Search

Mike Gaze devoted his career to understanding how nerves form precise connections. His experiments focused on the nerves connecting the eye to the brain in frogs and fish. Mike pioneered the use of electrophysiological recording in investigating how the nervous system develops. This technique enabled him a greater degree of anatomical precision than had previously been possible. The dominant theory on how nerve connections are formed was Sperry's chemoaffinity theory (Roger Wolcott Sperry (ForMemRS 1976)), based on the results of regeneration experiments. Mike repeated Sperry's experiments using his better technique. He then extended Sperry's work: first, to the development of retinotectal connections following various surgical operations on the embryonic eye; second, to regeneration following surgical reductions in the size of the tectum or retina; and third, to normal development. In each case he showed, for the first time, that connections are plastic . Even during normal development, retinal fibres are continually changing their connections. This was a radical finding. It implied, contrary to Sperry's theory, that retinal fibres interact with each other in forming tectal connections. Mike called this dynamic process systems matching . Mike then investigated how retinal fibres behave before they reach the brain. In further original work, Mike, with former student Mike Keating, showed, contrary to the prevailing view, that functional value can affect the development of specific nerve connections. In the 30 years since Mike retired there has been much work on the molecular bases underlying nerve connections. These have confirmed Mike's original findings and ideas.

Background/Aims The impact of dealing with COVID-19 for rheumatology higher specialist trainees has been profound. Sacrifices were made to their training to support the UK's pandemic response. Virtual Reality (VR) has long been used as a solution for specific surgical skills; providing a hands-on experience to enable specific delivery of outcomes. We utilised existing technology alongside a specialist VR and haptics team to review ways at delivering a valid and reliable training tool to administer joint injections, beginning with the review of this procedure specific to the knee. We aimed to describe this process. Methods A qualitative study using focus groups was undertaken, one medical student, four higher specialty trainees and two consultants were convened in a focus group to review existing mannequin-based training with the purpose of identifying a skill to develop in virtual reality. A story board was developed through collaboration with a graphic designer. The scenario was imbedded into a virtual reality environment in collaboration with a virtual reality partner. Results The focus group identified intra-articular knee injection as the most appropriate rheumatology skill to develop. Storyboarding built a series of scenarios around clinical situations which would require injection or aspiration. Working with the engineering team we successfully mapped knee joint anatomy and rendered an authentic clinical environment for the storyboards to run inside. Conclusion Virtual reality training scenarios are complex to develop but have enormous potential to create immersive training and assessment experiences which are not boundaried by the challenges of social distancing and COVID-19 risks. Disclosure B.D. Clarke: Honoraria; Abbvie. Grants/research support; Innovate UK. S. Balachandran: None. D. Nagra: None. M.D. Russell: Honoraria; Lilly, Pfizer, Janssen, UCB, Menarini. K. Bechman: None. M. Adas: None. A. Hope-Smith: None. M. Yates: Honoraria; Abbvie, UCB. A. Barrow: Grants/research support; Innovate UK. T. Smith: Grants/research support; Innovate UK. J. Galloway: Honoraria; Abbvie, Biovitrum, BMS, Celgene, Chugai, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Sobi and UCB.