Development of an Anatomical Silicone Model for Simulation-based Medical Training of Obstetric Anal Sphincter Injury Repair in Bangladesh

Abstract

Advancing global healthcare in developing countries has traditionally been an area of interest for many North American medical organizations, as they strive to improve patient outcomes by helping to control disease and death-related illnesses. Women’s healthcare in developing countries, in particular, presents a unique set of complexities, revealing high maternal mortality statistics surrounding pregnancy, labor, and childbirth, which is often tied to home births without medically trained attendants. In September 2018, Team Broken Earth, a Canadian-based outreach initiative, hosted a three-day women’s healthcare course in Dhaka, Bangladesh, which included simulation-based training stations, for the purpose of advancing clinical skills and education in regards to local labor and delivery. The training stations included the prevention of shoulder dystocia, helping babies breathe, the application of uterine compression sutures, and the repair of obstetric anal sphincter injuries (OASIS). The OASIS management station provided an opportunity to practice anal sphincter repair on anatomically accurate silicone models, which was a focus of the training course due to the high frequency of such injuries in rural Bangladesh. Evaluation surveys were supplied to workshop participants to capture their feedback about the use of the OASIS models and their efficacy as a training tool in Bangladesh. Overall, the models were considered superior as compared to pre-existing training methods, which traditionally involve textbook education and hands-on learning in emergency birthing scenarios by non-medically trained attendants. Two minor iterative improvements were suggested during the Team Broken Earth workshops in Dhaka, Bangladesh, with regards to improving the models for future use: (a) the ethnicity coloring of the models should be more inclusive, especially when delivering training in international countries, and (b) future silicone models should include the addition of mesh across the bottom layer to ensure participants fingers did not rupture the enclosed vaginal canal while suturing. The purpose of this technical report is to determine the efficacy of a silicone OASIS model, developed for practicing high-risk laceration repair that can occur during childbirth, which presents in higher frequency in developing countries, such as Bangladesh, due to the number of rural at-home deliveries. The original study in this series involved the investigation of silicone perineal repair models focusing on first- and second-degree lacerations, which were used at the Remote and Rural Conference in St. John’s, Newfoundland, in April 2018. The facilitators distributed the first iteration of the models to conference participants and collected participant feedback, which concluded that several improvements were required to enhance the models for medical training purposes. With the iterative revisions complete, the model is now under further validation testing to determine its efficacy within simulation-based medical ed...

3D Patient-Specific Virtual Models for Presurgical Planning in Patients with Recto-Sigmoid Endometriosis Nodules: A Pilot Study

“…In gynecology, preliminary experiences on the applications of 3D modelling are reported. Three-dimensional reconstruction was used for didactic purposes to provide realistic models for perineal repair and anal sphincter sutures and for cervical cancer recognition and diagnosis [42][43][44], as well as in the field of infertility and assisted reproductive technologies [45]. Three-dimensional modelling of female bone pelvis was employed to identify risk factors for pelvic floor disorders study and for dystocia [46,47].…”

Obstetrics and gynecology residents’ satisfaction and self-confidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study

“…This study is the first observational study of the creation of a perineal simulator in Indonesia using a 3-dimensional (3D)-printed mold. Goudie et al [ 9 ] also developed an anatomical silicone model of anal sphincter injury using a 3D-printed mold, and they found it a cost-effective model of obstetric anal sphincter injury repair and an effectively understandable learning tool for midwives, residents, and doctors.…”

3d printer uses in veterinary medicine

“…The latter serve to provide a learning tool close to the texture of living models, available and reusable for training students and the maintenance of their clinical skills. This has the advantage of the ability to create educational models with pre-inserted incisions that the students apply to close according to different suture techniques to be mastered and which will make it possible to differentiate the levels of competence between users (Goudie et al, 2018;Goudie et al, 2019).…”