Hands-On Practice on Sustainable Simulators in the Context of Training for Rural and Remote Practice Through a Fundamental Skills Workshop

Simulation-based medical education (SBME) offers a secure and controlled environment for training in ultrasound-related clinical skills such as nerve blocking and intravenous cannulation. Sonographer training for point-of-care ultrasound often adopts the train-the-trainer (TTT) model, wherein a select group of sonographers receive on-site training to subsequently instruct others. This model traditionally relies on expensive commercial ultrasound simulators, which presents a barrier to the scale-up of the TTT model. This study aims to address the need for cost-effective ultrasound simulators suitable for both initial and cascaded TTT. The objective of this report is to present the design and development of an affordable ultrasound simulator, which mimics anatomical features under ultrasound. The simulator was created using additive manufacturing techniques, including 3D printing, ballistic gel, and silicone work. We report on three development-feedback iterations, with feedback provided by an experienced sonographer from FUJIFILM Sonosite Canada Inc. using the think-aloud approach. Overall the results indicate that de-gassed silicone may serve as a good medium; vessels are best produced as hollow canals within the de-gassed silicone; 3D-printed bones cast acoustic shadows, which are reduced by increasing rigidity of the structures, and 3D printing filament and silicone can be used for nerve bundles. Future developments will focus on achieving anatomical accuracy, exploring alternative materials and printing parameters for the bones, and analyzing embedded structures at varying depths within the silicone. The next steps involve integrating the simulator into ultrasound curricula for a formal assessment of its effectiveness as a training tool.

Section: Discussionmentioning

confidence: 99%

The Iterative Design and Development of an Affordable Ultrasound Simulator

Jagannathan,

Micallef,

Clarke

et al. 2024

“…Because of the cost-effective nature of the simulator, and its overall acceptability as a training tool for general surgery residents, this BDA simulator is ideal for use in an SBME context. Due to its affordability, generally the main inhibitor of training in those areas, rural and remote areas would greatly benefit from this simulator [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Development and Initial Assessment of a Novel and Customized Bile Duct Simulator for Handsewn Anastomosis Training

Micallef¹,

Sivanathan²,

Clarke³

et al. 2022

Self Cite

Simulation-based medical education allows for the training and maintenance of healthcare skills in a safe and controlled environment. In this technical report, the development and initial evaluation of a bile duct anastomosis simulator are described. The simulator was developed using additive manufacturing techniques such as three-dimensional (3D) printing and silicone work. The final product was produced by maxSIMhealth, a research lab at Ontario Tech University (Oshawa, ON, Canada), and included four individual silicone bile ducts, based on the expert opinions from surgeons at the Centre Hospitalier de l'Université de Montréal (Montreal, QC, Canada), and a 3D-printed maxSIMclamp, which was described in a previous report. The evaluation was conducted by nine individuals consisting of surgeons, surgical residents, and medical students to assess the fidelity, functionality, and teaching quality of the simulator. The results from the evaluation indicate that the simulator needs to improve its fidelity by being softer, thinner, and beige. On the other hand, the results also indicate that this simulator is extremely durable and can be used as a training tool for surgical residents with some minor improvements.

“…For the purpose of moving the training outside of the simulation laboratories (i.e., converting the training into a De-SBE model), we have developed an inexpensive and scalable three-dimensional (3D) printed and silicone-based advanced adult proximal tibial IO access and infusion simulator [ 6 ] and a learning management system (LMS) for the simulation-based acquisition of psychomotor skills [ 7 ] that can be adapted to structure training.…”

Section: Introductionmentioning

confidence: 99%

Adapting the Gamified Educational Networking Online Learning Management System to Test a Decentralized Simulation-Based Education Model to Instruct Paramedics-in-Training on the Emergency Intraosseous Access and Infusion Skill

Jolly,

Selvarajah,

Micallef

et al. 2024

Self Cite

Intraosseous (IO) access and infusion is a safe and rapid alternative to intravenous access in obtaining vascular access for administering fluids and drugs. Healthcare professionals, such as primary and advanced care paramedics, use IO access and infusion in emergency circumstances where peripheral intravenous routes are inaccessible. IO access skills require hands-on training, which can be done remotely if the participants have access to simulation, instructions, guidance, and feedback. For the purpose of moving the training outside of the simulation laboratories, we have developed (1) an inexpensive and scalable three-dimensional (3D) printed and silicone-based advanced adult proximal tibial IO access and infusion simulator and (2) a unique learning management system (LMS) for remote simulation-based training. The LMS was built using the Django platform and supports experiential learning by providing access to educational and instructional content (including virtual simulation and serious games), allowing peers to communicate among themselves and with subject-matter experts, provide and receive feedback asynchronously, and engage in learning using gamification elements. The aim of this technical report is to describe the process of development and the final product of the LMS as a research and educational tool to scaffold remote learning of emergency IO skills by paramedics-in-training.