pieces; an augmented reality experience and a vibratory device that induces tactile stimulation at the site of the procedure. Currently, there is no standard tool or device utilized in conjunction with a local anesthetic to reduce patient anxiety, discomfort, and pain before and during IOPs. The vibratory array was created completely from scratch, utilizing small motors and electrical circuits for power, 3D-printed cases for protection, and silicone case molds for comfortability of the patient. This element was designed so that it could be easily implemented within a medical environment, as well as comfortable for the patient in terms of texture and weight. For the augmented reality experience, a new headset was ordered that is more compact and lighter in weight compared to the previous headset provided to our team. We hope that through a clinical study the effectiveness of PARVA in limiting discomfort and anxiety in patients undergoing a laryngeal IOP can be proved.
My STS work also explores how to address patient discomfort during laryngeal IOPs, but through a different lens. The research work focuses on evaluating the potential of inaccessibility of PARVA to surgeons and medical facilities due to socio-economic and socio-political factors. To understand how these factors may prohibit access, my STS research analyzes the case study of the Flint, Michigan water crisis. Aristotle’s virtue of ethics is utilized to demonstrate how the government officials and water professionals in charge of the water supply to the city of Flint lacked morality. The decisions that led to the lead contamination of the city’s tap water were economically persuaded and demographically overlooked. My paper demonstrates the a-morality of these actors and how their decisions ultimately led to thousands of Flint residents becoming contaminated with elevated blood lead levels.
Working on both projects simultaneously allowed for the betterment of the design and future implementation of PARVA. Through the analysis of the Flint, Michigan water crisis and seeing how the water engineers and government officials lacked morality in their decisions, it became apparent that my team and other associates could also let money and governmental pressure impact our technical decisions. This demonstrated the value of remaining resilient and holding pure intentions with the creation and implementation of the device. In conclusion, the collaboration of my STS research work and technical project have expanded my knowledge and allowed me to see potential pitfalls with PARVA. Without this awareness, my team and I could have failed to provide thousands of patients with an accessible device to limit their discomfort and anxiety during laryngeal IOPs.

BS (Bachelor of Science)
PARVA, Augmented Reality, Vibratory Array, Virtue Ethics, Flint, Michigan, Socio-Political, Socio-Economic

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisor: James Daniero, Claudia Gutierrez, Zoe Roecker
STS Advisor: Benjamin Laugelli
Technical Team Members: Marissa Marine, Lauren Gonzalez

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