This experiment required two International Space Station (ISS) crewmembers, one as a subject and one as an operator. Each scan was performed by the operator on the subject. Prior to a scan, the operator reviewed the On-board Proficiency Enhancer (OPE), a software refresher tool. After completing the OPE, the operator scanned the subject via real-time remote guidance from an expert sonographer located in the Telescience Support Center (TSC) in the Mission Control Center-Houston (MCC-H). Video and still images from all scans were stored on the ultrasound and downlinked for the investigator's analysis prior to that scan's session analysis. Restricted access real-time data downlinking was required for the ultrasound images (which are medically sensitive; therefore, private information) and voice communications between the ISS and the TSC. Video from cabin cameras was downlinked non real-time (also restricted/private data) to evaluate the real-time operations and for post-activity human factors-like analysis. Analysis of sessions were conducted within three days following the exams to obtain human factors information and feedback from the crewmember who functioned as the operator for the scan.

RESULTS:
Results of the CD-ROM-based On-board Proficiency Enhancer (OPE) sessions were used to modify the instructions during a complete 35 minute real-time thoracic, cardiac, and carotid/jugular ultrasound study. Following commands from the ground-based expert, the crewmember acquired all target views and images without difficulty. The anatomical content and fidelity of ultrasound video were adequate for clinical decision making.

Complex ultrasound experiments with expert guidance were performed with high accuracy following limited preflight training and multimedia based inflight review, despite a two-second communication delay. Inflight application of multimedia proficiency enhancement software, coupled with real-time remote expert guidance, facilitates the successful performance of ultrasound examinations in orbit and may have additional terrestrial and space applications.